| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,084.17 |
$2,545 |
1.2× |
| CT head/brain without contrast (70450) |
$404.73 |
$1,499 |
3.7× |
| MRI brain without contrast (70551) |
$638.18 |
$1,877 |
2.5× |
| MRI brain with contrast (70552) |
$797.98 |
$2,347 |
2.2× |
| MRI brain without and with contrast (70553) |
$957.44 |
$2,816 |
2.6× |
| X-ray lower spine, 4+ views (72110) |
$377.55 |
$839 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$454.83 |
$1,736 |
1.8× |
| CT pelvis with contrast (72193) |
$1,006.83 |
$3,729 |
5.4× |
| MRI lower-extremity joint without contrast (73721) |
$1,101.79 |
$2,390 |
4.4× |
| CT abdomen and pelvis with contrast (74177) |
$716.85 |
$2,655 |
1.9× |
| Ultrasound, abdomen complete (76700) |
$678.76 |
$1,195 |
6.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$598.10 |
$1,053 |
5.4× |
| Ultrasound, transvaginal (76830) |
$464.06 |
$817 |
4.2× |
| Mammography, one breast (diagnostic) (77065) |
$197.28 |
$288 |
2.3× |
| Mammography, both breasts (diagnostic) (77066) |
$297.29 |
$434 |
2.7× |
| Mammography, screening (bilateral) (77067) |
$215.84 |
$284 |
2.4× |
| Basic metabolic panel (80048) |
$36.63 |
$111 |
4.3× |
| Comprehensive metabolic panel (80053) |
$45.21 |
$137 |
4.3× |
| Lipid panel (80061) |
$24.92 |
$75.50 |
1.9× |
| Renal function panel (80069) |
$51.48 |
$156 |
5.9× |
| Hepatic function panel (80076) |
$35.64 |
$108 |
4.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$4.31 |
$11 |
1.2× |
| PSA, total (84153) |
$18.48 |
$56 |
1.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$26.73 |
$81 |
1.6× |
| CBC with automated differential (85025) |
$14.91 |
$44.50 |
1.9× |
| CBC, automated (85027) |
$18.09 |
$54 |
2.8× |
| Prothrombin time (PT) (85610) |
$10.72 |
$32 |
2.5× |
| Partial thromboplastin time (PTT) (85730) |
$12.22 |
$36.50 |
2.0× |
| Sleep study (attended polysomnography) (95810) |
$2,510.35 |
$4,895 |
2.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$75.88 |
$127 |
2.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$439.22 |
$582.50 |
3.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$549.54 |
$729 |
3.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$702.77 |
$932 |
5.0× |