| Epidural injection, lumbar/sacral (with imaging) (62322) |
$191.36 |
$832 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$485.07 |
$2,109 |
0.6× |
| CT head/brain without contrast (70450) |
$697.36 |
$3,032 |
7.4× |
| MRI brain without contrast (70551) |
$537.97 |
$2,339 |
2.5× |
| MRI brain with contrast (70552) |
$998.66 |
$4,342 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,388.74 |
$6,038 |
4.4× |
| X-ray lower spine, 4+ views (72110) |
$159.39 |
$693 |
1.7× |
| MRI lumbar spine without contrast (72148) |
$711.28 |
$3,092.50 |
3.3× |
| CT pelvis with contrast (72193) |
$960.02 |
$4,174 |
6.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,230.27 |
$5,349 |
5.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,145.21 |
$9,327 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$267.03 |
$1,161 |
2.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$365.24 |
$1,588 |
3.9× |
| Ultrasound, transvaginal (76830) |
$190.21 |
$827 |
2.0× |
| Mammography, one breast (diagnostic) (77065) |
$74.64 |
$324.50 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$100.97 |
$439 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$99.13 |
$431 |
1.1× |
| Basic metabolic panel (80048) |
$152.95 |
$665 |
18.1× |
| Comprehensive metabolic panel (80053) |
$159.16 |
$692 |
15.1× |
| Lipid panel (80061) |
$90.62 |
$394 |
6.8× |
| Renal function panel (80069) |
$155.71 |
$677 |
17.9× |
| Hepatic function panel (80076) |
$133.86 |
$582 |
16.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.66 |
$42 |
2.8× |
| PSA, total (84153) |
$76.13 |
$331 |
4.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$36.22 |
$157.50 |
2.2× |
| CBC with automated differential (85025) |
$39.33 |
$171 |
5.1× |
| CBC, automated (85027) |
$33.81 |
$147 |
5.2× |
| Prothrombin time (PT) (85610) |
$76.59 |
$333 |
17.9× |
| Partial thromboplastin time (PTT) (85730) |
$76.59 |
$333 |
12.7× |
| Left heart catheterization (93452) |
$3,162.27 |
$13,749 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$1,466.48 |
$6,376 |
1.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$60.26 |
$262 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$79.58 |
$346 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$98.90 |
$430 |
0.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$159.74 |
$694.50 |
1.3× |