| Psychotherapy 30 minutes | CPT 90832 | $154.8 |
| Psychotherapy 45 minutes | CPT 90834 | $207 |
| Psychotherapy 60 minutes | CPT 90837 | $309.6 |
| CT head without contrast | CPT 70450 | $2,112.3 |
| CT head with contrast | CPT 70460 | $789 |
| CT head with and without contrast | CPT 70470 | $789 |
| CT neck with contrast | CPT 70491 | $789 |
| MRI brain without contrast | CPT 70551 | $3,565.8 |
| MRI brain with and without contrast | CPT 70553 | $1,136 |
| Chest X-ray single view | CPT 71045 | $442.8 |
| Chest X-ray 2 views | CPT 71046 | $721.8 |
| Chest X-ray 3 views | CPT 71047 | $721.8 |
| CT chest without contrast | CPT 71250 | $789 |
| CT chest with contrast | CPT 71260 | $789 |
| Lumbosacral spine X-ray | CPT 72100 | $1,398.6 |
| CT cervical spine without contrast | CPT 72125 | $789 |
| CT thoracic spine without contrast | CPT 72128 | $789 |
| CT lumbar spine without contrast | CPT 72131 | $789 |
| MRI cervical spine without contrast | CPT 72141 | $1,136 |
| MRI thoracic spine without contrast | CPT 72146 | $1,136 |
| MRI lumbar spine without contrast | CPT 72148 | $1,136 |
| MRI lumbar spine with and without contrast | CPT 72149 | $1,136 |
| MRI cervical spine with and without contrast | CPT 72156 | $1,136 |
| MRI lumbar spine with contrast | CPT 72158 | $1,136 |
| CT pelvis without contrast | CPT 72192 | $789 |
| CT pelvis with contrast | CPT 72193 | $789 |
| Shoulder X-ray | CPT 73030 | $1,222.2 |
| Humerus X-ray | CPT 73060 | $668.7 |
| Hand X-ray 3 views | CPT 73130 | $1,133.1 |
| MRI upper extremity joint without contrast | CPT 73221 | $1,136 |
| Knee X-ray 1-2 views | CPT 73560 | $504 |
| Ankle X-ray 3 views | CPT 73610 | $951.3 |
| MRI lower extremity joint without contrast | CPT 73721 | $3,565.8 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $1,136 |
| CT abdomen without contrast | CPT 74150 | $789 |
| CT abdomen with contrast | CPT 74160 | $789 |
| CT abdomen with and without contrast | CPT 74170 | $789 |
| CT abdomen and pelvis without contrast | CPT 74176 | $789 |
| CT abdomen and pelvis with contrast | CPT 74177 | $789 |
| MRI abdomen without contrast | CPT 74181 | $1,136 |
| MRI abdomen with and without contrast | CPT 74183 | $1,136 |
| Abdominal ultrasound complete | CPT 76700 | $2,706.3 |
| Abdominal ultrasound limited | CPT 76705 | $1,035 |
| Retroperitoneal ultrasound complete | CPT 76770 | $1,012.5 |
| Obstetric ultrasound first trimester | CPT 76801 | $1,756.8 |
| Transvaginal ultrasound | CPT 76830 | $2,517.3 |
| Pelvic ultrasound complete | CPT 76856 | $2,517.3 |
| Scrotal ultrasound | CPT 76870 | $1,505.7 |
| EKG tracing only | CPT 93005 | $26.1 |
| Basic metabolic panel (BMP) | CPT 80048 | $57.6 |
| Electrolyte panel | CPT 80051 | $50.4 |
| Comprehensive metabolic panel | CPT 80053 | $71.1 |
| Lipid panel | CPT 80061 | $74.7 |
| Renal function panel | CPT 80069 | $48.6 |
| Hepatic function panel | CPT 80076 | $86.4 |
| Urinalysis non-automated | CPT 81002 | $23.4 |
| Urinalysis automated | CPT 81003 | $36.9 |
| Glucose quantitative | CPT 82947 | $29.7 |
| Hemoglobin A1c | CPT 83036 | $75.6 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $96.3 |
| Complete blood count with automated differential | CPT 85025 | $164.7 |
| Complete blood count without differential | CPT 85027 | $57.6 |
| Urine culture bacterial | CPT 87086 | $32.4 |
