| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,081.50 |
$1,081.50 |
1.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,046.85 |
$1,046.85 |
1.3× |
| Diagnostic colonoscopy (45378) |
$1,020.60 |
$1,020.60 |
1.2× |
| Colonoscopy with biopsy (45380) |
$1,253.70 |
$1,253.70 |
1.1× |
| Colonoscopy with lesion removal (45385) |
$1,064.70 |
$1,064.70 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$780.15 |
$780.15 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,506.75 |
$1,506.75 |
1.9× |
| CT head/brain without contrast (70450) |
$1,669.50 |
$1,669.50 |
17.4× |
| MRI brain without contrast (70551) |
$1,995 |
$1,995 |
9.1× |
| MRI brain with contrast (70552) |
$2,467.50 |
$2,467.50 |
7.7× |
| MRI brain without and with contrast (70553) |
$2,625 |
$2,625 |
8.2× |
| X-ray lower spine, 4+ views (72110) |
$546 |
$546 |
5.7× |
| MRI lumbar spine without contrast (72148) |
$2,100 |
$2,100 |
9.6× |
| CT pelvis with contrast (72193) |
$2,100 |
$2,100 |
13.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,680 |
$1,680 |
7.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,916.25 |
$1,916.25 |
6.0× |
| Ultrasound, abdomen complete (76700) |
$787.50 |
$787.50 |
8.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$624.88 |
$624.88 |
6.5× |
| Ultrasound, transvaginal (76830) |
$551.25 |
$551.25 |
5.7× |
| Mammography, one breast (diagnostic) (77065) |
$267.75 |
$267.75 |
3.1× |
| Mammography, both breasts (diagnostic) (77066) |
$414.75 |
$414.75 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$183.75 |
$183.75 |
2.0× |
| Basic metabolic panel (80048) |
$120.75 |
$120.75 |
14.3× |
| Comprehensive metabolic panel (80053) |
$67.20 |
$67.20 |
6.4× |
| Obstetric panel (80055) |
$226.28 |
$226.28 |
4.7× |
| Lipid panel (80061) |
$102.38 |
$102.38 |
7.6× |
| Renal function panel (80069) |
$147 |
$147 |
16.9× |
| Hepatic function panel (80076) |
$133.35 |
$133.35 |
16.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$57.75 |
$57.75 |
14.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$26.25 |
$26.25 |
7.5× |
| PSA, total (84153) |
$116.02 |
$116.02 |
6.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$110.78 |
$110.78 |
6.6× |
| CBC with automated differential (85025) |
$61.95 |
$61.95 |
8.0× |
| CBC, automated (85027) |
$54.60 |
$54.60 |
8.4× |
| Prothrombin time (PT) (85610) |
$40.95 |
$40.95 |
9.5× |
| Partial thromboplastin time (PTT) (85730) |
$67.20 |
$67.20 |
11.2× |
| Psychotherapy, 30 minutes (90832) |
$109.20 |
$109.20 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$138.60 |
$138.60 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$205.80 |
$205.80 |
1.3× |
| Electrocardiogram (ECG), complete (93000) |
$92.40 |
$92.40 |
1.7× |
| Sleep study (attended polysomnography) (95810) |
$3,990 |
$3,990 |
5.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$115.50 |
$115.50 |
4.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$190.05 |
$190.05 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$334.42 |
$334.42 |
2.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$341.25 |
$341.25 |
2.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$247.80 |
$247.80 |
2.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$246.75 |
$246.75 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$273 |
$273 |
— |