| behavioral |
| Psychiatric diagnostic evaluation | CPT | 90791 | 0 | $191.5 | $191.5 | — | — | — |
| Psychiatric eval with medical services | CPT | 90792 | 0 | $191.5 | $191.5 | — | — | — |
| Psychotherapy 30 minutes | CPT | 90832 | 0 | $174.01 | $174.01 | — | — | — |
| Psychotherapy 45 minutes | CPT | 90834 | 0 | $174.01 | $174.01 | — | — | — |
| Psychotherapy 60 minutes | CPT | 90837 | 0 | $320 | $320 | — | — | — |
| imaging |
| Chest X-ray single view | CPT | 71045 | 0 | $109.1 | $109.1 | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $109.1 | $109.1 | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $73.5 | $73.5 | — | — | — |
| EKG interpretation only | CPT | 93010 | 0 | $15.44 | $15.44 | — | — | — |
| inpatient |
| Initial hospital care, low complexity | CPT | 99221 | 0 | $155 | $155 | — | — | — |
| Initial hospital care, moderate complexity | CPT | 99222 | 0 | $211 | $211 | — | — | — |
| Initial hospital care, high complexity | CPT | 99223 | 0 | $311 | $311 | — | — | — |
| Hospital discharge, >30 min | CPT | 99239 | 0 | $164 | $164 | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $25.4 | $25.4 | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $21.1 | $21.1 | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $31.7 | $31.7 | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $40.2 | $40.2 | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $24.6 | $24.6 | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $6.8 | $6.8 | — | — | — |
| Glucose quantitative | CPT | 82947 | 0 | $11.8 | $11.8 | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $29.2 | $29.2 | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $50.4 | $50.4 | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $23.4 | $23.4 | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $19.5 | $19.5 | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $24.3 | $24.3 | — | — | — |
| office |
| Office visit, new patient, 60-74 min | CPT | 99205 | 0 | $306.08 | $306.08 | — | — | — |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 0 | $108.33 | $108.33 | — | — | — |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 0 | $159.24 | $159.24 | — | — | — |
| Office visit, established patient, 40-54 min | CPT | 99215 | 0 | $215.96 | $215.96 | — | — | — |
