| Transforaminal epidural injection, lumbar/sacral (64483) |
$5,334.50 |
$5,334.50 |
6.0× |
| CT head/brain without contrast (70450) |
$921 |
$921 |
8.8× |
| MRI brain without contrast (70551) |
$2,963.50 |
$2,963.50 |
12.4× |
| MRI brain with contrast (70552) |
$3,523 |
$3,523 |
10.1× |
| MRI brain without and with contrast (70553) |
$3,964.50 |
$3,964.50 |
11.3× |
| X-ray lower spine, 4+ views (72110) |
$156 |
$156 |
1.5× |
| MRI lumbar spine without contrast (72148) |
$3,783 |
$3,783 |
15.8× |
| CT pelvis with contrast (72193) |
$1,437 |
$1,437 |
8.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,703 |
$2,703 |
11.3× |
| CT abdomen and pelvis with contrast (74177) |
$2,783 |
$2,783 |
7.9× |
| Ultrasound, abdomen complete (76700) |
$990.50 |
$990.50 |
9.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,043.50 |
$1,043.50 |
9.9× |
| Ultrasound, transvaginal (76830) |
$695 |
$695 |
6.6× |
| Mammography, one breast (diagnostic) (77065) |
$457 |
$457 |
5.3× |
| Mammography, both breasts (diagnostic) (77066) |
$736 |
$736 |
6.7× |
| Mammography, screening (bilateral) (77067) |
$457.50 |
$457.50 |
5.0× |
| Basic metabolic panel (80048) |
$872.50 |
$872.50 |
103.1× |
| Comprehensive metabolic panel (80053) |
$1,462 |
$1,462 |
138.4× |
| Obstetric panel (80055) |
$1,244 |
$1,244 |
26.0× |
| Lipid panel (80061) |
$706.50 |
$706.50 |
52.8× |
| Renal function panel (80069) |
$695.50 |
$695.50 |
80.1× |
| Hepatic function panel (80076) |
$992.50 |
$992.50 |
121.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$269 |
$269 |
77.3× |
| PSA, total (84153) |
$573 |
$573 |
31.2× |
| Thyroid stimulating hormone (TSH) (84443) |
$355.50 |
$355.50 |
21.2× |
| CBC, automated (85027) |
$695 |
$695 |
107.4× |
| Prothrombin time (PT) (85610) |
$507.50 |
$507.50 |
118.3× |
| Partial thromboplastin time (PTT) (85730) |
$524 |
$524 |
87.2× |
| Left heart catheterization (93452) |
$31,667 |
$31,667 |
9.7× |
| Sleep study (attended polysomnography) (95810) |
$7,680 |
$7,680 |
8.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$374.50 |
$374.50 |
12.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$315 |
$315 |
2.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$487 |
$487 |
3.6× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$487 |
$487 |
3.6× |