| CT head/brain without contrast (70450) |
$1,530 |
$1,530 |
16.1× |
| MRI brain without contrast (70551) |
$3,300 |
$3,300 |
15.2× |
| MRI brain with contrast (70552) |
$3,360 |
$3,360 |
10.6× |
| MRI brain without and with contrast (70553) |
$4,320 |
$4,320 |
13.6× |
| X-ray lower spine, 4+ views (72110) |
$424 |
$424 |
4.4× |
| MRI lumbar spine without contrast (72148) |
$3,564 |
$3,564 |
16.4× |
| CT pelvis with contrast (72193) |
$1,308 |
$1,308 |
8.2× |
| MRI lower-extremity joint without contrast (73721) |
$3,300 |
$3,300 |
15.2× |
| CT abdomen and pelvis with contrast (74177) |
$2,616 |
$2,616 |
8.2× |
| Ultrasound, abdomen complete (76700) |
$636 |
$636 |
6.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$480 |
$480 |
5.0× |
| Ultrasound, transvaginal (76830) |
$277 |
$277 |
2.9× |
| Mammography, one breast (diagnostic) (77065) |
$244.04 |
$244.04 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$252.84 |
$252.84 |
2.3× |
| Mammography, screening (bilateral) (77067) |
$321.70 |
$321.70 |
3.5× |
| Basic metabolic panel (80048) |
$59 |
$59 |
7.0× |
| Comprehensive metabolic panel (80053) |
$131 |
$131 |
12.4× |
| Lipid panel (80061) |
$90 |
$90 |
6.7× |
| Renal function panel (80069) |
$84 |
$84 |
9.7× |
| Hepatic function panel (80076) |
$79.50 |
$79.50 |
9.7× |
| PSA, total (84153) |
$475.35 |
$475.35 |
25.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$86.76 |
$86.76 |
5.2× |
| CBC with automated differential (85025) |
$46 |
$46 |
5.9× |
| CBC, automated (85027) |
$13.10 |
$13.10 |
2.0× |
| Prothrombin time (PT) (85610) |
$36.42 |
$36.42 |
8.5× |
| Partial thromboplastin time (PTT) (85730) |
$58.18 |
$58.18 |
9.7× |
| Psychotherapy, 30 minutes (90832) |
$108 |
$108 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$150 |
$150 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$228 |
$228 |
1.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$226 |
$226 |
1.4× |
| Family psychotherapy, with patient (50 min) (90847) |
$213.42 |
$213.42 |
1.3× |
| Left heart catheterization (93452) |
$6,545 |
$6,545 |
2.2× |
| Sleep study (attended polysomnography) (95810) |
$3,360 |
$3,360 |
4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$125 |
$125 |
4.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$308.79 |
$308.79 |
2.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$360.26 |
$360.26 |
3.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$411.72 |
$411.72 |
3.4× |