| ED visit level 1 | CPT 99281 | $237.73 |
| ED visit level 2 | CPT 99282 | $427.57 |
| ED visit level 3 | CPT 99283 | $747.6 |
| ED visit level 4 | CPT 99284 | $1,149.71 |
| ED visit level 5 | CPT 99285 | $1,655.37 |
| Critical care, first hour | CPT 99291 | $2,275.05 |
| CT head without contrast | CPT 70450 | $953.23 |
| CT head with contrast | CPT 70460 | $1,011.6 |
| CT head with and without contrast | CPT 70470 | $1,260 |
| CT neck with contrast | CPT 70491 | $1,365.3 |
| MRI brain without contrast | CPT 70551 | $1,342.8 |
| MRI brain with and without contrast | CPT 70553 | $3,457.93 |
| Chest X-ray single view | CPT 71045 | $94.18 |
| Chest X-ray 2 views | CPT 71046 | $130.41 |
| CT chest without contrast | CPT 71250 | $1,223.37 |
| CT chest with contrast | CPT 71260 | $1,580.44 |
| CT chest with and without contrast | CPT 71270 | $1,692.9 |
| MRI chest without contrast | CPT 71550 | $2,978.1 |
| MRI chest with and without contrast | CPT 71552 | $4,060.8 |
| Lumbosacral spine X-ray | CPT 72100 | $139.5 |
| CT cervical spine without contrast | CPT 72125 | $1,342.39 |
| CT thoracic spine without contrast | CPT 72128 | $1,163.7 |
| CT lumbar spine without contrast | CPT 72131 | $1,332.05 |
| MRI cervical spine without contrast | CPT 72141 | $2,053.44 |
| MRI thoracic spine without contrast | CPT 72146 | $1,905.3 |
| MRI lumbar spine without contrast | CPT 72148 | $2,191.09 |
| MRI cervical spine with and without contrast | CPT 72156 | $2,953.8 |
| MRI lumbar spine with contrast | CPT 72158 | $2,949.3 |
| CT pelvis without contrast | CPT 72192 | $1,028.7 |
| CT pelvis with contrast | CPT 72193 | $1,781.1 |
| Shoulder X-ray | CPT 73030 | $122.4 |
| Humerus X-ray | CPT 73060 | $117 |
| Hand X-ray 3 views | CPT 73130 | $135.9 |
| MRI upper extremity joint without contrast | CPT 73221 | $2,214.9 |
| MRI upper extremity joint with and without contrast | CPT 73223 | $3,125.7 |
| Knee X-ray 1-2 views | CPT 73560 | $127.8 |
| Ankle X-ray 3 views | CPT 73610 | $136.8 |
| MRI lower extremity joint without contrast | CPT 73721 | $2,270.79 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $3,159.9 |
| CT abdomen without contrast | CPT 74150 | $996.3 |
| CT abdomen with contrast | CPT 74160 | $1,773.9 |
| CT abdomen with and without contrast | CPT 74170 | $2,010.6 |
| CT abdomen and pelvis without contrast | CPT 74176 | $1,195.42 |
| CT abdomen and pelvis with contrast | CPT 74177 | $2,596.82 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $2,935.26 |
| MRI abdomen without contrast | CPT 74181 | $1,374.3 |
| Abdominal ultrasound complete | CPT 76700 | $443.7 |
| Abdominal ultrasound limited | CPT 76705 | $341.1 |
| Retroperitoneal ultrasound complete | CPT 76770 | $434.7 |
| Obstetric ultrasound first trimester | CPT 76801 | $360 |
| Obstetric ultrasound after first trimester | CPT 76805 | $454.5 |
| Transvaginal ultrasound | CPT 76830 | $442.8 |
| Pelvic ultrasound complete | CPT 76856 | $399.6 |
| Scrotal ultrasound | CPT 76870 | $404.1 |
| Diagnostic mammography unilateral | CPT 77065 | $449.1 |
| Diagnostic mammography bilateral | CPT 77066 | $574.2 |
| Screening mammography bilateral | CPT 77067 | $474.3 |
| EKG tracing only | CPT 93005 | $66.83 |
| Transthoracic echocardiogram complete | CPT 93306 | $746.24 |
| Basic metabolic panel (BMP) | CPT 80048 | $76.14 |
| General health panel | CPT 80050 | $201.6 |
| Electrolyte panel | CPT 80051 | $44.1 |
| Comprehensive metabolic panel | CPT 80053 | $95.04 |
| Lipid panel | CPT 80061 | $120.51 |
| Renal function panel | CPT 80069 | $55.8 |
| Hepatic function panel | CPT 80076 | $52.2 |
| Urinalysis non-automated | CPT 81002 | $20.7 |
| Urinalysis automated | CPT 81003 | $15.3 |
| Glucose quantitative | CPT 82947 | $26.1 |
| Hemoglobin A1c | CPT 83036 | $87.39 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $151.2 |
| Complete blood count with automated differential | CPT 85025 | $69.93 |
| Complete blood count without differential | CPT 85027 | $40.5 |
| Urine culture bacterial | CPT 87086 | $72.63 |
| Urine culture identification | CPT 87088 | $52.2 |
| Tissue exam by pathologist level IV | CPT 88305 | $195.3 |
| Vaginal delivery only | CPT 59409 | $4,824.9 |
| Office visit, established patient, 5 min | CPT 99211 | $44.1 |
