| Breast lesion removal (open) (19120) |
$3,114.30 |
$8,898 |
0.8× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$936.25 |
$2,675 |
1.1× |
| CT head/brain without contrast (70450) |
$2,399.25 |
$6,855 |
22.8× |
| MRI brain without contrast (70551) |
$1,647.80 |
$4,708 |
6.9× |
| MRI brain with contrast (70552) |
$2,224.60 |
$6,356 |
6.3× |
| MRI brain without and with contrast (70553) |
$4,119.50 |
$11,770 |
11.8× |
| X-ray lower spine, 4+ views (72110) |
$926.80 |
$2,648 |
8.8× |
| MRI lumbar spine without contrast (72148) |
$3,528.70 |
$10,082 |
14.7× |
| CT pelvis with contrast (72193) |
$2,722.65 |
$7,779 |
15.5× |
| MRI lower-extremity joint without contrast (73721) |
$2,725.80 |
$7,788 |
11.4× |
| CT abdomen and pelvis with contrast (74177) |
$6,736.45 |
$19,247 |
19.2× |
| Ultrasound, abdomen complete (76700) |
$1,812.30 |
$5,178 |
17.3× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$1,088.50 |
$3,110 |
10.4× |
| Ultrasound, transvaginal (76830) |
$705.25 |
$2,015 |
6.7× |
| Mammography, one breast (diagnostic) (77065) |
$449.40 |
$1,284 |
5.2× |
| Mammography, both breasts (diagnostic) (77066) |
$680.75 |
$1,945 |
6.2× |
| Mammography, screening (bilateral) (77067) |
$297.50 |
$850 |
3.3× |
| Basic metabolic panel (80048) |
$380.10 |
$1,086 |
44.9× |
| Comprehensive metabolic panel (80053) |
$472.85 |
$1,351 |
44.8× |
| Lipid panel (80061) |
$155.05 |
$443 |
11.6× |
| Hepatic function panel (80076) |
$326.55 |
$933 |
40.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$13.65 |
$39 |
3.9× |
| PSA, total (84153) |
$126.70 |
$362 |
6.9× |
| Thyroid stimulating hormone (TSH) (84443) |
$151.55 |
$433 |
9.0× |
| CBC with automated differential (85025) |
$93.80 |
$268 |
12.1× |
| CBC, automated (85027) |
$174.30 |
$498 |
26.9× |
| Prothrombin time (PT) (85610) |
$178.15 |
$509 |
41.5× |
| Partial thromboplastin time (PTT) (85730) |
$210.70 |
$602 |
35.1× |
| Left heart catheterization (93452) |
$4,753.35 |
$13,581 |
1.5× |
| Sleep study (attended polysomnography) (95810) |
$2,948.75 |
$8,425 |
3.4× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$122.50 |
$350 |
4.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$207.90 |
$594 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$238.35 |
$681 |
1.8× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$251.65 |
$719 |
1.9× |