| CT head/brain without contrast (70450) |
$1,453.20 |
$2,422 |
14.8× |
| MRI brain without contrast (70551) |
$3,022.20 |
$5,037 |
13.5× |
| MRI brain with contrast (70552) |
$3,399.60 |
$5,666 |
10.4× |
| MRI brain without and with contrast (70553) |
$4,344 |
$7,240 |
13.3× |
| X-ray lower spine, 4+ views (72110) |
$446.40 |
$744 |
4.6× |
| MRI lumbar spine without contrast (72148) |
$3,066.60 |
$5,111 |
13.7× |
| CT pelvis with contrast (72193) |
$2,375.40 |
$3,959 |
14.4× |
| MRI lower-extremity joint without contrast (73721) |
$3,022.20 |
$5,037 |
13.5× |
| CT abdomen and pelvis with contrast (74177) |
$4,282.80 |
$7,138 |
13.1× |
| Ultrasound, abdomen complete (76700) |
$857.40 |
$1,429 |
8.7× |
| Ultrasound, transvaginal (76830) |
$808.20 |
$1,347 |
8.2× |
| Mammography, one breast (diagnostic) (77065) |
$364.80 |
$608 |
4.2× |
| Mammography, both breasts (diagnostic) (77066) |
$729.60 |
$1,216 |
6.6× |
| Mammography, screening (bilateral) (77067) |
$186 |
$310 |
2.0× |
| Basic metabolic panel (80048) |
$130.20 |
$217 |
15.4× |
| Comprehensive metabolic panel (80053) |
$150.60 |
$251 |
14.3× |
| Lipid panel (80061) |
$214.20 |
$357 |
16.0× |
| Renal function panel (80069) |
$184.20 |
$307 |
21.2× |
| Hepatic function panel (80076) |
$164.40 |
$274 |
20.1× |
| Urinalysis, non-automated, with microscopy (81000) |
$58.20 |
$97 |
14.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$13.80 |
$23 |
4.0× |
| PSA, total (84153) |
$184.20 |
$307 |
10.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$158.40 |
$264 |
9.4× |
| CBC with automated differential (85025) |
$71.40 |
$119 |
9.2× |
| CBC, automated (85027) |
$57.60 |
$96 |
8.9× |
| Prothrombin time (PT) (85610) |
$112.80 |
$188 |
26.3× |
| Partial thromboplastin time (PTT) (85730) |
$260.40 |
$434 |
43.3× |
| Sleep study (attended polysomnography) (95810) |
$3,183.60 |
$5,306 |
4.0× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$156.60 |
$261 |
5.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$178.80 |
$298 |
1.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$440.70 |
$734.50 |
3.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$584.40 |
$974 |
4.7× |
| Office consultation (low complexity, ~30 min) (99243) |
$75 |
$125 |
0.6× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$90 |
$150 |
0.7× |