| behavioral |
| Psychotherapy 30 minutes | CPT | 90832 | 15 | — | $48 | $34.06 | $60.63 | 0.41× | $92.3 |
| Psychotherapy 45 minutes | CPT | 90834 | 15 | — | $63.9 | $45.31 | $80.67 | 0.50× | $122.8 |
| Psychotherapy 60 minutes | CPT | 90837 | 15 | — | $80.8 | $57.31 | $100.4 | 0.53× | $126.73 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 15 | — | $84.3 | $59.78 | $104.73 | 0.66× | $127.49 |
| emergency |
| ED visit level 4 | CPT | 99284 | 14 | — | $285 | $202.21 | $344.95 | 0.52× | $431.28 |
| imaging |
| CT head without contrast | CPT | 70450 | 15 | — | $871.1 | $66.47 | $972.07 | 4.7× | $1,318.38 |
| CT head with contrast | CPT | 70460 | 15 | — | $971.8 | $108.92 | $1,084.4 | 4.6× | $1,470.75 |
| CT head with and without contrast | CPT | 70470 | 15 | — | $2,026.9 | $108.92 | $1,877.5 | 7.0× | $3,067.65 |
| CT neck with contrast | CPT | 70491 | 15 | — | $1,175.9 | $108.92 | $1,089.2 | 4.0× | $1,779.64 |
| MRI brain without contrast | CPT | 70551 | 15 | — | $1,721.7 | $140.38 | $1,984.5 | 4.9× | $2,605.76 |
| MRI brain with contrast | CPT | 70552 | 15 | — | $1,871.6 | $224.55 | $2,174.22 | 4.5× | $2,832.49 |
| MRI brain with and without contrast | CPT | 70553 | 15 | — | $3,116.1 | $224.55 | $3,620.07 | 6.1× | $4,716.1 |
| Chest X-ray single view | CPT | 71045 | 15 | — | $71.9 | $41.84 | $77.32 | 0.82× | $108.84 |
| Chest X-ray 2 views | CPT | 71046 | 15 | — | $135.4 | $49.35 | $145.66 | 1.5× | $204.86 |
| Chest X-ray 3 views | CPT | 71047 | 15 | — | $175.9 | $49.35 | $202.92 | 2.1× | $266.16 |
| CT chest without contrast | CPT | 71250 | 15 | — | $901.2 | $66.47 | $656.11 | 3.1× | $1,363.87 |
| CT chest with contrast | CPT | 71260 | 15 | — | $1,175.9 | $108.92 | $1,089.2 | 3.9× | $1,779.64 |
| CT chest with and without contrast | CPT | 71270 | 15 | — | $1,579.2 | $108.92 | $1,820.48 | 6.2× | $2,389.96 |
| MRI chest without contrast | CPT | 71550 | 15 | — | $1,625.2 | $140.38 | $1,875.24 | 4.4× | $2,459.69 |
| MRI chest with contrast | CPT | 71551 | 15 | — | $1,652.6 | $436.26 | $1,906.8 | 2.3× | $2,501.09 |
| MRI chest with and without contrast | CPT | 71552 | 15 | — | $2,187.8 | $224.55 | $2,464.3 | 4.1× | $3,311.15 |
| Lumbosacral spine X-ray | CPT | 72100 | 15 | — | $140.4 | $66.47 | $163.05 | 1.6× | $212.41 |
| CT cervical spine without contrast | CPT | 72125 | 15 | — | $871.1 | $66.47 | $972.07 | 4.8× | $1,318.38 |
| CT thoracic spine without contrast | CPT | 72128 | 15 | — | $871.1 | $66.47 | $972.07 | 4.9× | $1,318.38 |
| CT lumbar spine without contrast | CPT | 72131 | 15 | — | $958.3 | $66.47 | $976.39 | 4.8× | $1,450.28 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | — | $1,502.7 | $140.38 | $1,720.53 | 4.3× | $2,274.19 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | — | $1,459.5 | $140.38 | $1,677.51 | 4.5× | $2,208.79 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | — | $1,945.7 | $140.38 | $1,982.22 | 5.3× | $2,944.64 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 15 | — | $2,014.1 | $224.55 | $2,247.54 | 5.0× | $3,048.29 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | — | $2,666.8 | $224.55 | $3,109.7 | 5.8× | $4,036.13 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | — | $2,653.9 | $224.55 | $3,062.22 | 5.6× | $4,016.61 |
| CT pelvis without contrast | CPT | 72192 | 15 | — | $1,054.1 | $66.47 | $976.39 | 4.9× | $1,595.33 |
| CT pelvis with contrast | CPT | 72193 | 15 | — | $1,175.9 | $108.92 | $1,089.2 | 3.9× | $1,779.64 |
