| Upper GI endoscopy (EGD), diagnostic (43235) |
— |
$947 |
— |
| Upper GI endoscopy (EGD) with biopsy (43239) |
— |
$1,068 |
— |
| Diagnostic colonoscopy (45378) |
— |
$1,406 |
— |
| Colonoscopy with biopsy (45380) |
— |
$1,527 |
— |
| Colonoscopy with lesion removal (45385) |
— |
$1,926 |
— |
| Obstetric care, vaginal delivery (global) (59400) |
— |
$7,660 |
— |
| Obstetric care, cesarean delivery (global) (59510) |
— |
$4,539 |
— |
| Obstetric care, VBAC delivery (global) (59610) |
— |
$5,362 |
— |
Transforaminal epidural injection, lumbar/sacral (64483)
range across 2 matching MRF lines |
— |
$818–$3,608 |
— |
| CT head/brain without contrast (70450) |
— |
$2,468 |
— |
| MRI brain without contrast (70551) |
— |
$3,417 |
— |
| MRI brain with contrast (70552) |
— |
$4,084 |
— |
| MRI brain without and with contrast (70553) |
— |
$5,598 |
— |
| X-ray lower spine, 4+ views (72110) |
— |
$922 |
— |
| MRI lumbar spine without contrast (72148) |
— |
$3,306 |
— |
| CT pelvis with contrast (72193) |
— |
$4,798 |
— |
| MRI lower-extremity joint without contrast (73721) |
— |
$3,509 |
— |
| CT abdomen and pelvis with contrast (74177) |
— |
$6,598 |
— |
| Ultrasound, abdomen complete (76700) |
— |
$1,193 |
— |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
— |
$1,385 |
— |
| Ultrasound, transvaginal (76830) |
— |
$1,189 |
— |
| Mammography, one breast (diagnostic) (77065) |
— |
$440 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$565 |
— |
Mammography, screening (bilateral) (77067)
range across 3 matching MRF lines |
— |
$185–$528 |
— |
| Basic metabolic panel (80048) |
— |
$81 |
— |
| Comprehensive metabolic panel (80053) |
— |
$113 |
— |
Lipid panel (80061)
range across 4 matching MRF lines |
— |
$171–$215 |
— |
| Renal function panel (80069) |
— |
$81 |
— |
| Hepatic function panel (80076) |
— |
$81 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$37 |
— |
| PSA, total (84153) |
— |
$237 |
— |
Thyroid stimulating hormone (TSH) (84443)
range across 4 matching MRF lines |
— |
$219–$267 |
— |
CBC with automated differential (85025)
range across 3 matching MRF lines |
— |
$75–$102 |
— |
| CBC, automated (85027) |
— |
$83 |
— |
Prothrombin time (PT) (85610)
range across 7 matching MRF lines |
— |
$40–$115 |
— |
Partial thromboplastin time (PTT) (85730)
range across 8 matching MRF lines |
— |
$23–$107 |
— |
| Psychotherapy, 30 minutes (90832) |
— |
$183 |
— |
| Psychotherapy, 45 minutes (90834) |
— |
$230 |
— |
| Psychotherapy, 60 minutes (90837) |
— |
$291 |
— |
| Family psychotherapy, with patient (50 min) (90847) |
— |
$352 |
— |
| Electrocardiogram (ECG), complete (93000) |
— |
$71 |
— |
Sleep study (attended polysomnography) (95810)
range across 2 matching MRF lines |
— |
$1,635–$3,281 |
— |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
— |
$115 |
— |
| Office visit, new patient (low complexity, ~30 min) (99203) |
— |
$305 |
— |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
— |
$517 |
— |
| Office visit, new patient (high complexity, ~60 min) (99205) |
— |
$671 |
— |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$355 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$429 |
— |