| Breast lesion removal (open) (19120) |
$3,206.40 |
$3,206.40 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,057.27 |
$1,057.27 |
1.0× |
| CT head/brain without contrast (70450) |
$1,043 |
$1,043 |
8.3× |
| MRI brain without contrast (70551) |
$1,986 |
$1,986 |
6.9× |
| MRI brain without and with contrast (70553) |
$3,834 |
$3,834 |
9.2× |
| X-ray lower spine, 4+ views (72110) |
$673 |
$673 |
5.4× |
| MRI lumbar spine without contrast (72148) |
$1,961 |
$1,961 |
6.9× |
| CT pelvis with contrast (72193) |
$1,549 |
$1,549 |
7.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,754 |
$1,754 |
6.1× |
| CT abdomen and pelvis with contrast (74177) |
$3,095 |
$3,095 |
7.4× |
| Ultrasound, abdomen complete (76700) |
$1,001 |
$1,001 |
8.0× |
| Ultrasound, transvaginal (76830) |
$932 |
$932 |
7.4× |
| Mammography, one breast (diagnostic) (77065) |
$572 |
$572 |
6.6× |
| Mammography, both breasts (diagnostic) (77066) |
$795.30 |
$795.30 |
7.2× |
| Mammography, screening (bilateral) (77067) |
$689.20 |
$689.20 |
7.6× |
| Basic metabolic panel (80048) |
$62 |
$62 |
7.3× |
| Comprehensive metabolic panel (80053) |
$93 |
$93 |
8.8× |
| Lipid panel (80061) |
$65 |
$65 |
4.9× |
| Renal function panel (80069) |
$74 |
$74 |
8.5× |
| Hepatic function panel (80076) |
$63 |
$63 |
7.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$27 |
$27 |
7.8× |
| PSA, total (84153) |
$83 |
$83 |
4.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$60 |
$60 |
3.6× |
| CBC with automated differential (85025) |
$36 |
$36 |
4.6× |
| CBC, automated (85027) |
$33 |
$33 |
5.1× |
| Prothrombin time (PT) (85610) |
$24 |
$24 |
5.6× |
| Partial thromboplastin time (PTT) (85730) |
$28 |
$28 |
4.7× |
| Psychotherapy, 30 minutes (90832) |
$232.27 |
$232.27 |
1.1× |
| Psychotherapy, 45 minutes (90834) |
$285 |
$285 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$332 |
$332 |
1.6× |
| Family psychotherapy, without patient (50 min) (90846) |
$320 |
$320 |
1.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$320 |
$320 |
1.5× |
| Group psychotherapy (90853) |
$135.20 |
$135.20 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$2,738 |
$2,738 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$163.54 |
$163.54 |
5.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$414 |
$414 |
2.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$440 |
$440 |
2.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$608 |
$608 |
3.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$373 |
$373 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$373 |
$373 |
— |