| Upper GI endoscopy (EGD), diagnostic (43235) |
$810.60 |
$1,158 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$866.60 |
$1,238 |
0.8× |
| Diagnostic colonoscopy (45378) |
$846.30 |
$1,209 |
0.8× |
| Laparoscopic gallbladder removal (47562) |
$4,802.70 |
$6,861 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,620.50 |
$2,315 |
1.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,607.20 |
$2,296 |
1.5× |
| CT head/brain without contrast (70450) |
$1,225.70 |
$1,751 |
9.8× |
| MRI brain without contrast (70551) |
$1,864.80 |
$2,664 |
6.5× |
| MRI brain with contrast (70552) |
$2,563.40 |
$3,662 |
6.1× |
| MRI brain without and with contrast (70553) |
$4,738.30 |
$6,769 |
11.3× |
| X-ray lower spine, 4+ views (72110) |
$432.60 |
$618 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$2,475.90 |
$3,537 |
8.7× |
| CT pelvis with contrast (72193) |
$2,249.80 |
$3,214 |
10.7× |
| MRI lower-extremity joint without contrast (73721) |
$2,069.20 |
$2,956 |
7.2× |
| CT abdomen and pelvis with contrast (74177) |
$4,123 |
$5,890 |
9.9× |
| Ultrasound, abdomen complete (76700) |
$755.30 |
$1,079 |
6.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$853.30 |
$1,219 |
6.8× |
| Ultrasound, transvaginal (76830) |
$651.70 |
$931 |
5.2× |
| Mammography, one breast (diagnostic) (77065) |
$466.90 |
$667 |
5.4× |
| Mammography, both breasts (diagnostic) (77066) |
$578.20 |
$826 |
5.2× |
| Mammography, screening (bilateral) (77067) |
$530.60 |
$758 |
5.8× |
| Basic metabolic panel (80048) |
$88.90 |
$127 |
10.5× |
| Comprehensive metabolic panel (80053) |
$107.10 |
$153 |
10.1× |
| Lipid panel (80061) |
$165.90 |
$237 |
12.4× |
| Renal function panel (80069) |
$107.10 |
$153 |
12.3× |
| Hepatic function panel (80076) |
$85.40 |
$122 |
10.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$70.70 |
$101 |
17.6× |
| PSA, total (84153) |
$205.80 |
$294 |
11.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$233.80 |
$334 |
13.9× |
| CBC with automated differential (85025) |
$72.80 |
$104 |
9.4× |
| CBC, automated (85027) |
$63.70 |
$91 |
9.8× |
| Prothrombin time (PT) (85610) |
$30.80 |
$44 |
7.2× |
| Partial thromboplastin time (PTT) (85730) |
$50.40 |
$72 |
8.4× |
| Group psychotherapy (90853) |
$109.90 |
$157 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$3,613.40 |
$5,162 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$184.80 |
$264 |
6.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$288.40 |
$412 |
1.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$340.20 |
$486 |
2.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$380.10 |
$543 |
2.4× |