| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,162 |
$2,324 |
1.1× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,411.50 |
$2,823 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$924.50 |
$1,849 |
0.9× |
| CT head/brain without contrast (70450) |
$584.50 |
$1,169 |
4.7× |
| MRI brain without contrast (70551) |
$1,141.50 |
$2,283 |
4.0× |
| MRI brain with contrast (70552) |
$2,869 |
$5,738 |
6.9× |
| MRI brain without and with contrast (70553) |
$1,457 |
$2,914 |
3.5× |
| X-ray lower spine, 4+ views (72110) |
$176.50 |
$353 |
1.4× |
| MRI lumbar spine without contrast (72148) |
$1,447.50 |
$2,895 |
5.1× |
| CT pelvis with contrast (72193) |
$852 |
$1,704 |
4.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,642 |
$3,284 |
5.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,076.50 |
$2,153 |
2.6× |
| Ultrasound, abdomen complete (76700) |
$251.50 |
$503 |
2.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$230 |
$460 |
1.8× |
| Ultrasound, transvaginal (76830) |
$199.50 |
$399 |
1.6× |
| Mammography, one breast (diagnostic) (77065) |
$214.50 |
$429 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$254.50 |
$509 |
2.3× |
| Mammography, screening (bilateral) (77067) |
$254.50 |
$509 |
2.8× |
| Basic metabolic panel (80048) |
$92.50 |
$185 |
10.9× |
| Comprehensive metabolic panel (80053) |
$184 |
$368 |
17.4× |
| Lipid panel (80061) |
$105 |
$210 |
7.8× |
| Renal function panel (80069) |
$41 |
$82 |
4.7× |
| Hepatic function panel (80076) |
$197 |
$394 |
24.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.50 |
$11 |
1.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.50 |
$9 |
1.3× |
| PSA, total (84153) |
$58.50 |
$117 |
3.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$73 |
$146 |
4.3× |
| CBC with automated differential (85025) |
$50 |
$100 |
6.4× |
| CBC, automated (85027) |
$21 |
$42 |
3.2× |
| Prothrombin time (PT) (85610) |
$18 |
$36 |
4.2× |
| Partial thromboplastin time (PTT) (85730) |
$29.50 |
$59 |
4.9× |
| Psychotherapy, 45 minutes (90834) |
$250.50 |
$501 |
1.2× |
| Psychotherapy, 60 minutes (90837) |
$250.50 |
$501 |
1.2× |
| Group psychotherapy (90853) |
$144.50 |
$289 |
1.2× |
| Left heart catheterization (93452) |
$4,854.50 |
$9,709 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$107.50 |
$215 |
3.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$313 |
$626 |
2.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$458 |
$916 |
2.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$633.25 |
$1,266.50 |
4.0× |