| Epidural injection, lumbar/sacral (with imaging) (62322) |
$617.65 |
$1,123 |
0.7× |
| CT head/brain without contrast (70450) |
$1,230.90 |
$2,238 |
11.2× |
| MRI brain without contrast (70551) |
$1,869.45 |
$3,399 |
7.4× |
| MRI brain with contrast (70552) |
$1,985.50 |
$3,610 |
5.4× |
| MRI brain without and with contrast (70553) |
$2,458.50 |
$4,470 |
6.7× |
| X-ray lower spine, 4+ views (72110) |
$336.60 |
$612 |
3.1× |
| MRI lumbar spine without contrast (72148) |
$1,526.25 |
$2,775 |
6.1× |
| CT pelvis with contrast (72193) |
$1,147.30 |
$2,086 |
6.2× |
| MRI lower-extremity joint without contrast (73721) |
$1,437.15 |
$2,613 |
5.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,192.85 |
$3,987 |
6.0× |
| Ultrasound, abdomen complete (76700) |
$341.55 |
$621 |
3.1× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$262.90 |
$478 |
2.4× |
| Ultrasound, transvaginal (76830) |
$253 |
$460 |
2.3× |
| Mammography, one breast (diagnostic) (77065) |
$290.95 |
$529 |
3.4× |
| Mammography, both breasts (diagnostic) (77066) |
$321.75 |
$585 |
2.9× |
| Mammography, screening (bilateral) (77067) |
$290.95 |
$529 |
3.2× |
| Basic metabolic panel (80048) |
$64.90 |
$118 |
7.7× |
| Comprehensive metabolic panel (80053) |
$77.55 |
$141 |
7.3× |
| Lipid panel (80061) |
$72.60 |
$132 |
5.4× |
| Renal function panel (80069) |
$65.45 |
$119 |
7.5× |
| Hepatic function panel (80076) |
$84.15 |
$153 |
10.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$12.65 |
$23 |
3.6× |
| PSA, total (84153) |
$91.85 |
$167 |
5.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$49.50 |
$90 |
2.9× |
| CBC with automated differential (85025) |
$41.25 |
$75 |
5.3× |
| CBC, automated (85027) |
$29.70 |
$54 |
4.6× |
| Prothrombin time (PT) (85610) |
$30.80 |
$56 |
7.2× |
| Partial thromboplastin time (PTT) (85730) |
$44.55 |
$81 |
7.4× |
| Sleep study (attended polysomnography) (95810) |
$1,860.65 |
$3,383 |
2.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$74.25 |
$135 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$36.30 |
$66 |
0.3× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$57.75 |
$105 |
0.4× |