| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,738.20 |
$2,897 |
1.8× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,952.40 |
$3,254 |
2.0× |
| Diagnostic colonoscopy (45378) |
$1,511.40 |
$2,519 |
1.5× |
| Colonoscopy with biopsy (45380) |
$2,869.20 |
$4,782 |
2.3× |
| Colonoscopy with lesion removal (45385) |
$2,869.20 |
$4,782 |
2.3× |
| Colonoscopy with endoscopic ultrasound (45391) |
$2,098.80 |
$3,498 |
1.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,333.80 |
$2,223 |
1.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,226 |
$3,710 |
2.4× |
| CT head/brain without contrast (70450) |
$1,692.60 |
$2,821 |
15.3× |
| MRI brain without contrast (70551) |
$1,859.40 |
$3,099 |
7.4× |
| MRI brain with contrast (70552) |
$2,226 |
$3,710 |
6.0× |
| MRI brain without and with contrast (70553) |
$2,530.20 |
$4,217 |
6.9× |
| X-ray lower spine, 4+ views (72110) |
$526.20 |
$877 |
4.8× |
| MRI lumbar spine without contrast (72148) |
$1,848.60 |
$3,081 |
7.3× |
| CT pelvis with contrast (72193) |
$1,449.60 |
$2,416 |
7.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,578 |
$2,630 |
6.3× |
| CT abdomen and pelvis with contrast (74177) |
$3,988.80 |
$6,648 |
10.8× |
| Ultrasound, abdomen complete (76700) |
$705 |
$1,175 |
6.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$705 |
$1,175 |
6.4× |
| Ultrasound, transvaginal (76830) |
$705 |
$1,175 |
6.4× |
| Mammography, one breast (diagnostic) (77065) |
$348 |
$580 |
4.0× |
| Mammography, both breasts (diagnostic) (77066) |
$423 |
$705 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$309.90 |
$516.50 |
3.4× |
| Basic metabolic panel (80048) |
$157.20 |
$262 |
18.6× |
| Comprehensive metabolic panel (80053) |
$197.40 |
$329 |
18.7× |
| Obstetric panel (80055) |
$101.40 |
$169 |
2.1× |
| Lipid panel (80061) |
$185.64 |
$309.40 |
13.9× |
| Renal function panel (80069) |
$106.20 |
$177 |
12.2× |
| Hepatic function panel (80076) |
$163.20 |
$272 |
20.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$57 |
$95 |
16.4× |
| PSA, total (84153) |
$228.60 |
$381 |
12.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$279.60 |
$466 |
16.6× |
| CBC with automated differential (85025) |
$170.40 |
$284 |
21.9× |
| CBC, automated (85027) |
$92.40 |
$154 |
14.3× |
| Prothrombin time (PT) (85610) |
$74.40 |
$124 |
17.3× |
| Partial thromboplastin time (PTT) (85730) |
$70.92 |
$118.20 |
11.8× |
| Psychotherapy, 45 minutes (90834) |
$307.20 |
$512 |
1.6× |
| Psychotherapy, 60 minutes (90837) |
$367.20 |
$612 |
2.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$194.40 |
$324 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$369.60 |
$616 |
2.0× |
| Group psychotherapy (90853) |
$249.60 |
$416 |
2.3× |
| Left heart catheterization (93452) |
$6,895.20 |
$11,492 |
2.0× |
| Sleep study (attended polysomnography) (95810) |
$4,813.20 |
$8,022 |
5.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75.60 |
$126 |
2.6× |