| Shoulder arthroscopy with decompression (29826) |
$1,573.65 |
$2,421 |
— |
| Knee arthroscopy with meniscectomy (29881) |
$1,811.55 |
$2,787 |
0.6× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$560.30 |
$862 |
0.7× |
| CT head/brain without contrast (70450) |
$1,325.35 |
$2,039 |
13.2× |
| MRI brain without contrast (70551) |
$2,162.55 |
$3,327 |
9.4× |
| MRI brain with contrast (70552) |
$2,419.95 |
$3,723 |
7.2× |
| MRI brain without and with contrast (70553) |
$2,609.10 |
$4,014 |
7.8× |
| X-ray lower spine, 4+ views (72110) |
$516.10 |
$794 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$2,408.25 |
$3,705 |
10.5× |
| CT pelvis with contrast (72193) |
$2,035.15 |
$3,131 |
12.1× |
| MRI lower-extremity joint without contrast (73721) |
$2,232.75 |
$3,435 |
9.7× |
| CT abdomen and pelvis with contrast (74177) |
$1,862.25 |
$2,865 |
5.6× |
| Ultrasound, abdomen complete (76700) |
$800.80 |
$1,232 |
8.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$571.35 |
$879 |
5.7× |
| Ultrasound, transvaginal (76830) |
$537.55 |
$827 |
5.3× |
| Mammography, one breast (diagnostic) (77065) |
$236.60 |
$364 |
2.7× |
| Mammography, both breasts (diagnostic) (77066) |
$297.70 |
$458 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$232.05 |
$357 |
2.5× |
| Basic metabolic panel (80048) |
$96.20 |
$148 |
11.4× |
| Comprehensive metabolic panel (80053) |
$133.90 |
$206 |
12.7× |
| Lipid panel (80061) |
$100.75 |
$155 |
7.5× |
| Renal function panel (80069) |
$109.85 |
$169 |
12.7× |
| Hepatic function panel (80076) |
$95.55 |
$147 |
11.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$27.95 |
$43 |
8.0× |
| PSA, total (84153) |
$105.30 |
$162 |
5.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$57.20 |
$88 |
3.4× |
| CBC with automated differential (85025) |
$67.60 |
$104 |
8.7× |
| CBC, automated (85027) |
$58.50 |
$90 |
9.0× |
| Prothrombin time (PT) (85610) |
$48.75 |
$75 |
11.4× |
| Partial thromboplastin time (PTT) (85730) |
$78 |
$120 |
13.0× |
| Psychotherapy, 30 minutes (90832) |
$200.20 |
$308 |
1.2× |
| Psychotherapy, 45 minutes (90834) |
$222.95 |
$343 |
1.3× |
| Psychotherapy, 60 minutes (90837) |
$235.30 |
$362 |
1.4× |
| Family psychotherapy, without patient (50 min) (90846) |
$294.45 |
$453 |
1.7× |
| Family psychotherapy, with patient (50 min) (90847) |
$222.95 |
$343 |
1.3× |
| Group psychotherapy (90853) |
$274.95 |
$423 |
2.8× |
| Sleep study (attended polysomnography) (95810) |
$3,783 |
$5,820 |
4.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75.40 |
$116 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$198.90 |
$306 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$254.80 |
$392 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$297.70 |
$458 |
2.3× |
| Office consultation (low complexity, ~30 min) (99243) |
$199.55 |
$307 |
1.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$270.40 |
$416 |
2.1× |