| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,102.20 |
$2,004 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,361.25 |
$2,475 |
1.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,713.25 |
$3,115 |
1.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,289.38 |
$4,162.50 |
2.6× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$296.78 |
$539.60 |
0.5× |
| CT head/brain without contrast (70450) |
$990 |
$1,800 |
9.5× |
| MRI brain without contrast (70551) |
$1,265 |
$2,300 |
5.3× |
| MRI brain with contrast (70552) |
$2,145 |
$3,900 |
6.1× |
| MRI brain without and with contrast (70553) |
$2,255 |
$4,100 |
6.5× |
| X-ray lower spine, 4+ views (72110) |
$418 |
$760 |
4.0× |
| MRI lumbar spine without contrast (72148) |
$1,375 |
$2,500 |
5.8× |
| CT pelvis with contrast (72193) |
$1,375 |
$2,500 |
7.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,344.20 |
$2,444 |
5.6× |
| CT abdomen and pelvis with contrast (74177) |
$2,062.50 |
$3,750 |
5.9× |
| Ultrasound, abdomen complete (76700) |
$556.60 |
$1,012 |
5.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$287.65 |
$523 |
2.7× |
| Ultrasound, transvaginal (76830) |
$522.50 |
$950 |
5.0× |
| Mammography, one breast (diagnostic) (77065) |
$165 |
$300 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$319 |
$580 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$165 |
$300 |
1.8× |
| Basic metabolic panel (80048) |
$126.50 |
$230 |
15.0× |
| Comprehensive metabolic panel (80053) |
$165 |
$300 |
15.6× |
| Lipid panel (80061) |
$55.82 |
$101.50 |
4.2× |
| Renal function panel (80069) |
$71.50 |
$130 |
8.2× |
| Hepatic function panel (80076) |
$135.85 |
$247 |
16.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$16.28 |
$29.60 |
4.7× |
| PSA, total (84153) |
$77 |
$140 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$54.18 |
$98.50 |
3.2× |
| CBC with automated differential (85025) |
$71.50 |
$130 |
9.2× |
| CBC, automated (85027) |
$60.50 |
$110 |
9.4× |
| Prothrombin time (PT) (85610) |
$24.75 |
$45 |
5.8× |
| Partial thromboplastin time (PTT) (85730) |
$27.50 |
$50 |
4.6× |
| Left heart catheterization (93452) |
$4,510 |
$8,200 |
1.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$88 |
$160 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$218.35 |
$397 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$368.50 |
$670 |
2.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$420.20 |
$764 |
3.2× |
| Preventive visit, new patient (age 18–39) (99385) |
$41.25 |
$75 |
— |