| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,125 |
$1,500 |
1.5× |
| CT head/brain without contrast (70450) |
$1,254.63 |
$1,672.84 |
13.7× |
| MRI brain without contrast (70551) |
$2,342.51 |
$3,123.35 |
11.2× |
| MRI brain with contrast (70552) |
$2,868 |
$3,824 |
9.4× |
| MRI brain without and with contrast (70553) |
$3,292.50 |
$4,390 |
10.8× |
| X-ray lower spine, 4+ views (72110) |
$859.95 |
$1,146.60 |
9.4× |
| MRI lumbar spine without contrast (72148) |
$8,615.88 |
$11,487.84 |
41.2× |
| CT pelvis with contrast (72193) |
$2,379 |
$3,172 |
15.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,760.26 |
$3,680.35 |
9.0× |
| Ultrasound, abdomen complete (76700) |
$947.70 |
$1,263.60 |
10.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$517.50 |
$690 |
5.6× |
| Ultrasound, transvaginal (76830) |
$784.50 |
$1,046 |
8.6× |
| Mammography, one breast (diagnostic) (77065) |
$380.62 |
$507.50 |
4.4× |
| Mammography, both breasts (diagnostic) (77066) |
$845.21 |
$1,126.94 |
7.6× |
| Mammography, screening (bilateral) (77067) |
$1,423.70 |
$1,898.26 |
15.6× |
| Basic metabolic panel (80048) |
$64.93 |
$86.57 |
7.7× |
| Comprehensive metabolic panel (80053) |
$344.24 |
$458.98 |
32.6× |
| Obstetric panel (80055) |
$691.50 |
$922 |
14.5× |
| Lipid panel (80061) |
$259.35 |
$345.80 |
19.4× |
| Renal function panel (80069) |
$119.37 |
$159.16 |
13.8× |
| Hepatic function panel (80076) |
$208 |
$277.33 |
25.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$69.75 |
$93 |
17.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$35.25 |
$47 |
10.1× |
| PSA, total (84153) |
$98.75 |
$131.66 |
5.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$266.18 |
$354.90 |
15.8× |
| CBC with automated differential (85025) |
$118.07 |
$157.43 |
15.2× |
| CBC, automated (85027) |
$123.56 |
$164.74 |
19.1× |
| Prothrombin time (PT) (85610) |
$70.91 |
$94.54 |
16.5× |
| Partial thromboplastin time (PTT) (85730) |
$82.21 |
$109.61 |
13.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$171 |
$228 |
1.1× |
| Group psychotherapy (90853) |
$432 |
$576 |
4.9× |
| Electrocardiogram (ECG), complete (93000) |
$129 |
$172 |
2.5× |
| Sleep study (attended polysomnography) (95810) |
$2,703.75 |
$3,605 |
3.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$276.75 |
$369 |
2.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$360 |
$480 |
3.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$432 |
$576 |
3.7× |