| Epidural injection, lumbar/sacral (with imaging) (62322) |
$876.39 |
$1,338 |
1.0× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,766.23 |
$2,545 |
2.0× |
| CT head/brain without contrast (70450) |
$966.86 |
$1,499 |
9.1× |
| MRI brain without contrast (70551) |
$1,430.27 |
$1,877 |
5.9× |
| MRI brain with contrast (70552) |
$1,788.41 |
$2,347 |
5.0× |
| MRI brain without and with contrast (70553) |
$2,145.79 |
$2,816 |
6.0× |
| X-ray lower spine, 4+ views (72110) |
$635.12 |
$839 |
5.9× |
| MRI lumbar spine without contrast (72148) |
$1,175.27 |
$1,736 |
4.8× |
| CT pelvis with contrast (72193) |
$2,561.82 |
$3,729 |
14.3× |
| MRI lower-extremity joint without contrast (73721) |
$1,818.79 |
$2,390 |
7.5× |
| CT abdomen and pelvis with contrast (74177) |
$1,823.99 |
$2,655 |
5.1× |
| Ultrasound, abdomen complete (76700) |
$1,030.09 |
$1,195 |
9.6× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$907.69 |
$1,053 |
8.5× |
| Ultrasound, transvaginal (76830) |
$704.25 |
$817 |
6.6× |
| Mammography, one breast (diagnostic) (77065) |
$252.86 |
$288 |
2.9× |
| Mammography, both breasts (diagnostic) (77066) |
$381.05 |
$434 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$226.92 |
$284 |
2.5× |
| Basic metabolic panel (80048) |
$73.82 |
$111 |
8.7× |
| Comprehensive metabolic panel (80053) |
$91.11 |
$137 |
8.6× |
| Lipid panel (80061) |
$50.20 |
$75.50 |
3.7× |
| Renal function panel (80069) |
$103.74 |
$156 |
12.0× |
| Hepatic function panel (80076) |
$71.82 |
$108 |
8.8× |
| Urinalysis, non-automated, without microscopy (81002) |
$7.30 |
$11 |
2.1× |
| PSA, total (84153) |
$37.24 |
$56 |
2.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$53.87 |
$81 |
3.2× |
| CBC with automated differential (85025) |
$30.58 |
$44.50 |
3.9× |
| CBC, automated (85027) |
$37.10 |
$54 |
5.7× |
| Prothrombin time (PT) (85610) |
$21.98 |
$32 |
5.1× |
| Partial thromboplastin time (PTT) (85730) |
$25.08 |
$36.50 |
4.2× |
| Sleep study (attended polysomnography) (95810) |
$4,178.81 |
$4,895 |
4.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$85.09 |
$127 |
2.9× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$215.82 |
$330 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$297.57 |
$455 |
2.2× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$370.50 |
$520 |
2.7× |