| CT head/brain without contrast (70450) |
$1,151.25 |
$1,535 |
10.7× |
| MRI brain without contrast (70551) |
$1,595.25 |
$2,127 |
6.5× |
| MRI brain with contrast (70552) |
$1,731 |
$2,308 |
4.8× |
| MRI brain without and with contrast (70553) |
$2,074.50 |
$2,766 |
5.8× |
| X-ray lower spine, 4+ views (72110) |
$380.25 |
$507 |
3.5× |
| MRI lumbar spine without contrast (72148) |
$1,519.50 |
$2,026 |
6.2× |
| CT pelvis with contrast (72193) |
$1,425 |
$1,900 |
7.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,595.25 |
$2,127 |
6.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,287.50 |
$3,050 |
6.3× |
| Ultrasound, abdomen complete (76700) |
$717.75 |
$957 |
6.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$420 |
$560 |
3.9× |
| Ultrasound, transvaginal (76830) |
$433.50 |
$578 |
4.0× |
| Mammography, one breast (diagnostic) (77065) |
$250.50 |
$334 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$319.50 |
$426 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$251.25 |
$335 |
2.8× |
| Basic metabolic panel (80048) |
$126.75 |
$169 |
15.0× |
| Comprehensive metabolic panel (80053) |
$129 |
$172 |
12.2× |
| Lipid panel (80061) |
$42.75 |
$57 |
3.2× |
| Renal function panel (80069) |
$144.75 |
$193 |
16.7× |
| Hepatic function panel (80076) |
$144 |
$192 |
17.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$19.50 |
$26 |
5.6× |
| PSA, total (84153) |
$76.88 |
$102.50 |
4.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$98.25 |
$131 |
5.8× |
| CBC with automated differential (85025) |
$91.50 |
$122 |
11.8× |
| CBC, automated (85027) |
$79.50 |
$106 |
12.3× |
| Prothrombin time (PT) (85610) |
$34.12 |
$45.50 |
8.0× |
| Partial thromboplastin time (PTT) (85730) |
$52.50 |
$70 |
8.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$105.75 |
$141 |
0.6× |
| Group psychotherapy (90853) |
$208.50 |
$278 |
2.0× |
| Left heart catheterization (93452) |
$7,727.25 |
$10,303 |
2.3× |
| Sleep study (attended polysomnography) (95810) |
$4,059 |
$5,412 |
4.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$94.50 |
$126 |
3.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$202.50 |
$270 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$262.50 |
$350 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$315 |
$420 |
2.3× |