| imaging |
| CT head without contrast | CPT | 70450 | 17 | $2,101.4 | $2,101.4 | $1,639.09 | $1,786.19 | 8.6× | $2,059.37 |
| CT neck with contrast | CPT | 70491 | 17 | $2,735.75 | $2,735.75 | $2,133.89 | $2,325.39 | 8.5× | $2,681.04 |
| MRI brain without contrast | CPT | 70551 | 17 | $3,027.8 | $3,027.8 | $2,361.68 | $2,573.63 | 6.4× | $2,967.24 |
| MRI brain with and without contrast | CPT | 70553 | 17 | $4,713.55 | $4,713.55 | $3,676.57 | $4,006.52 | 6.8× | $4,619.28 |
| Chest X-ray single view | CPT | 71045 | 17 | $322.85 | $322.85 | $251.82 | $274.42 | 2.9× | $316.39 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $355.1 | $355.1 | $276.98 | $301.84 | 3.1× | $348 |
| CT chest without contrast | CPT | 71250 | 17 | $2,194.7 | $2,194.7 | $1,711.87 | $1,865.5 | 8.7× | $2,150.81 |
| CT chest with contrast | CPT | 71260 | 17 | $2,907 | $2,907 | $2,267.46 | $2,470.95 | 8.8× | $2,848.86 |
| CT chest with and without contrast | CPT | 71270 | 17 | $3,165.15 | $3,165.15 | $2,468.82 | $2,690.38 | 9.2× | $3,101.85 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $451.9 | $451.9 | $352.48 | $384.12 | 3.7× | $442.86 |
| CT cervical spine without contrast | CPT | 72125 | 17 | $2,452.95 | $2,452.95 | $1,913.3 | $2,085.01 | 10.4× | $2,403.89 |
| CT thoracic spine without contrast | CPT | 72128 | 17 | $2,248.65 | $2,248.65 | $1,753.95 | $1,911.35 | 9.6× | $2,203.68 |
| CT lumbar spine without contrast | CPT | 72131 | 17 | $2,581.95 | $2,581.95 | $2,013.92 | $2,194.66 | 10.8× | $2,530.31 |
| MRI cervical spine without contrast | CPT | 72141 | 17 | $3,027.8 | $3,027.8 | $2,361.68 | $2,573.63 | 6.5× | $2,967.24 |
| MRI thoracic spine without contrast | CPT | 72146 | 17 | $3,438.4 | $3,438.4 | $2,681.95 | $2,922.64 | 7.8× | $3,369.63 |
| MRI lumbar spine without contrast | CPT | 72148 | 17 | $3,247.2 | $3,247.2 | $2,532.82 | $2,760.12 | 7.3× | $3,182.26 |
| CT pelvis without contrast | CPT | 72192 | 17 | $2,014.45 | $2,014.45 | $1,571.27 | $1,712.28 | 8.6× | $1,974.16 |
| CT pelvis with contrast | CPT | 72193 | 17 | $2,673.25 | $2,673.25 | $2,085.14 | $2,272.26 | 8.1× | $2,619.79 |
| Shoulder X-ray | CPT | 73030 | 17 | $342.3 | $342.3 | $266.99 | $290.96 | 3.1× | $335.45 |
| Humerus X-ray | CPT | 73060 | 17 | $312.1 | $312.1 | $243.44 | $265.29 | 3.0× | $305.86 |
| Hand X-ray 3 views | CPT | 73130 | 17 | $323.6 | $323.6 | $252.41 | $275.06 | 3.0× | $317.13 |
| MRI upper extremity joint without contrast | CPT | 73221 | 17 | $3,227.45 | $3,227.45 | $2,517.41 | $2,743.33 | 6.6× | $3,162.9 |
| Knee X-ray 1-2 views | CPT | 73560 | 17 | $292.6 | $292.6 | $228.23 | $248.71 | 2.7× | $286.75 |
| Ankle X-ray 3 views | CPT | 73610 | 17 | $387.4 | $387.4 | $302.17 | $329.29 | 3.6× | $379.65 |
| MRI lower extremity joint without contrast | CPT | 73721 | 17 | $3,227.45 | $3,227.45 | $2,517.41 | $2,743.33 | 5.9× | $3,162.9 |
| CT abdomen without contrast | CPT | 74150 | 17 | $2,118 | $2,118 | $1,652.04 | $1,800.3 | 9.6× | $2,075.64 |
| CT abdomen with contrast | CPT | 74160 | 17 | $2,961.85 | $2,961.85 | $2,310.24 | $2,517.57 | 8.8× | $2,902.61 |
