| Epidural injection, lumbar/sacral (with imaging) (62322) |
$558 |
$1,395 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$558 |
$1,395 |
0.7× |
| CT head/brain without contrast (70450) |
$495.60 |
$1,239 |
5.5× |
| MRI brain without contrast (70551) |
$477.60 |
$1,194 |
2.3× |
| MRI brain with contrast (70552) |
$565.20 |
$1,413 |
1.9× |
| MRI brain without and with contrast (70553) |
$652.40 |
$1,631 |
2.2× |
| X-ray lower spine, 4+ views (72110) |
$146 |
$365 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$478.40 |
$1,196 |
2.3× |
| CT pelvis with contrast (72193) |
$521.60 |
$1,304 |
3.4× |
| MRI lower-extremity joint without contrast (73721) |
$501.60 |
$1,254 |
2.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,753.60 |
$4,384 |
5.8× |
| Ultrasound, abdomen complete (76700) |
$324.80 |
$812 |
3.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$246 |
$615 |
2.7× |
| Ultrasound, transvaginal (76830) |
$228 |
$570 |
2.5× |
| Mammography, one breast (diagnostic) (77065) |
$152 |
$380 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$165.60 |
$414 |
1.5× |
| Mammography, screening (bilateral) (77067) |
$162.40 |
$406 |
1.8× |
| Basic metabolic panel (80048) |
$17.20 |
$43 |
2.0× |
| Comprehensive metabolic panel (80053) |
$21.20 |
$53 |
2.0× |
| Obstetric panel (80055) |
$65.60 |
$164 |
1.4× |
| Lipid panel (80061) |
$22.80 |
$57 |
1.7× |
| Renal function panel (80069) |
$67.20 |
$168 |
7.7× |
| Hepatic function panel (80076) |
$18 |
$45 |
2.2× |
| PSA, total (84153) |
$30.80 |
$77 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$23.20 |
$58 |
1.4× |
| CBC with automated differential (85025) |
$12.80 |
$32 |
1.6× |
| CBC, automated (85027) |
$7.60 |
$19 |
1.2× |
| Prothrombin time (PT) (85610) |
$7.60 |
$19 |
1.8× |
| Partial thromboplastin time (PTT) (85730) |
$36 |
$90 |
6.0× |
| Group psychotherapy (90853) |
$55.60 |
$139 |
0.6× |
| Left heart catheterization (93452) |
$2,279.60 |
$5,699 |
0.8× |
| Sleep study (attended polysomnography) (95810) |
$2,085.60 |
$5,214 |
2.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$51.20 |
$128 |
1.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$88 |
$220 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$116.80 |
$292 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$159.60 |
$399 |
1.4× |