| Shoulder X-ray | CPT | 73030 | 15 | — | $133.4 | $49.35 | $152.72 | 1.6× | $201.87 |
| Humerus X-ray | CPT | 73060 | 15 | — | $110.8 | $49.35 | $126.82 | 1.4× | $167.63 |
| Hand X-ray 3 views | CPT | 73130 | 15 | — | $162.4 | $49.35 | $185.88 | 2.0× | $245.7 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | — | $1,394.6 | $140.38 | $1,606.68 | 3.9× | $2,110.66 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | — | $2,125 | $224.55 | $2,364.93 | 3.9× | $3,216 |
| Knee X-ray 1-2 views | CPT | 73560 | 15 | — | $94.4 | $49.35 | $104.96 | 1.1× | $142.84 |
| Ankle X-ray 3 views | CPT | 73610 | 15 | — | $86.2 | $49.35 | $98.72 | 1.1× | $130.48 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | — | $1,278.5 | $140.38 | $1,472.92 | 3.1× | $1,934.92 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | — | $2,125 | $224.55 | $2,364.93 | 3.7× | $3,216 |
| CT abdomen without contrast | CPT | 74150 | 15 | — | $871.1 | $66.47 | $972.07 | 5.2× | $1,318.38 |
| CT abdomen with contrast | CPT | 74160 | 15 | — | $1,175.9 | $108.92 | $1,089.2 | 3.8× | $1,779.64 |
| CT abdomen with and without contrast | CPT | 74170 | 15 | — | $1,815.6 | $108.92 | $1,877.5 | 5.6× | $2,747.81 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | — | $1,130.6 | $140.38 | $823.15 | 2.3× | $1,711.1 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 15 | — | $1,283.4 | $224.55 | $934.38 | 1.7× | $1,942.32 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | — | $2,026.9 | $224.55 | $1,475.74 | 2.6× | $3,067.65 |
| MRI abdomen without contrast | CPT | 74181 | 15 | — | $1,502.7 | $140.38 | $1,720.53 | 4.4× | $2,274.19 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | — | $2,910.1 | $224.55 | $2,777.47 | 4.9× | $4,404.29 |
| Abdominal ultrasound complete | CPT | 76700 | 15 | — | $496.9 | $66.47 | $573.36 | 3.8× | $752.06 |
| Abdominal ultrasound limited | CPT | 76705 | 15 | — | $373.3 | $66.47 | $391.56 | 2.7× | $564.99 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 15 | — | $683.8 | $66.47 | $782.89 | 5.4× | $1,034.83 |
| Obstetric ultrasound first trimester | CPT | 76801 | 15 | — | $467.3 | $66.47 | $539.16 | 3.8× | $707.2 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 15 | — | $426.5 | $66.47 | $492.12 | 3.2× | $645.5 |
| Transvaginal ultrasound | CPT | 76830 | 15 | — | $628.4 | $66.47 | $698.22 | 4.7× | $951.01 |
| Pelvic ultrasound complete | CPT | 76856 | 15 | — | $683.8 | $66.47 | $794.33 | 5.5× | $1,034.83 |
| Scrotal ultrasound | CPT | 76870 | 15 | — | $600.3 | $66.47 | $678.44 | 5.2× | $908.51 |
| Diagnostic mammography unilateral | CPT | 77065 | 15 | — | $257.2 | $55.73 | $296.7 | 2.0× | $389.17 |
| Diagnostic mammography bilateral | CPT | 77066 | 15 | — | $297.7 | $71.22 | $346.97 | 1.8× | $450.48 |
| Screening mammography bilateral | CPT | 77067 | 15 | — | $243.1 | $58.91 | $284.27 | 1.8× | $367.84 |
| EKG tracing only | CPT | 93005 | 15 | — | $58 | $14.91 | $50.13 | 0.43× | $87.67 |
| Transthoracic echocardiogram complete | CPT | 93306 | 15 | — | $825.4 | $210 | $692.13 | 1.2× | $1,249.21 |
| Transthoracic echocardiogram | CPT | 93307 | 15 | — | $613.8 | $140.38 | $604.68 | 2.4× | $928.97 |
| Stress echocardiogram | CPT | 93350 | 15 | — | $890.4 | $294.56 | $1,027.38 | 2.0× | $1,347.58 |
| inpatient |
| Initial hospital care, low complexity | CPT | 99221 | 13 | — | $66.6 | $47.23 | $82.75 | 0.89× | $100.74 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 15 | — | $123.8 | $4.4 | $141.71 | 4.4× | $187.31 |
