| Upper GI endoscopy (EGD) with biopsy (43239) |
$954.75 |
$1,273 |
1.0× |
| Diagnostic colonoscopy (45378) |
$1,503.75 |
$2,005 |
1.5× |
| Colonoscopy with biopsy (45380) |
$2,624.25 |
$3,499 |
2.1× |
| Colonoscopy with lesion removal (45385) |
$4,106.25 |
$5,475 |
3.3× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,699.50 |
$2,266 |
1.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,688.25 |
$2,251 |
1.8× |
| CT head/brain without contrast (70450) |
$1,473.75 |
$1,965 |
13.4× |
| MRI brain without contrast (70551) |
$1,249.50 |
$1,666 |
5.0× |
| MRI brain with contrast (70552) |
$1,400.25 |
$1,867 |
3.8× |
| MRI brain without and with contrast (70553) |
$1,746 |
$2,328 |
4.7× |
| X-ray lower spine, 4+ views (72110) |
$486 |
$648 |
4.4× |
| MRI lumbar spine without contrast (72148) |
$1,247.25 |
$1,663 |
5.0× |
| CT pelvis with contrast (72193) |
$1,793.25 |
$2,391 |
9.7× |
| MRI lower-extremity joint without contrast (73721) |
$1,195.50 |
$1,594 |
4.7× |
| CT abdomen and pelvis with contrast (74177) |
$3,430.50 |
$4,574 |
9.3× |
| Ultrasound, abdomen complete (76700) |
$612.75 |
$817 |
5.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$677.25 |
$903 |
6.1× |
| Ultrasound, transvaginal (76830) |
$504 |
$672 |
4.6× |
| Mammography, one breast (diagnostic) (77065) |
$182.25 |
$243 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$225.38 |
$300.50 |
2.0× |
| Mammography, screening (bilateral) (77067) |
$419.25 |
$559 |
4.6× |
| Basic metabolic panel (80048) |
$102 |
$136 |
12.1× |
| Comprehensive metabolic panel (80053) |
$276 |
$368 |
26.1× |
| Obstetric panel (80055) |
$381.75 |
$509 |
8.0× |
| Lipid panel (80061) |
$88.50 |
$118 |
6.6× |
| Renal function panel (80069) |
$211.50 |
$282 |
24.4× |
| Hepatic function panel (80076) |
$161.25 |
$215 |
19.7× |
| Urinalysis, non-automated, with microscopy (81000) |
$48.75 |
$65 |
12.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$33.75 |
$45 |
9.7× |
| PSA, total (84153) |
$152.25 |
$203 |
8.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$146.25 |
$195 |
8.7× |
| CBC with automated differential (85025) |
$129 |
$172 |
16.6× |
| Prothrombin time (PT) (85610) |
$56.25 |
$75 |
13.1× |
| Partial thromboplastin time (PTT) (85730) |
$66 |
$88 |
11.0× |
| Sleep study (attended polysomnography) (95810) |
$3,693 |
$4,924 |
4.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$91.50 |
$122 |
3.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$216 |
$288 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$280.50 |
$374 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$327 |
$436 |
2.3× |