| CT head/brain without contrast (70450) |
$742 |
$1,060 |
7.9× |
| MRI brain without contrast (70551) |
$1,666 |
$2,380 |
7.7× |
| MRI brain with contrast (70552) |
$1,974 |
$2,820 |
6.3× |
| MRI brain without and with contrast (70553) |
$2,737 |
$3,910 |
8.7× |
| X-ray lower spine, 4+ views (72110) |
$196 |
$280 |
2.1× |
| MRI lumbar spine without contrast (72148) |
$1,771 |
$2,530 |
8.2× |
| CT pelvis with contrast (72193) |
$1,092 |
$1,560 |
6.9× |
| MRI lower-extremity joint without contrast (73721) |
$1,722 |
$2,460 |
8.0× |
| CT abdomen and pelvis with contrast (74177) |
$1,778 |
$2,540 |
5.6× |
| Ultrasound, abdomen complete (76700) |
$441 |
$630 |
4.7× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$490 |
$700 |
5.2× |
| Ultrasound, transvaginal (76830) |
$420 |
$600 |
4.5× |
| Mammography, one breast (diagnostic) (77065) |
$25.20 |
$36 |
0.3× |
| Mammography, both breasts (diagnostic) (77066) |
$25.20 |
$36 |
0.2× |
| Mammography, screening (bilateral) (77067) |
$462 |
$660 |
5.1× |
| Basic metabolic panel (80048) |
$103.25 |
$147.50 |
12.2× |
| Comprehensive metabolic panel (80053) |
$117.60 |
$168 |
11.1× |
| Obstetric panel (80055) |
$140 |
$200 |
2.9× |
| Lipid panel (80061) |
$44.80 |
$64 |
3.3× |
| Renal function panel (80069) |
$110.25 |
$157.50 |
12.7× |
| Hepatic function panel (80076) |
$91.35 |
$130.50 |
11.2× |
| Urinalysis, non-automated, with microscopy (81000) |
$16.80 |
$24 |
4.2× |
| Urinalysis, non-automated, without microscopy (81002) |
$16.80 |
$24 |
4.8× |
| PSA, total (84153) |
$54.60 |
$78 |
3.0× |
| Thyroid stimulating hormone (TSH) (84443) |
$58.80 |
$84 |
3.5× |
| CBC with automated differential (85025) |
$32.90 |
$47 |
4.2× |
| CBC, automated (85027) |
$32.90 |
$47 |
5.1× |
| Prothrombin time (PT) (85610) |
$28 |
$40 |
6.5× |
| Partial thromboplastin time (PTT) (85730) |
$35 |
$50 |
5.8× |
| Psychotherapy, 30 minutes (90832) |
$101.15 |
$144.50 |
0.6× |
| Psychotherapy, 45 minutes (90834) |
$127.40 |
$182 |
0.8× |
| Psychotherapy, 60 minutes (90837) |
$175 |
$250 |
1.1× |
| Family psychotherapy, without patient (50 min) (90846) |
$191.45 |
$273.50 |
1.2× |
| Family psychotherapy, with patient (50 min) (90847) |
$191.45 |
$273.50 |
1.2× |
| Group psychotherapy (90853) |
$95.60 |
$136.58 |
1.0× |
| Sleep study (attended polysomnography) (95810) |
$1,167.10 |
$1,667.28 |
1.5× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$64.07 |
$91.53 |
2.2× |