| Psychotherapy 30 minutes | CPT 90832 | $505.51 |
| Psychotherapy 45 minutes | CPT 90834 | $327.25 |
| Psychotherapy 60 minutes | CPT 90837 | $852.72 |
| ED visit level 1 | CPT 99281 | $859.95 |
| ED visit level 2 | CPT 99282 | $417.45 |
| ED visit level 3 | CPT 99283 | $598.23 |
| ED visit level 4 | CPT 99284 | $2,204.41 |
| ED visit level 5 | CPT 99285 | $3,083.1 |
| Critical care, first hour | CPT 99291 | $1,720.4 |
| CT head without contrast | CPT 70450 | $2,109.1 |
| CT head with contrast | CPT 70460 | $2,142.69 |
| CT head with and without contrast | CPT 70470 | $2,575.01 |
| CT neck with contrast | CPT 70491 | $1,703.03 |
| MRI brain without contrast | CPT 70551 | $1,599.2 |
| MRI brain with contrast | CPT 70552 | $1,758.62 |
| MRI brain with and without contrast | CPT 70553 | $2,194.02 |
| Chest X-ray single view | CPT 71045 | $446.86 |
| Chest X-ray 2 views | CPT 71046 | $761.89 |
| Chest X-ray 3 views | CPT 71047 | $838.7 |
| CT chest without contrast | CPT 71250 | $1,207.02 |
| CT chest with contrast | CPT 71260 | $1,567.93 |
| CT chest with and without contrast | CPT 71270 | $1,709.21 |
| MRI chest without contrast | CPT 71550 | $2,558.79 |
| MRI chest with and without contrast | CPT 71552 | $2,427.55 |
| Lumbosacral spine X-ray | CPT 72100 | $761.89 |
| CT cervical spine without contrast | CPT 72125 | $1,911.09 |
| CT thoracic spine without contrast | CPT 72128 | $1,494.59 |
| CT lumbar spine without contrast | CPT 72131 | $1,484.94 |
| MRI cervical spine without contrast | CPT 72141 | $1,613.87 |
| MRI thoracic spine without contrast | CPT 72146 | $1,753.6 |
| MRI lumbar spine without contrast | CPT 72148 | $1,775.6 |
| MRI lumbar spine with and without contrast | CPT 72149 | $2,366.95 |
| MRI cervical spine with and without contrast | CPT 72156 | $2,678.84 |
| MRI lumbar spine with contrast | CPT 72158 | $2,820.12 |
| CT pelvis without contrast | CPT 72192 | $1,056.1 |
| CT pelvis with contrast | CPT 72193 | $1,501.54 |
| Shoulder X-ray | CPT 73030 | $933.15 |
| Humerus X-ray | CPT 73060 | $1,112.48 |
| Hand X-ray 3 views | CPT 73130 | $1,212.12 |
| MRI upper extremity joint without contrast | CPT 73221 | $2,685.98 |
| MRI upper extremity joint with and without contrast | CPT 73223 | $2,246.91 |
| Knee X-ray 1-2 views | CPT 73560 | $1,024.51 |
| Ankle X-ray 3 views | CPT 73610 | $1,187.21 |
| MRI lower extremity joint without contrast | CPT 73721 | $3,308.99 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $4,190.22 |
| CT abdomen without contrast | CPT 74150 | $1,303.91 |
| CT abdomen with contrast | CPT 74160 | $1,439.78 |
| CT abdomen with and without contrast | CPT 74170 | $1,897.19 |
| CT abdomen and pelvis without contrast | CPT 74176 | $2,622.48 |
| CT abdomen and pelvis with contrast | CPT 74177 | $2,939.78 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $3,589.03 |
| MRI abdomen without contrast | CPT 74181 | $1,735.07 |
| MRI abdomen with and without contrast | CPT 74183 | $2,583.11 |
| Abdominal ultrasound complete | CPT 76700 | $1,042.59 |
| Abdominal ultrasound limited | CPT 76705 | $802.11 |
| Retroperitoneal ultrasound complete | CPT 76770 | $1,003.99 |
| Obstetric ultrasound first trimester | CPT 76801 | $1,000.63 |
| Obstetric ultrasound after first trimester | CPT 76805 | $1,307.36 |
| Obstetric ultrasound with fetal anatomy | CPT 76811 | $1,750.59 |
| Transvaginal ultrasound | CPT 76830 | $1,074.33 |
| Pelvic ultrasound complete | CPT 76856 | $921.77 |
| Scrotal ultrasound | CPT 76870 | $787.83 |
| Diagnostic mammography unilateral | CPT 77065 | $540.17 |
| Diagnostic mammography bilateral | CPT 77066 | $709.43 |
| Screening mammography bilateral | CPT 77067 | $645.25 |
| EKG tracing only | CPT 93005 | $508.62 |
| Transthoracic echocardiogram complete | CPT 93306 | $2,802.6 |
| Transthoracic echocardiogram | CPT 93307 | $1,409.09 |
| Stress echocardiogram | CPT 93350 | $3,153.44 |
| Basic metabolic panel (BMP) | CPT 80048 | $373.18 |
| General health panel | CPT 80050 | $505.43 |
| Electrolyte panel | CPT 80051 | $281.73 |
| Comprehensive metabolic panel | CPT 80053 | $399.3 |
| Lipid panel | CPT 80061 | $332.28 |
| Renal function panel | CPT 80069 | $375.45 |
| Hepatic function panel | CPT 80076 | $168.13 |
| Urinalysis non-automated | CPT 81002 | $131.78 |
| Urinalysis automated | CPT 81003 | $118.14 |
| Glucose quantitative | CPT 82947 | $202.21 |
| Hemoglobin A1c | CPT 83036 | $73.63 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $563.46 |
| Complete blood count with automated differential | CPT 85025 | $350.46 |
| Complete blood count without differential | CPT 85027 | $247.08 |
| Urine culture bacterial | CPT 87086 | $137.46 |
| Urine culture identification | CPT 87088 | $141.43 |
| Tissue exam by pathologist level IV | CPT 88305 | $738.4 |
| Fetal non-stress test | CPT 59025 | $398.07 |
| Office visit, established patient, 5 min | CPT 99211 | $448.2 |
| Upper GI endoscopy diagnostic | CPT 43235 | $2,187.08 |
| Upper GI endoscopy with biopsy | CPT 43239 | $2,212.17 |
| Sigmoidoscopy diagnostic | CPT 45330 | $1,305.45 |
| Sigmoidoscopy with biopsy | CPT 45331 | $1,393.07 |
| Colonoscopy diagnostic | CPT 45378 | $1,832.73 |
| Colonoscopy with biopsy | CPT 45380 | $2,239.96 |
| Colonoscopy with polyp removal | CPT 45385 | $2,239.96 |
| PCI single major coronary artery | CPT 92920 | $12,421 |
| PCI with drug-eluting stent | CPT 92928 | $18,018 |
| PCI bypass graft | CPT 92937 | $18,018 |
| Left heart catheterization | CPT 93452 | $5,247.95 |
| Coronary angiography with cath | CPT 93455 | $11,394 |
| Coronary angiography with bypass cath | CPT 93458 | $12,348 |
