| Epidural injection, lumbar/sacral (with imaging) (62322) |
$226.20 |
$386 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,098.04 |
$1,655 |
1.2× |
| CT head/brain without contrast (70450) |
$448.24 |
$793.50 |
4.1× |
| MRI brain without contrast (70551) |
$659.52 |
$1,015 |
2.6× |
| MRI brain with contrast (70552) |
$822.54 |
$1,265 |
2.2× |
| MRI brain without and with contrast (70553) |
$990.85 |
$1,525.50 |
2.7× |
| X-ray lower spine, 4+ views (72110) |
$285.46 |
$433 |
2.6× |
| MRI lumbar spine without contrast (72148) |
$567.78 |
$944.50 |
2.3× |
| CT pelvis with contrast (72193) |
$1,141.70 |
$1,924 |
6.2× |
| MRI lower-extremity joint without contrast (73721) |
$142.34 |
$278 |
0.6× |
| CT abdomen and pelvis with contrast (74177) |
$839.06 |
$1,421 |
2.3× |
| Ultrasound, abdomen complete (76700) |
$486.96 |
$639.50 |
4.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$436.26 |
$577.50 |
4.0× |
| Ultrasound, transvaginal (76830) |
$336.40 |
$444 |
3.1× |
| Mammography, one breast (diagnostic) (77065) |
$133.97 |
$186 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$195.84 |
$268.50 |
1.8× |
| Mammography, screening (bilateral) (77067) |
$185.23 |
$227 |
2.0× |
| Basic metabolic panel (80048) |
$68.38 |
$111 |
8.1× |
| Comprehensive metabolic panel (80053) |
$84.39 |
$137 |
8.0× |
| Lipid panel (80061) |
$46.50 |
$75.50 |
3.5× |
| Renal function panel (80069) |
$96.10 |
$156 |
11.1× |
| Hepatic function panel (80076) |
$66.53 |
$108 |
8.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.05 |
$11 |
1.7× |
| PSA, total (84153) |
$34.50 |
$56 |
1.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$49.90 |
$81 |
3.0× |
| CBC with automated differential (85025) |
$27.72 |
$44.50 |
3.6× |
| CBC, automated (85027) |
$33.64 |
$54 |
5.2× |
| Prothrombin time (PT) (85610) |
$8.10 |
$13 |
1.9× |
| Partial thromboplastin time (PTT) (85730) |
$22.74 |
$36.50 |
3.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$86.48 |
$127 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$479.56 |
$582.50 |
3.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$592.92 |
$729 |
4.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$768.67 |
$932 |
5.5× |