| Breast lesion removal (open) (19120) |
$2,611 |
$9,359 |
0.7× |
| Upper GI endoscopy (EGD), diagnostic (43235) |
$598 |
$2,145 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$442 |
$1,585 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,138 |
$4,079 |
1.3× |
| CT head/brain without contrast (70450) |
$724 |
$2,598 |
6.9× |
| MRI brain without contrast (70551) |
$877 |
$3,146.50 |
3.7× |
| MRI brain with contrast (70552) |
$1,146 |
$4,110.50 |
3.3× |
| MRI brain without and with contrast (70553) |
$1,330 |
$4,770 |
3.8× |
| X-ray lower spine, 4+ views (72110) |
$194 |
$698 |
1.9× |
| MRI lumbar spine without contrast (72148) |
$977 |
$3,504 |
4.1× |
| CT pelvis with contrast (72193) |
$797 |
$2,859 |
4.5× |
| MRI lower-extremity joint without contrast (73721) |
$944 |
$3,387 |
3.9× |
| CT abdomen and pelvis with contrast (74177) |
$1,402 |
$5,028 |
4.0× |
| Ultrasound, abdomen complete (76700) |
$479 |
$1,717 |
4.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$213 |
$767 |
2.0× |
| Ultrasound, transvaginal (76830) |
$279 |
$1,002 |
2.7× |
| Mammography, one breast (diagnostic) (77065) |
$136 |
$488 |
1.6× |
| Mammography, both breasts (diagnostic) (77066) |
$153 |
$550 |
1.4× |
| Mammography, screening (bilateral) (77067) |
$143 |
$515 |
1.6× |
| Basic metabolic panel (80048) |
$71 |
$257 |
8.4× |
| Comprehensive metabolic panel (80053) |
$119 |
$430 |
11.3× |
| Obstetric panel (80055) |
$80 |
$289 |
1.7× |
| Lipid panel (80061) |
$44 |
$160 |
3.3× |
| Renal function panel (80069) |
$59 |
$214 |
6.8× |
| Hepatic function panel (80076) |
$52 |
$188 |
6.4× |
| Urinalysis, non-automated, with microscopy (81000) |
$9 |
$33 |
2.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$10 |
$36 |
2.9× |
| PSA, total (84153) |
$37 |
$136 |
2.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$46 |
$165 |
2.7× |
| CBC with automated differential (85025) |
$44 |
$161 |
5.7× |
| CBC, automated (85027) |
$39 |
$141 |
6.0× |
| Prothrombin time (PT) (85610) |
$27 |
$99 |
6.3× |
| Partial thromboplastin time (PTT) (85730) |
$41 |
$150 |
6.8× |
| Electrocardiogram (ECG), complete (93000) |
$13 |
$48 |
0.2× |
| Left heart catheterization (93452) |
$4,022 |
$14,417 |
1.2× |
| Sleep study (attended polysomnography) (95810) |
$2,117 |
$7,590.50 |
2.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$42 |
$151 |
1.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$55 |
$198 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$55 |
$198 |
0.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$55 |
$198 |
0.4× |
| Office consultation (low complexity, ~30 min) (99243) |
$82 |
$295 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$93 |
$335 |
0.7× |