| Breast lesion removal (open) (19120) |
$2,861.55 |
$6,359 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$835.20 |
$1,856 |
0.9× |
| CT head/brain without contrast (70450) |
$1,537.20 |
$3,416 |
13.8× |
| MRI brain without contrast (70551) |
$2,125.80 |
$4,724 |
8.3× |
| MRI brain with contrast (70552) |
$2,494.80 |
$5,544 |
6.7× |
| MRI brain without and with contrast (70553) |
$2,893.50 |
$6,430 |
7.8× |
| X-ray lower spine, 4+ views (72110) |
$283.05 |
$629 |
2.5× |
| MRI lumbar spine without contrast (72148) |
$2,027.70 |
$4,506 |
8.0× |
| CT pelvis with contrast (72193) |
$1,937.70 |
$4,306 |
10.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,038.15 |
$2,307 |
4.1× |
| CT abdomen and pelvis with contrast (74177) |
$4,876.65 |
$10,837 |
13.1× |
| Ultrasound, abdomen complete (76700) |
$786.60 |
$1,748 |
7.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$400.95 |
$891 |
3.6× |
| Ultrasound, transvaginal (76830) |
$231.75 |
$515 |
2.1× |
| Mammography, one breast (diagnostic) (77065) |
$253.35 |
$563 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$256.50 |
$570 |
2.3× |
| Mammography, screening (bilateral) (77067) |
$192.82 |
$428.50 |
2.1× |
| Basic metabolic panel (80048) |
$162 |
$360 |
19.1× |
| Comprehensive metabolic panel (80053) |
$180 |
$400 |
17.0× |
| Lipid panel (80061) |
$36 |
$80 |
2.7× |
| Renal function panel (80069) |
$132.75 |
$295 |
15.3× |
| Hepatic function panel (80076) |
$251.10 |
$558 |
30.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$23.40 |
$52 |
6.7× |
| PSA, total (84153) |
$60.30 |
$134 |
3.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$33.75 |
$75 |
2.0× |
| CBC with automated differential (85025) |
$115.65 |
$257 |
14.9× |
| CBC, automated (85027) |
$94.95 |
$211 |
14.7× |
| Prothrombin time (PT) (85610) |
$28.12 |
$62.50 |
6.6× |
| Partial thromboplastin time (PTT) (85730) |
$26.10 |
$58 |
4.3× |
| Sleep study (attended polysomnography) (95810) |
$1,865.70 |
$4,146 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$95.40 |
$212 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$160.20 |
$356 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$170.55 |
$379 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$235.80 |
$524 |
1.7× |