| Upper GI endoscopy (EGD), diagnostic (43235) |
$256.10 |
$2,561 |
0.3× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$326.90 |
$3,269 |
0.4× |
| Diagnostic colonoscopy (45378) |
$216.90 |
$2,169 |
0.2× |
| Colonoscopy with biopsy (45380) |
$326.90 |
$3,269 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$326.90 |
$3,269 |
0.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$197.10 |
$1,971 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$329.12 |
$3,291.25 |
0.4× |
| CT head/brain without contrast (70450) |
$547.60 |
$5,476 |
5.2× |
| MRI brain without contrast (70551) |
$783.20 |
$7,832 |
3.3× |
| MRI brain with contrast (70552) |
$932 |
$9,320 |
2.7× |
| MRI brain without and with contrast (70553) |
$1,059.50 |
$10,595 |
3.0× |
| X-ray lower spine, 4+ views (72110) |
$166.50 |
$1,665 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$746.50 |
$7,465 |
3.1× |
| CT pelvis with contrast (72193) |
$728.80 |
$7,288 |
4.1× |
| MRI lower-extremity joint without contrast (73721) |
$933.12 |
$9,331.25 |
3.9× |
| CT abdomen and pelvis with contrast (74177) |
$1,457.30 |
$14,573 |
4.2× |
| Ultrasound, abdomen complete (76700) |
$217.90 |
$2,179 |
2.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$177.10 |
$1,771 |
1.7× |
| Ultrasound, transvaginal (76830) |
$181.40 |
$1,814 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$82.90 |
$829 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$108.20 |
$1,082 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$92.20 |
$922 |
1.0× |
| Basic metabolic panel (80048) |
$44.90 |
$449 |
5.3× |
| Comprehensive metabolic panel (80053) |
$56.20 |
$562 |
5.3× |
| Lipid panel (80061) |
$71.30 |
$713 |
5.3× |
| Renal function panel (80069) |
$46.20 |
$462 |
5.3× |
| Hepatic function panel (80076) |
$43.60 |
$436 |
5.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$15.50 |
$155 |
4.5× |
| PSA, total (84153) |
$71.30 |
$713 |
3.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$65.10 |
$651 |
3.9× |
| CBC with automated differential (85025) |
$37.10 |
$371 |
4.8× |
| CBC, automated (85027) |
$29.50 |
$295 |
4.6× |
| Prothrombin time (PT) (85610) |
$18.90 |
$189 |
4.4× |
| Partial thromboplastin time (PTT) (85730) |
$28.70 |
$287 |
4.8× |
| Sleep study (attended polysomnography) (95810) |
$392.30 |
$3,923 |
0.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$31.20 |
$312 |
1.1× |