| CT abdomen with and without contrast | CPT | 74170 | 17 | $3,338.8 | $3,338.8 | $2,604.26 | $2,837.98 | 8.5× | $3,272.02 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 17 | $3,743.85 | $3,743.85 | $2,920.2 | $3,182.27 | 8.7× | $3,668.97 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 17 | $4,456.1 | $4,456.1 | $3,475.76 | $3,787.69 | 6.9× | $4,366.98 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 17 | $4,972.5 | $4,972.5 | $3,878.55 | $4,226.63 | 7.4× | $4,873.05 |
| MRI abdomen without contrast | CPT | 74181 | 17 | $2,909.65 | $2,909.65 | $2,269.53 | $2,473.2 | 6.3× | $2,851.46 |
| MRI abdomen with and without contrast | CPT | 74183 | 17 | $4,246.75 | $4,246.75 | $3,312.47 | $3,609.74 | 6.4× | $4,161.82 |
| Abdominal ultrasound complete | CPT | 76700 | 17 | $970 | $970 | $756.6 | $824.5 | 5.5× | $950.6 |
| Abdominal ultrasound limited | CPT | 76705 | 17 | $777.85 | $777.85 | $606.72 | $661.17 | 4.5× | $762.29 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 17 | $927.1 | $927.1 | $723.14 | $788.04 | 5.5× | $908.56 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 17 | $748.4 | $748.4 | $583.75 | $636.14 | 4.2× | $733.43 |
| Transvaginal ultrasound | CPT | 76830 | 17 | $646.8 | $646.8 | $504.5 | $549.78 | 3.7× | $633.86 |
| Pelvic ultrasound complete | CPT | 76856 | 17 | $773.45 | $773.45 | $603.29 | $657.43 | 4.6× | $757.98 |
| Scrotal ultrasound | CPT | 76870 | 17 | $956.6 | $956.6 | $746.15 | $813.11 | 6.2× | $937.47 |
| Diagnostic mammography unilateral | CPT | 77065 | 17 | $470.5 | $470.5 | $277.52 | $357.84 | 2.4× | $461.09 |
| Diagnostic mammography bilateral | CPT | 77066 | 17 | $599.85 | $599.85 | $378.42 | $471.67 | 2.5× | $587.85 |
| Screening mammography bilateral | CPT | 77067 | 17 | $433.05 | $433.05 | $493.98 | $648.1 | 4.1× | $848.78 |
| EKG tracing only | CPT | 93005 | 17 | $271.2 | $271.2 | $211.54 | $230.52 | 2.0× | $265.78 |
| Transthoracic echocardiogram complete | CPT | 93306 | 17 | $2,085.65 | $2,085.65 | $1,626.81 | $1,772.8 | 3.0× | $2,043.94 |
| inpatient |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 17 | $31,983 | $31,983 | $1,100 | $27,115 | 1.8× | $31,343 |
| COPD w CC | MS-DRG | 191 | 17 | $14,816 | $14,816 | $3,300 | $12,593 | 1.4× | $14,519 |
| COPD w/o CC/MCC | MS-DRG | 192 | 17 | $28,191 | $28,191 | $3,300 | $23,962 | 3.4× | $27,627 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 17 | $25,556 | $25,556 | $4,400 | $21,723 | 2.6× | $25,045 |
| Heart failure & shock w CC | MS-DRG | 292 | 17 | $19,812 | $19,812 | $3,300 | $16,840 | 1.9× | $19,415 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 17 | $21,113 | $21,113 | $4,400 | $17,946 | 2.9× | $20,690 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 17 | $4,230.05 | $4,230.05 | $2,200 | $3,595.54 | 0.43× | $4,145.45 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 17 | $32,231 | $32,231 | $1,100 | $27,396 | 1.5× | $31,586 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 17 | $216.95 | $216.95 | $169.22 | $184.41 | 5.7× | $212.61 |
| Comprehensive metabolic panel | CPT | 80053 | 17 | $278.55 | $278.55 | $217.27 | $236.77 | 5.3× | $272.98 |
