| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,127 |
$1,127 |
1.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,225.50 |
$1,225.50 |
1.6× |
| CT head/brain without contrast (70450) |
$1,703.90 |
$1,703.90 |
18.9× |
| MRI brain without contrast (70551) |
$1,864.50 |
$1,864.50 |
9.1× |
| MRI brain with contrast (70552) |
$2,164.80 |
$2,164.80 |
7.2× |
| MRI brain without and with contrast (70553) |
$3,640.40 |
$3,640.40 |
12.1× |
| X-ray lower spine, 4+ views (72110) |
$455.40 |
$455.40 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$1,864.50 |
$1,864.50 |
9.1× |
| CT pelvis with contrast (72193) |
$1,703.90 |
$1,703.90 |
11.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,864.50 |
$1,864.50 |
9.1× |
| CT abdomen and pelvis with contrast (74177) |
$2,046 |
$2,046 |
6.8× |
| Ultrasound, abdomen complete (76700) |
$509.30 |
$509.30 |
5.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$602.65 |
$602.65 |
6.7× |
| Ultrasound, transvaginal (76830) |
$634.15 |
$634.15 |
7.0× |
| Mammography, one breast (diagnostic) (77065) |
$209 |
$209 |
2.4× |
| Mammography, both breasts (diagnostic) (77066) |
$234.30 |
$234.30 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$210.10 |
$210.10 |
2.3× |
| Basic metabolic panel (80048) |
$170.50 |
$170.50 |
20.2× |
| Comprehensive metabolic panel (80053) |
$224 |
$224 |
21.2× |
| Lipid panel (80061) |
$270 |
$270 |
20.2× |
| Renal function panel (80069) |
$208 |
$208 |
24.0× |
| Hepatic function panel (80076) |
$165 |
$165 |
20.2× |
| Urinalysis, non-automated, with microscopy (81000) |
$103 |
$103 |
25.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$7 |
$7 |
2.0× |
| PSA, total (84153) |
$138 |
$138 |
7.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$140.50 |
$140.50 |
8.4× |
| CBC with automated differential (85025) |
$44 |
$44 |
5.7× |
| CBC, automated (85027) |
$95.50 |
$95.50 |
14.8× |
| Prothrombin time (PT) (85610) |
$78.30 |
$78.30 |
18.3× |
| Partial thromboplastin time (PTT) (85730) |
$112.92 |
$112.92 |
18.8× |
| Psychotherapy, 30 minutes (90832) |
$218 |
$218 |
1.4× |
| Psychotherapy, 45 minutes (90834) |
$327 |
$327 |
2.1× |
| Psychotherapy, 60 minutes (90837) |
$436 |
$436 |
2.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$234 |
$234 |
1.5× |
| Group psychotherapy (90853) |
$128.50 |
$128.50 |
1.5× |
| Left heart catheterization (93452) |
$4,678.50 |
$4,678.50 |
1.7× |
| Sleep study (attended polysomnography) (95810) |
$3,305.30 |
$3,305.30 |
4.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$114.50 |
$114.50 |
3.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$250 |
$250 |
2.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$363 |
$363 |
3.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$434.50 |
$434.50 |
3.8× |
| Office consultation (low complexity, ~30 min) (99243) |
$355 |
$355 |
3.1× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$355 |
$355 |
3.1× |