| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,443.60 |
$2,406 |
1.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,059.60 |
$1,766 |
1.2× |
| CT head/brain without contrast (70450) |
$1,042.20 |
$1,737 |
9.6× |
| MRI brain without contrast (70551) |
$2,013 |
$3,355 |
8.1× |
| MRI brain with contrast (70552) |
$2,344.20 |
$3,907 |
6.5× |
| MRI brain without and with contrast (70553) |
$2,595 |
$4,325 |
7.2× |
| X-ray lower spine, 4+ views (72110) |
$309 |
$515 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$2,097.60 |
$3,496 |
8.5× |
| CT pelvis with contrast (72193) |
$1,564.20 |
$2,607 |
8.6× |
| MRI lower-extremity joint without contrast (73721) |
$1,851.60 |
$3,086 |
7.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,636.40 |
$4,394 |
7.3× |
| Ultrasound, abdomen complete (76700) |
$503.40 |
$839 |
4.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$522 |
$870 |
4.8× |
| Ultrasound, transvaginal (76830) |
$403.20 |
$672 |
3.7× |
| Mammography, one breast (diagnostic) (77065) |
$182.40 |
$304 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$179.70 |
$299.50 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$192 |
$320 |
2.1× |
| Basic metabolic panel (80048) |
$120 |
$200 |
14.2× |
| Comprehensive metabolic panel (80053) |
$202.20 |
$337 |
19.1× |
| Obstetric panel (80055) |
$331.80 |
$553 |
6.9× |
| Lipid panel (80061) |
$95.40 |
$159 |
7.1× |
| Renal function panel (80069) |
$142.20 |
$237 |
16.4× |
| Hepatic function panel (80076) |
$117.60 |
$196 |
14.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$26.70 |
$44.50 |
7.7× |
| PSA, total (84153) |
$56.10 |
$93.50 |
3.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$79.80 |
$133 |
4.8× |
| CBC with automated differential (85025) |
$84.60 |
$141 |
10.9× |
| CBC, automated (85027) |
$73.20 |
$122 |
11.3× |
| Prothrombin time (PT) (85610) |
$55.80 |
$93 |
13.0× |
| Partial thromboplastin time (PTT) (85730) |
$37.80 |
$63 |
6.3× |
| Psychotherapy, 30 minutes (90832) |
$130.80 |
$218 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$142.20 |
$237 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$170.40 |
$284 |
0.9× |
| Family psychotherapy, without patient (50 min) (90846) |
$233.40 |
$389 |
1.3× |
| Family psychotherapy, with patient (50 min) (90847) |
$213.60 |
$356 |
1.2× |
| Group psychotherapy (90853) |
$86.40 |
$144 |
0.8× |
| Left heart catheterization (93452) |
$5,679 |
$9,465 |
1.7× |
| Sleep study (attended polysomnography) (95810) |
$2,890.20 |
$4,817 |
3.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75 |
$125 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$216 |
$360 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$351.60 |
$586 |
2.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$501.30 |
$835.50 |
3.6× |