| Breast lesion removal (open) (19120) |
$4,799.50 |
$9,599 |
1.2× |
| Diagnostic colonoscopy (45378) |
$931.50 |
$1,863 |
1.0× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$2,532.50 |
$5,065 |
2.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$2,189.50 |
$4,379 |
2.5× |
| After-cataract laser surgery (YAG capsulotomy) (66821) |
$937 |
$1,874 |
1.7× |
| CT head/brain without contrast (70450) |
$937.50 |
$1,875 |
9.1× |
| MRI brain without contrast (70551) |
$1,813 |
$3,626 |
7.7× |
| MRI brain with contrast (70552) |
$2,286.50 |
$4,573 |
6.7× |
| MRI brain without and with contrast (70553) |
$2,579 |
$5,158 |
7.5× |
| X-ray lower spine, 4+ views (72110) |
$312.50 |
$625 |
3.0× |
| MRI lumbar spine without contrast (72148) |
$2,130 |
$4,260 |
9.1× |
| CT pelvis with contrast (72193) |
$1,656.50 |
$3,313 |
9.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,230.50 |
$4,461 |
9.5× |
| CT abdomen and pelvis with contrast (74177) |
$1,820.50 |
$3,641 |
5.3× |
| Ultrasound, abdomen complete (76700) |
$714.50 |
$1,429 |
6.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$682 |
$1,364 |
6.6× |
| Ultrasound, transvaginal (76830) |
$431.75 |
$863.50 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$188.50 |
$377 |
2.2× |
| Mammography, both breasts (diagnostic) (77066) |
$379 |
$758 |
3.4× |
| Mammography, screening (bilateral) (77067) |
$311.50 |
$623 |
3.4× |
| Basic metabolic panel (80048) |
$90.50 |
$181 |
10.7× |
| Comprehensive metabolic panel (80053) |
$102.50 |
$205 |
9.7× |
| Obstetric panel (80055) |
$270.50 |
$541 |
5.7× |
| Lipid panel (80061) |
$84 |
$168 |
6.3× |
| Renal function panel (80069) |
$61 |
$122 |
7.0× |
| Hepatic function panel (80076) |
$81.50 |
$163 |
10.0× |
| Urinalysis, non-automated, with microscopy (81000) |
$10 |
$20 |
2.5× |
| Urinalysis, non-automated, without microscopy (81002) |
$16.50 |
$33 |
4.7× |
| PSA, total (84153) |
$74.50 |
$149 |
4.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$98.50 |
$197 |
5.9× |
| CBC with automated differential (85025) |
$40.50 |
$81 |
5.2× |
| CBC, automated (85027) |
$50.50 |
$101 |
7.8× |
| Prothrombin time (PT) (85610) |
$29.50 |
$59 |
6.9× |
| Partial thromboplastin time (PTT) (85730) |
$23.75 |
$47.50 |
4.0× |
| Psychotherapy, 30 minutes (90832) |
$92 |
$184 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$142 |
$284 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$372.50 |
$745 |
2.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$98 |
$196 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$154 |
$308 |
0.9× |
| Group psychotherapy (90853) |
$57.25 |
$114.50 |
0.6× |
| Left heart catheterization (93452) |
$5,291 |
$10,582 |
1.7× |
| Sleep study (attended polysomnography) (95810) |
$2,305 |
$4,610 |
2.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$95 |
$190 |
3.3× |