| Epidural injection, lumbar/sacral (with imaging) (62322) |
$1,170 |
$1,950 |
1.3× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$1,506.60 |
$2,511 |
1.7× |
| CT head/brain without contrast (70450) |
$1,356.60 |
$2,261 |
12.8× |
| MRI brain without contrast (70551) |
$2,305.80 |
$3,843 |
9.5× |
| MRI brain with contrast (70552) |
$2,643 |
$4,405 |
7.5× |
| MRI brain without and with contrast (70553) |
$3,117.60 |
$5,196 |
8.8× |
| X-ray lower spine, 4+ views (72110) |
$426 |
$710 |
4.0× |
| MRI lumbar spine without contrast (72148) |
$2,113.80 |
$3,523 |
8.7× |
| CT pelvis with contrast (72193) |
$1,719 |
$2,865 |
9.7× |
| MRI lower-extremity joint without contrast (73721) |
$2,205 |
$3,675 |
9.1× |
| CT abdomen and pelvis with contrast (74177) |
$3,827.40 |
$6,379 |
10.8× |
| Ultrasound, abdomen complete (76700) |
$685.20 |
$1,142 |
6.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$495 |
$825 |
4.7× |
| Ultrasound, transvaginal (76830) |
$580.20 |
$967 |
5.5× |
| Mammography, one breast (diagnostic) (77065) |
$235.20 |
$392 |
2.7× |
| Mammography, both breasts (diagnostic) (77066) |
$275.40 |
$459 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$223.80 |
$373 |
2.5× |
| Basic metabolic panel (80048) |
$159 |
$265 |
18.8× |
| Comprehensive metabolic panel (80053) |
$258.60 |
$431 |
24.5× |
| Obstetric panel (80055) |
$190.20 |
$317 |
4.0× |
| Lipid panel (80061) |
$151.80 |
$253 |
11.3× |
| Renal function panel (80069) |
$172.80 |
$288 |
19.9× |
| Hepatic function panel (80076) |
$168.60 |
$281 |
20.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$30.60 |
$51 |
8.8× |
| PSA, total (84153) |
$129 |
$215 |
7.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$114 |
$190 |
6.8× |
| CBC with automated differential (85025) |
$90 |
$150 |
11.6× |
| CBC, automated (85027) |
$70.80 |
$118 |
10.9× |
| Prothrombin time (PT) (85610) |
$47.40 |
$79 |
11.0× |
| Partial thromboplastin time (PTT) (85730) |
$57 |
$95 |
9.5× |
| Left heart catheterization (93452) |
$6,535.80 |
$10,893 |
2.0× |
| Sleep study (attended polysomnography) (95810) |
$2,520 |
$4,200 |
2.9× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$97.80 |
$163 |
3.4× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$149.40 |
$249 |
1.1× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$232.80 |
$388 |
1.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$285 |
$475 |
2.1× |
| Office consultation (low complexity, ~30 min) (99243) |
$190.20 |
$317 |
1.4× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$285 |
$475 |
2.1× |