| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,726.80 |
$2,878 |
2.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,956.20 |
$4,927 |
3.5× |
| CT head/brain without contrast (70450) |
$1,592.40 |
$2,654 |
15.9× |
| MRI brain without contrast (70551) |
$2,222.40 |
$3,704 |
9.7× |
| MRI brain with contrast (70552) |
$3,096.60 |
$5,161 |
9.3× |
| MRI brain without and with contrast (70553) |
$3,643.20 |
$6,072 |
10.9× |
| X-ray lower spine, 4+ views (72110) |
$677.40 |
$1,129 |
6.8× |
| MRI lumbar spine without contrast (72148) |
$2,709.60 |
$4,516 |
11.9× |
| CT pelvis with contrast (72193) |
$781.80 |
$1,303 |
4.7× |
| MRI lower-extremity joint without contrast (73721) |
$2,886 |
$4,810 |
12.7× |
| CT abdomen and pelvis with contrast (74177) |
$3,745.20 |
$6,242 |
11.2× |
| Ultrasound, abdomen complete (76700) |
$979.20 |
$1,632 |
9.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$594.60 |
$991 |
6.0× |
| Ultrasound, transvaginal (76830) |
$628.80 |
$1,048 |
6.3× |
| Mammography, one breast (diagnostic) (77065) |
$290.40 |
$484 |
3.4× |
| Mammography, both breasts (diagnostic) (77066) |
$480 |
$800 |
4.3× |
| Mammography, screening (bilateral) (77067) |
$312.90 |
$521.50 |
3.4× |
| Basic metabolic panel (80048) |
$72 |
$120 |
8.5× |
| Comprehensive metabolic panel (80053) |
$196.20 |
$327 |
18.6× |
| Lipid panel (80061) |
$80.40 |
$134 |
6.0× |
| Renal function panel (80069) |
$12.60 |
$21 |
1.5× |
| Hepatic function panel (80076) |
$228 |
$380 |
27.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$30 |
$50 |
8.6× |
| PSA, total (84153) |
$30.60 |
$51 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$69 |
$115 |
4.1× |
| CBC with automated differential (85025) |
$56.40 |
$94 |
7.3× |
| CBC, automated (85027) |
$8.40 |
$14 |
1.3× |
| Prothrombin time (PT) (85610) |
$9 |
$15 |
2.1× |
| Partial thromboplastin time (PTT) (85730) |
$24.60 |
$41 |
4.1× |
| Electrocardiogram (ECG), complete (93000) |
$288.60 |
$481 |
5.1× |
| Sleep study (attended polysomnography) (95810) |
$3,565.80 |
$5,943 |
4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$82.20 |
$137 |
2.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$357 |
$595 |
2.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$429 |
$715 |
3.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$574.20 |
$957 |
4.5× |