| Cataract removal with lens insertion (66984) |
$2,233.50 |
$4,467 |
1.0× |
| CT head/brain without contrast (70450) |
$1,570.50 |
$3,141 |
15.5× |
| MRI brain without contrast (70551) |
$2,045 |
$4,090 |
8.9× |
| MRI brain with contrast (70552) |
$2,375.50 |
$4,751 |
7.0× |
| MRI brain without and with contrast (70553) |
$2,678.50 |
$5,357 |
7.9× |
| X-ray lower spine, 4+ views (72110) |
$467 |
$934 |
4.6× |
| MRI lumbar spine without contrast (72148) |
$1,983.50 |
$3,967 |
8.6× |
| CT pelvis with contrast (72193) |
$1,533 |
$3,066 |
9.0× |
| MRI lower-extremity joint without contrast (73721) |
$1,951.50 |
$3,903 |
8.5× |
| CT abdomen and pelvis with contrast (74177) |
$3,079.50 |
$6,159 |
9.1× |
| Ultrasound, abdomen complete (76700) |
$873 |
$1,746 |
8.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$631.50 |
$1,263 |
6.2× |
| Ultrasound, transvaginal (76830) |
$533 |
$1,066 |
5.3× |
| Mammography, one breast (diagnostic) (77065) |
$358 |
$716 |
4.2× |
| Mammography, both breasts (diagnostic) (77066) |
$413.50 |
$827 |
3.7× |
| Mammography, screening (bilateral) (77067) |
$275.50 |
$551 |
3.0× |
| Basic metabolic panel (80048) |
$139.50 |
$279 |
16.5× |
| Comprehensive metabolic panel (80053) |
$271.50 |
$543 |
25.7× |
| Lipid panel (80061) |
$122 |
$244 |
9.1× |
| Renal function panel (80069) |
$155.50 |
$311 |
17.9× |
| Hepatic function panel (80076) |
$155.50 |
$311 |
19.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$14.50 |
$29 |
4.2× |
| PSA, total (84153) |
$117.50 |
$235 |
6.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$126.50 |
$253 |
7.5× |
| CBC with automated differential (85025) |
$107.50 |
$215 |
13.8× |
| CBC, automated (85027) |
$84 |
$168 |
13.0× |
| Prothrombin time (PT) (85610) |
$67.25 |
$134.50 |
15.7× |
| Partial thromboplastin time (PTT) (85730) |
$87.25 |
$174.50 |
14.5× |
| Left heart catheterization (93452) |
$2,407 |
$4,814 |
0.8× |
| Sleep study (attended polysomnography) (95810) |
$2,137.75 |
$4,275.50 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$88.50 |
$177 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$189 |
$378 |
1.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$224.50 |
$449 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$264 |
$528 |
2.1× |