| Transforaminal epidural injection, lumbar/sacral (64483) |
$907.34 |
$2,145 |
1.1× |
| CT head/brain without contrast (70450) |
$1,325.69 |
$3,134 |
13.7× |
| MRI brain without contrast (70551) |
$1,754.40 |
$4,147.50 |
8.0× |
| MRI brain with contrast (70552) |
$1,860.78 |
$4,399 |
5.8× |
| MRI brain without and with contrast (70553) |
$3,543.90 |
$8,378 |
11.0× |
| X-ray lower spine, 4+ views (72110) |
$784.25 |
$1,854 |
8.1× |
| MRI lumbar spine without contrast (72148) |
$1,525.14 |
$3,605.50 |
6.9× |
| CT pelvis with contrast (72193) |
$837.97 |
$1,981 |
5.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,180.17 |
$2,790 |
5.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,021.13 |
$2,414 |
3.2× |
| Ultrasound, abdomen complete (76700) |
$893.38 |
$2,112 |
9.3× |
| Ultrasound, transvaginal (76830) |
$456.84 |
$1,080 |
4.7× |
| Mammography, one breast (diagnostic) (77065) |
$139.59 |
$330 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$181.47 |
$429 |
1.6× |
| Mammography, screening (bilateral) (77067) |
$140.44 |
$332 |
1.5× |
| Basic metabolic panel (80048) |
$150.59 |
$356 |
17.8× |
| Comprehensive metabolic panel (80053) |
$261.84 |
$619 |
24.8× |
| Lipid panel (80061) |
$35.11 |
$83 |
2.6× |
| Renal function panel (80069) |
$207.27 |
$490 |
23.9× |
| Hepatic function panel (80076) |
$214.47 |
$507 |
26.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$13.54 |
$32 |
3.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.81 |
$35 |
4.3× |
| PSA, total (84153) |
$44.84 |
$106 |
2.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$82.49 |
$195 |
4.9× |
| CBC with automated differential (85025) |
$118.44 |
$280 |
15.2× |
| CBC, automated (85027) |
$121.41 |
$287 |
18.8× |
| Prothrombin time (PT) (85610) |
$109.56 |
$259 |
25.5× |
| Partial thromboplastin time (PTT) (85730) |
$117.60 |
$278 |
19.6× |
| Left heart catheterization (93452) |
$6,835.68 |
$16,160 |
2.3× |
| Sleep study (attended polysomnography) (95810) |
$2,274.26 |
$5,376.50 |
2.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$129.44 |
$306 |
4.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$222.50 |
$526 |
1.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$323.60 |
$765 |
2.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$411.16 |
$972 |
3.3× |