| Upper GI endoscopy (EGD), diagnostic (43235) |
$855.50 |
$1,711 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$875 |
$1,750 |
1.1× |
| Colonoscopy with biopsy (45380) |
$941 |
$1,882 |
0.9× |
| Colonoscopy with lesion removal (45385) |
$917 |
$1,834 |
0.8× |
| Laparoscopic gallbladder removal (47562) |
$6,968.50 |
$13,937 |
1.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,350 |
$2,700 |
1.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,734 |
$3,468 |
2.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$778 |
$1,556 |
1.6× |
| Cataract removal with lens insertion (66984) |
$1,496.50 |
$2,993 |
0.7× |
| CT head/brain without contrast (70450) |
$939 |
$1,878 |
9.9× |
| MRI brain without contrast (70551) |
$1,209.50 |
$2,419 |
5.6× |
| MRI brain with contrast (70552) |
$1,549.50 |
$3,099 |
4.9× |
| MRI brain without and with contrast (70553) |
$2,281.50 |
$4,563 |
7.2× |
| X-ray lower spine, 4+ views (72110) |
$175 |
$350 |
1.9× |
| MRI lumbar spine without contrast (72148) |
$1,310.50 |
$2,621 |
6.1× |
| CT pelvis with contrast (72193) |
$1,102.50 |
$2,205 |
7.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,150.50 |
$2,301 |
5.3× |
| CT abdomen and pelvis with contrast (74177) |
$2,233.50 |
$4,467 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$440 |
$880 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$655 |
$1,310 |
6.9× |
| Ultrasound, transvaginal (76830) |
$311.50 |
$623 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$262.50 |
$525 |
3.0× |
| Mammography, both breasts (diagnostic) (77066) |
$276 |
$552 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$213.50 |
$427 |
2.3× |
| Basic metabolic panel (80048) |
$87.50 |
$175 |
10.3× |
| Comprehensive metabolic panel (80053) |
$132 |
$264 |
12.5× |
| Lipid panel (80061) |
$62.50 |
$125 |
4.7× |
| Renal function panel (80069) |
$80 |
$160 |
9.2× |
| Hepatic function panel (80076) |
$83 |
$166 |
10.2× |
| PSA, total (84153) |
$20.50 |
$41 |
1.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$65.75 |
$131.50 |
3.9× |
| CBC with automated differential (85025) |
$70 |
$140 |
9.0× |
| CBC, automated (85027) |
$49.50 |
$99 |
7.7× |
| Prothrombin time (PT) (85610) |
$22.50 |
$45 |
5.2× |
| Partial thromboplastin time (PTT) (85730) |
$51 |
$102 |
8.5× |
| Psychotherapy, 30 minutes (90832) |
$101 |
$202 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$133 |
$266 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$153 |
$306 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$154 |
$308 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$154 |
$308 |
1.0× |
| Group psychotherapy (90853) |
$77 |
$154 |
0.8× |
| Sleep study (attended polysomnography) (95810) |
$1,603.50 |
$3,207 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$73.50 |
$147 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$197.50 |
$395 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$286 |
$572 |
2.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$411.50 |
$823 |
3.4× |