| Transforaminal epidural injection, lumbar/sacral (64483) |
$686.61 |
$1,907.25 |
0.8× |
| CT head/brain without contrast (70450) |
$678.69 |
$1,885.25 |
6.5× |
| MRI brain without contrast (70551) |
$468.27 |
$1,300.75 |
2.0× |
| MRI brain with contrast (70552) |
$940.36 |
$2,612.12 |
2.7× |
| MRI brain without and with contrast (70553) |
$1,394.06 |
$3,872.38 |
4.0× |
| X-ray lower spine, 4+ views (72110) |
$236.52 |
$657 |
2.3× |
| MRI lumbar spine without contrast (72148) |
$915.98 |
$2,544.38 |
3.8× |
| CT pelvis with contrast (72193) |
$462.20 |
$1,283.88 |
2.6× |
| MRI lower-extremity joint without contrast (73721) |
$915.98 |
$2,544.38 |
3.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,850.36 |
$5,139.88 |
5.3× |
| Ultrasound, abdomen complete (76700) |
$378.09 |
$1,050.25 |
3.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$274.32 |
$762 |
2.6× |
| Ultrasound, transvaginal (76830) |
$253.53 |
$704.25 |
2.4× |
| Mammography, one breast (diagnostic) (77065) |
$118.62 |
$329.50 |
1.4× |
| Mammography, both breasts (diagnostic) (77066) |
$189.76 |
$527.12 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$130.50 |
$362.50 |
1.4× |
| Basic metabolic panel (80048) |
$98.42 |
$273.38 |
11.6× |
| Comprehensive metabolic panel (80053) |
$118.26 |
$328.50 |
11.2× |
| Lipid panel (80061) |
$74.48 |
$206.88 |
5.6× |
| Renal function panel (80069) |
$92.25 |
$256.25 |
10.6× |
| Hepatic function panel (80076) |
$46.04 |
$127.88 |
5.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.06 |
$47.38 |
4.9× |
| PSA, total (84153) |
$57.69 |
$160.25 |
3.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$71.68 |
$199.12 |
4.3× |
| CBC with automated differential (85025) |
$43.06 |
$119.62 |
5.5× |
| CBC, automated (85027) |
$31.10 |
$86.38 |
4.8× |
| Prothrombin time (PT) (85610) |
$32.13 |
$89.25 |
7.5× |
| Partial thromboplastin time (PTT) (85730) |
$50.26 |
$139.62 |
8.4× |
| Left heart catheterization (93452) |
$3,751.20 |
$10,420 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$2,818.26 |
$7,828.50 |
3.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$44.37 |
$123.25 |
1.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$195.57 |
$543.25 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$229.77 |
$638.25 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$273.87 |
$760.75 |
2.0× |