| Epidural injection, lumbar/sacral (with imaging) (62322) |
$923.50 |
$2,066 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$672.74 |
$1,505 |
0.7× |
| CT head/brain without contrast (70450) |
$364.82 |
$1,126 |
3.3× |
| MRI brain without contrast (70551) |
$437.67 |
$1,525 |
1.7× |
| MRI brain with contrast (70552) |
$547.31 |
$1,907 |
1.5× |
| MRI brain without and with contrast (70553) |
$656.66 |
$2,288 |
1.8× |
| X-ray lower spine, 4+ views (72110) |
$73.57 |
$209 |
0.7× |
| MRI lumbar spine without contrast (72148) |
$305.16 |
$1,067 |
1.2× |
| CT pelvis with contrast (72193) |
$425.85 |
$1,275 |
2.3× |
| MRI lower-extremity joint without contrast (73721) |
$411.86 |
$1,067 |
1.6× |
| CT abdomen and pelvis with contrast (74177) |
$451.57 |
$1,352 |
1.2× |
| Ultrasound, abdomen complete (76700) |
$228.39 |
$413 |
2.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$311.34 |
$563 |
2.8× |
| Ultrasound, transvaginal (76830) |
$252.72 |
$457 |
2.3× |
| Mammography, one breast (diagnostic) (77065) |
$125.15 |
$310 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$283.82 |
$703 |
2.6× |
| Mammography, screening (bilateral) (77067) |
$135.85 |
$336.50 |
1.5× |
| Basic metabolic panel (80048) |
$5.98 |
$26 |
0.7× |
| Comprehensive metabolic panel (80053) |
$7.36 |
$32 |
0.7× |
| Lipid panel (80061) |
$14.14 |
$61.50 |
1.1× |
| Renal function panel (80069) |
$6.21 |
$27 |
0.7× |
| Hepatic function panel (80076) |
$5.75 |
$25 |
0.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$1.96 |
$11 |
0.6× |
| PSA, total (84153) |
$12.88 |
$56 |
0.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$12.08 |
$52.50 |
0.7× |
| CBC with automated differential (85025) |
$6.77 |
$24 |
0.9× |
| CBC, automated (85027) |
$5.64 |
$20 |
0.9× |
| Prothrombin time (PT) (85610) |
$3.67 |
$13 |
0.9× |
| Partial thromboplastin time (PTT) (85730) |
$10.30 |
$36.50 |
1.7× |
| Left heart catheterization (93452) |
$3,624.41 |
$11,291 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$2,483.66 |
$5,507 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$59.72 |
$133 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$457.50 |
$615 |
3.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$573.36 |
$769.50 |
4.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$769.10 |
$1,032 |
5.5× |