| Epidural injection, lumbar/sacral (with imaging) (62322) |
$545.10 |
$908.50 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,187.40 |
$1,979 |
1.1× |
| CT head/brain without contrast (70450) |
$1,059 |
$1,765 |
8.6× |
| MRI brain without contrast (70551) |
$1,481.40 |
$2,469 |
5.3× |
| MRI brain with contrast (70552) |
$1,696.20 |
$2,827 |
4.1× |
| MRI brain without and with contrast (70553) |
$1,967.40 |
$3,279 |
4.8× |
| X-ray lower spine, 4+ views (72110) |
$316.80 |
$528 |
2.6× |
| MRI lumbar spine without contrast (72148) |
$1,510.20 |
$2,517 |
5.4× |
| CT pelvis with contrast (72193) |
$1,291.80 |
$2,153 |
6.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,479 |
$2,465 |
5.2× |
| CT abdomen and pelvis with contrast (74177) |
$2,353.80 |
$3,923 |
5.7× |
| Ultrasound, abdomen complete (76700) |
$501 |
$835 |
4.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$551.40 |
$919 |
4.5× |
| Ultrasound, transvaginal (76830) |
$324.90 |
$541.50 |
2.6× |
| Mammography, one breast (diagnostic) (77065) |
$299.40 |
$499 |
3.5× |
| Mammography, both breasts (diagnostic) (77066) |
$417 |
$695 |
3.8× |
| Mammography, screening (bilateral) (77067) |
$238.20 |
$397 |
2.6× |
| Basic metabolic panel (80048) |
$54 |
$90 |
6.4× |
| Comprehensive metabolic panel (80053) |
$66.90 |
$111.50 |
6.3× |
| Obstetric panel (80055) |
$393 |
$655 |
8.2× |
| Lipid panel (80061) |
$62.70 |
$104.50 |
4.7× |
| Renal function panel (80069) |
$54.60 |
$91 |
6.3× |
| Hepatic function panel (80076) |
$54 |
$90 |
6.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$19.20 |
$32 |
4.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$43.80 |
$73 |
12.6× |
| PSA, total (84153) |
$66.60 |
$111 |
3.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$81 |
$135 |
4.8× |
| CBC with automated differential (85025) |
$42.60 |
$71 |
5.5× |
| CBC, automated (85027) |
$36.60 |
$61 |
5.7× |
| Prothrombin time (PT) (85610) |
$30.90 |
$51.50 |
7.2× |
| Partial thromboplastin time (PTT) (85730) |
$32.10 |
$53.50 |
5.3× |
| Left heart catheterization (93452) |
$4,191 |
$6,985 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$93.60 |
$156 |
3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$81.30 |
$135.50 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$108.30 |
$180.50 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$143.40 |
$239 |
0.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$75 |
$125 |
0.5× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$101.40 |
$169 |
0.6× |