| Epidural injection, lumbar/sacral (with imaging) (62322) |
$215.05 |
$935 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$485.07 |
$2,109 |
0.6× |
| CT head/brain without contrast (70450) |
$688.16 |
$2,992 |
7.3× |
| MRI brain without contrast (70551) |
$546.60 |
$2,376.50 |
2.5× |
| MRI brain with contrast (70552) |
$1,020.74 |
$4,438 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,158.74 |
$5,038 |
3.7× |
| X-ray lower spine, 4+ views (72110) |
$173.65 |
$755 |
1.8× |
| MRI lumbar spine without contrast (72148) |
$660.33 |
$2,871 |
3.1× |
| CT pelvis with contrast (72193) |
$808.68 |
$3,516 |
5.1× |
| MRI lower-extremity joint without contrast (73721) |
$780.39 |
$3,393 |
3.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,617.13 |
$7,031 |
5.1× |
| Ultrasound, abdomen complete (76700) |
$288.19 |
$1,253 |
3.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$288.19 |
$1,253 |
3.0× |
| Ultrasound, transvaginal (76830) |
$277.84 |
$1,208 |
2.9× |
| Mammography, one breast (diagnostic) (77065) |
$81.54 |
$354.50 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$109.82 |
$477.50 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$109.25 |
$475 |
1.2× |
| Basic metabolic panel (80048) |
$116.15 |
$505 |
13.7× |
| Comprehensive metabolic panel (80053) |
$149.73 |
$651 |
14.2× |
| Lipid panel (80061) |
$46 |
$200 |
3.4× |
| Renal function panel (80069) |
$112.01 |
$487 |
12.9× |
| Hepatic function panel (80076) |
$95.68 |
$416 |
11.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.43 |
$41 |
2.7× |
| PSA, total (84153) |
$73.83 |
$321 |
4.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$36.11 |
$157 |
2.1× |
| CBC with automated differential (85025) |
$39.33 |
$171 |
5.1× |
| CBC, automated (85027) |
$33.81 |
$147 |
5.2× |
| Prothrombin time (PT) (85610) |
$37.95 |
$165 |
8.8× |
| Partial thromboplastin time (PTT) (85730) |
$37.95 |
$165 |
6.3× |
| Psychotherapy, 30 minutes (90832) |
$75.67 |
$329 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$90.62 |
$394 |
0.6× |
| Group psychotherapy (90853) |
$33.35 |
$145 |
0.4× |
| Left heart catheterization (93452) |
$3,162.27 |
$13,749 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,229.35 |
$5,345 |
1.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$46.92 |
$204 |
1.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$93.38 |
$406 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$112.01 |
$487 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$136.85 |
$595 |
1.1× |