| Breast lesion removal (open) (19120) |
$2,403.69 |
$9,614.75 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$633.50 |
$2,534 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$724.44 |
$2,897.75 |
0.9× |
| CT head/brain without contrast (70450) |
$669.31 |
$2,677.25 |
6.8× |
| MRI brain without contrast (70551) |
$1,062.19 |
$4,248.75 |
4.7× |
| MRI brain with contrast (70552) |
$1,213.81 |
$4,855.25 |
3.7× |
| MRI brain without and with contrast (70553) |
$1,384.75 |
$5,539 |
4.2× |
| X-ray lower spine, 4+ views (72110) |
$300 |
$1,200 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$1,115.50 |
$4,462 |
5.0× |
| CT pelvis with contrast (72193) |
$790.19 |
$3,160.75 |
4.8× |
| MRI lower-extremity joint without contrast (73721) |
$2,239.25 |
$8,957 |
10.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,512.94 |
$6,051.75 |
4.6× |
| Ultrasound, abdomen complete (76700) |
$411.63 |
$1,646.50 |
4.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$156.19 |
$624.75 |
1.6× |
| Ultrasound, transvaginal (76830) |
$284.81 |
$1,139.25 |
2.9× |
| Basic metabolic panel (80048) |
$55.63 |
$222.50 |
6.6× |
| Comprehensive metabolic panel (80053) |
$99 |
$396 |
9.4× |
| Lipid panel (80061) |
$8.25 |
$33 |
0.6× |
| Renal function panel (80069) |
$69.81 |
$279.25 |
8.0× |
| Hepatic function panel (80076) |
$66.31 |
$265.25 |
8.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.50 |
$18 |
1.3× |
| PSA, total (84153) |
$62.44 |
$249.75 |
3.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$84.50 |
$338 |
5.0× |
| CBC with automated differential (85025) |
$34.10 |
$136.38 |
4.4× |
| CBC, automated (85027) |
$43 |
$172 |
6.6× |
| Prothrombin time (PT) (85610) |
$31.56 |
$126.25 |
7.4× |
| Partial thromboplastin time (PTT) (85730) |
$29.40 |
$117.62 |
4.9× |
| Left heart catheterization (93452) |
$3,199.69 |
$12,798.75 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$1,409.40 |
$5,637.62 |
1.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$54.94 |
$219.75 |
1.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$115.44 |
$461.75 |
0.9× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$161.63 |
$646.50 |
1.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$212.06 |
$848.25 |
1.7× |