| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,947.20 |
$4,912 |
3.3× |
| CT head/brain without contrast (70450) |
$1,412.40 |
$2,354 |
13.5× |
| MRI brain without contrast (70551) |
$2,853.60 |
$4,756 |
11.9× |
| MRI brain with contrast (70552) |
$3,728.40 |
$6,214 |
10.7× |
| MRI brain without and with contrast (70553) |
$4,846.80 |
$8,078 |
13.9× |
| X-ray lower spine, 4+ views (72110) |
$539.40 |
$899 |
5.2× |
| MRI lumbar spine without contrast (72148) |
$3,182.40 |
$5,304 |
13.3× |
| CT pelvis with contrast (72193) |
$2,668.20 |
$4,447 |
15.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,649.60 |
$4,416 |
11.1× |
| CT abdomen and pelvis with contrast (74177) |
$5,062.20 |
$8,437 |
14.5× |
| Ultrasound, abdomen complete (76700) |
$1,024.80 |
$1,708 |
9.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$576 |
$960 |
5.5× |
| Ultrasound, transvaginal (76830) |
$730.20 |
$1,217 |
7.0× |
| Mammography, one breast (diagnostic) (77065) |
$280.20 |
$467 |
3.3× |
| Mammography, both breasts (diagnostic) (77066) |
$375 |
$625 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$298.20 |
$497 |
3.3× |
| Basic metabolic panel (80048) |
$96 |
$160 |
11.3× |
| Comprehensive metabolic panel (80053) |
$121.20 |
$202 |
11.5× |
| Lipid panel (80061) |
$124.20 |
$207 |
9.3× |
| Renal function panel (80069) |
$111 |
$185 |
12.8× |
| Hepatic function panel (80076) |
$151.80 |
$253 |
18.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$25.80 |
$43 |
6.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$22.20 |
$37 |
6.4× |
| PSA, total (84153) |
$111 |
$185 |
6.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$118.80 |
$198 |
7.1× |
| CBC with automated differential (85025) |
$69.60 |
$116 |
9.0× |
| CBC, automated (85027) |
$57.60 |
$96 |
8.9× |
| Prothrombin time (PT) (85610) |
$56.40 |
$94 |
13.1× |
| Partial thromboplastin time (PTT) (85730) |
$82.80 |
$138 |
13.8× |
| Left heart catheterization (93452) |
$13,575 |
$22,625 |
4.2× |
| Sleep study (attended polysomnography) (95810) |
$3,111 |
$5,185 |
3.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$52.20 |
$87 |
1.8× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$120 |
$200 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$126 |
$210 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$132 |
$220 |
1.0× |