| Breast lesion removal (open) (19120) |
$4,500.50 |
$9,001 |
1.2× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,346.50 |
$2,693 |
1.5× |
| Diagnostic colonoscopy (45378) |
$1,356 |
$2,712 |
1.5× |
| Colonoscopy with biopsy (45380) |
$1,665 |
$3,330 |
1.4× |
| Colonoscopy with lesion removal (45385) |
$1,576.25 |
$3,152.50 |
1.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,087.50 |
$2,175 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,017.50 |
$2,035 |
1.2× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$632 |
$1,264 |
1.2× |
| CT head/brain without contrast (70450) |
$602 |
$1,204 |
6.0× |
| MRI brain without contrast (70551) |
$1,467.50 |
$2,935 |
6.4× |
| MRI brain with contrast (70552) |
$2,042.50 |
$4,085 |
6.1× |
| MRI brain without and with contrast (70553) |
$2,005 |
$4,010 |
5.9× |
| X-ray lower spine, 4+ views (72110) |
$283 |
$566 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$1,381 |
$2,762 |
6.0× |
| CT pelvis with contrast (72193) |
$935 |
$1,870 |
5.5× |
| MRI lower-extremity joint without contrast (73721) |
$911 |
$1,822 |
3.9× |
| CT abdomen and pelvis with contrast (74177) |
$1,278 |
$2,556 |
3.8× |
| Ultrasound, abdomen complete (76700) |
$451 |
$902 |
4.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$424 |
$848 |
4.2× |
| Ultrasound, transvaginal (76830) |
$381.50 |
$763 |
3.8× |
| Mammography, one breast (diagnostic) (77065) |
$250.75 |
$501.50 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$322.75 |
$645.50 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$285 |
$570 |
3.1× |
| Basic metabolic panel (80048) |
$39 |
$78 |
4.6× |
| Comprehensive metabolic panel (80053) |
$49 |
$98 |
4.6× |
| Obstetric panel (80055) |
$221.50 |
$443 |
4.6× |
| Lipid panel (80061) |
$66 |
$132 |
4.9× |
| Renal function panel (80069) |
$40 |
$80 |
4.6× |
| Hepatic function panel (80076) |
$38 |
$76 |
4.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$25 |
$50 |
6.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.75 |
$19.50 |
2.8× |
| PSA, total (84153) |
$79 |
$158 |
4.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$49 |
$98 |
2.9× |
| CBC with automated differential (85025) |
$46.75 |
$93.50 |
6.0× |
| CBC, automated (85027) |
$40.75 |
$81.50 |
6.3× |
| Prothrombin time (PT) (85610) |
$30.50 |
$61 |
7.1× |
| Partial thromboplastin time (PTT) (85730) |
$51.50 |
$103 |
8.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$596 |
$1,192 |
3.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$596 |
$1,192 |
3.5× |
| Electrocardiogram (ECG), complete (93000) |
$190.50 |
$381 |
3.3× |
| Left heart catheterization (93452) |
$5,990.50 |
$11,981 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$2,319.50 |
$4,639 |
2.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$70.50 |
$141 |
2.4× |
| Preventive visit, new patient (age 18–39) (99385) |
$9.50 |
$19 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$9.50 |
$19 |
— |