| Epidural injection, lumbar/sacral (with imaging) (62322) |
$323.10 |
$1,077 |
0.4× |
| CT head/brain without contrast (70450) |
$725.68 |
$2,418.94 |
6.9× |
| MRI brain without contrast (70551) |
$882.87 |
$2,942.91 |
3.7× |
| MRI brain with contrast (70552) |
$882.87 |
$2,942.91 |
2.5× |
| MRI brain without and with contrast (70553) |
$997.75 |
$3,325.84 |
2.8× |
| X-ray lower spine, 4+ views (72110) |
$230.16 |
$767.20 |
2.2× |
| MRI lumbar spine without contrast (72148) |
$844.31 |
$2,814.37 |
3.5× |
| CT pelvis with contrast (72193) |
$921.43 |
$3,071.44 |
5.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,093.23 |
$3,644.11 |
4.5× |
| CT abdomen and pelvis with contrast (74177) |
$1,381.99 |
$4,606.62 |
3.9× |
| Ultrasound, abdomen complete (76700) |
$247.07 |
$823.56 |
2.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$211.80 |
$705.99 |
2.0× |
| Ultrasound, transvaginal (76830) |
$185.43 |
$618.10 |
1.8× |
| Mammography, one breast (diagnostic) (77065) |
$137.58 |
$458.59 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$139.28 |
$464.25 |
1.3× |
| Mammography, screening (bilateral) (77067) |
$124.63 |
$415.44 |
1.4× |
| Basic metabolic panel (80048) |
$89.01 |
$296.71 |
10.5× |
| Comprehensive metabolic panel (80053) |
$136.84 |
$456.12 |
13.0× |
| Lipid panel (80061) |
$134.98 |
$449.93 |
10.1× |
| Renal function panel (80069) |
$123.02 |
$410.07 |
14.2× |
| Hepatic function panel (80076) |
$129.25 |
$430.83 |
15.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$10.85 |
$36.18 |
3.1× |
| PSA, total (84153) |
$90.23 |
$300.75 |
4.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$111.51 |
$371.70 |
6.6× |
| CBC with automated differential (85025) |
$44.95 |
$149.82 |
5.8× |
| CBC, automated (85027) |
$40.16 |
$133.86 |
6.2× |
| Prothrombin time (PT) (85610) |
$35.12 |
$117.05 |
8.2× |
| Partial thromboplastin time (PTT) (85730) |
$44.13 |
$147.10 |
7.3× |
| Left heart catheterization (93452) |
$3,943.38 |
$13,144.61 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$1,715.02 |
$5,716.73 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$43.79 |
$145.95 |
1.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$47.81 |
$159.35 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$71.28 |
$237.61 |
0.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$94.25 |
$314.16 |
0.7× |