| Upper GI endoscopy (EGD), diagnostic (43235) |
$880 |
$1,100 |
1.1× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$940 |
$1,175 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,024.40 |
$1,280.50 |
1.2× |
| Colonoscopy with biopsy (45380) |
$1,051.20 |
$1,314 |
1.0× |
| Colonoscopy with lesion removal (45385) |
$1,108 |
$1,385 |
1.0× |
| CT head/brain without contrast (70450) |
$1,003.20 |
$1,254 |
10.4× |
| MRI brain without contrast (70551) |
$918.40 |
$1,148 |
4.2× |
| MRI brain with contrast (70552) |
$918.40 |
$1,148 |
2.9× |
| MRI brain without and with contrast (70553) |
$918.40 |
$1,148 |
2.9× |
| X-ray lower spine, 4+ views (72110) |
$418.40 |
$523 |
4.4× |
| MRI lumbar spine without contrast (72148) |
$918.40 |
$1,148 |
4.2× |
| CT pelvis with contrast (72193) |
$1,003.20 |
$1,254 |
6.2× |
| MRI lower-extremity joint without contrast (73721) |
$918.40 |
$1,148 |
4.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,003.20 |
$1,254 |
3.1× |
| Ultrasound, abdomen complete (76700) |
$455.20 |
$569 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$455.20 |
$569 |
4.7× |
| Ultrasound, transvaginal (76830) |
$455.20 |
$569 |
4.7× |
| Mammography, one breast (diagnostic) (77065) |
$188.80 |
$236 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$188.80 |
$236 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$188.80 |
$236 |
2.1× |
| Basic metabolic panel (80048) |
$72 |
$90 |
8.5× |
| Comprehensive metabolic panel (80053) |
$72 |
$90 |
6.8× |
| Lipid panel (80061) |
$56 |
$70 |
4.2× |
| Renal function panel (80069) |
$92 |
$115 |
10.6× |
| Hepatic function panel (80076) |
$64 |
$80 |
7.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$13.60 |
$17 |
3.9× |
| PSA, total (84153) |
$92 |
$115 |
5.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$72 |
$90 |
4.3× |
| CBC with automated differential (85025) |
$40 |
$50 |
5.1× |
| CBC, automated (85027) |
$40 |
$50 |
6.2× |
| Prothrombin time (PT) (85610) |
$44.80 |
$56 |
10.4× |
| Partial thromboplastin time (PTT) (85730) |
$28.80 |
$36 |
4.8× |
| Psychotherapy, 30 minutes (90832) |
$72 |
$90 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$120 |
$150 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$160 |
$200 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$160 |
$200 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$84 |
$105 |
0.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$57.20 |
$71.50 |
2.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$116 |
$145 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$160 |
$200 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$180 |
$225 |
1.5× |