| Upper GI endoscopy (EGD), diagnostic (43235) |
$466.20 |
$777 |
0.5× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$631.80 |
$1,053 |
0.7× |
| Diagnostic colonoscopy (45378) |
$573.60 |
$956 |
0.6× |
| Colonoscopy with biopsy (45380) |
$729 |
$1,215 |
0.6× |
| Colonoscopy with lesion removal (45385) |
$762.60 |
$1,271 |
0.6× |
Laparoscopic gallbladder removal (47562)
likely a partial charge, not the full procedure |
$1,081.20 |
$1,802 |
0.2× |
| Inguinal hernia repair (age 5+) (49505) |
$862.20 |
$1,437 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$567 |
$945 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,498.20 |
$2,497 |
1.6× |
| CT head/brain without contrast (70450) |
$823.80 |
$1,373 |
7.6× |
| MRI brain without contrast (70551) |
$2,080.20 |
$3,467 |
8.4× |
| MRI brain with contrast (70552) |
$2,530.80 |
$4,218 |
7.0× |
| MRI brain without and with contrast (70553) |
$3,466.20 |
$5,777 |
9.6× |
| X-ray lower spine, 4+ views (72110) |
$347.40 |
$579 |
3.2× |
| MRI lumbar spine without contrast (72148) |
$2,253.60 |
$3,756 |
9.2× |
| CT pelvis with contrast (72193) |
$1,636.80 |
$2,728 |
9.0× |
| CT abdomen and pelvis with contrast (74177) |
$2,553.60 |
$4,256 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$535.20 |
$892 |
5.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$504.60 |
$841 |
4.7× |
| Ultrasound, transvaginal (76830) |
$439.80 |
$733 |
4.1× |
| Mammography, both breasts (diagnostic) (77066) |
$375.60 |
$626 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$316.20 |
$527 |
3.5× |
| Basic metabolic panel (80048) |
$65.40 |
$109 |
7.7× |
| Comprehensive metabolic panel (80053) |
$81.60 |
$136 |
7.7× |
| Lipid panel (80061) |
$73.80 |
$123 |
5.5× |
| Renal function panel (80069) |
$84.60 |
$141 |
9.7× |
| Hepatic function panel (80076) |
$105 |
$175 |
12.9× |
| PSA, total (84153) |
$78.06 |
$130.08 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$67.32 |
$112.20 |
4.0× |
| CBC with automated differential (85025) |
$98.40 |
$164 |
12.7× |
| CBC, automated (85027) |
$84 |
$140 |
13.0× |
| Prothrombin time (PT) (85610) |
$34.20 |
$57 |
8.0× |
| Partial thromboplastin time (PTT) (85730) |
$49.80 |
$83 |
8.3× |
| Psychotherapy, 30 minutes (90832) |
$121.50 |
$202.50 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$160.20 |
$267 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$237.30 |
$395.50 |
1.3× |
| Family psychotherapy, without patient (50 min) (90846) |
$151.20 |
$252 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$157.50 |
$262.50 |
0.9× |
| Group psychotherapy (90853) |
$798 |
$1,330 |
7.6× |
| Electrocardiogram (ECG), complete (93000) |
$24 |
$40 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$1,664.40 |
$2,774 |
1.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$116.10 |
$193.50 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$173.40 |
$289 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$280.80 |
$468 |
2.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$328.20 |
$547 |
2.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$113.40 |
$189 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$130.80 |
$218 |
— |