| Breast lesion removal (open) (19120) |
$2,495.40 |
$8,318 |
0.7× |
| Epidural injection, lumbar/sacral (with imaging) (62322) |
$737.40 |
$2,458 |
0.9× |
| Transforaminal epidural injection, lumbar/sacral (64483) |
$934.95 |
$3,116.50 |
1.2× |
| CT head/brain without contrast (70450) |
$118.50 |
$395 |
1.2× |
| MRI brain without contrast (70551) |
$215.40 |
$718 |
1.0× |
| MRI brain with contrast (70552) |
$295.20 |
$984 |
0.9× |
| MRI brain without and with contrast (70553) |
$340.80 |
$1,136 |
1.1× |
| X-ray lower spine, 4+ views (72110) |
$271.50 |
$905 |
2.9× |
| MRI lumbar spine without contrast (72148) |
$215.40 |
$718 |
1.0× |
| CT pelvis with contrast (72193) |
$153 |
$510 |
1.0× |
| MRI lower-extremity joint without contrast (73721) |
$279.90 |
$933 |
1.3× |
| CT abdomen and pelvis with contrast (74177) |
$201 |
$670 |
0.6× |
| Ultrasound, abdomen complete (76700) |
$426.30 |
$1,421 |
4.5× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$231.60 |
$772 |
2.4× |
| Ultrasound, transvaginal (76830) |
$307.20 |
$1,024 |
3.2× |
| Mammography, one breast (diagnostic) (77065) |
$72.30 |
$241 |
0.8× |
| Mammography, both breasts (diagnostic) (77066) |
$201.30 |
$671 |
1.8× |
| Mammography, screening (bilateral) (77067) |
$117 |
$390 |
1.3× |
| Basic metabolic panel (80048) |
$37.20 |
$124 |
4.4× |
| Comprehensive metabolic panel (80053) |
$54 |
$180 |
5.1× |
| Lipid panel (80061) |
$40.80 |
$136 |
3.0× |
| Renal function panel (80069) |
$40.20 |
$134 |
4.6× |
| Hepatic function panel (80076) |
$38.10 |
$127 |
4.7× |
| PSA, total (84153) |
$48 |
$160 |
2.6× |
| Thyroid stimulating hormone (TSH) (84443) |
$31.20 |
$104 |
1.9× |
| CBC with automated differential (85025) |
$54.90 |
$183 |
7.1× |
| CBC, automated (85027) |
$21 |
$70 |
3.2× |
| Prothrombin time (PT) (85610) |
$15 |
$50 |
3.5× |
| Partial thromboplastin time (PTT) (85730) |
$19.50 |
$65 |
3.2× |
| Left heart catheterization (93452) |
$3,234.30 |
$10,781 |
1.1× |
| Sleep study (attended polysomnography) (95810) |
$2,053.20 |
$6,844 |
2.6× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$36.90 |
$123 |
1.3× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$76.50 |
$255 |
0.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$80.40 |
$268 |
0.7× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$128.10 |
$427 |
1.1× |