| Breast lesion removal (open) (19120) |
$3,832 |
$7,664 |
1.0× |
| CT head/brain without contrast (70450) |
$961.50 |
$1,923 |
9.5× |
| MRI brain without contrast (70551) |
$1,549.50 |
$3,099 |
6.7× |
| MRI brain with contrast (70552) |
$1,701.75 |
$3,403.50 |
5.0× |
| MRI brain without and with contrast (70553) |
$2,254.50 |
$4,509 |
6.7× |
| X-ray lower spine, 4+ views (72110) |
$259 |
$518 |
2.5× |
| MRI lumbar spine without contrast (72148) |
$1,755.75 |
$3,511.50 |
7.6× |
| CT pelvis with contrast (72193) |
$1,286.50 |
$2,573 |
7.5× |
| MRI lower-extremity joint without contrast (73721) |
$1,529.50 |
$3,059 |
6.6× |
| CT abdomen and pelvis with contrast (74177) |
$2,524.75 |
$5,049.50 |
7.4× |
| Ultrasound, abdomen complete (76700) |
$591.75 |
$1,183.50 |
5.8× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$354.25 |
$708.50 |
3.5× |
| Ultrasound, transvaginal (76830) |
$460 |
$920 |
4.5× |
| Mammography, one breast (diagnostic) (77065) |
$180 |
$360 |
2.1× |
| Mammography, both breasts (diagnostic) (77066) |
$228.50 |
$457 |
2.1× |
| Mammography, screening (bilateral) (77067) |
$182.50 |
$365 |
2.0× |
| Basic metabolic panel (80048) |
$40.50 |
$81 |
4.8× |
| Comprehensive metabolic panel (80053) |
$78.50 |
$157 |
7.4× |
| Obstetric panel (80055) |
$306 |
$612 |
6.4× |
| Lipid panel (80061) |
$62.75 |
$125.50 |
4.7× |
| Renal function panel (80069) |
$71 |
$142 |
8.2× |
| Hepatic function panel (80076) |
$40.50 |
$81 |
5.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$14 |
$28 |
3.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$23.75 |
$47.50 |
6.8× |
| PSA, total (84153) |
$92.25 |
$184.50 |
5.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$79.75 |
$159.50 |
4.7× |
| CBC with automated differential (85025) |
$60 |
$120 |
7.7× |
| CBC, automated (85027) |
$30.25 |
$60.50 |
4.7× |
| Prothrombin time (PT) (85610) |
$40 |
$80 |
9.3× |
| Partial thromboplastin time (PTT) (85730) |
$54.75 |
$109.50 |
9.1× |
| Psychotherapy, 30 minutes (90832) |
$134 |
$268 |
0.8× |
| Psychotherapy, 45 minutes (90834) |
$172 |
$344 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$182 |
$364 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$184.50 |
$369 |
1.1× |
| Family psychotherapy, with patient (50 min) (90847) |
$304.25 |
$608.50 |
1.8× |
| Group psychotherapy (90853) |
$183.50 |
$367 |
1.9× |
| Sleep study (attended polysomnography) (95810) |
$2,253 |
$4,506 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$66.50 |
$133 |
2.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$179.75 |
$359.50 |
1.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$262.50 |
$525 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$324 |
$648 |
2.5× |