| CT head/brain without contrast (70450) |
$676.55 |
$1,828.50 |
6.2× |
| MRI brain without contrast (70551) |
$962.10 |
$2,600.25 |
3.9× |
| MRI brain with contrast (70552) |
$590.15 |
$1,595 |
1.6× |
| MRI brain without and with contrast (70553) |
$755.59 |
$2,042.12 |
2.1× |
| X-ray lower spine, 4+ views (72110) |
$417.59 |
$1,128.62 |
3.8× |
| MRI lumbar spine without contrast (72148) |
$989.66 |
$2,674.75 |
4.0× |
| CT pelvis with contrast (72193) |
$670.16 |
$1,811.25 |
3.7× |
| MRI lower-extremity joint without contrast (73721) |
$716.60 |
$1,936.75 |
2.9× |
| CT abdomen and pelvis with contrast (74177) |
$693.10 |
$1,873.25 |
1.9× |
| Ultrasound, abdomen complete (76700) |
$822.33 |
$2,222.50 |
7.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$312.56 |
$844.75 |
2.9× |
| Ultrasound, transvaginal (76830) |
$651.11 |
$1,759.75 |
6.0× |
| Mammography, one breast (diagnostic) (77065) |
$276.44 |
$747.12 |
3.2× |
| Mammography, both breasts (diagnostic) (77066) |
$278.62 |
$753 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$248.08 |
$670.50 |
2.7× |
| Basic metabolic panel (80048) |
$71.50 |
$193.25 |
8.5× |
| Comprehensive metabolic panel (80053) |
$122.38 |
$330.75 |
11.6× |
| Lipid panel (80061) |
$156.97 |
$424.25 |
11.7× |
| Renal function panel (80069) |
$77.70 |
$210 |
9.0× |
| Hepatic function panel (80076) |
$50.14 |
$135.50 |
6.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.90 |
$13.25 |
1.4× |
| PSA, total (84153) |
$12.67 |
$34.25 |
0.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$36.17 |
$97.75 |
2.2× |
| CBC with automated differential (85025) |
$51.25 |
$138.50 |
6.6× |
| CBC, automated (85027) |
$46.62 |
$126 |
7.2× |
| Prothrombin time (PT) (85610) |
$19.06 |
$51.50 |
4.4× |
| Partial thromboplastin time (PTT) (85730) |
$24.79 |
$67 |
4.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$32.10 |
$86.75 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$135.70 |
$366.75 |
1.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$186.11 |
$503 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$313.67 |
$847.75 |
2.3× |