| ED visit level 1 | CPT 99281 | $319.69 |
| Critical care, first hour | CPT 99291 | $3,461.64 |
| CT head without contrast | CPT 70450 | $2,763.5 |
| CT head with contrast | CPT 70460 | $4,269.75 |
| CT head with and without contrast | CPT 70470 | $4,756.02 |
| CT neck with contrast | CPT 70491 | $4,269.75 |
| MRI brain without contrast | CPT 70551 | $4,886.46 |
| MRI brain with contrast | CPT 70552 | $3,117.98 |
| MRI brain with and without contrast | CPT 70553 | $7,590.62 |
| Chest X-ray single view | CPT 71045 | $239.09 |
| Chest X-ray 2 views | CPT 71046 | $426.06 |
| Chest X-ray 3 views | CPT 71047 | $157.72 |
| CT chest without contrast | CPT 71250 | $2,763.5 |
| CT chest with contrast | CPT 71260 | $4,269.75 |
| CT chest with and without contrast | CPT 71270 | $4,756.02 |
| MRI chest without contrast | CPT 71550 | $4,886.46 |
| MRI chest with and without contrast | CPT 71552 | $7,590.62 |
| Lumbosacral spine X-ray | CPT 72100 | $385.6 |
| CT cervical spine without contrast | CPT 72125 | $2,763.5 |
| CT thoracic spine without contrast | CPT 72128 | $2,763.5 |
| CT lumbar spine without contrast | CPT 72131 | $2,763.5 |
| MRI cervical spine without contrast | CPT 72141 | $4,886.46 |
| MRI thoracic spine without contrast | CPT 72146 | $4,886.46 |
| MRI lumbar spine without contrast | CPT 72148 | $4,886.46 |
| MRI lumbar spine with and without contrast | CPT 72149 | $4,886.46 |
| MRI cervical spine with and without contrast | CPT 72156 | $7,590.62 |
| MRI lumbar spine with contrast | CPT 72158 | $7,590.62 |
| CT pelvis without contrast | CPT 72192 | $2,763.5 |
| CT pelvis with contrast | CPT 72193 | $4,269.75 |
| Shoulder X-ray | CPT 73030 | $568.43 |
| Humerus X-ray | CPT 73060 | $286.64 |
| Hand X-ray 3 views | CPT 73130 | $269.59 |
| MRI upper extremity joint without contrast | CPT 73221 | $4,886.46 |
| MRI upper extremity joint with and without contrast | CPT 73223 | $4,924.49 |
| Knee X-ray 1-2 views | CPT 73560 | $245.33 |
| Ankle X-ray 3 views | CPT 73610 | $157.72 |
| MRI lower extremity joint without contrast | CPT 73721 | $4,886.46 |
| MRI lower extremity joint with and without contrast | CPT 73723 | $4,886.46 |
| CT abdomen without contrast | CPT 74150 | $2,763.5 |
| CT abdomen with contrast | CPT 74160 | $4,269.75 |
| CT abdomen with and without contrast | CPT 74170 | $4,756.02 |
| CT abdomen and pelvis without contrast | CPT 74176 | $4,145.25 |
| CT abdomen and pelvis with contrast | CPT 74177 | $6,404.6 |
| CT abdomen and pelvis with and without contrast | CPT 74178 | $7,134.03 |
| MRI abdomen without contrast | CPT 74181 | $4,886.46 |
| MRI abdomen with and without contrast | CPT 74183 | $4,886.46 |
| Abdominal ultrasound complete | CPT 76700 | $876.33 |
| Abdominal ultrasound limited | CPT 76705 | $758.61 |
| Retroperitoneal ultrasound complete | CPT 76770 | $791.16 |
| Transvaginal ultrasound | CPT 76830 | $513.21 |
| Pelvic ultrasound complete | CPT 76856 | $876.33 |
| Scrotal ultrasound | CPT 76870 | $346.27 |
| Screening mammography bilateral | CPT 77067 | $1,262.31 |
| EKG tracing only | CPT 93005 | $270.52 |
| Transthoracic echocardiogram complete | CPT 93306 | $824.37 |
| Transthoracic echocardiogram | CPT 93307 | $824.37 |
| Stress echocardiogram | CPT 93350 | $1,759.25 |
| Basic metabolic panel (BMP) | CPT 80048 | $348.17 |
| Electrolyte panel | CPT 80051 | $220.68 |
| Comprehensive metabolic panel | CPT 80053 | $454.11 |
| Lipid panel | CPT 80061 | $181.62 |
| Renal function panel | CPT 80069 | $443.65 |
| Hepatic function panel | CPT 80076 | $290.82 |
| Urinalysis automated | CPT 81003 | $60.8 |
| Glucose quantitative | CPT 82947 | $324.38 |
| Hemoglobin A1c | CPT 83036 | $114.08 |
| Thyroid stimulating hormone (TSH) | CPT 84443 | $170.35 |
| Complete blood count with automated differential | CPT 85025 | $105.17 |
| Complete blood count without differential | CPT 85027 | $108.27 |
| Urine culture bacterial | CPT 87086 | $179.07 |
| Urine culture identification | CPT 87088 | $928.03 |
| Tissue exam by pathologist level IV | CPT 88305 | $380.33 |
| Upper GI endoscopy with biopsy | CPT 43239 | $1,940.17 |