| Epidural injection, lumbar/sacral (with imaging) (62322) |
$867.72 |
$2,066 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$761.88 |
$1,814 |
0.8× |
| CT head/brain without contrast (70450) |
$649.32 |
$1,546 |
6.1× |
| MRI brain without contrast (70551) |
$800.52 |
$1,906 |
3.3× |
| MRI brain with contrast (70552) |
$1,000.86 |
$2,383 |
2.8× |
| MRI brain without and with contrast (70553) |
$1,200.78 |
$2,859 |
3.4× |
| X-ray lower spine, 4+ views (72110) |
$110.88 |
$264 |
1.0× |
| MRI lumbar spine without contrast (72148) |
$800.52 |
$1,906 |
3.3× |
| CT pelvis with contrast (72193) |
$481.74 |
$1,147 |
2.7× |
| MRI lower-extremity joint without contrast (73721) |
$800.52 |
$1,906 |
3.3× |
| CT abdomen and pelvis with contrast (74177) |
$1,063.44 |
$2,532 |
3.0× |
| Ultrasound, abdomen complete (76700) |
$377.16 |
$898 |
3.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$323.82 |
$771 |
3.0× |
| Ultrasound, transvaginal (76830) |
$281.40 |
$670 |
2.6× |
| Basic metabolic panel (80048) |
$10.92 |
$26 |
1.3× |
| Comprehensive metabolic panel (80053) |
$13.44 |
$32 |
1.3× |
| Lipid panel (80061) |
$22.68 |
$54 |
1.7× |
| Renal function panel (80069) |
$11.34 |
$27 |
1.3× |
| Hepatic function panel (80076) |
$10.50 |
$25 |
1.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.62 |
$11 |
1.3× |
| PSA, total (84153) |
$23.52 |
$56 |
1.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$22.05 |
$52.50 |
1.3× |
| CBC with automated differential (85025) |
$10.08 |
$24 |
1.3× |
| CBC, automated (85027) |
$8.40 |
$20 |
1.3× |
| Prothrombin time (PT) (85610) |
$5.46 |
$13 |
1.3× |
| Partial thromboplastin time (PTT) (85730) |
$15.33 |
$36.50 |
2.6× |
| Left heart catheterization (93452) |
$4,742.22 |
$11,291 |
1.4× |
| Sleep study (attended polysomnography) (95810) |
$2,312.94 |
$5,507 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$45.78 |
$109 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$197.82 |
$471 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$245.91 |
$585.50 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$330.12 |
$786 |
2.4× |