| Breast lesion removal (open) (19120) |
$727 |
$1,454 |
0.2× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$582.04 |
$1,164.07 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,105.11 |
$2,210.22 |
1.4× |
| CT head/brain without contrast (70450) |
$941.75 |
$1,883.50 |
10.3× |
| MRI brain without contrast (70551) |
$1,713 |
$3,426 |
8.2× |
| MRI brain with contrast (70552) |
$1,978.50 |
$3,957 |
6.5× |
| MRI brain without and with contrast (70553) |
$2,432.50 |
$4,865 |
8.0× |
| X-ray lower spine, 4+ views (72110) |
$72 |
$144 |
0.8× |
| MRI lumbar spine without contrast (72148) |
$1,562.18 |
$3,124.36 |
7.5× |
| CT pelvis with contrast (72193) |
$1,417.50 |
$2,835 |
9.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,713 |
$3,426 |
8.2× |
| CT abdomen and pelvis with contrast (74177) |
$2,952.95 |
$5,905.90 |
9.7× |
| Ultrasound, abdomen complete (76700) |
$812 |
$1,624 |
8.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$193.50 |
$387 |
2.1× |
| Ultrasound, transvaginal (76830) |
$158.50 |
$317 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$88 |
$176 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$219.39 |
$438.77 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$219.39 |
$438.77 |
2.4× |
| Basic metabolic panel (80048) |
$38.57 |
$77.14 |
4.6× |
| Comprehensive metabolic panel (80053) |
$57.25 |
$114.49 |
5.4× |
| Obstetric panel (80055) |
$136.08 |
$272.16 |
2.8× |
| Lipid panel (80061) |
$57.25 |
$114.49 |
4.3× |
| Renal function panel (80069) |
$147.60 |
$295.19 |
17.0× |
| Hepatic function panel (80076) |
$53.50 |
$107 |
6.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$9 |
$18 |
2.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$7.50 |
$15 |
2.2× |
| PSA, total (84153) |
$77 |
$154 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$60 |
$120 |
3.6× |
| CBC with automated differential (85025) |
$28.43 |
$56.86 |
3.7× |
| CBC, automated (85027) |
$30.72 |
$61.43 |
4.7× |
| Prothrombin time (PT) (85610) |
$17.28 |
$34.54 |
4.0× |
| Partial thromboplastin time (PTT) (85730) |
$26.50 |
$53 |
4.4× |
| Psychotherapy, 30 minutes (90832) |
$95 |
$190 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$105 |
$210 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$126 |
$252 |
0.8× |
| Electrocardiogram (ECG), complete (93000) |
$28 |
$56 |
0.5× |
| Left heart catheterization (93452) |
$3,263.64 |
$6,527.27 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,625 |
$3,250 |
2.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$63.50 |
$127 |
2.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$199.50 |
$399 |
1.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$338.55 |
$677.09 |
2.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$401.34 |
$802.68 |
3.4× |