| Epidural injection, lumbar/sacral (with imaging) (62322) |
$410.40 |
$1,080 |
0.5× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$823.98 |
$2,168.36 |
0.9× |
| CT head/brain without contrast (70450) |
$821.18 |
$2,161 |
7.8× |
| MRI brain without contrast (70551) |
$1,347.10 |
$3,545 |
5.6× |
| MRI brain with contrast (70552) |
$1,560.66 |
$4,107 |
4.4× |
| MRI brain without and with contrast (70553) |
$1,832.74 |
$4,823 |
5.2× |
| X-ray lower spine, 4+ views (72110) |
$292.98 |
$771 |
2.8× |
| MRI lumbar spine without contrast (72148) |
$1,513.54 |
$3,983 |
6.3× |
| CT pelvis with contrast (72193) |
$1,217.52 |
$3,204 |
6.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,629.44 |
$4,288 |
6.7× |
| CT abdomen and pelvis with contrast (74177) |
$2,430.48 |
$6,396 |
6.9× |
| Ultrasound, abdomen complete (76700) |
$553.66 |
$1,457 |
5.2× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$395.96 |
$1,042 |
3.7× |
| Ultrasound, transvaginal (76830) |
$388.36 |
$1,022 |
3.7× |
| Mammography, one breast (diagnostic) (77065) |
$242.06 |
$637 |
2.8× |
| Mammography, both breasts (diagnostic) (77066) |
$271.32 |
$714 |
2.5× |
| Mammography, screening (bilateral) (77067) |
$201.78 |
$531 |
2.2× |
| Basic metabolic panel (80048) |
$12.31 |
$32.40 |
1.5× |
| Comprehensive metabolic panel (80053) |
$65.93 |
$173.50 |
6.2× |
| Obstetric panel (80055) |
$85.12 |
$224 |
1.8× |
| Lipid panel (80061) |
$38.38 |
$101 |
2.9× |
| Renal function panel (80069) |
$14.44 |
$38 |
1.7× |
| Hepatic function panel (80076) |
$12.16 |
$32 |
1.5× |
| PSA, total (84153) |
$36.86 |
$97 |
2.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$26.60 |
$70 |
1.6× |
| CBC with automated differential (85025) |
$17.10 |
$45 |
2.2× |
| CBC, automated (85027) |
$27.55 |
$72.50 |
4.3× |
| Prothrombin time (PT) (85610) |
$13.11 |
$34.50 |
3.1× |
| Partial thromboplastin time (PTT) (85730) |
$20.90 |
$55 |
3.5× |
| Psychotherapy, 30 minutes (90832) |
$86.26 |
$227 |
0.5× |
| Psychotherapy, 45 minutes (90834) |
$129.20 |
$340 |
0.7× |
| Psychotherapy, 60 minutes (90837) |
$172.52 |
$454 |
1.0× |
| Family psychotherapy, without patient (50 min) (90846) |
$157.70 |
$415 |
0.9× |
| Family psychotherapy, with patient (50 min) (90847) |
$153.90 |
$405 |
0.9× |
| Group psychotherapy (90853) |
$57.76 |
$152 |
0.6× |
| Left heart catheterization (93452) |
$4,142.76 |
$10,902 |
1.3× |
| Sleep study (attended polysomnography) (95810) |
$1,170.40 |
$3,080 |
1.3× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$49.40 |
$130 |
1.7× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$114 |
$300 |
0.8× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$133 |
$350 |
1.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$152 |
$400 |
1.1× |