| Epidural injection, lumbar/sacral (with imaging) (62322) |
$675 |
$2,142 |
0.7× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$875 |
$434 |
0.9× |
CT head/brain without contrast (70450)
range across 2 matching MRF lines |
$116 |
$1,479–$1,561 |
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)
range across 2 matching MRF lines |
$116 |
$836–$914 |
1.1× |
| MRI lumbar spine without contrast (72148) |
$245 |
$2,939 |
1.0× |
CT pelvis with contrast (72193)
range across 2 matching MRF lines |
$190 |
$2,378–$2,489 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$245 |
$2,166 |
1.0× |
CT abdomen and pelvis with contrast (74177)
range across 2 matching MRF lines |
$392 |
$5,999–$6,177 |
1.1× |
Ultrasound, abdomen complete (76700)
range across 2 matching MRF lines |
$116 |
$1,481–$1,559 |
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)
range across 2 matching MRF lines |
— |
$25–$104 |
— |
| Thyroid stimulating hormone (TSH) (84443) |
— |
$99 |
— |
| CBC with automated differential (85025) |
— |
$209 |
— |
| CBC, automated (85027) |
— |
$135 |
— |
Prothrombin time (PT) (85610)
range across 2 matching MRF lines |
— |
$4.29–$76 |
— |
Partial thromboplastin time (PTT) (85730)
range across 3 matching MRF lines |
— |
$6.01–$94 |
— |
Psychotherapy, 30 minutes (90832)
range across 2 matching MRF lines |
$142 |
$278–$279 |
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 |
$160 |
0.8× |
| Left heart catheterization (93452) |
$3,084 |
$16,008 |
0.9× |
| Sleep study (attended polysomnography) (95810) |
$978 |
$1,346 |
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 |
— |