| Lipid panel | CPT | 80061 | 17 | $226.75 | $226.75 | $353.74 | $385.48 | 10.1× | $444.44 |
| Renal function panel | CPT | 80069 | 17 | $249.5 | $249.5 | $194.61 | $212.08 | 7.8× | $244.51 |
| Hepatic function panel | CPT | 80076 | 17 | $216.95 | $216.95 | $169.22 | $184.41 | 6.9× | $212.61 |
| Urinalysis automated | CPT | 81003 | 17 | $84.05 | $84.05 | $65.56 | $71.44 | 5.1× | $82.37 |
| Glucose quantitative | CPT | 82947 | 17 | $110.15 | $110.15 | $171.84 | $187.26 | 10.6× | $215.9 |
| Hemoglobin A1c | CPT | 83036 | 17 | $168.25 | $168.25 | $131.24 | $143.01 | 5.3× | $164.89 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 17 | $245.75 | $245.75 | $191.69 | $208.89 | 4.4× | $240.84 |
| Complete blood count with automated differential | CPT | 85025 | 17 | $125.7 | $125.7 | $98.05 | $106.85 | 4.0× | $123.19 |
| Complete blood count without differential | CPT | 85027 | 17 | $107.55 | $107.55 | $83.89 | $91.42 | 4.2× | $105.4 |
| Urine culture identification | CPT | 87088 | 17 | $152.4 | $152.4 | $118.87 | $129.54 | 5.8× | $149.35 |
| Tissue exam by pathologist level IV | CPT | 88305 | 17 | $356.45 | $356.45 | $556.06 | $605.96 | 5.9× | $698.64 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 17 | $176 | $176 | $137.28 | $149.6 | 1.7× | $172.48 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 17 | $259 | $259 | $202.02 | $220.15 | 1.8× | $253.82 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 17 | $365 | $365 | $284.7 | $310.25 | 1.8× | $357.7 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 17 | $463 | $463 | $361.14 | $393.55 | 1.8× | $453.74 |
| Office visit, established patient, 5 min | CPT | 99211 | 17 | $173 | $173 | $134.94 | $147.05 | 2.3× | $169.54 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 17 | $246 | $246 | $191.88 | $209.1 | 2.6× | $241.08 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 17 | $277 | $277 | $216.06 | $235.45 | 2.1× | $271.46 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 17 | $327 | $327 | $255.06 | $277.95 | 1.8× | $320.46 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 17 | $421 | $421 | $328.38 | $357.85 | 1.9× | $412.58 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 17 | $6,670.12 | $6,670.12 | $4,083.44 | $4,789.22 | 5.2× | $6,336.61 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 17 | $7,801.59 | $7,801.59 | $5,069.62 | $5,945.86 | 6.2× | $7,411.51 |
| Colonoscopy diagnostic | CPT | 45378 | 17 | $6,036.44 | $6,036.44 | $3,874.17 | $4,543.77 | 5.2× | $5,734.62 |
| Colonoscopy with biopsy | CPT | 45380 | 17 | $7,360.7 | $7,360.7 | $4,685.31 | $5,495.12 | 4.5× | $6,992.67 |
| Colonoscopy with polyp removal | CPT | 45385 | 17 | $7,328.92 | $7,328.92 | $4,513.33 | $5,293.41 | 4.4× | $6,962.47 |
| surgery |
| Laparoscopic cholecystectomy | CPT | 47562 | 17 | $13,501 | $13,501 | $9,156.33 | $10,531 | 5.9× | $12,826 |
| OR procedure for obesity w CC | MS-DRG | 620 | 17 | $27,079 | $27,079 | $1,200 | $22,476 | 1.4× | $26,538 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 17 | $24,565 | $24,565 | $1,200 | $20,389 | 1.3× | $24,073 |