| behavioral |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $253.15 | $248.09 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $303.78 | $297.7 | — | — | — |
| emergency |
| ED visit level 1 | CPT | 99281 | 0 | $108.66 | $106.49 | — | — | — |
| ED visit level 2 | CPT | 99282 | 0 | $108.66 | $106.49 | — | — | — |
| ED visit level 3 | CPT | 99283 | 0 | $217.32 | $212.97 | — | — | — |
| ED visit level 4 | CPT | 99284 | 0 | $434.64 | $425.95 | — | — | — |
| ED visit level 5 | CPT | 99285 | 0 | $760.62 | $745.41 | — | — | — |
| imaging |
| CT head without contrast | CPT | 70450 | 0 | $62.58 | $61.33 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $89.4 | $87.61 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $107.28 | $105.13 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $140.06 | $137.26 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $242 | $237.16 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $357.5 | $350.35 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $407 | $398.86 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $44.31 | $43.42 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $73.85 | $72.37 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $103.39 | $101.32 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $107.28 | $105.13 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $140.06 | $137.26 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $172.84 | $169.38 | — | — | — |
| MRI chest without contrast | CPT | 71550 | 0 | $528 | $517.44 | — | — | — |
| MRI chest with contrast | CPT | 71551 | 0 | $577.5 | $565.95 | — | — | — |
| MRI chest with and without contrast | CPT | 71552 | 0 | $720.5 | $706.09 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $103.39 | $101.32 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $110.26 | $108.05 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $107.28 | $105.13 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $107.28 | $105.13 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $231 | $226.38 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $231 | $226.38 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $231 | $226.38 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $357.5 | $350.35 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $407 | $398.86 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $407 | $398.86 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $77.48 | $75.93 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $140.06 | $137.26 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $73.85 | $72.37 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $88.62 | $86.85 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $88.62 | $86.85 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $258.5 | $253.33 | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $561 | $549.78 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $88.62 | $86.85 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $88.62 | $86.85 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $258.5 | $253.33 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $561 | $549.78 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $74.5 | $73.01 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $140.06 | $137.26 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $160.92 | $157.7 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $95.36 | $93.45 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $184.76 | $181.06 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $211.58 | $207.35 | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $401.5 | $393.47 | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $610.5 | $598.29 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $339.71 | $332.92 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $265.86 | $260.54 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $324.94 | $318.44 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $521.7 | $511.27 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $521.7 | $511.27 | — | — | — |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 0 | $521.7 | $511.27 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $369.25 | $361.87 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $521.7 | $511.27 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $147.7 | $144.75 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $86.52 | $84.79 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $432.6 | $423.95 | — | — | — |
| Transthoracic echocardiogram | CPT | 93307 | 0 | $324.45 | $317.96 | — | — | — |
| Stress echocardiogram | CPT | 93350 | 0 | $432.6 | $423.95 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $26.51 | $25.98 | — | — | — |
| General health panel | CPT | 80050 | 0 | $96.4 | $94.47 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $19.28 | $18.89 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $36.15 | $35.43 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $45.79 | $44.87 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $28.92 | $28.34 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $26.51 | $25.98 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $9.64 | $9.45 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $48.2 | $47.24 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $36.15 | $35.43 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $24.1 | $23.62 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $19.28 | $18.89 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $48.2 | $47.24 | — | — | — |
| Urine culture identification | CPT | 87088 | 0 | $24.1 | $23.62 | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $144.6 | $141.71 | — | — | — |
| maternity |
| Fetal non-stress test | CPT | 59025 | 0 | $869.5 | $852.11 | — | — | — |
| Vaginal delivery only | CPT | 59409 | 0 | $5,564.8 | $5,453.5 | — | — | — |
| C-section delivery only | CPT | 59514 | 0 | $10,608 | $10,396 | — | — | — |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $151.89 | $148.85 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $202.52 | $198.47 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $253.15 | $248.09 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $303.78 | $297.7 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $173.9 | $170.42 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $151.89 | $148.85 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $202.52 | $198.47 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $253.15 | $248.09 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $303.78 | $297.7 | — | — | — |
| surgery |
| Left heart catheterization | CPT | 93452 | 0 | $80.3 | $78.69 | — | — | — |
| Coronary angiography with cath | CPT | 93455 | 0 | $80.3 | $78.69 | — | — | — |
| Coronary angiography with bypass cath | CPT | 93458 | 0 | $80.3 | $78.69 | — | — | — |