| Upper GI endoscopy (EGD), diagnostic (43235) |
$137.75 |
$229.58 |
0.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$154.76 |
$257.94 |
0.2× |
| Diagnostic colonoscopy (45378) |
$344.34 |
$573.90 |
0.4× |
| Colonoscopy with biopsy (45380) |
$225.14 |
$375.24 |
0.2× |
| Colonoscopy with lesion removal (45385) |
$283.75 |
$472.92 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$222.60 |
$371 |
0.3× |
| CT head/brain without contrast (70450) |
$913.86 |
$1,523.10 |
8.7× |
| MRI brain without contrast (70551) |
$1,559.94 |
$2,599.90 |
6.5× |
| MRI brain with contrast (70552) |
$1,668.60 |
$2,781 |
4.8× |
| MRI brain without and with contrast (70553) |
$2,106.24 |
$3,510.40 |
6.0× |
| X-ray lower spine, 4+ views (72110) |
$388.08 |
$646.80 |
3.7× |
| MRI lumbar spine without contrast (72148) |
$1,765.74 |
$2,942.90 |
7.4× |
| CT pelvis with contrast (72193) |
$1,236.66 |
$2,061.10 |
7.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,416.48 |
$2,360.80 |
5.9× |
| CT abdomen and pelvis with contrast (74177) |
$2,476.92 |
$4,128.20 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$638.34 |
$1,063.90 |
6.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$93 |
$155 |
0.9× |
| Ultrasound, transvaginal (76830) |
$424.44 |
$707.40 |
4.1× |
| Mammography, one breast (diagnostic) (77065) |
$182.58 |
$304.30 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$222.96 |
$371.60 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$206.34 |
$343.90 |
2.3× |
| Basic metabolic panel (80048) |
$93 |
$155 |
11.0× |
| Comprehensive metabolic panel (80053) |
$119.10 |
$198.50 |
11.3× |
| Lipid panel (80061) |
$66.33 |
$110.55 |
5.0× |
| Renal function panel (80069) |
$150.78 |
$251.30 |
17.4× |
| Hepatic function panel (80076) |
$168 |
$280 |
20.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$39.60 |
$66 |
9.9× |
| PSA, total (84153) |
$88.80 |
$148 |
4.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$106.74 |
$177.90 |
6.4× |
| CBC with automated differential (85025) |
$62.64 |
$104.40 |
8.1× |
| CBC, automated (85027) |
$59.88 |
$99.80 |
9.3× |
| Prothrombin time (PT) (85610) |
$33.12 |
$55.20 |
7.7× |
| Partial thromboplastin time (PTT) (85730) |
$35.30 |
$58.82 |
5.9× |
| Left heart catheterization (93452) |
$3,593.58 |
$5,989.30 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$810 |
$1,350 |
0.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$112.20 |
$187 |
3.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$129 |
$215 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$171.84 |
$286.40 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$244.14 |
$406.90 |
1.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$146.40 |
$244 |
1.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$216 |
$360 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
$205.80 |
$343 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$204.60 |
$341 |
— |