| Transforaminal epidural injection, lumbar/sacral (64483) |
$801.36 |
$2,968.02 |
0.9× |
| CT head/brain without contrast (70450) |
$540 |
$2,000 |
5.3× |
| MRI brain without contrast (70551) |
$748.44 |
$2,772 |
3.2× |
| MRI brain with contrast (70552) |
$868.05 |
$3,215 |
2.6× |
| MRI brain without and with contrast (70553) |
$1,008.18 |
$3,734 |
3.0× |
| X-ray lower spine, 4+ views (72110) |
$167.13 |
$619 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$705.24 |
$2,612 |
3.0× |
| CT pelvis with contrast (72193) |
$494.64 |
$1,832 |
2.9× |
| MRI lower-extremity joint without contrast (73721) |
$777.06 |
$2,878 |
3.4× |
| CT abdomen and pelvis with contrast (74177) |
$1,215 |
$4,500 |
3.6× |
| Ultrasound, abdomen complete (76700) |
$279.99 |
$1,037 |
2.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$161.38 |
$597.70 |
1.6× |
| Ultrasound, transvaginal (76830) |
$191.92 |
$710.84 |
1.9× |
| Mammography, one breast (diagnostic) (77065) |
$67.50 |
$250 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$67.50 |
$250 |
0.6× |
| Mammography, screening (bilateral) (77067) |
$67.50 |
$250 |
0.7× |
| Basic metabolic panel (80048) |
$80.29 |
$297.38 |
9.5× |
| Comprehensive metabolic panel (80053) |
$112.59 |
$417 |
10.7× |
| Lipid panel (80061) |
$63.99 |
$237 |
4.8× |
| Renal function panel (80069) |
$98.01 |
$363 |
11.3× |
| Hepatic function panel (80076) |
$58.32 |
$216 |
7.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.42 |
$46 |
3.6× |
| PSA, total (84153) |
$63.18 |
$234 |
3.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$77.76 |
$288 |
4.6× |
| CBC with automated differential (85025) |
$45.98 |
$170.28 |
5.9× |
| CBC, automated (85027) |
$67.50 |
$250 |
10.4× |
| Prothrombin time (PT) (85610) |
$21.87 |
$81 |
5.1× |
| Partial thromboplastin time (PTT) (85730) |
$39.15 |
$145 |
6.5× |
| Left heart catheterization (93452) |
$1,291.41 |
$4,783 |
0.4× |
| Sleep study (attended polysomnography) (95810) |
$976.86 |
$3,618 |
1.2× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$59.40 |
$220 |
2.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$80.44 |
$297.92 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$140.67 |
$521 |
1.1× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$201.80 |
$747.42 |
1.6× |