| CT head/brain without contrast (70450) |
$843.75 |
$1,125 |
9.4× |
| MRI brain without contrast (70551) |
$2,098.50 |
$2,798 |
10.2× |
| MRI brain with contrast (70552) |
$2,098.50 |
$2,798 |
7.0× |
| MRI brain without and with contrast (70553) |
$2,742 |
$3,656 |
9.1× |
| X-ray lower spine, 4+ views (72110) |
$310.50 |
$414 |
3.4× |
| MRI lumbar spine without contrast (72148) |
$2,098.50 |
$2,798 |
10.2× |
| CT pelvis with contrast (72193) |
$754.50 |
$1,006 |
5.0× |
| MRI lower-extremity joint without contrast (73721) |
$2,098.50 |
$2,798 |
10.2× |
| CT abdomen and pelvis with contrast (74177) |
$1,347 |
$1,796 |
4.5× |
| Ultrasound, abdomen complete (76700) |
$675.75 |
$901 |
7.5× |
| Ultrasound, transvaginal (76830) |
$339 |
$452 |
3.8× |
| Mammography, one breast (diagnostic) (77065) |
$155.25 |
$207 |
1.8× |
| Mammography, both breasts (diagnostic) (77066) |
$550.50 |
$734 |
5.0× |
| Mammography, screening (bilateral) (77067) |
$304.12 |
$405.50 |
3.3× |
| Basic metabolic panel (80048) |
$99 |
$132 |
11.7× |
| Comprehensive metabolic panel (80053) |
$261 |
$348 |
24.7× |
| Lipid panel (80061) |
$149.25 |
$199 |
11.1× |
| Renal function panel (80069) |
$216.75 |
$289 |
25.0× |
| Hepatic function panel (80076) |
$81.38 |
$108.50 |
10.0× |
| Urinalysis, non-automated, without microscopy (81002) |
$18.75 |
$25 |
5.4× |
| PSA, total (84153) |
$81.38 |
$108.50 |
4.4× |
| Thyroid stimulating hormone (TSH) (84443) |
$137.25 |
$183 |
8.2× |
| CBC with automated differential (85025) |
$154.88 |
$206.50 |
19.9× |
| CBC, automated (85027) |
$86.25 |
$115 |
13.3× |
| Prothrombin time (PT) (85610) |
$37.50 |
$50 |
8.7× |
| Partial thromboplastin time (PTT) (85730) |
$69 |
$92 |
11.5× |
| Psychotherapy, 30 minutes (90832) |
$147.75 |
$197 |
1.0× |
| Psychotherapy, 45 minutes (90834) |
$147.75 |
$197 |
1.0× |
| Psychotherapy, 60 minutes (90837) |
$147.75 |
$197 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$147.75 |
$197 |
1.0× |
| Family psychotherapy, with patient (50 min) (90847) |
$147.75 |
$197 |
1.0× |
| Group psychotherapy (90853) |
$94.50 |
$126 |
1.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$72 |
$96 |
2.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$232.50 |
$310 |
2.0× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$259.50 |
$346 |
2.3× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$283.12 |
$377.50 |
2.5× |
| Office consultation (low complexity, ~30 min) (99243) |
$114.75 |
$153 |
1.0× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$169.50 |
$226 |
1.5× |
| Preventive visit, new patient (age 18–39) (99385) |
$113.25 |
$151 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$132 |
$176 |
— |