| ED visit level 1 | CPT 99281 | $49.3 |
| ED visit level 2 | CPT 99282 | $96.9 |
| ED visit level 3 | CPT 99283 | $141.1 |
| ED visit level 4 | CPT 99284 | $259.25 |
| ED visit level 5 | CPT 99285 | $377.4 |
| Critical care, first hour | CPT 99291 | $608.6 |
| CT head without contrast | CPT 70450 | $780.3 |
| CT neck with contrast | CPT 70491 | $998.75 |
| MRI brain without contrast | CPT 70551 | $1,437.35 |
| MRI brain with and without contrast | CPT 70553 | $2,356.2 |
| Chest X-ray single view | CPT 71045 | $91.8 |
| Chest X-ray 2 views | CPT 71046 | $113.05 |
| Chest X-ray 3 views | CPT 71047 | $107.1 |
| CT chest without contrast | CPT 71250 | $980.9 |
| CT chest with contrast | CPT 71260 | $1,225.7 |
| CT chest with and without contrast | CPT 71270 | $1,539.35 |
| MRI chest without contrast | CPT 71550 | $1,668.55 |
| Lumbosacral spine X-ray | CPT 72100 | $130.9 |
| CT cervical spine without contrast | CPT 72125 | $1,076.1 |
| CT thoracic spine without contrast | CPT 72128 | $833 |
| CT lumbar spine without contrast | CPT 72131 | $1,004.7 |
| MRI cervical spine without contrast | CPT 72141 | $1,786.7 |
| MRI thoracic spine without contrast | CPT 72146 | $1,370.2 |
| MRI lumbar spine without contrast | CPT 72148 | $1,841.95 |
| MRI cervical spine with and without contrast | CPT 72156 | $2,144.55 |
| MRI lumbar spine with contrast | CPT 72158 | $2,154.75 |
| CT pelvis without contrast | CPT 72192 | $696.15 |
| CT pelvis with contrast | CPT 72193 | $1,611.6 |
| Shoulder X-ray | CPT 73030 | $111.35 |
| Humerus X-ray | CPT 73060 | $101.15 |
| Hand X-ray 3 views | CPT 73130 | $124.1 |
| MRI upper extremity joint without contrast | CPT 73221 | $2,023 |
| MRI upper extremity joint with and without contrast | CPT 73223 | $2,306.05 |
| Hip X-ray 2 views | CPT 73510 | $83.3 |
| Knee X-ray 1-2 views | CPT 73560 | $115.6 |
| Ankle X-ray 3 views | CPT 73610 | $125.8 |
| MRI lower extremity joint without contrast | CPT 73721 | $2,084.2 |
| CT abdomen without contrast | CPT 74150 | $600.1 |
| CT abdomen with contrast | CPT 74160 | $884 |
| CT abdomen with and without contrast | CPT 74170 | $1,198.5 |
| CT abdomen and pelvis without contrast | CPT 74176 | $1,187.45 |
| CT abdomen and pelvis with contrast | CPT 74177 | $2,006 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $2,302.65 |
| MRI abdomen with and without contrast | CPT 74183 | $1,961.8 |
| Abdominal ultrasound complete | CPT 76700 | $470.05 |
| Abdominal ultrasound limited | CPT 76705 | $276.25 |
| Retroperitoneal ultrasound complete | CPT 76770 | $427.55 |
| Transvaginal ultrasound | CPT 76830 | $278.8 |
| Pelvic ultrasound complete | CPT 76856 | $393.55 |
| Scrotal ultrasound | CPT 76870 | $335.75 |
| Diagnostic mammography unilateral | CPT 77065 | $362.95 |
| Diagnostic mammography bilateral | CPT 77066 | $478.55 |
| Screening mammography bilateral | CPT 77067 | $368.9 |
| EKG tracing only | CPT 93005 | $113.05 |
| EKG interpretation only | CPT 93010 | $22.1 |
| Transthoracic echocardiogram complete | CPT 93306 | $583.1 |
| Transthoracic echocardiogram | CPT 93307 | $238 |
| Initial hospital care, low complexity | CPT 99221 | $127.5 |
| Initial hospital care, moderate complexity | CPT 99222 | $245.65 |
| Hospital discharge, <30 min | CPT 99238 | $157.25 |
| Electrolyte panel | CPT 80051 | $65.45 |
| Glucose quantitative | CPT 82947 | $39.1 |
| Vaginal delivery only | CPT 59409 | $2,712.35 |
| Office visit, established patient, 5 min | CPT 99211 | $96.9 |
| Total shoulder arthroplasty | CPT 23472 | $85 |
| Total hip replacement | CPT 27130 | $85 |
| Total knee replacement | CPT 27447 | $85 |
