| Critical care, first hour | CPT 99291 | $3,349.97 |
| CT head without contrast | CPT 70450 | $2,993.59 |
| CT head with contrast | CPT 70460 | $4,625.21 |
| CT head with and without contrast | CPT 70470 | $5,149.90 |
| CT neck with contrast | CPT 70491 | $629.38 |
| MRI brain without contrast | CPT 70551 | $5,293.28 |
| MRI brain with contrast | CPT 70552 | $3,505.01 |
| MRI brain with and without contrast | CPT 70553 | $8,532.86 |
| Chest X-ray single view | CPT 71045 | $259.01 |
| Chest X-ray 2 views | CPT 71046 | $461.55 |
| CT chest without contrast | CPT 71250 | $785.46 |
| CT chest with contrast | CPT 71260 | $4,625.21 |
| CT chest with and without contrast | CPT 71270 | $5,152.01 |
| Lumbosacral spine X-ray | CPT 72100 | $417.68 |
| CT cervical spine without contrast | CPT 72125 | $2,993.59 |
| CT thoracic spine without contrast | CPT 72128 | $3,106.54 |
| CT lumbar spine without contrast | CPT 72131 | $2,993.59 |
| MRI cervical spine without contrast | CPT 72141 | $5,293.28 |
| MRI thoracic spine without contrast | CPT 72146 | $5,293.28 |
| MRI lumbar spine without contrast | CPT 72148 | $5,493.00 |
| MRI lumbar spine with and without contrast | CPT 72149 | $5,493.00 |
| MRI cervical spine with and without contrast | CPT 72156 | $8,222.55 |
| MRI lumbar spine with contrast | CPT 72158 | $8,532.86 |
| CT pelvis without contrast | CPT 72192 | $2,993.59 |
| CT pelvis with contrast | CPT 72193 | $4,625.21 |
| Shoulder X-ray | CPT 73030 | $638.96 |
| Humerus X-ray | CPT 73060 | $322.24 |
| Hand X-ray 3 views | CPT 73130 | $303.08 |
| Knee X-ray 1-2 views | CPT 73560 | $265.73 |
| Ankle X-ray 3 views | CPT 73610 | $177.30 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $1,310.21 |
| CT abdomen without contrast | CPT 74150 | $2,993.59 |
| CT abdomen with contrast | CPT 74160 | $4,625.21 |
| CT abdomen with and without contrast | CPT 74170 | $5,152.01 |
| CT abdomen and pelvis without contrast | CPT 74176 | $4,659.79 |
| CT abdomen and pelvis with contrast | CPT 74177 | $7,199.59 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $8,019.53 |
| MRI abdomen without contrast | CPT 74181 | $5,493.00 |
| Abdominal ultrasound complete | CPT 76700 | $949.28 |
| Abdominal ultrasound limited | CPT 76705 | $852.79 |
| Retroperitoneal ultrasound complete | CPT 76770 | $857.03 |
| Pelvic ultrasound complete | CPT 76856 | $985.09 |
| Scrotal ultrasound | CPT 76870 | $375.11 |
| EKG tracing only | CPT 93005 | $293.03 |
| Transthoracic echocardiogram complete | CPT 93306 | $926.70 |
| Transthoracic echocardiogram | CPT 93307 | $926.70 |
| Basic metabolic panel (BMP) | CPT 80048 | $377.14 |
| Comprehensive metabolic panel | CPT 80053 | $491.85 |
| Lipid panel | CPT 80061 | $196.76 |
| Renal function panel | CPT 80069 | $480.56 |
| Hepatic function panel | CPT 80076 | $315.00 |
| Urinalysis automated | CPT 81003 | $65.81 |
| Hemoglobin A1c | CPT 83036 | $123.53 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $184.54 |
| Complete blood count with automated differential | CPT 85025 | $107.40 |
| Complete blood count without differential | CPT 85027 | $117.26 |
| Urine culture bacterial | CPT 87086 | $193.99 |
| Urine culture identification | CPT 87088 | $224.33 |
| Tissue exam by pathologist level IV | CPT 88305 | $239.40 |
| Upper GI endoscopy diagnostic | CPT 43235 | $3,591.38 |
| Upper GI endoscopy with biopsy | CPT 43239 | $1,877.58 |
| Colonoscopy diagnostic | CPT 45378 | $3,420.41 |
