| Epidural injection, lumbar/sacral (with imaging) (62322) |
$520.31 |
$1,406.25 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$642.60 |
$1,736.75 |
0.8× |
| CT head/brain without contrast (70450) |
$891.79 |
$2,410.25 |
8.9× |
| MRI brain without contrast (70551) |
$870.98 |
$2,354 |
3.8× |
| MRI brain with contrast (70552) |
$985.40 |
$2,663.25 |
2.9× |
| MRI brain without and with contrast (70553) |
$1,278.91 |
$3,456.50 |
3.8× |
| X-ray lower spine, 4+ views (72110) |
$227 |
$613.50 |
2.3× |
| MRI lumbar spine without contrast (72148) |
$924.82 |
$2,499.50 |
4.0× |
| CT pelvis with contrast (72193) |
$971.25 |
$2,625 |
5.8× |
| MRI lower-extremity joint without contrast (73721) |
$976.80 |
$2,640 |
4.3× |
| CT abdomen and pelvis with contrast (74177) |
$1,187.61 |
$3,209.75 |
3.5× |
| Ultrasound, abdomen complete (76700) |
$526.79 |
$1,423.75 |
5.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$566.29 |
$1,530.50 |
5.6× |
| Ultrasound, transvaginal (76830) |
$378.88 |
$1,024 |
3.8× |
| Mammography, one breast (diagnostic) (77065) |
$161.69 |
$437 |
1.9× |
| Mammography, both breasts (diagnostic) (77066) |
$208.87 |
$564.50 |
1.9× |
| Mammography, screening (bilateral) (77067) |
$140.60 |
$380 |
1.5× |
| Basic metabolic panel (80048) |
$31.73 |
$85.75 |
3.8× |
| Comprehensive metabolic panel (80053) |
$40.79 |
$110.25 |
3.9× |
| Obstetric panel (80055) |
$76.04 |
$205.50 |
1.6× |
| Lipid panel (80061) |
$47.01 |
$127.05 |
3.5× |
| Renal function panel (80069) |
$26.55 |
$71.75 |
3.1× |
| Hepatic function panel (80076) |
$44.31 |
$119.75 |
5.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$18.59 |
$50.25 |
5.3× |
| PSA, total (84153) |
$76.96 |
$208 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$41.08 |
$111 |
2.4× |
| CBC with automated differential (85025) |
$45.33 |
$122.50 |
5.8× |
| CBC, automated (85027) |
$29.60 |
$80 |
4.6× |
| Prothrombin time (PT) (85610) |
$29.60 |
$80 |
6.9× |
| Partial thromboplastin time (PTT) (85730) |
$22.11 |
$59.75 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$33.02 |
$89.25 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$165.39 |
$447 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$228.20 |
$616.75 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$277.69 |
$750.50 |
2.2× |