| Epidural injection, lumbar/sacral (with imaging) (62322) |
$675 |
$2,142 |
0.7× |
| CT head/brain without contrast (70450) |
$116 |
$1,520 |
1.1× |
| MRI brain without contrast (70551) |
$245 |
$2,913 |
1.0× |
| MRI brain with contrast (70552) |
$392 |
$3,332 |
1.1× |
| MRI brain without and with contrast (70553) |
$392 |
$3,922 |
1.1× |
| X-ray lower spine, 4+ views (72110) |
$116 |
$875 |
1.1× |
| MRI lumbar spine without contrast (72148) |
$245 |
$2,939 |
1.0× |
| CT pelvis with contrast (72193) |
$190 |
$2,433.50 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$245 |
$2,166 |
1.0× |
| CT abdomen and pelvis with contrast (74177) |
$392 |
$6,088 |
1.1× |
| Ultrasound, abdomen complete (76700) |
$116 |
$1,520 |
1.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$116 |
$836 |
1.1× |
| Ultrasound, transvaginal (76830) |
$116 |
$487 |
1.1× |
| Mammography, one breast (diagnostic) (77065) |
— |
$348 |
— |
| Mammography, both breasts (diagnostic) (77066) |
— |
$438 |
— |
| Mammography, screening (bilateral) (77067) |
— |
$395 |
— |
| Basic metabolic panel (80048) |
— |
$314 |
— |
| Comprehensive metabolic panel (80053) |
— |
$454 |
— |
| Lipid panel (80061) |
— |
$115 |
— |
| Renal function panel (80069) |
— |
$368 |
— |
| Hepatic function panel (80076) |
— |
$237 |
— |
| Urinalysis, non-automated, without microscopy (81002) |
— |
$34 |
— |
| PSA, total (84153) |
— |
$64.50 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$99 |
— |
| CBC with automated differential (85025) |
— |
$209 |
— |
| CBC, automated (85027) |
— |
$135 |
— |
| Prothrombin time (PT) (85610) |
— |
$40.14 |
— |
| Partial thromboplastin time (PTT) (85730) |
— |
$21 |
— |
| Psychotherapy, 30 minutes (90832) |
$142 |
$195 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$142 |
$282 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$142 |
$288 |
0.8× |
| Family psychotherapy, without patient (50 min) (90846) |
$142 |
$334 |
0.8× |
| Family psychotherapy, with patient (50 min) (90847) |
$142 |
$349 |
0.8× |
| Group psychotherapy (90853) |
$80 |
$135 |
0.8× |
| Left heart catheterization (93452) |
$3,084 |
$16,008 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$978 |
$1,334 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$50 |
$185 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$100 |
$409 |
0.7× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$170 |
$430 |
1.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$225 |
$452 |
1.6× |
| Preventive visit, new patient (age 18–39) (99385) |
— |
$73 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
— |
$73 |
— |