| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,094.40 |
$1,216 |
1.2× |
| Cataract removal with lens insertion (66984) |
$3,799.80 |
$4,222 |
1.6× |
| CT head/brain without contrast (70450) |
$1,222.20 |
$1,358 |
11.1× |
| MRI brain without contrast (70551) |
$940.50 |
$1,045 |
3.7× |
| MRI brain with contrast (70552) |
$1,512 |
$1,680 |
4.1× |
| MRI brain without and with contrast (70553) |
$1,565.10 |
$1,739 |
4.3× |
| X-ray lower spine, 4+ views (72110) |
$486.90 |
$541 |
4.4× |
| MRI lumbar spine without contrast (72148) |
$940.50 |
$1,045 |
3.7× |
| CT pelvis with contrast (72193) |
$1,326.60 |
$1,474 |
7.2× |
| MRI lower-extremity joint without contrast (73721) |
$940.50 |
$1,045 |
3.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,179.80 |
$2,422 |
5.9× |
| Ultrasound, abdomen complete (76700) |
$513 |
$570 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$387.90 |
$431 |
3.5× |
| Ultrasound, transvaginal (76830) |
$513 |
$570 |
4.7× |
| Mammography, one breast (diagnostic) (77065) |
$426.60 |
$474 |
5.0× |
| Mammography, both breasts (diagnostic) (77066) |
$434.70 |
$483 |
3.9× |
| Mammography, screening (bilateral) (77067) |
$390.60 |
$434 |
4.3× |
| Basic metabolic panel (80048) |
$67.50 |
$75 |
8.0× |
| Comprehensive metabolic panel (80053) |
$76.50 |
$85 |
7.2× |
| Lipid panel (80061) |
$77.70 |
$86.34 |
5.8× |
| Renal function panel (80069) |
$58.50 |
$65 |
6.7× |
| Hepatic function panel (80076) |
$60.30 |
$67 |
7.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$36.90 |
$41 |
10.6× |
| PSA, total (84153) |
$189.81 |
$210.90 |
10.3× |
| Thyroid stimulating hormone (TSH) (84443) |
$122.40 |
$136 |
7.3× |
| CBC with automated differential (85025) |
$52.20 |
$58 |
6.7× |
| CBC, automated (85027) |
$36.90 |
$41 |
5.7× |
| Prothrombin time (PT) (85610) |
$27.90 |
$31 |
6.5× |
| Partial thromboplastin time (PTT) (85730) |
$71.89 |
$79.87 |
12.0× |
| Sleep study (attended polysomnography) (95810) |
$3,371.85 |
$3,746.50 |
3.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$94.30 |
$104.77 |
3.2× |