| Epidural injection, lumbar/sacral (with imaging) (62322) |
$383.25 |
$1,533 |
0.4× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$417 |
$1,668 |
0.5× |
| CT head/brain without contrast (70450) |
$918.75 |
$3,675 |
8.7× |
| MRI brain without contrast (70551) |
$1,739 |
$6,956 |
7.3× |
| MRI brain with contrast (70552) |
$1,792.25 |
$7,169 |
5.1× |
| MRI brain without and with contrast (70553) |
$1,965.50 |
$7,862 |
5.6× |
| X-ray lower spine, 4+ views (72110) |
$165.50 |
$662 |
1.6× |
| MRI lumbar spine without contrast (72148) |
$789.50 |
$3,158 |
3.3× |
| CT pelvis with contrast (72193) |
$592 |
$2,368 |
3.4× |
| MRI lower-extremity joint without contrast (73721) |
$412.50 |
$1,650 |
1.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,008.75 |
$8,035 |
5.7× |
| Ultrasound, abdomen complete (76700) |
$308 |
$1,232 |
2.9× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$149.50 |
$598 |
1.4× |
| Ultrasound, transvaginal (76830) |
$158.75 |
$635 |
1.5× |
| Mammography, one breast (diagnostic) (77065) |
$95 |
$380 |
1.1× |
| Mammography, both breasts (diagnostic) (77066) |
$121.75 |
$487 |
1.1× |
| Mammography, screening (bilateral) (77067) |
$100.50 |
$402 |
1.1× |
| Basic metabolic panel (80048) |
$41.50 |
$166 |
4.9× |
| Comprehensive metabolic panel (80053) |
$69.75 |
$279 |
6.6× |
| Lipid panel (80061) |
$36.25 |
$145 |
2.7× |
| Renal function panel (80069) |
$32 |
$128 |
3.7× |
| Hepatic function panel (80076) |
$36.25 |
$145 |
4.4× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.50 |
$38 |
2.7× |
| PSA, total (84153) |
$64.25 |
$257 |
3.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$28 |
$112 |
1.7× |
| CBC with automated differential (85025) |
$23.75 |
$95 |
3.1× |
| CBC, automated (85027) |
$14 |
$56 |
2.2× |
| Prothrombin time (PT) (85610) |
$29.25 |
$117 |
6.8× |
| Partial thromboplastin time (PTT) (85730) |
$50.50 |
$202 |
8.4× |
| Psychotherapy, 30 minutes (90832) |
$76.25 |
$305 |
0.4× |
| Psychotherapy, 45 minutes (90834) |
$95.50 |
$382 |
0.5× |
| Psychotherapy, 60 minutes (90837) |
$112.50 |
$450 |
0.6× |
| Family psychotherapy, with patient (50 min) (90847) |
$90.50 |
$362 |
0.5× |
| Electrocardiogram (ECG), complete (93000) |
$82.25 |
$329 |
1.4× |
| Left heart catheterization (93452) |
$2,389.25 |
$9,557 |
0.7× |
| Sleep study (attended polysomnography) (95810) |
$606.50 |
$2,426 |
0.7× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$63.50 |
$254 |
2.2× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$59 |
$236 |
0.4× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$100 |
$400 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$130.50 |
$522 |
1.0× |
| Preventive visit, new patient (age 18–39) (99385) |
$75.75 |
$303 |
— |
| Preventive visit, new patient (age 40–64) (99386) |
$92.25 |
$369 |
— |