| behavioral |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $287.12 | $244.05 | — | — | — |
| Psychiatric eval with medical services | CPT | 90792 | 0 | $287.12 | $244.05 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $231.27 | $196.57 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $270.67 | $230.06 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $335.03 | $284.77 | — | — | — |
| emergency |
| ED visit level 1 | CPT | 99281 | 0 | $438.03 | $372.32 | — | — | — |
| ED visit level 2 | CPT | 99282 | 0 | $653.68 | $555.62 | — | — | — |
| ED visit level 3 | CPT | 99283 | 0 | $913.37 | $776.36 | — | — | — |
| ED visit level 4 | CPT | 99284 | 0 | $1,852.33 | $1,574.48 | — | — | — |
| ED visit level 5 | CPT | 99285 | 0 | $2,887.6 | $2,454.46 | — | — | — |
| Critical care, first hour | CPT | 99291 | 0 | $3,716.85 | $3,159.32 | — | — | — |
| imaging |
| CT head without contrast | CPT | 70450 | 0 | $2,224.68 | $1,890.97 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $3,124.71 | $2,656 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $3,473.08 | $2,952.11 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $2,906.28 | $2,470.33 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $3,956.08 | $3,362.66 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $4,640.43 | $3,944.36 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $7,320.66 | $6,222.56 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $393.69 | $334.63 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $445.05 | $378.29 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $857.84 | $729.16 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $2,542.1 | $2,160.78 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $3,163.82 | $2,689.24 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $3,666.39 | $3,116.43 | — | — | — |
| MRI chest without contrast | CPT | 71550 | 0 | $3,344.25 | $2,842.61 | — | — | — |
| MRI chest with and without contrast | CPT | 71552 | 0 | $6,568.65 | $5,583.35 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $468.66 | $398.36 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $2,760.35 | $2,346.29 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $2,421.04 | $2,057.88 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $2,421.04 | $2,057.88 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $3,935.79 | $3,345.42 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $3,537.17 | $3,006.59 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $3,935.79 | $3,345.42 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $5,229.04 | $4,444.68 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $6,083.11 | $5,170.64 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $7,258.23 | $6,169.49 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $2,194.39 | $1,865.23 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $3,124.71 | $2,656 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $629.05 | $534.69 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $382.03 | $324.72 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $390.26 | $331.72 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $4,429.25 | $3,764.86 | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $7,425.01 | $6,311.25 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $356.47 | $302.99 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $397.6 | $337.96 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $3,935.79 | $3,345.42 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $4,270.82 | $3,630.19 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $2,202.47 | $1,872.09 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $3,095.76 | $2,631.39 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $3,558.61 | $3,024.81 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $3,614.56 | $3,072.37 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $4,449.57 | $3,782.13 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $4,477.68 | $3,806.02 | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $4,769.33 | $4,053.93 | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $6,568.65 | $5,583.35 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $1,704.11 | $1,448.49 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $829.63 | $705.18 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $1,121.8 | $953.53 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $572.99 | $487.04 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $1,192.43 | $1,013.56 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $1,069.51 | $909.08 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $1,069.51 | $909.08 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $889.14 | $755.76 | — | — | — |
| Diagnostic mammography unilateral | CPT | 77065 | 0 | $613.61 | $521.56 | — | — | — |
| Diagnostic mammography bilateral | CPT | 77066 | 0 | $796.72 | $677.21 | — | — | — |
| Screening mammography bilateral | CPT | 77067 | 0 | $796.72 | $677.21 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $352.25 | $299.41 | — | — | — |
| EKG interpretation only | CPT | 93010 | 0 | $45.05 | $38.29 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $2,395.66 | $2,036.31 | — | — | — |
| inpatient |
| Initial hospital care, low complexity | CPT | 99221 | 0 | $231.27 | $196.57 | — | — | — |
| Initial hospital care, moderate complexity | CPT | 99222 | 0 | $346.83 | $294.8 | — | — | — |
| Initial hospital care, high complexity | CPT | 99223 | 0 | $461.18 | $392 | — | — | — |
| Hospital discharge, <30 min | CPT | 99238 | 0 | $197.08 | $167.51 | — | — | — |
| Hospital discharge, >30 min | CPT | 99239 | 0 | $247.01 | $209.95 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $152.43 | $129.56 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $122.84 | $104.41 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $237.45 | $201.83 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $169.84 | $144.36 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $195.24 | $165.95 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $162.57 | $138.18 | — | — | — |
| Urinalysis non-automated | CPT | 81002 | 0 | $46.38 | $39.42 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $54.34 | $46.18 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $66.98 | $56.93 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $111.68 | $94.92 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $142.42 | $121.05 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $162.71 | $138.3 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $89.69 | $76.23 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $103.2 | $87.72 | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $205.31 | $174.51 | — | — | — |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $311.24 | $264.55 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $409.58 | $348.14 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $542.83 | $461.4 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $742.57 | $631.18 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $239.75 | $203.78 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $311.24 | $264.55 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $409.58 | $348.14 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $542.83 | $461.4 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $542.83 | $461.4 | — | — | — |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 0 | $803.94 | $683.34 | — | — | — |
| Upper GI endoscopy with biopsy | CPT | 43239 | 0 | $951.98 | $809.18 | — | — | — |
| Sigmoidoscopy diagnostic | CPT | 45330 | 0 | $466.54 | $396.55 | — | — | — |
| Sigmoidoscopy with biopsy | CPT | 45331 | 0 | $714.21 | $607.07 | — | — | — |
| Colonoscopy diagnostic | CPT | 45378 | 0 | $1,892.95 | $1,609 | — | — | — |
| Colonoscopy with biopsy | CPT | 45380 | 0 | $2,438.91 | $2,073.07 | — | — | — |
| Colonoscopy with polyp removal | CPT | 45385 | 0 | $2,546.06 | $2,164.15 | — | — | — |
| surgery |
| Laparoscopic appendectomy | CPT | 44970 | 0 | $3,257.83 | $2,769.15 | — | — | — |
| Laparoscopic cholecystectomy | CPT | 47562 | 0 | $3,574.17 | $3,038.04 | — | — | — |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 0 | $3,890.51 | $3,306.93 | — | — | — |
| Lap inguinal hernia repair | CPT | 49650 | 0 | $2,329.21 | $1,979.82 | — | — | — |
