| Transforaminal epidural injection, lumbar/sacral (64483) |
$634.92 |
$2,145 |
0.8× |
| CT head/brain without contrast (70450) |
$927.67 |
$3,134 |
9.6× |
| MRI brain without contrast (70551) |
$1,227.66 |
$4,147.50 |
5.6× |
| MRI brain with contrast (70552) |
$1,302.10 |
$4,399 |
4.0× |
| MRI brain without and with contrast (70553) |
$2,479.89 |
$8,378 |
7.7× |
| X-ray lower spine, 4+ views (72110) |
$548.79 |
$1,854 |
5.7× |
| MRI lumbar spine without contrast (72148) |
$1,067.24 |
$3,605.50 |
4.8× |
| CT pelvis with contrast (72193) |
$586.38 |
$1,981 |
3.6× |
| MRI lower-extremity joint without contrast (73721) |
$825.84 |
$2,790 |
3.8× |
| CT abdomen and pelvis with contrast (74177) |
$714.55 |
$2,414 |
2.2× |
| Ultrasound, abdomen complete (76700) |
$625.16 |
$2,112 |
6.5× |
| Ultrasound, transvaginal (76830) |
$319.68 |
$1,080 |
3.3× |
| Mammography, one breast (diagnostic) (77065) |
$97.68 |
$330 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$126.99 |
$429 |
1.1× |
| Mammography, screening (bilateral) (77067) |
$98.28 |
$332 |
1.1× |
| Basic metabolic panel (80048) |
$105.38 |
$356 |
12.5× |
| Comprehensive metabolic panel (80053) |
$183.23 |
$619 |
17.4× |
| Lipid panel (80061) |
$24.57 |
$83 |
1.8× |
| Renal function panel (80069) |
$145.04 |
$490 |
16.7× |
| Hepatic function panel (80076) |
$150.08 |
$507 |
18.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$9.48 |
$32 |
2.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$10.36 |
$35 |
3.0× |
| PSA, total (84153) |
$31.38 |
$106 |
1.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$57.72 |
$195 |
3.4× |
| CBC with automated differential (85025) |
$82.88 |
$280 |
10.7× |
| CBC, automated (85027) |
$84.96 |
$287 |
13.1× |
| Prothrombin time (PT) (85610) |
$76.67 |
$259 |
17.9× |
| Partial thromboplastin time (PTT) (85730) |
$82.29 |
$278 |
13.7× |
| Left heart catheterization (93452) |
$4,783.36 |
$16,160 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$1,591.45 |
$5,376.50 |
2.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$90.58 |
$306 |
3.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$155.70 |
$526 |
1.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$226.44 |
$765 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$287.72 |
$972 |
2.3× |