| behavioral |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $743.04 | $728.18 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $309.6 | $303.41 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $371.52 | $364.09 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $557.28 | $546.13 | — | — | — |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 0 | $557.28 | $546.13 | — | — | — |
| emergency |
| ED visit level 1 | CPT | 99281 | 0 | $134.44 | $131.75 | — | — | — |
| ED visit level 2 | CPT | 99282 | 0 | $134.44 | $131.75 | — | — | — |
| ED visit level 3 | CPT | 99283 | 0 | $268.88 | $263.5 | — | — | — |
| ED visit level 4 | CPT | 99284 | 0 | $537.76 | $527 | — | — | — |
| ED visit level 5 | CPT | 99285 | 0 | $941.08 | $922.26 | — | — | — |
| imaging |
| CT head without contrast | CPT | 70450 | 0 | $145.53 | $142.62 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $207.9 | $203.74 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $249.48 | $244.49 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $325.71 | $319.2 | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $1,487.2 | $1,457.46 | — | — | — |
| MRI brain with contrast | CPT | 70552 | 0 | $2,197 | $2,153.06 | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $2,501.2 | $2,451.18 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $95.7 | $93.79 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $159.5 | $156.31 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $223.3 | $218.83 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $249.48 | $244.49 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $325.71 | $319.2 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $401.94 | $393.9 | — | — | — |
| MRI chest without contrast | CPT | 71550 | 0 | $3,244.8 | $3,179.9 | — | — | — |
| MRI chest with contrast | CPT | 71551 | 0 | $3,549 | $3,478.02 | — | — | — |
| MRI chest with and without contrast | CPT | 71552 | 0 | $4,427.8 | $4,339.24 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $223.3 | $218.83 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $256.41 | $251.28 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $249.48 | $244.49 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $249.48 | $244.49 | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $1,419.6 | $1,391.21 | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $1,419.6 | $1,391.21 | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $1,419.6 | $1,391.21 | — | — | — |
| MRI lumbar spine with and without contrast | CPT | 72149 | 0 | $2,197 | $2,153.06 | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $2,501.2 | $2,451.18 | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $2,501.2 | $2,451.18 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $180.18 | $176.58 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $325.71 | $319.2 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $159.5 | $156.31 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $191.4 | $187.57 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $191.4 | $187.57 | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $1,588.6 | $1,556.83 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $191.4 | $187.57 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $191.4 | $187.57 | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $1,588.6 | $1,556.83 | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $3,447.6 | $3,378.65 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $173.25 | $169.79 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $325.71 | $319.2 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $374.22 | $366.74 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $221.76 | $217.32 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $429.66 | $421.07 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $492.03 | $482.19 | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $2,467.4 | $2,418.05 | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $3,751.8 | $3,676.76 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $733.7 | $719.03 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $574.2 | $562.72 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $701.8 | $687.76 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $669.9 | $656.5 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $829.4 | $812.81 | — | — | — |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 0 | $765.6 | $750.29 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $797.5 | $781.55 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $669.9 | $656.5 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $319 | $312.62 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $121.56 | $119.13 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $607.8 | $595.64 | — | — | — |
| Transthoracic echocardiogram | CPT | 93307 | 0 | $455.85 | $446.73 | — | — | — |
| Stress echocardiogram | CPT | 93350 | 0 | $607.8 | $595.64 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $23.21 | $22.75 | — | — | — |
| General health panel | CPT | 80050 | 0 | $84.4 | $82.71 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $16.88 | $16.54 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $31.65 | $31.02 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $40.09 | $39.29 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $25.32 | $24.81 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $23.21 | $22.75 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $8.44 | $8.27 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $8.44 | $8.27 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $42.2 | $41.36 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $31.65 | $31.02 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $21.1 | $20.68 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $16.88 | $16.54 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $42.2 | $41.36 | — | — | — |
| Urine culture identification | CPT | 87088 | 0 | $21.1 | $20.68 | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $126.6 | $124.07 | — | — | — |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $185.76 | $182.04 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $247.68 | $242.73 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $309.6 | $303.41 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $371.52 | $364.09 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $123.84 | $121.36 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $185.76 | $182.04 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $247.68 | $242.73 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $309.6 | $303.41 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $371.52 | $364.09 | — | — | — |