| Upper GI endoscopy (EGD), diagnostic (43235) |
$326.70 |
$3,267 |
0.4× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$272.10 |
$2,721 |
0.3× |
| Diagnostic colonoscopy (45378) |
$530.60 |
$5,306 |
0.6× |
| Colonoscopy with biopsy (45380) |
$412 |
$4,120 |
0.3× |
| Colonoscopy with lesion removal (45385) |
$578.70 |
$5,787 |
0.5× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$204.40 |
$2,044 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$311.20 |
$3,112 |
0.4× |
| CT head/brain without contrast (70450) |
$388.90 |
$3,889 |
3.7× |
| MRI brain without contrast (70551) |
$470.30 |
$4,703 |
2.0× |
| MRI brain with contrast (70552) |
$746.30 |
$7,463 |
2.1× |
| MRI brain without and with contrast (70553) |
$848.50 |
$8,485 |
2.4× |
| X-ray lower spine, 4+ views (72110) |
$230.80 |
$2,308 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$664 |
$6,640 |
2.8× |
| CT pelvis with contrast (72193) |
$693.50 |
$6,935 |
3.9× |
| MRI lower-extremity joint without contrast (73721) |
$664 |
$6,640 |
2.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,040.30 |
$10,403 |
3.0× |
| Ultrasound, abdomen complete (76700) |
$363.10 |
$3,631 |
3.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$295.10 |
$2,951 |
2.8× |
| Ultrasound, transvaginal (76830) |
$209.90 |
$2,099 |
2.0× |
| Mammography, one breast (diagnostic) (77065) |
$87.10 |
$871 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$107.30 |
$1,073 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$107.30 |
$1,073 |
1.2× |
| Basic metabolic panel (80048) |
$50.20 |
$502 |
5.9× |
| Comprehensive metabolic panel (80053) |
$62.90 |
$629 |
6.0× |
| Lipid panel (80061) |
$79.60 |
$796 |
5.9× |
| Renal function panel (80069) |
$107.80 |
$1,078 |
12.4× |
| Hepatic function panel (80076) |
$48.50 |
$485 |
5.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$1.40 |
$14 |
0.4× |
| PSA, total (84153) |
$84 |
$840 |
4.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$76.70 |
$767 |
4.6× |
| CBC with automated differential (85025) |
$40.40 |
$404 |
5.2× |
| CBC, automated (85027) |
$33.60 |
$336 |
5.2× |
| Prothrombin time (PT) (85610) |
$20.50 |
$205 |
4.8× |
| Partial thromboplastin time (PTT) (85730) |
$31.30 |
$313 |
5.2× |
| Sleep study (attended polysomnography) (95810) |
$1,623 |
$16,230 |
1.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$31.20 |
$312 |
1.1× |