| Transforaminal epidural injection, lumbar/sacral (64483) |
$413.85 |
$1,335 |
0.5× |
| CT head/brain without contrast (70450) |
$385.95 |
$1,245 |
4.1× |
| MRI brain without contrast (70551) |
$549.32 |
$1,772 |
2.5× |
| MRI brain with contrast (70552) |
$627.13 |
$2,023 |
2.0× |
| MRI brain without and with contrast (70553) |
$783.06 |
$2,526 |
2.5× |
| X-ray lower spine, 4+ views (72110) |
$128.96 |
$416 |
1.4× |
| MRI lumbar spine without contrast (72148) |
$728.50 |
$2,350 |
3.4× |
| CT pelvis with contrast (72193) |
$409.20 |
$1,320 |
2.6× |
| MRI lower-extremity joint without contrast (73721) |
$480.81 |
$1,551 |
2.2× |
| CT abdomen and pelvis with contrast (74177) |
$818.40 |
$2,640 |
2.6× |
| Ultrasound, abdomen complete (76700) |
$277.14 |
$894 |
2.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$205.22 |
$662 |
2.2× |
| Ultrasound, transvaginal (76830) |
$86.49 |
$279 |
0.9× |
| Mammography, one breast (diagnostic) (77065) |
$84.01 |
$271 |
1.0× |
| Mammography, both breasts (diagnostic) (77066) |
$107.88 |
$348 |
1.0× |
| Mammography, screening (bilateral) (77067) |
$72.54 |
$234 |
0.8× |
| Basic metabolic panel (80048) |
$40.61 |
$66.22 |
4.8× |
| Comprehensive metabolic panel (80053) |
$72.54 |
$117.62 |
6.9× |
| Lipid panel (80061) |
$25.11 |
$27 |
1.9× |
| Renal function panel (80069) |
$21.70 |
$70 |
2.5× |
| Hepatic function panel (80076) |
$37.20 |
$60.74 |
4.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.51 |
$21 |
1.9× |
| PSA, total (84153) |
$16.43 |
$53 |
0.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$33.64 |
$48 |
2.0× |
| CBC with automated differential (85025) |
$27.90 |
$45.62 |
3.6× |
| CBC, automated (85027) |
$20.15 |
$65 |
3.1× |
| Prothrombin time (PT) (85610) |
$7.60 |
$24.50 |
1.8× |
| Partial thromboplastin time (PTT) (85730) |
$11.78 |
$38 |
2.0× |
| Psychotherapy, 30 minutes (90832) |
$46.81 |
$151 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$63.24 |
$204 |
0.4× |
| Psychotherapy, 60 minutes (90837) |
$66.65 |
$215 |
0.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$74.40 |
$240 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$70.99 |
$229 |
0.4× |
| Group psychotherapy (90853) |
$41.23 |
$133 |
0.4× |
| Left heart catheterization (93452) |
$1,235.66 |
$3,986 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$874.82 |
$2,822 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$15.50 |
$50 |
0.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$68.82 |
$222 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$85.40 |
$275.50 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$99.98 |
$322.50 |
0.8× |