| behavioral |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $300 | $294 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $150 | $147 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $225 | $220.5 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $400 | $392 | — | — | — |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 0 | $300 | $294 | — | — | — |
| emergency |
| ED visit level 1 | CPT | 99281 | 0 | $121.36 | $118.93 | — | — | — |
| ED visit level 2 | CPT | 99282 | 0 | $121.36 | $118.93 | — | — | — |
| ED visit level 3 | CPT | 99283 | 0 | $242.72 | $237.87 | — | — | — |
| ED visit level 4 | CPT | 99284 | 0 | $485.44 | $475.73 | — | — | — |
| ED visit level 5 | CPT | 99285 | 0 | $849.52 | $832.53 | — | — | — |
| imaging |
| CT head without contrast | CPT | 70450 | 0 | $63.21 | $61.95 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $90.3 | $88.49 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $108.36 | $106.19 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $141.47 | $138.64 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $554.84 | $543.74 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $819.65 | $803.26 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $933.14 | $914.48 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $127.16 | $124.62 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $158.95 | $155.77 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $190.74 | $186.93 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $108.36 | $106.19 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $141.47 | $138.64 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $174.58 | $171.09 | — | — | — |
| MRI chest without contrast | CPT | 71550 | 0 | $1,210.56 | $1,186.35 | — | — | — |
| MRI chest with contrast | CPT | 71551 | 0 | $1,324.05 | $1,297.57 | — | — | — |
| MRI chest with and without contrast | CPT | 71552 | 0 | $1,651.91 | $1,618.87 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $222.53 | $218.08 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $111.37 | $109.14 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $108.36 | $106.19 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $108.36 | $106.19 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $529.62 | $519.03 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $529.62 | $519.03 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $529.62 | $519.03 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $819.65 | $803.26 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $933.14 | $914.48 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $933.14 | $914.48 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $78.26 | $76.69 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $141.47 | $138.64 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $158.95 | $155.77 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $190.74 | $186.93 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $190.74 | $186.93 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $592.67 | $580.82 | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $1,286.22 | $1,260.5 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $190.74 | $186.93 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $190.74 | $186.93 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $592.67 | $580.82 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $1,286.22 | $1,260.5 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $75.25 | $73.75 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $141.47 | $138.64 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $162.54 | $159.29 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $96.32 | $94.39 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $186.62 | $182.89 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $213.71 | $209.44 | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $920.53 | $902.12 | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $1,399.71 | $1,371.72 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $731.17 | $716.55 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $572.22 | $560.78 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $699.38 | $685.39 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $667.59 | $654.24 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $826.54 | $810.01 | — | — | — |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 0 | $762.96 | $747.7 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $794.75 | $778.86 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $667.59 | $654.24 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $317.9 | $311.54 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $34.08 | $33.4 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $170.4 | $166.99 | — | — | — |
| Transthoracic echocardiogram | CPT | 93307 | 0 | $127.8 | $125.24 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $36.63 | $35.9 | — | — | — |
| General health panel | CPT | 80050 | 0 | $133.2 | $130.54 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $26.64 | $26.11 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $49.95 | $48.95 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $63.27 | $62 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $39.96 | $39.16 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $36.63 | $35.9 | — | — | — |
| Urinalysis non-automated | CPT | 81002 | 0 | $13.32 | $13.05 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $13.32 | $13.05 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $13.32 | $13.05 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $66.6 | $65.27 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $49.95 | $48.95 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $33.3 | $32.63 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $26.64 | $26.11 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $66.6 | $65.27 | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $199.8 | $195.8 | — | — | — |
| maternity |
| Fetal non-stress test | CPT | 59025 | 0 | $833.2 | $816.54 | — | — | — |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $131.16 | $128.54 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $174.88 | $171.38 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $218.6 | $214.23 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $262.32 | $257.07 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $87.44 | $85.69 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $131.16 | $128.54 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $174.88 | $171.38 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $218.6 | $214.23 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $262.32 | $257.07 | — | — | — |