| CT head without contrast | CPT 70450 | $1,713.8 |
| CT head with contrast | CPT 70460 | $2,314.2 |
| CT head with and without contrast | CPT 70470 | $2,570.7 |
| CT neck with contrast | CPT 70491 | $2,297.1 |
| MRI brain without contrast | CPT 70551 | $3,016.25 |
| MRI brain with and without contrast | CPT 70553 | $4,370.95 |
| Chest X-ray single view | CPT 71045 | $3.8 |
| Chest X-ray 2 views | CPT 71046 | $233.7 |
| CT chest without contrast | CPT 71250 | $1,938 |
| CT chest with contrast | CPT 71260 | $2,584.95 |
| CT chest with and without contrast | CPT 71270 | $3,153.05 |
| MRI chest without contrast | CPT 71550 | $3,340.2 |
| Lumbosacral spine X-ray | CPT 72100 | $295.45 |
| CT cervical spine without contrast | CPT 72125 | $2,408.25 |
| CT thoracic spine without contrast | CPT 72128 | $2,016.85 |
| CT lumbar spine without contrast | CPT 72131 | $2,016.85 |
| MRI cervical spine without contrast | CPT 72141 | $3,157.8 |
| MRI thoracic spine without contrast | CPT 72146 | $3,000.1 |
| MRI lumbar spine without contrast | CPT 72148 | $2,987.75 |
| MRI lumbar spine with and without contrast | CPT 72149 | $3,161.6 |
| MRI cervical spine with and without contrast | CPT 72156 | $5,337.1 |
| MRI lumbar spine with contrast | CPT 72158 | $5,338.05 |
| CT pelvis without contrast | CPT 72192 | $2,968.75 |
| CT pelvis with contrast | CPT 72193 | $2,915.55 |
| MRI upper extremity joint without contrast | CPT 73221 | $2,641 |
| MRI upper extremity joint with and without contrast | CPT 73223 | $3,169.2 |
| MRI lower extremity joint without contrast | CPT 73721 | $3,569.15 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $4,149.6 |
| CT abdomen without contrast | CPT 74150 | $2,915.55 |
| CT abdomen with contrast | CPT 74160 | $2,338.9 |
| CT abdomen with and without contrast | CPT 74170 | $5,659.15 |
| CT abdomen and pelvis without contrast | CPT 74176 | $2,132.75 |
| CT abdomen and pelvis with contrast | CPT 74177 | $4,264.55 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $4,862.1 |
| MRI abdomen without contrast | CPT 74181 | $3,026.7 |
| MRI abdomen with and without contrast | CPT 74183 | $5,820.65 |
| Abdominal ultrasound complete | CPT 76700 | $836.95 |
| Abdominal ultrasound limited | CPT 76705 | $527.25 |
| Retroperitoneal ultrasound complete | CPT 76770 | $701.1 |
| Obstetric ultrasound first trimester | CPT 76801 | $686.85 |
| Obstetric ultrasound after first trimester | CPT 76805 | $745.75 |
| Transvaginal ultrasound | CPT 76830 | $629.85 |
| Pelvic ultrasound complete | CPT 76856 | $629.85 |
| Scrotal ultrasound | CPT 76870 | $546.25 |
| Diagnostic mammography bilateral | CPT 77066 | $592.8 |
| Screening mammography bilateral | CPT 77067 | $701.1 |
| EKG tracing only | CPT 93005 | $256.5 |
| Transthoracic echocardiogram complete | CPT 93306 | $1,163.75 |
| Transthoracic echocardiogram | CPT 93307 | $950 |
| Basic metabolic panel (BMP) | CPT 80048 | $199.5 |
| Electrolyte panel | CPT 80051 | $105.45 |
| Comprehensive metabolic panel | CPT 80053 | $235.6 |
| Lipid panel | CPT 80061 | $170.05 |
| Renal function panel | CPT 80069 | $104.5 |
| Hepatic function panel | CPT 80076 | $127.3 |
| Urinalysis automated | CPT 81003 | $63.65 |
| Glucose quantitative | CPT 82947 | $56.05 |
| Hemoglobin A1c | CPT 83036 | $124.45 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $47.88 |
| Complete blood count with automated differential | CPT 85025 | $98.8 |
| Complete blood count without differential | CPT 85027 | $83.6 |
| Urine culture bacterial | CPT 87086 | $102.6 |
| Urine culture identification | CPT 87088 | $108.3 |
| Tissue exam by pathologist level IV | CPT 88305 | $147.15 |
| Total shoulder arthroplasty | CPT 23472 | $89 |
| Total hip replacement | CPT 27130 | $89 |
| Total knee replacement | CPT 27447 | $89 |
