| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,107.50 |
$2,215 |
1.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,113.50 |
$2,227 |
1.3× |
| CT head/brain without contrast (70450) |
$1,789 |
$3,578 |
17.0× |
| MRI brain without contrast (70551) |
$2,324 |
$4,648 |
9.7× |
| MRI brain with contrast (70552) |
$2,672.50 |
$5,345 |
7.6× |
| MRI brain without and with contrast (70553) |
$3,021 |
$6,042 |
8.6× |
| X-ray lower spine, 4+ views (72110) |
$531 |
$1,062 |
5.1× |
| MRI lumbar spine without contrast (72148) |
$2,455 |
$4,910 |
10.2× |
| CT pelvis with contrast (72193) |
$2,251.50 |
$4,503 |
12.8× |
| MRI lower-extremity joint without contrast (73721) |
$2,439 |
$4,878 |
10.2× |
| CT abdomen and pelvis with contrast (74177) |
$4,335 |
$8,670 |
12.4× |
| Ultrasound, abdomen complete (76700) |
$783 |
$1,566 |
7.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$567 |
$1,134 |
5.4× |
| Ultrasound, transvaginal (76830) |
$661.50 |
$1,323 |
6.3× |
| Mammography, one breast (diagnostic) (77065) |
$469 |
$938 |
5.4× |
| Mammography, both breasts (diagnostic) (77066) |
$580 |
$1,160 |
5.2× |
| Mammography, screening (bilateral) (77067) |
$358.25 |
$716.50 |
3.9× |
| Basic metabolic panel (80048) |
$349.50 |
$699 |
41.3× |
| Comprehensive metabolic panel (80053) |
$405 |
$810 |
38.4× |
| Lipid panel (80061) |
$247 |
$494 |
18.4× |
| Renal function panel (80069) |
$387 |
$774 |
44.6× |
| Hepatic function panel (80076) |
$288 |
$576 |
35.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$32 |
$64 |
9.2× |
| PSA, total (84153) |
$17 |
$34 |
0.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$345 |
$690 |
20.5× |
| CBC with automated differential (85025) |
$156.50 |
$313 |
20.1× |
| Prothrombin time (PT) (85610) |
$32 |
$64 |
7.5× |
| Partial thromboplastin time (PTT) (85730) |
$19 |
$38 |
3.2× |
| Psychotherapy, 30 minutes (90832) |
$156 |
$312 |
0.9× |
| Psychotherapy, 60 minutes (90837) |
$172.50 |
$345 |
1.0× |
| Electrocardiogram (ECG), complete (93000) |
$334.50 |
$669 |
5.6× |
| Left heart catheterization (93452) |
$8,694 |
$17,388 |
2.7× |
| Sleep study (attended polysomnography) (95810) |
$3,734.50 |
$7,469 |
4.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$112 |
$224 |
3.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$211 |
$422 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$321 |
$642 |
2.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$367.50 |
$735 |
2.7× |