| CT head/brain without contrast (70450) |
$919.80 |
$1,533 |
9.1× |
| MRI brain without contrast (70551) |
$1,377.90 |
$2,296.50 |
6.0× |
| MRI brain with contrast (70552) |
$1,343.70 |
$2,239.50 |
4.0× |
| MRI brain without and with contrast (70553) |
$2,192.70 |
$3,654.50 |
6.5× |
| X-ray lower spine, 4+ views (72110) |
$256.80 |
$428 |
2.5× |
| MRI lumbar spine without contrast (72148) |
$1,386 |
$2,310 |
6.0× |
| CT pelvis with contrast (72193) |
$1,230 |
$2,050 |
7.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,302 |
$2,170 |
5.6× |
| CT abdomen and pelvis with contrast (74177) |
$2,414.40 |
$4,024 |
7.1× |
| Ultrasound, abdomen complete (76700) |
$573 |
$955 |
5.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$343.80 |
$573 |
3.4× |
| Ultrasound, transvaginal (76830) |
$445.20 |
$742 |
4.4× |
| Mammography, one breast (diagnostic) (77065) |
$216 |
$360 |
2.5× |
| Mammography, both breasts (diagnostic) (77066) |
$274.20 |
$457 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$195 |
$325 |
2.1× |
| Basic metabolic panel (80048) |
$75.60 |
$126 |
8.9× |
| Comprehensive metabolic panel (80053) |
$69 |
$115 |
6.5× |
| Obstetric panel (80055) |
$470.40 |
$784 |
9.8× |
| Lipid panel (80061) |
$74.40 |
$124 |
5.6× |
| Renal function panel (80069) |
$77.40 |
$129 |
8.9× |
| Hepatic function panel (80076) |
$72.60 |
$121 |
8.9× |
| Urinalysis, non-automated, without microscopy (81002) |
$24 |
$40 |
6.9× |
| PSA, total (84153) |
$102.60 |
$171 |
5.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$104.40 |
$174 |
6.2× |
| CBC with automated differential (85025) |
$68.40 |
$114 |
8.8× |
| CBC, automated (85027) |
$58.20 |
$97 |
9.0× |
| Prothrombin time (PT) (85610) |
$42 |
$70 |
9.8× |
| Partial thromboplastin time (PTT) (85730) |
$53.40 |
$89 |
8.9× |
| Psychotherapy, 30 minutes (90832) |
$103.80 |
$173 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$168 |
$280 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$180.60 |
$301 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$174 |
$290 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$301.20 |
$502 |
1.7× |
| Group psychotherapy (90853) |
$172.20 |
$287 |
1.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$72.60 |
$121 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$190.20 |
$317 |
1.5× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$385.20 |
$642 |
3.0× |