| CT head/brain without contrast (70450) |
$423.36 |
$1,764 |
4.2× |
| MRI brain without contrast (70551) |
$1,079.28 |
$4,497 |
4.7× |
| MRI brain with contrast (70552) |
$1,104 |
$4,600 |
3.3× |
| MRI brain without and with contrast (70553) |
$1,228.32 |
$5,118 |
3.7× |
| X-ray lower spine, 4+ views (72110) |
$179.28 |
$747 |
1.8× |
| MRI lumbar spine without contrast (72148) |
$1,228.32 |
$5,118 |
5.4× |
| CT pelvis with contrast (72193) |
$625.44 |
$2,606 |
3.7× |
| MRI lower-extremity joint without contrast (73721) |
$918.72 |
$3,828 |
4.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,056.24 |
$4,401 |
3.1× |
| Ultrasound, abdomen complete (76700) |
$367.20 |
$1,530 |
3.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$289.44 |
$1,206 |
2.9× |
| Ultrasound, transvaginal (76830) |
$433.68 |
$1,807 |
4.3× |
| Mammography, one breast (diagnostic) (77065) |
$62.64 |
$261 |
0.7× |
| Mammography, both breasts (diagnostic) (77066) |
$99.12 |
$413 |
0.9× |
| Mammography, screening (bilateral) (77067) |
$97.44 |
$406 |
1.1× |
| Basic metabolic panel (80048) |
$81.12 |
$338 |
9.6× |
| Comprehensive metabolic panel (80053) |
$141.60 |
$590 |
13.4× |
| Lipid panel (80061) |
$146.16 |
$609 |
10.9× |
| Renal function panel (80069) |
$92.16 |
$384 |
10.6× |
| Hepatic function panel (80076) |
$67.68 |
$282 |
8.3× |
| Urinalysis, non-automated, with microscopy (81000) |
$2.40 |
$10 |
0.6× |
| Urinalysis, non-automated, without microscopy (81002) |
$9.36 |
$39 |
2.7× |
| PSA, total (84153) |
$57.12 |
$238 |
3.1× |
| Thyroid stimulating hormone (TSH) (84443) |
$23.28 |
$97 |
1.4× |
| CBC with automated differential (85025) |
$41.52 |
$173 |
5.3× |
| CBC, automated (85027) |
$36.72 |
$153 |
5.7× |
| Prothrombin time (PT) (85610) |
$12.72 |
$53 |
3.0× |
| Partial thromboplastin time (PTT) (85730) |
$48.72 |
$203 |
8.1× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$44.40 |
$185 |
1.5× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$66.48 |
$277 |
0.5× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$92.16 |
$384 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$110.40 |
$460 |
0.9× |
| Office consultation (low complexity, ~30 min) (99243) |
$44.16 |
$184 |
0.3× |
| Office consultation (moderate complexity, ~40 min) (99244) |
$49.68 |
$207 |
0.4× |