| Breast lesion removal (open) (19120) |
$2,203 |
$4,406 |
0.5× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$2,048 |
$4,096 |
2.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,387 |
$4,774 |
2.5× |
| Diagnostic colonoscopy (45378) |
$2,757.50 |
$5,515 |
2.8× |
| Colonoscopy with biopsy (45380) |
$2,724 |
$5,448 |
2.1× |
| Colonoscopy with lesion removal (45385) |
$3,167.50 |
$6,335 |
2.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,298 |
$2,596 |
1.4× |
| CT head/brain without contrast (70450) |
$901 |
$1,802 |
8.0× |
| MRI brain without contrast (70551) |
$1,761.50 |
$3,523 |
6.9× |
| MRI brain with contrast (70552) |
$2,156 |
$4,312 |
5.8× |
| MRI brain without and with contrast (70553) |
$2,383.50 |
$4,767 |
6.4× |
| X-ray lower spine, 4+ views (72110) |
$322 |
$644 |
2.9× |
| MRI lumbar spine without contrast (72148) |
$1,764 |
$3,528 |
6.9× |
| CT pelvis with contrast (72193) |
$1,409 |
$2,818 |
7.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,296 |
$2,592 |
5.1× |
| CT abdomen and pelvis with contrast (74177) |
$3,592 |
$7,184 |
9.6× |
| Ultrasound, abdomen complete (76700) |
$847.50 |
$1,695 |
7.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$618 |
$1,236 |
5.5× |
Ultrasound, transvaginal (76830)
range across 2 matching MRF lines |
$286.50–$656 |
$573–$1,312 |
varies |
| Mammography, one breast (diagnostic) (77065) |
$322 |
$644 |
3.7× |
| Mammography, both breasts (diagnostic) (77066) |
$559.50 |
$1,119 |
5.1× |
| Mammography, screening (bilateral) (77067) |
$458 |
$916 |
5.0× |
| Basic metabolic panel (80048) |
$66.50 |
$133 |
7.9× |
| Comprehensive metabolic panel (80053) |
$117 |
$234 |
11.1× |
| Lipid panel (80061) |
$119.50 |
$239 |
8.9× |
| Renal function panel (80069) |
$71 |
$142 |
8.2× |
| Hepatic function panel (80076) |
$102 |
$204 |
12.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$10.50 |
$21 |
3.0× |
| PSA, total (84153) |
$87.50 |
$175 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$90.50 |
$181 |
5.4× |
| CBC with automated differential (85025) |
$56 |
$112 |
7.2× |
| CBC, automated (85027) |
$26 |
$52 |
4.0× |
| Prothrombin time (PT) (85610) |
$20 |
$40 |
4.7× |
| Partial thromboplastin time (PTT) (85730) |
$50 |
$100 |
8.3× |
| Psychotherapy, 30 minutes (90832) |
$126.50 |
$253 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$156 |
$312 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$181.50 |
$363 |
1.0× |
| Left heart catheterization (93452) |
$4,657.50 |
$9,315 |
1.3× |
| Sleep study (attended polysomnography) (95810) |
$3,406 |
$6,812 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$99 |
$198 |
3.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$107 |
$214 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$125 |
$250 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$137.50 |
$275 |
1.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$44 |
$88 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$42.50 |
$85 |
— |