| CT head/brain without contrast (70450) |
$855.60 |
$2,139 |
7.8× |
| MRI brain without contrast (70551) |
$817.40 |
$2,043.50 |
3.3× |
| MRI brain with contrast (70552) |
$1,394.40 |
$3,486 |
3.8× |
| MRI brain without and with contrast (70553) |
$1,631.60 |
$4,079 |
4.5× |
| X-ray lower spine, 4+ views (72110) |
$414.20 |
$1,035.50 |
3.8× |
| MRI lumbar spine without contrast (72148) |
$985.40 |
$2,463.50 |
4.0× |
| CT pelvis with contrast (72193) |
$1,335.20 |
$3,338 |
7.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,405.20 |
$3,513 |
5.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,754.60 |
$4,386.50 |
4.8× |
| Ultrasound, abdomen complete (76700) |
$1,252.40 |
$3,131 |
11.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$338.80 |
$847 |
3.1× |
| Ultrasound, transvaginal (76830) |
$1,068 |
$2,670 |
9.8× |
| Mammography, one breast (diagnostic) (77065) |
$401.60 |
$1,004 |
4.7× |
| Mammography, both breasts (diagnostic) (77066) |
$606.80 |
$1,517 |
5.5× |
| Mammography, screening (bilateral) (77067) |
$494.40 |
$1,236 |
5.4× |
| Basic metabolic panel (80048) |
$20.36 |
$50.90 |
2.4× |
| Comprehensive metabolic panel (80053) |
$28.04 |
$70.10 |
2.7× |
| Obstetric panel (80055) |
$41.80 |
$104.50 |
0.9× |
| Lipid panel (80061) |
$20.36 |
$50.90 |
1.5× |
| Renal function panel (80069) |
$26.46 |
$66.15 |
3.0× |
| Hepatic function panel (80076) |
$21.14 |
$52.85 |
2.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$5.40 |
$13.50 |
1.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.36 |
$10.90 |
1.3× |
| PSA, total (84153) |
$46.64 |
$116.60 |
2.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$30.24 |
$75.60 |
1.8× |
| CBC with automated differential (85025) |
$14.32 |
$35.80 |
1.8× |
| CBC, automated (85027) |
$11.52 |
$28.80 |
1.8× |
| Prothrombin time (PT) (85610) |
$14.14 |
$35.35 |
3.3× |
| Partial thromboplastin time (PTT) (85730) |
$14.84 |
$37.10 |
2.5× |
| Sleep study (attended polysomnography) (95810) |
$3,304.40 |
$8,261 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$77.20 |
$193 |
2.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$292.80 |
$732 |
2.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$282.80 |
$707 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$433.20 |
$1,083 |
3.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$113.60 |
$284 |
0.8× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$100.60 |
$251.50 |
0.7× |