| Epidural injection, lumbar/sacral (with imaging) (62322) |
$208 |
$832 |
0.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$500.50 |
$2,002 |
0.6× |
| CT head/brain without contrast (70450) |
$758 |
$3,032 |
8.1× |
| MRI brain without contrast (70551) |
$606.12 |
$2,424.50 |
2.8× |
| MRI brain with contrast (70552) |
$950.25 |
$3,801 |
3.0× |
| MRI brain without and with contrast (70553) |
$1,701.50 |
$6,806 |
5.4× |
| X-ray lower spine, 4+ views (72110) |
$123.50 |
$494 |
1.3× |
| MRI lumbar spine without contrast (72148) |
$773.12 |
$3,092.50 |
3.6× |
| CT pelvis with contrast (72193) |
$1,043.50 |
$4,174 |
6.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,025 |
$4,100 |
4.8× |
| CT abdomen and pelvis with contrast (74177) |
$1,541.25 |
$6,165 |
4.9× |
| Ultrasound, abdomen complete (76700) |
$356.25 |
$1,425 |
3.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$397 |
$1,588 |
4.2× |
| Ultrasound, transvaginal (76830) |
$157.75 |
$631 |
1.7× |
| Mammography, one breast (diagnostic) (77065) |
$103 |
$412 |
1.2× |
| Mammography, both breasts (diagnostic) (77066) |
$189.50 |
$758 |
1.7× |
| Mammography, screening (bilateral) (77067) |
$136.25 |
$545 |
1.5× |
| Basic metabolic panel (80048) |
$166.25 |
$665 |
19.7× |
| Comprehensive metabolic panel (80053) |
$173 |
$692 |
16.4× |
| Lipid panel (80061) |
$97.50 |
$390 |
7.3× |
| Renal function panel (80069) |
$80.25 |
$321 |
9.2× |
| Hepatic function panel (80076) |
$145.50 |
$582 |
17.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.50 |
$38 |
2.7× |
| PSA, total (84153) |
$137.50 |
$550 |
7.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$48.38 |
$193.50 |
2.9× |
| CBC with automated differential (85025) |
$42.75 |
$171 |
5.5× |
| CBC, automated (85027) |
$36.75 |
$147 |
5.7× |
| Prothrombin time (PT) (85610) |
$43 |
$172 |
10.0× |
| Partial thromboplastin time (PTT) (85730) |
$56.25 |
$225 |
9.4× |
| Psychotherapy, 30 minutes (90832) |
$58.75 |
$235 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$137.50 |
$550 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$164 |
$656 |
1.0× |
| Group psychotherapy (90853) |
$106.50 |
$426 |
1.2× |
| Left heart catheterization (93452) |
$3,437.25 |
$13,749 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$1,363 |
$5,452 |
1.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$54.38 |
$217.50 |
1.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$97.25 |
$389 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$122 |
$488 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$173.62 |
$694.50 |
1.4× |