| Upper GI endoscopy (EGD), diagnostic (43235) |
$232.20 |
$774 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$302.40 |
$1,008 |
0.4× |
| Diagnostic colonoscopy (45378) |
$662.70 |
$2,209 |
0.8× |
| Colonoscopy with biopsy (45380) |
$351.30 |
$1,171 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$370.80 |
$1,236 |
0.3× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$561.90 |
$1,873 |
0.1× |
| Inguinal hernia repair (age 5+) (49505) |
$444.90 |
$1,483 |
0.1× |
| CT head/brain without contrast (70450) |
$368.70 |
$1,229 |
3.9× |
| X-ray lower spine, 4+ views (72110) |
$54 |
$180 |
0.6× |
| CT pelvis with contrast (72193) |
$350.70 |
$1,169 |
2.2× |
| CT abdomen and pelvis with contrast (74177) |
$403.80 |
$1,346 |
1.3× |
| Ultrasound, abdomen complete (76700) |
$197.70 |
$659 |
2.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$104.55 |
$348.50 |
1.1× |
| Ultrasound, transvaginal (76830) |
$144.30 |
$481 |
1.5× |
| Mammography, one breast (diagnostic) (77065) |
$34.95 |
$116.50 |
0.4× |
| Mammography, both breasts (diagnostic) (77066) |
$95.70 |
$319 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$95.70 |
$319 |
1.0× |
| Basic metabolic panel (80048) |
$28.80 |
$96 |
3.4× |
| Comprehensive metabolic panel (80053) |
$34.20 |
$114 |
3.2× |
| Lipid panel (80061) |
$27 |
$90 |
2.0× |
| Renal function panel (80069) |
$31.80 |
$106 |
3.7× |
| Hepatic function panel (80076) |
$35.40 |
$118 |
4.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$13.20 |
$44 |
3.8× |
| PSA, total (84153) |
$34.80 |
$116 |
1.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$27.60 |
$92 |
1.6× |
| CBC with automated differential (85025) |
$21.45 |
$71.50 |
2.8× |
| Prothrombin time (PT) (85610) |
$19.80 |
$66 |
4.6× |
| Partial thromboplastin time (PTT) (85730) |
$31.50 |
$105 |
5.2× |
| Psychotherapy, 45 minutes (90834) |
$99 |
$330 |
0.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$33 |
$110 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$69.80 |
$232.65 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$102.30 |
$341 |
0.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$78 |
$260 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$115.80 |
$386 |
1.0× |