| Epidural injection, lumbar/sacral (with imaging) (62322) |
$750.40 |
$1,876 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$750.40 |
$1,876 |
0.9× |
| CT head/brain without contrast (70450) |
$633.60 |
$1,584 |
6.6× |
| MRI brain without contrast (70551) |
$833.20 |
$2,083 |
3.8× |
| MRI brain with contrast (70552) |
$803 |
$2,007.50 |
2.5× |
| MRI brain without and with contrast (70553) |
$1,173 |
$2,932.50 |
3.7× |
| X-ray lower spine, 4+ views (72110) |
$127.60 |
$319 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$830.80 |
$2,077 |
3.8× |
| CT pelvis with contrast (72193) |
$729.60 |
$1,824 |
4.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,270.80 |
$3,177 |
5.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,231 |
$3,077.50 |
3.8× |
| Ultrasound, abdomen complete (76700) |
$713.20 |
$1,783 |
7.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$555.20 |
$1,388 |
5.8× |
| Ultrasound, transvaginal (76830) |
$404.40 |
$1,011 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$140.80 |
$352 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$179.60 |
$449 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$140.80 |
$352 |
1.5× |
| Basic metabolic panel (80048) |
$29.20 |
$73 |
3.5× |
| Comprehensive metabolic panel (80053) |
$86.20 |
$215.50 |
8.2× |
| Lipid panel (80061) |
$59.20 |
$148 |
4.4× |
| Renal function panel (80069) |
$44.80 |
$112 |
5.2× |
| Hepatic function panel (80076) |
$39.60 |
$99 |
4.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$15.60 |
$39 |
4.5× |
| PSA, total (84153) |
$61.20 |
$153 |
3.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$56 |
$140 |
3.3× |
| CBC with automated differential (85025) |
$51.40 |
$128.50 |
6.6× |
| CBC, automated (85027) |
$35.20 |
$88 |
5.4× |
| Prothrombin time (PT) (85610) |
$14.40 |
$36 |
3.4× |
| Partial thromboplastin time (PTT) (85730) |
$14.40 |
$36 |
2.4× |
| Psychotherapy, 30 minutes (90832) |
$74.80 |
$187 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$74.80 |
$187 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$81.20 |
$203 |
0.5× |
| Sleep study (attended polysomnography) (95810) |
$1,174.40 |
$2,936 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$30.40 |
$76 |
1.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$103.40 |
$258.50 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$103.20 |
$258 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$346 |
$865 |
2.8× |