| Breast lesion removal (open) (19120) |
$796.25 |
$1,225 |
0.2× |
| CT head/brain without contrast (70450) |
$1,016.60 |
$1,564 |
10.4× |
| MRI brain without contrast (70551) |
$1,430 |
$2,200 |
6.4× |
| MRI brain with contrast (70552) |
$1,533.35 |
$2,359 |
4.7× |
| MRI brain without and with contrast (70553) |
$2,925 |
$4,500 |
8.9× |
| X-ray lower spine, 4+ views (72110) |
$323.05 |
$497 |
3.3× |
| MRI lumbar spine without contrast (72148) |
$1,755.65 |
$2,701 |
7.8× |
| CT pelvis with contrast (72193) |
$1,279.85 |
$1,969 |
7.8× |
| MRI lower-extremity joint without contrast (73721) |
$2,125.50 |
$3,270 |
9.5× |
| CT abdomen and pelvis with contrast (74177) |
$2,559.05 |
$3,937 |
7.8× |
| Ultrasound, abdomen complete (76700) |
$630.50 |
$970 |
6.4× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$231.40 |
$356 |
2.4× |
| Ultrasound, transvaginal (76830) |
$437.45 |
$673 |
4.5× |
| Basic metabolic panel (80048) |
$68.90 |
$106 |
8.1× |
| Comprehensive metabolic panel (80053) |
$120.25 |
$185 |
11.4× |
| Lipid panel (80061) |
$54.28 |
$83.50 |
4.1× |
| Renal function panel (80069) |
$85.80 |
$132 |
9.9× |
| Hepatic function panel (80076) |
$59.80 |
$92 |
7.3× |
| Urinalysis, non-automated, without microscopy (81002) |
$13 |
$20 |
3.7× |
| PSA, total (84153) |
$39 |
$60 |
2.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$83.20 |
$128 |
5.0× |
| CBC with automated differential (85025) |
$37.05 |
$57 |
4.8× |
| CBC, automated (85027) |
$67.60 |
$104 |
10.4× |
| Prothrombin time (PT) (85610) |
$39.98 |
$61.50 |
9.3× |
| Partial thromboplastin time (PTT) (85730) |
$59.15 |
$91 |
9.8× |
| Psychotherapy, 30 minutes (90832) |
$124.80 |
$192 |
0.7× |
| Psychotherapy, 45 minutes (90834) |
$164.45 |
$253 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$243.75 |
$375 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$60.45 |
$93 |
2.1× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$151.78 |
$233.50 |
1.2× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$236.28 |
$363.50 |
1.9× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$315.90 |
$486 |
2.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$116.35 |
$179 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$116.35 |
$179 |
— |