| Breast lesion removal (open) (19120) |
$1,323 |
$6,300 |
0.4× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$174.72 |
$832 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$442.89 |
$2,109 |
0.6× |
| CT head/brain without contrast (70450) |
$578.55 |
$2,755 |
6.1× |
| MRI brain without contrast (70551) |
$893.86 |
$4,256.50 |
4.1× |
| MRI brain with contrast (70552) |
$1,501.08 |
$7,148 |
4.8× |
| MRI brain without and with contrast (70553) |
$1,842.12 |
$8,772 |
5.8× |
| X-ray lower spine, 4+ views (72110) |
$177.03 |
$843 |
1.9× |
| MRI lumbar spine without contrast (72148) |
$682.50 |
$3,250 |
3.2× |
| CT pelvis with contrast (72193) |
$955.50 |
$4,550 |
6.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,364.79 |
$6,499 |
6.3× |
| CT abdomen and pelvis with contrast (74177) |
$1,705.83 |
$8,123 |
5.4× |
| Ultrasound, abdomen complete (76700) |
$313.53 |
$1,493 |
3.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$266.28 |
$1,268 |
2.8× |
| Ultrasound, transvaginal (76830) |
$375.27 |
$1,787 |
4.0× |
| Mammography, one breast (diagnostic) (77065) |
$128.73 |
$613 |
1.5× |
| Mammography, both breasts (diagnostic) (77066) |
$130.62 |
$622 |
1.2× |
| Mammography, screening (bilateral) (77067) |
$145.53 |
$693 |
1.6× |
| Basic metabolic panel (80048) |
$159.18 |
$758 |
18.8× |
| Comprehensive metabolic panel (80053) |
$180.81 |
$861 |
17.1× |
| Obstetric panel (80055) |
$221.76 |
$1,056 |
4.6× |
| Lipid panel (80061) |
$37.59 |
$179 |
2.8× |
| Renal function panel (80069) |
$180.81 |
$861 |
20.8× |
| Hepatic function panel (80076) |
$167.79 |
$799 |
20.5× |
| Urinalysis, non-automated, with microscopy (81000) |
$2.10 |
$10 |
0.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.81 |
$61 |
3.7× |
| PSA, total (84153) |
$55.65 |
$265 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$75.60 |
$360 |
4.5× |
| CBC with automated differential (85025) |
$66.15 |
$315 |
8.5× |
| CBC, automated (85027) |
$55.02 |
$262 |
8.5× |
| Prothrombin time (PT) (85610) |
$41.37 |
$197 |
9.6× |
| Partial thromboplastin time (PTT) (85730) |
$48.51 |
$231 |
8.1× |
| Left heart catheterization (93452) |
$4,264.68 |
$20,308 |
1.5× |
| Sleep study (attended polysomnography) (95810) |
$1,008.84 |
$4,804 |
1.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$37.59 |
$179 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$41.37 |
$197 |
0.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$48.51 |
$231 |
0.4× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$92.40 |
$440 |
0.8× |
| Preventive visit, new patient (age 18–39) (99385) |
$61.11 |
$291 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$71.19 |
$339 |
— |