| Upper GI endoscopy (EGD) with biopsy (43239) |
$2,041 |
$2,041 |
2.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,527 |
$1,527 |
1.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,527 |
$1,527 |
1.6× |
| CT head/brain without contrast (70450) |
$2,250 |
$2,250 |
20.2× |
| MRI brain without contrast (70551) |
$3,468.50 |
$3,468.50 |
13.7× |
| MRI brain with contrast (70552) |
$4,616 |
$4,616 |
12.4× |
| MRI brain without and with contrast (70553) |
$5,814 |
$5,814 |
15.7× |
| X-ray lower spine, 4+ views (72110) |
$1,160 |
$1,160 |
10.4× |
| MRI lumbar spine without contrast (72148) |
$3,969.50 |
$3,969.50 |
15.6× |
| CT pelvis with contrast (72193) |
$3,357 |
$3,357 |
18.0× |
| MRI lower-extremity joint without contrast (73721) |
$3,702 |
$3,702 |
14.6× |
| CT abdomen and pelvis with contrast (74177) |
$6,610 |
$6,610 |
17.8× |
| Ultrasound, abdomen complete (76700) |
$1,756 |
$1,756 |
15.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,524 |
$1,524 |
13.7× |
| Ultrasound, transvaginal (76830) |
$1,606 |
$1,606 |
14.4× |
| Mammography, one breast (diagnostic) (77065) |
$870 |
$870 |
10.1× |
| Mammography, both breasts (diagnostic) (77066) |
$989 |
$989 |
8.9× |
| Mammography, screening (bilateral) (77067) |
$569 |
$569 |
6.2× |
| Basic metabolic panel (80048) |
$157.50 |
$157.50 |
18.6× |
| Comprehensive metabolic panel (80053) |
$183.50 |
$183.50 |
17.4× |
| Lipid panel (80061) |
$262 |
$262 |
19.6× |
| Renal function panel (80069) |
$150 |
$150 |
17.3× |
| Hepatic function panel (80076) |
$143.50 |
$143.50 |
17.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$38 |
$38 |
9.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$27 |
$27 |
7.8× |
| PSA, total (84153) |
$173.50 |
$173.50 |
9.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$237.50 |
$237.50 |
14.1× |
| CBC with automated differential (85025) |
$83 |
$83 |
10.7× |
| CBC, automated (85027) |
$106 |
$106 |
16.4× |
| Prothrombin time (PT) (85610) |
$65 |
$65 |
15.2× |
| Partial thromboplastin time (PTT) (85730) |
$74.50 |
$74.50 |
12.4× |
| Sleep study (attended polysomnography) (95810) |
$6,833 |
$6,833 |
7.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$228 |
$228 |
7.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$190 |
$190 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$239 |
$239 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$288 |
$288 |
2.0× |