| Epidural injection, lumbar/sacral (with imaging) (62322) |
$158.08 |
$832 |
0.2× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$393.30 |
$2,070 |
0.5× |
| CT head/brain without contrast (70450) |
$610.85 |
$3,215 |
6.2× |
| MRI brain without contrast (70551) |
$620.64 |
$3,266.50 |
2.8× |
| MRI brain with contrast (70552) |
$1,527.60 |
$8,040 |
4.7× |
| MRI brain without and with contrast (70553) |
$1,730.52 |
$9,108 |
5.3× |
| X-ray lower spine, 4+ views (72110) |
$142.31 |
$749 |
1.5× |
| MRI lumbar spine without contrast (72148) |
$679.25 |
$3,575 |
3.0× |
| CT pelvis with contrast (72193) |
$687.04 |
$3,616 |
4.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,018.21 |
$5,359 |
4.6× |
| CT abdomen and pelvis with contrast (74177) |
$1,526.46 |
$8,034 |
4.7× |
| Ultrasound, abdomen complete (76700) |
$258.02 |
$1,358 |
2.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$206.15 |
$1,085 |
2.1× |
| Ultrasound, transvaginal (76830) |
$180.88 |
$952 |
1.8× |
| Mammography, one breast (diagnostic) (77065) |
$109.92 |
$578.50 |
1.3× |
| Mammography, both breasts (diagnostic) (77066) |
$139.94 |
$736.50 |
1.3× |
| Mammography, screening (bilateral) (77067) |
$102.22 |
$538 |
1.1× |
| Basic metabolic panel (80048) |
$91.96 |
$484 |
10.9× |
| Comprehensive metabolic panel (80053) |
$133.76 |
$704 |
12.7× |
| Obstetric panel (80055) |
$25.46 |
$134 |
0.5× |
| Lipid panel (80061) |
$79.80 |
$420 |
6.0× |
| Renal function panel (80069) |
$87.02 |
$458 |
10.0× |
| Hepatic function panel (80076) |
$63.46 |
$334 |
7.8× |
| Urinalysis, non-automated, with microscopy (81000) |
$2.28 |
$12 |
0.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$17.96 |
$94.50 |
5.2× |
| PSA, total (84153) |
$103.93 |
$547 |
5.7× |
| Thyroid stimulating hormone (TSH) (84443) |
$34.10 |
$179.50 |
2.0× |
| CBC with automated differential (85025) |
$32.49 |
$171 |
4.2× |
| CBC, automated (85027) |
$27.93 |
$147 |
4.3× |
| Prothrombin time (PT) (85610) |
$30.02 |
$158 |
7.0× |
| Partial thromboplastin time (PTT) (85730) |
$35.53 |
$187 |
5.9× |
| Left heart catheterization (93452) |
$2,612.31 |
$13,749 |
0.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$31.35 |
$165 |
1.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$62.32 |
$328 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$77.52 |
$408 |
0.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$123.02 |
$647.50 |
1.0× |