| Epidural injection, lumbar/sacral (with imaging) (62322) |
$868.40 |
$2,171 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$824.80 |
$2,062 |
0.9× |
| CT head/brain without contrast (70450) |
$1,603.60 |
$4,009 |
14.7× |
| MRI brain without contrast (70551) |
$1,466 |
$3,665 |
5.9× |
| MRI brain with contrast (70552) |
$2,102.40 |
$5,256 |
5.8× |
| MRI brain without and with contrast (70553) |
$2,590 |
$6,475 |
7.1× |
| X-ray lower spine, 4+ views (72110) |
$854 |
$2,135 |
7.8× |
| MRI lumbar spine without contrast (72148) |
$1,723.20 |
$4,308 |
6.9× |
| CT pelvis with contrast (72193) |
$4,079.60 |
$10,199 |
22.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,632.80 |
$4,082 |
6.6× |
| CT abdomen and pelvis with contrast (74177) |
$4,613.20 |
$11,533 |
12.7× |
| Ultrasound, abdomen complete (76700) |
$965.20 |
$2,413 |
8.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$625.60 |
$1,564 |
5.7× |
| Ultrasound, transvaginal (76830) |
$522.40 |
$1,306 |
4.8× |
| Basic metabolic panel (80048) |
$34 |
$85 |
4.0× |
| Comprehensive metabolic panel (80053) |
$49.20 |
$123 |
4.7× |
| Lipid panel (80061) |
$43 |
$107.50 |
3.2× |
| Renal function panel (80069) |
$57.20 |
$143 |
6.6× |
| Hepatic function panel (80076) |
$61.20 |
$153 |
7.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$36.80 |
$92 |
10.6× |
| PSA, total (84153) |
$58 |
$145 |
3.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$63.20 |
$158 |
3.8× |
| CBC with automated differential (85025) |
$32 |
$80 |
4.1× |
| CBC, automated (85027) |
$50.40 |
$126 |
7.8× |
| Prothrombin time (PT) (85610) |
$31.60 |
$79 |
7.4× |
| Partial thromboplastin time (PTT) (85730) |
$44.60 |
$111.50 |
7.4× |
| Left heart catheterization (93452) |
$6,140 |
$15,350 |
1.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$88.40 |
$221 |
3.0× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$317.20 |
$793 |
2.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$516 |
$1,290 |
3.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$730.40 |
$1,826 |
5.3× |