| Upper GI endoscopy (EGD) with biopsy (43239) |
$320.34 |
$800.85 |
0.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$625.48 |
$1,563.70 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$953.42 |
$2,383.55 |
1.1× |
| CT head/brain without contrast (70450) |
$924.16 |
$2,310.40 |
9.2× |
| MRI brain without contrast (70551) |
$711.17 |
$1,777.92 |
3.1× |
| MRI brain with contrast (70552) |
$1,128.22 |
$2,820.55 |
3.4× |
| MRI brain without and with contrast (70553) |
$1,327.34 |
$3,318.35 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$313.88 |
$784.70 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$1,030.18 |
$2,575.45 |
4.5× |
| CT pelvis with contrast (72193) |
$1,083.38 |
$2,708.45 |
6.4× |
| MRI lower-extremity joint without contrast (73721) |
$2,009.44 |
$5,023.60 |
8.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,610.82 |
$4,027.05 |
4.8× |
| Ultrasound, abdomen complete (76700) |
$581.78 |
$1,454.45 |
5.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$324.91 |
$812.28 |
3.2× |
| Ultrasound, transvaginal (76830) |
$416.86 |
$1,042.15 |
4.1× |
| Mammography, one breast (diagnostic) (77065) |
$202.08 |
$505.20 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$260.64 |
$651.60 |
2.4× |
| Mammography, screening (bilateral) (77067) |
$211.20 |
$528 |
2.3× |
| Basic metabolic panel (80048) |
$31.92 |
$79.80 |
3.8× |
| Comprehensive metabolic panel (80053) |
$41.04 |
$102.60 |
3.9× |
| Lipid panel (80061) |
$65.36 |
$163.40 |
4.9× |
| Renal function panel (80069) |
$33.06 |
$82.65 |
3.8× |
| Hepatic function panel (80076) |
$44.08 |
$110.20 |
5.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$33.72 |
$84.30 |
9.7× |
| PSA, total (84153) |
$75.24 |
$188.10 |
4.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$110.45 |
$276.12 |
6.6× |
| CBC with automated differential (85025) |
$45.60 |
$114 |
5.9× |
| CBC, automated (85027) |
$46.56 |
$116.40 |
7.2× |
| Prothrombin time (PT) (85610) |
$67.92 |
$169.80 |
15.8× |
| Partial thromboplastin time (PTT) (85730) |
$74.16 |
$185.40 |
12.3× |
| Group psychotherapy (90853) |
$159.22 |
$398.05 |
1.6× |
| Electrocardiogram (ECG), complete (93000) |
$20.80 |
$52 |
0.4× |
| Left heart catheterization (93452) |
$4,675.14 |
$11,687.85 |
1.5× |
| Sleep study (attended polysomnography) (95810) |
$2,763.36 |
$6,908.40 |
3.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.40 |
$123.50 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$83.20 |
$208 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$126.80 |
$317 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$160.61 |
$401.53 |
1.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$45.60 |
$114 |
0.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$66.35 |
$165.88 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$74.35 |
$185.88 |
— |