| ED visit level 1 | CPT 99281 | $196.3 |
| ED visit level 2 | CPT 99282 | $260.97 |
| ED visit level 3 | CPT 99283 | $466.51 |
| ED visit level 4 | CPT 99284 | $709 |
| ED visit level 5 | CPT 99285 | $1,038.1 |
| Critical care, first hour | CPT 99291 | $1,274.82 |
| CT head without contrast | CPT 70450 | $1,806 |
| CT head with contrast | CPT 70460 | $2,468.81 |
| CT head with and without contrast | CPT 70470 | $2,968.81 |
| CT neck with contrast | CPT 70491 | $3,290.98 |
| MRI brain without contrast | CPT 70551 | $3,197.45 |
| MRI brain with contrast | CPT 70552 | $3,397.22 |
| MRI brain with and without contrast | CPT 70553 | $3,872.97 |
| Chest X-ray single view | CPT 71045 | $259.81 |
| Chest X-ray 2 views | CPT 71046 | $337.18 |
| Chest X-ray 3 views | CPT 71047 | $427.25 |
| CT chest without contrast | CPT 71250 | $2,508.08 |
| CT chest with contrast | CPT 71260 | $2,796.76 |
| CT chest with and without contrast | CPT 71270 | $3,099.3 |
| MRI chest without contrast | CPT 71550 | $3,053.11 |
| MRI chest with contrast | CPT 71551 | $3,452.65 |
| MRI chest with and without contrast | CPT 71552 | $4,344.1 |
| Lumbosacral spine X-ray | CPT 72100 | $548.5 |
| CT cervical spine without contrast | CPT 72125 | $2,598.14 |
| CT thoracic spine without contrast | CPT 72128 | $2,802.53 |
| CT lumbar spine without contrast | CPT 72131 | $2,792.14 |
| MRI cervical spine without contrast | CPT 72141 | $2,758.65 |
| MRI thoracic spine without contrast | CPT 72146 | $2,758.65 |
| MRI lumbar spine without contrast | CPT 72148 | $2,724.01 |
| MRI lumbar spine with and without contrast | CPT 72149 | $2,900.68 |
| MRI cervical spine with and without contrast | CPT 72156 | $3,733.25 |
| MRI lumbar spine with contrast | CPT 72158 | $3,712.46 |
| CT pelvis without contrast | CPT 72192 | $2,203.23 |
| CT pelvis with contrast | CPT 72193 | $3,448.03 |
| Shoulder X-ray | CPT 73030 | $346.42 |
| Humerus X-ray | CPT 73060 | $323.32 |
| Hand X-ray 3 views | CPT 73130 | $366.05 |
| MRI upper extremity joint without contrast | CPT 73221 | $2,588.91 |
| MRI upper extremity joint with and without contrast | CPT 73223 | $3,017.31 |
| Knee X-ray 1-2 views | CPT 73560 | $342.96 |
| Ankle X-ray 3 views | CPT 73610 | $374.13 |
| MRI lower extremity joint without contrast | CPT 73721 | $2,872.97 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $3,551.95 |
| CT abdomen without contrast | CPT 74150 | $2,252.88 |
| CT abdomen with contrast | CPT 74160 | $2,804.84 |
| CT abdomen with and without contrast | CPT 74170 | $3,314.08 |
| CT abdomen and pelvis without contrast | CPT 74176 | $3,155.88 |
| CT abdomen and pelvis with contrast | CPT 74177 | $3,579.67 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $4,272.5 |
| MRI abdomen without contrast | CPT 74181 | $2,840.64 |
| MRI abdomen with and without contrast | CPT 74183 | $3,384.52 |
| Abdominal ultrasound complete | CPT 76700 | $1,064.66 |
| Abdominal ultrasound limited | CPT 76705 | $915.7 |
| Retroperitoneal ultrasound complete | CPT 76770 | $924.94 |
| Obstetric ultrasound first trimester | CPT 76801 | $825.63 |
| Obstetric ultrasound after first trimester | CPT 76805 | $966.51 |
| Transvaginal ultrasound | CPT 76830 | $839.49 |
| Pelvic ultrasound complete | CPT 76856 | $956.12 |
| Scrotal ultrasound | CPT 76870 | $876.44 |
| EKG complete | CPT 93000 | $265.59 |
| EKG tracing only | CPT 93005 | $184.76 |
| EKG interpretation only | CPT 93010 | $80.83 |
| Initial hospital care, low complexity | CPT 99221 | $234.41 |
| Initial hospital care, moderate complexity | CPT 99222 | $383.37 |
| Initial hospital care, high complexity | CPT 99223 | $533.49 |
| Hospital discharge, <30 min | CPT 99238 | $386.83 |
| Hospital discharge, >30 min | CPT 99239 | $315.24 |
| Basic metabolic panel (BMP) | CPT 80048 | $148.96 |
| General health panel | CPT 80050 | $323.32 |
| Electrolyte panel | CPT 80051 | $91.22 |
| Comprehensive metabolic panel | CPT 80053 | $34.07 |
| Lipid panel | CPT 80061 | $34.07 |
| Renal function panel | CPT 80069 | $155.89 |
| Hepatic function panel | CPT 80076 | $110.85 |
| Urinalysis non-automated | CPT 81002 | $33.49 |
| Urinalysis automated | CPT 81003 | $36.95 |
| Glucose quantitative | CPT 82947 | $63.51 |
| Hemoglobin A1c | CPT 83036 | $99.31 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $176.67 |
| Complete blood count with automated differential | CPT 85025 | $118.94 |
| Complete blood count without differential | CPT 85027 | $98.15 |
| Urine culture bacterial | CPT 87086 | $83.14 |
| Urine culture identification | CPT 87088 | $99.31 |
| Tissue exam by pathologist level IV | CPT 88305 | $103.93 |
| Vaginal delivery only | CPT 59409 | $2,909.92 |
| Vaginal delivery with postpartum | CPT 59410 | $3,725.16 |
| Office visit, established patient, 5 min | CPT 99211 | $135.1 |
