| Upper GI endoscopy (EGD), diagnostic (43235) |
$227.66 |
$464.61 |
0.2× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$868.47 |
$1,772.39 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,295.38 |
$2,643.63 |
1.2× |
| CT head/brain without contrast (70450) |
$322.80 |
$658.77 |
2.6× |
| MRI brain without contrast (70551) |
$832.88 |
$1,699.75 |
2.9× |
| MRI brain with contrast (70552) |
$1,038.41 |
$2,119.21 |
2.5× |
| MRI brain without and with contrast (70553) |
$1,200.15 |
$2,449.29 |
2.9× |
| X-ray lower spine, 4+ views (72110) |
$135.46 |
$276.45 |
1.1× |
| MRI lumbar spine without contrast (72148) |
$832.88 |
$1,699.75 |
2.9× |
| CT pelvis with contrast (72193) |
$635.47 |
$1,296.88 |
3.0× |
| MRI lower-extremity joint without contrast (73721) |
$832.88 |
$1,699.75 |
2.9× |
| CT abdomen and pelvis with contrast (74177) |
$996.02 |
$2,032.69 |
2.4× |
| Ultrasound, abdomen complete (76700) |
$328.29 |
$669.97 |
2.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$328.29 |
$669.97 |
2.6× |
| Ultrasound, transvaginal (76830) |
$214.61 |
$437.98 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$186.49 |
$380.60 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$238.80 |
$487.35 |
2.2× |
| Mammography, screening (bilateral) (77067) |
$233.04 |
$475.59 |
2.6× |
| Basic metabolic panel (80048) |
$32.86 |
$67.06 |
3.9× |
| Comprehensive metabolic panel (80053) |
$39.43 |
$80.46 |
3.7× |
| Lipid panel (80061) |
$27.78 |
$56.70 |
2.1× |
| Renal function panel (80069) |
$34.13 |
$69.66 |
3.9× |
| Hepatic function panel (80076) |
$18.44 |
$37.63 |
2.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.49 |
$35.69 |
5.0× |
| PSA, total (84153) |
$45.81 |
$93.48 |
2.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$36.61 |
$74.70 |
2.2× |
| CBC with automated differential (85025) |
$43.51 |
$88.80 |
5.6× |
| CBC, automated (85027) |
$28.45 |
$58.06 |
4.4× |
| Prothrombin time (PT) (85610) |
$9.90 |
$20.21 |
2.3× |
| Partial thromboplastin time (PTT) (85730) |
$21.05 |
$42.95 |
3.5× |
| Sleep study (attended polysomnography) (95810) |
$1,310.83 |
$2,675.16 |
1.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$45.70 |
$93.26 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$143.32 |
$292.50 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$200.34 |
$408.85 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$159.74 |
$326 |
1.0× |
| Office consultation (low complexity, ~30 min) (99243) |
$97.51 |
$199 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$123.48 |
$252 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$116.80 |
$238.36 |
— |