| Transforaminal epidural injection, lumbar/sacral (64483) |
$287.98 |
$1,439.90 |
0.4× |
| CT head/brain without contrast (70450) |
$373.41 |
$1,867.03 |
4.0× |
| MRI brain without contrast (70551) |
$377.52 |
$1,887.60 |
1.8× |
| MRI brain with contrast (70552) |
$497.07 |
$2,485.34 |
1.6× |
| MRI brain without and with contrast (70553) |
$571.61 |
$2,858.02 |
1.9× |
| X-ray lower spine, 4+ views (72110) |
$73.57 |
$367.84 |
0.8× |
| MRI lumbar spine without contrast (72148) |
$373.89 |
$1,869.45 |
1.8× |
| CT pelvis with contrast (72193) |
$416 |
$2,079.99 |
2.7× |
| MRI lower-extremity joint without contrast (73721) |
$373.89 |
$1,869.45 |
1.8× |
| CT abdomen and pelvis with contrast (74177) |
$803.93 |
$4,019.62 |
2.6× |
| Ultrasound, abdomen complete (76700) |
$164.08 |
$820.38 |
1.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$137.10 |
$685.46 |
1.5× |
| Ultrasound, transvaginal (76830) |
$127.78 |
$638.88 |
1.4× |
| Mammography, one breast (diagnostic) (77065) |
$76.23 |
$381.15 |
0.9× |
| Mammography, both breasts (diagnostic) (77066) |
$82.28 |
$411.40 |
0.7× |
| Mammography, screening (bilateral) (77067) |
$70.78 |
$353.92 |
0.8× |
| Basic metabolic panel (80048) |
$37.27 |
$186.34 |
4.4× |
| Comprehensive metabolic panel (80053) |
$44.90 |
$224.46 |
4.3× |
| Lipid panel (80061) |
$38.72 |
$193.60 |
2.9× |
| Renal function panel (80069) |
$29.53 |
$147.62 |
3.4× |
| Hepatic function panel (80076) |
$84.95 |
$424.71 |
10.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.44 |
$47.19 |
2.7× |
| PSA, total (84153) |
$33.16 |
$165.77 |
1.8× |
| Thyroid stimulating hormone (TSH) (84443) |
$31.22 |
$156.09 |
1.9× |
| CBC with automated differential (85025) |
$16.94 |
$84.70 |
2.2× |
| CBC, automated (85027) |
$14.52 |
$72.60 |
2.2× |
| Prothrombin time (PT) (85610) |
$11.86 |
$59.29 |
2.8× |
| Partial thromboplastin time (PTT) (85730) |
$17.91 |
$89.54 |
3.0× |
| Psychotherapy, 30 minutes (90832) |
$44.05 |
$220.22 |
0.3× |
| Psychotherapy, 45 minutes (90834) |
$66.07 |
$330.33 |
0.4× |
| Psychotherapy, 60 minutes (90837) |
$78.65 |
$393.25 |
0.5× |
| Family psychotherapy, without patient (50 min) (90846) |
$82.04 |
$410.19 |
0.5× |
| Family psychotherapy, with patient (50 min) (90847) |
$78.66 |
$393.25 |
0.5× |
| Group psychotherapy (90853) |
$110.60 |
$552.97 |
1.2× |
| Left heart catheterization (93452) |
$1,966.50 |
$9,832.46 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$21.54 |
$107.69 |
0.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$94.63 |
$473.11 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$110.11 |
$550.55 |
0.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$125.12 |
$625.57 |
1.1× |