| behavioral |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $951.48 | $932.45 | — | — | — |
| Psychiatric eval with medical services | CPT | 90792 | 0 | $1,189.35 | $1,165.56 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $396.45 | $388.52 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $475.74 | $466.23 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $713.61 | $699.34 | — | — | — |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 0 | $158.58 | $155.41 | — | — | — |
| emergency |
| ED visit level 1 | CPT | 99281 | 0 | $136.69 | $133.96 | — | — | — |
| ED visit level 2 | CPT | 99282 | 0 | $136.69 | $133.96 | — | — | — |
| ED visit level 3 | CPT | 99283 | 0 | $273.38 | $267.91 | — | — | — |
| ED visit level 4 | CPT | 99284 | 0 | $546.76 | $535.82 | — | — | — |
| ED visit level 5 | CPT | 99285 | 0 | $956.83 | $937.69 | — | — | — |
| imaging |
| CT head without contrast | CPT | 70450 | 0 | $61.95 | $60.71 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $88.5 | $86.73 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $106.2 | $104.08 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $138.65 | $135.88 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $760.76 | $745.54 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $1,123.85 | $1,101.37 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $1,279.46 | $1,253.87 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $74.46 | $72.97 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $124.1 | $121.62 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $173.74 | $170.27 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $106.2 | $104.08 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $138.65 | $135.88 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $171.1 | $167.68 | — | — | — |
| MRI chest without contrast | CPT | 71550 | 0 | $1,659.84 | $1,626.64 | — | — | — |
| MRI chest with contrast | CPT | 71551 | 0 | $1,815.45 | $1,779.14 | — | — | — |
| MRI chest with and without contrast | CPT | 71552 | 0 | $2,264.99 | $2,219.69 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $173.74 | $170.27 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $109.15 | $106.97 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $106.2 | $104.08 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $106.2 | $104.08 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $726.18 | $711.66 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $726.18 | $711.66 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $726.18 | $711.66 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $1,123.85 | $1,101.37 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $1,279.46 | $1,253.87 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $1,279.46 | $1,253.87 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $76.7 | $75.17 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $138.65 | $135.88 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $124.1 | $121.62 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $148.92 | $145.94 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $148.92 | $145.94 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $812.63 | $796.38 | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $1,763.58 | $1,728.31 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $148.92 | $145.94 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $148.92 | $145.94 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $812.63 | $796.38 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $1,763.58 | $1,728.31 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $73.75 | $72.28 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $138.65 | $135.88 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $159.3 | $156.11 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $94.4 | $92.51 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $182.9 | $179.24 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $209.45 | $205.26 | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $1,262.17 | $1,236.93 | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $1,919.19 | $1,880.81 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $570.86 | $559.44 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $446.76 | $437.82 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $546.04 | $535.12 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $521.22 | $510.8 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $645.32 | $632.41 | — | — | — |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 0 | $595.68 | $583.77 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $620.5 | $608.09 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $521.22 | $510.8 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $248.2 | $243.24 | — | — | — |
| Diagnostic mammography unilateral | CPT | 77065 | 0 | $645.32 | $632.41 | — | — | — |
| Diagnostic mammography bilateral | CPT | 77066 | 0 | $843.88 | $827 | — | — | — |
| Screening mammography bilateral | CPT | 77067 | 0 | $694.96 | $681.06 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $240.6 | $235.79 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $1,203 | $1,178.94 | — | — | — |
| Stress echocardiogram | CPT | 93350 | 0 | $1,203 | $1,178.94 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $30.03 | $29.43 | — | — | — |
| General health panel | CPT | 80050 | 0 | $109.2 | $107.02 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $21.84 | $21.4 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $40.95 | $40.13 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $51.87 | $50.83 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $32.76 | $32.1 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $30.03 | $29.43 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $10.92 | $10.7 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $10.92 | $10.7 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $54.6 | $53.51 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $40.95 | $40.13 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $27.3 | $26.75 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $21.84 | $21.4 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $54.6 | $53.51 | — | — | — |
| Urine culture identification | CPT | 87088 | 0 | $27.3 | $26.75 | — | — | — |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $237.87 | $233.11 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $317.16 | $310.82 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $396.45 | $388.52 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $475.74 | $466.23 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $158.58 | $155.41 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $237.87 | $233.11 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $317.16 | $310.82 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $396.45 | $388.52 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $475.74 | $466.23 | — | — | — |