| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,947.40 |
$4,868.50 |
2.3× |
| CT head/brain without contrast (70450) |
$930 |
$2,325 |
9.2× |
| MRI brain without contrast (70551) |
$905.20 |
$2,263 |
3.9× |
| MRI brain with contrast (70552) |
$1,084 |
$2,710 |
3.2× |
| MRI brain without and with contrast (70553) |
$1,508 |
$3,770 |
4.5× |
| X-ray lower spine, 4+ views (72110) |
$150 |
$375 |
1.5× |
| MRI lumbar spine without contrast (72148) |
$1,003.60 |
$2,509 |
4.4× |
| CT pelvis with contrast (72193) |
$691.20 |
$1,728 |
4.1× |
| MRI lower-extremity joint without contrast (73721) |
$1,056.80 |
$2,642 |
4.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,671.60 |
$4,179 |
5.0× |
| Ultrasound, abdomen complete (76700) |
$243.60 |
$609 |
2.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$243.60 |
$609 |
2.4× |
| Ultrasound, transvaginal (76830) |
$259.20 |
$648 |
2.6× |
| Mammography, one breast (diagnostic) (77065) |
$281.60 |
$704 |
3.3× |
| Mammography, both breasts (diagnostic) (77066) |
$356.40 |
$891 |
3.2× |
| Mammography, screening (bilateral) (77067) |
$281.60 |
$704 |
3.1× |
| Basic metabolic panel (80048) |
$45.20 |
$113 |
5.3× |
| Comprehensive metabolic panel (80053) |
$33.40 |
$83.50 |
3.2× |
| Obstetric panel (80055) |
$182.80 |
$457 |
3.8× |
| Lipid panel (80061) |
$14.58 |
$36.45 |
1.1× |
| Renal function panel (80069) |
$52 |
$130 |
6.0× |
| Hepatic function panel (80076) |
$42 |
$105 |
5.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$29.60 |
$74 |
7.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$6.40 |
$16 |
1.8× |
| PSA, total (84153) |
$36.40 |
$91 |
2.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$34.80 |
$87 |
2.1× |
| CBC with automated differential (85025) |
$40 |
$100 |
5.1× |
| CBC, automated (85027) |
$41 |
$102.50 |
6.3× |
| Prothrombin time (PT) (85610) |
$14.89 |
$37.22 |
3.5× |
| Partial thromboplastin time (PTT) (85730) |
$32.80 |
$82 |
5.5× |
| Electrocardiogram (ECG), complete (93000) |
$91.60 |
$229 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$1,203.20 |
$3,008 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$41.60 |
$104 |
1.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$96 |
$240 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$137.60 |
$344 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$185.20 |
$463 |
1.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$137.60 |
$344 |
1.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$179.60 |
$449 |
1.4× |