| Upper GI endoscopy (EGD), diagnostic (43235) |
$619.13 |
$2,027.55 |
0.6× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$896.72 |
$2,936.62 |
0.9× |
| CT head/brain without contrast (70450) |
$1,404.74 |
$4,600.33 |
11.6× |
| MRI brain without contrast (70551) |
$1,663.18 |
$5,446.69 |
6.0× |
| MRI brain with contrast (70552) |
$2,035.54 |
$6,666.10 |
5.0× |
| MRI brain without and with contrast (70553) |
$1,831.98 |
$5,999.50 |
4.5× |
| X-ray lower spine, 4+ views (72110) |
$335.85 |
$1,099.86 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$2,088.46 |
$6,839.41 |
7.5× |
| CT pelvis with contrast (72193) |
$1,730.24 |
$5,666.31 |
8.5× |
| CT abdomen and pelvis with contrast (74177) |
$3,878.14 |
$12,700.38 |
9.6× |
| Ultrasound, abdomen complete (76700) |
$622.55 |
$2,038.75 |
5.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$492.09 |
$1,611.51 |
4.1× |
| Ultrasound, transvaginal (76830) |
$444.90 |
$1,456.99 |
3.7× |
| Mammography, both breasts (diagnostic) (77066) |
$352 |
$1,152.74 |
3.2× |
| Mammography, screening (bilateral) (77067) |
$300.60 |
$984.42 |
3.3× |
| Basic metabolic panel (80048) |
$45.97 |
$150.54 |
5.4× |
| Comprehensive metabolic panel (80053) |
$38.63 |
$126.49 |
3.7× |
| Lipid panel (80061) |
$68.12 |
$223.07 |
5.1× |
| Renal function panel (80069) |
$30.34 |
$99.35 |
3.5× |
| Hepatic function panel (80076) |
$35.08 |
$114.85 |
4.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$15.97 |
$52.28 |
4.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$19.53 |
$63.95 |
5.6× |
| PSA, total (84153) |
$88.90 |
$291.11 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$73.44 |
$240.49 |
4.4× |
| CBC with automated differential (85025) |
$48.27 |
$158.07 |
6.2× |
| CBC, automated (85027) |
$33.35 |
$109.19 |
5.2× |
| Prothrombin time (PT) (85610) |
$34.59 |
$113.27 |
8.1× |
| Partial thromboplastin time (PTT) (85730) |
$25.19 |
$82.48 |
4.2× |
| Left heart catheterization (93452) |
$10,080.36 |
$33,011.87 |
2.7× |
| Sleep study (attended polysomnography) (95810) |
$3,246.33 |
$10,631.31 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$152.38 |
$499 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$187.80 |
$615 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$241.54 |
$791 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$132.86 |
$435.09 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$147.27 |
$482.26 |
— |