| Upper GI endoscopy (EGD), diagnostic (43235) |
$537.62 |
$2,150.50 |
0.7× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$518.38 |
$2,073.50 |
0.6× |
| Diagnostic colonoscopy (45378) |
$543.50 |
$2,174 |
0.6× |
| Colonoscopy with biopsy (45380) |
$489.25 |
$1,957 |
0.5× |
| Colonoscopy with lesion removal (45385) |
$538 |
$2,152 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$387.75 |
$1,551 |
0.5× |
| CT head/brain without contrast (70450) |
$349.12 |
$1,396.50 |
3.7× |
| MRI brain without contrast (70551) |
$815.75 |
$3,263 |
3.8× |
| MRI brain with contrast (70552) |
$937.62 |
$3,750.50 |
3.0× |
| MRI brain without and with contrast (70553) |
$1,066 |
$4,264 |
3.4× |
| X-ray lower spine, 4+ views (72110) |
$128.75 |
$515 |
1.4× |
| MRI lumbar spine without contrast (72148) |
$734.50 |
$2,938 |
3.4× |
| CT pelvis with contrast (72193) |
$475.75 |
$1,903 |
3.0× |
| MRI lower-extremity joint without contrast (73721) |
$735.25 |
$2,941 |
3.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,213.75 |
$4,855 |
3.8× |
| Ultrasound, abdomen complete (76700) |
$203.75 |
$815 |
2.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$112 |
$448 |
1.2× |
| Ultrasound, transvaginal (76830) |
$107.25 |
$429 |
1.1× |
| Mammography, one breast (diagnostic) (77065) |
$110.25 |
$441 |
1.3× |
| Mammography, both breasts (diagnostic) (77066) |
$131.25 |
$525 |
1.2× |
| Mammography, screening (bilateral) (77067) |
$105.12 |
$420.50 |
1.2× |
| Basic metabolic panel (80048) |
$40.38 |
$161.50 |
4.8× |
| Comprehensive metabolic panel (80053) |
$43.12 |
$172.50 |
4.1× |
| Lipid panel (80061) |
$93.25 |
$373 |
7.0× |
| Renal function panel (80069) |
$104.75 |
$419 |
12.1× |
| Hepatic function panel (80076) |
$24 |
$96 |
2.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$7.25 |
$29 |
2.1× |
| PSA, total (84153) |
$60 |
$240 |
3.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$31.75 |
$127 |
1.9× |
| CBC with automated differential (85025) |
$19.50 |
$78 |
2.5× |
| CBC, automated (85027) |
$17.25 |
$69 |
2.7× |
| Prothrombin time (PT) (85610) |
$20.62 |
$82.50 |
4.8× |
| Partial thromboplastin time (PTT) (85730) |
$19.50 |
$78 |
3.2× |
| Left heart catheterization (93452) |
$2,107.88 |
$8,431.50 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$2,019.88 |
$8,079.50 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$25.38 |
$101.50 |
0.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$135.75 |
$543 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$144 |
$576 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$181.75 |
$727 |
1.5× |