| behavioral |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $1,496.64 | $1,466.71 | — | — | — |
| Psychiatric eval with medical services | CPT | 90792 | 0 | $1,870.8 | $1,833.38 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $623.6 | $611.13 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $748.32 | $733.35 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $1,122.48 | $1,100.03 | — | — | — |
| imaging |
| CT head without contrast | CPT | 70450 | 0 | $136.08 | $133.36 | — | — | — |
| CT head with contrast | CPT | 70460 | 0 | $194.4 | $190.51 | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $233.28 | $228.61 | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $304.56 | $298.47 | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $120.18 | $117.78 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $200.3 | $196.29 | — | — | — |
| Chest X-ray 3 views | CPT | 71047 | 0 | $280.42 | $274.81 | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $233.28 | $228.61 | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $304.56 | $298.47 | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $375.84 | $368.32 | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $280.42 | $274.81 | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $239.76 | $234.96 | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $233.28 | $228.61 | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $233.28 | $228.61 | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $168.48 | $165.11 | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $304.56 | $298.47 | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $200.3 | $196.29 | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $240.36 | $235.55 | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $240.36 | $235.55 | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $240.36 | $235.55 | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $240.36 | $235.55 | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $162 | $158.76 | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $304.56 | $298.47 | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $349.92 | $342.92 | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $207.36 | $203.21 | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $401.76 | $393.72 | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $460.08 | $450.88 | — | — | — |
| Abdominal ultrasound complete | CPT | 76700 | 0 | $921.38 | $902.95 | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $721.08 | $706.66 | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $881.32 | $863.69 | — | — | — |
| Obstetric ultrasound first trimester | CPT | 76801 | 0 | $841.26 | $824.43 | — | — | — |
| Obstetric ultrasound after first trimester | CPT | 76805 | 0 | $1,041.56 | $1,020.73 | — | — | — |
| Transvaginal ultrasound | CPT | 76830 | 0 | $1,001.5 | $981.47 | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $841.26 | $824.43 | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $400.6 | $392.59 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $30.72 | $30.11 | — | — | — |
| Transthoracic echocardiogram complete | CPT | 93306 | 0 | $153.6 | $150.53 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $57.09 | $55.95 | — | — | — |
| General health panel | CPT | 80050 | 0 | $207.6 | $203.45 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $41.52 | $40.69 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $77.85 | $76.29 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $98.61 | $96.64 | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $62.28 | $61.03 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $57.09 | $55.95 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $20.76 | $20.34 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $20.76 | $20.34 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $103.8 | $101.72 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $77.85 | $76.29 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $51.9 | $50.86 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $41.52 | $40.69 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $103.8 | $101.72 | — | — | — |
| Urine culture identification | CPT | 87088 | 0 | $51.9 | $50.86 | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $311.4 | $305.17 | — | — | — |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 0 | $374.16 | $366.68 | — | — | — |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 0 | $498.88 | $488.9 | — | — | — |
| Office visit, new patient, 45-59 min | CPT | 99204 | 0 | $623.6 | $611.13 | — | — | — |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $748.32 | $733.35 | — | — | — |
| Office visit, established patient, 5 min | CPT | 99211 | 0 | $249.44 | $244.45 | — | — | — |
| Office visit, established patient, 10-19 min | CPT | 99212 | 0 | $374.16 | $366.68 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $498.88 | $488.9 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $623.6 | $611.13 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $748.32 | $733.35 | — | — | — |
