| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,075 |
$4,150 |
2.3× |
| CT head/brain without contrast (70450) |
$1,965.50 |
$3,931 |
18.7× |
| MRI brain without contrast (70551) |
$2,782 |
$5,564 |
11.6× |
| MRI brain with contrast (70552) |
$3,408 |
$6,816 |
9.7× |
| MRI brain without and with contrast (70553) |
$3,436.75 |
$6,873.50 |
9.8× |
| X-ray lower spine, 4+ views (72110) |
$819 |
$1,638 |
7.8× |
| MRI lumbar spine without contrast (72148) |
$2,614.50 |
$5,229 |
10.9× |
| CT pelvis with contrast (72193) |
$2,334 |
$4,668 |
13.2× |
| MRI lower-extremity joint without contrast (73721) |
$2,974.50 |
$5,949 |
12.4× |
| CT abdomen and pelvis with contrast (74177) |
$2,828.50 |
$5,657 |
8.1× |
| Ultrasound, abdomen complete (76700) |
$992.50 |
$1,985 |
9.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,327.50 |
$2,655 |
12.6× |
| Ultrasound, transvaginal (76830) |
$692.50 |
$1,385 |
6.6× |
| Mammography, one breast (diagnostic) (77065) |
$384.50 |
$769 |
4.5× |
| Mammography, both breasts (diagnostic) (77066) |
$473 |
$946 |
4.3× |
| Mammography, screening (bilateral) (77067) |
$377 |
$754 |
4.1× |
| Basic metabolic panel (80048) |
$180 |
$360 |
21.3× |
| Comprehensive metabolic panel (80053) |
$483 |
$966 |
45.7× |
| Obstetric panel (80055) |
$78 |
$156 |
1.6× |
| Lipid panel (80061) |
$251.50 |
$503 |
18.8× |
| Renal function panel (80069) |
$136.50 |
$273 |
15.7× |
| Hepatic function panel (80076) |
$266 |
$532 |
32.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$39 |
$78 |
9.7× |
| Urinalysis, non-automated, without microscopy (81002) |
$76 |
$152 |
21.8× |
| PSA, total (84153) |
$214 |
$428 |
11.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$294 |
$588 |
17.5× |
| CBC with automated differential (85025) |
$159 |
$318 |
20.5× |
| CBC, automated (85027) |
$133 |
$266 |
20.6× |
| Prothrombin time (PT) (85610) |
$79.50 |
$159 |
18.5× |
| Partial thromboplastin time (PTT) (85730) |
$124 |
$248 |
20.6× |
| Group psychotherapy (90853) |
$100.50 |
$201 |
1.0× |
| Left heart catheterization (93452) |
$5,225.50 |
$10,451 |
1.6× |
| Sleep study (attended polysomnography) (95810) |
$3,049 |
$6,098 |
3.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$91.75 |
$183.50 |
3.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$405 |
$810 |
3.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$441 |
$882 |
3.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$307.25 |
$614.50 |
2.3× |