| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,178.40 |
$1,473 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,540 |
$1,925 |
1.6× |
| Diagnostic colonoscopy (45378) |
$1,472 |
$1,840 |
1.5× |
| Colonoscopy with biopsy (45380) |
$1,600.80 |
$2,001 |
1.3× |
| Colonoscopy with lesion removal (45385) |
$2,017.60 |
$2,522 |
1.6× |
| Colonoscopy with endoscopic ultrasound (45391) |
$2,044 |
$2,555 |
1.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,992.80 |
$3,741 |
3.2× |
| CT head/brain without contrast (70450) |
$1,911.20 |
$2,389 |
17.3× |
| MRI brain without contrast (70551) |
$1,552.80 |
$1,941 |
6.2× |
| MRI brain with contrast (70552) |
$1,659.20 |
$2,074 |
4.5× |
| MRI brain without and with contrast (70553) |
$2,432 |
$3,040 |
6.6× |
| X-ray lower spine, 4+ views (72110) |
$344 |
$430 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$1,956.80 |
$2,446 |
7.8× |
| CT pelvis with contrast (72193) |
$1,257.60 |
$1,572 |
6.8× |
| MRI lower-extremity joint without contrast (73721) |
$1,552.80 |
$1,941 |
6.2× |
| CT abdomen and pelvis with contrast (74177) |
$3,712.80 |
$4,641 |
10.1× |
| Ultrasound, abdomen complete (76700) |
$872.80 |
$1,091 |
7.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$476.80 |
$596 |
4.3× |
| Ultrasound, transvaginal (76830) |
$623.20 |
$779 |
5.7× |
| Mammography, one breast (diagnostic) (77065) |
$353.60 |
$442 |
4.1× |
| Mammography, both breasts (diagnostic) (77066) |
$399.20 |
$499 |
3.6× |
| Mammography, screening (bilateral) (77067) |
$348.40 |
$435.50 |
3.8× |
| Basic metabolic panel (80048) |
$68.80 |
$86 |
8.1× |
| Comprehensive metabolic panel (80053) |
$171.20 |
$214 |
16.2× |
| Lipid panel (80061) |
$170.40 |
$213 |
12.7× |
| Renal function panel (80069) |
$128 |
$160 |
14.7× |
| Hepatic function panel (80076) |
$162.40 |
$203 |
19.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$92 |
$115 |
26.4× |
| PSA, total (84153) |
$152 |
$190 |
8.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$107.20 |
$134 |
6.4× |
| CBC with automated differential (85025) |
$93.60 |
$117 |
12.0× |
| CBC, automated (85027) |
$80 |
$100 |
12.4× |
| Prothrombin time (PT) (85610) |
$27.20 |
$34 |
6.3× |
| Partial thromboplastin time (PTT) (85730) |
$38.40 |
$48 |
6.4× |
| Sleep study (attended polysomnography) (95810) |
$3,628 |
$4,535 |
4.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$113.60 |
$142 |
3.9× |