| Electrolyte panel | CPT | 80051 | 15 | — | $61.4 | $3.65 | $44.71 | 1.9× | $92.94 |
| Comprehensive metabolic panel | CPT | 80053 | 15 | — | $133.1 | $5.49 | $152.42 | 3.4× | $201.47 |
| Lipid panel | CPT | 80061 | 15 | — | $109.3 | $6.96 | $125.09 | 3.3× | $165.35 |
| Renal function panel | CPT | 80069 | 15 | — | $159 | $4.51 | $55.31 | 2.0× | $240.66 |
| Hepatic function panel | CPT | 80076 | 15 | — | $34.9 | $4.25 | $39.89 | 1.5× | $52.73 |
| Urinalysis non-automated | CPT | 81002 | 15 | — | $5.8 | $1.33 | $6.61 | 0.95× | $8.74 |
| Urinalysis automated | CPT | 81003 | 15 | — | $9.7 | $1.17 | $8.47 | 0.61× | $14.72 |
| Glucose quantitative | CPT | 82947 | 15 | — | $36.4 | $2.04 | $32.91 | 1.9× | $55.01 |
| Hemoglobin A1c | CPT | 83036 | 15 | — | $19.9 | $5.04 | $20.11 | 0.75× | $30.14 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 15 | — | $107.3 | $8.73 | $122.83 | 2.6× | $162.36 |
| Complete blood count with automated differential | CPT | 85025 | 15 | — | $21.8 | $4.04 | $22.17 | 0.84× | $32.98 |
| Complete blood count without differential | CPT | 85027 | 15 | — | $15.2 | $3.36 | $17.33 | 0.80× | $22.9 |
| Urine culture bacterial | CPT | 87086 | 15 | — | $41.1 | $4.2 | $47.04 | 2.0× | $62.17 |
| Urine culture identification | CPT | 87088 | 15 | — | $8.6 | $4.21 | $10.67 | 0.48× | $12.99 |
| Tissue exam by pathologist level IV | CPT | 88305 | 15 | — | $138.1 | $14.4 | $78.53 | 0.77× | $208.95 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 15 | — | $356.8 | $40.62 | $411.72 | 2.2× | $540.04 |
| office |
| Office visit, new patient, 15-29 min | CPT | 99202 | 13 | — | $111.3 | $35.42 | $83.53 | 0.97× | $168.42 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 13 | — | $188.8 | $47.6 | $163.74 | 1.3× | $285.68 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | — | $230.9 | $63.84 | $143.58 | 0.82× | $349.43 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | — | $230.9 | $80.44 | $177.97 | 0.80× | $349.43 |
| Office visit, established patient, 5 min | CPT | 99211 | 13 | — | $105.1 | $12.18 | $33 | 0.51× | $158.97 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 13 | — | $108.7 | $22.88 | $59.81 | 0.75× | $164.48 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 13 | — | $116.5 | $32.84 | $82.05 | 0.72× | $176.29 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 13 | — | $178.4 | $88.19 | $177.59 | 1.2× | $343 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 13 | — | $243.4 | $52.4 | $142.12 | 0.75× | $468 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 15 | — | $2,558.95 | $140.95 | $792.95 | 0.87× | $4,027.78 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 15 | — | $3,166.52 | $138.83 | $765.67 | 0.79× | $4,984.11 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 15 | — | $201.9 | $143.28 | $277.63 | 0.33× | $653.58 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 15 | — | $557.2 | $395.35 | $692.66 | 0.78× | $1,071.4 |
| Colonoscopy diagnostic | CPT | 45378 | 15 | — | $1,347.19 | $236.4 | $1,014.11 | 1.2× | $2,694.38 |
| Colonoscopy with biopsy | CPT | 45380 | 15 | — | $1,498.08 | $263.5 | $778.78 | 0.64× | $2,996.15 |
| Colonoscopy with polyp removal | CPT | 45385 | 15 | — | $1,686.33 | $381.32 | $1,071 | 0.89× | $3,319 |
| surgery |
| Laparoscopic appendectomy | CPT | 44970 | 15 | — | $6,243.26 | $1,886.33 | $4,799.02 | 3.1× | $9,826.89 |
| Laparoscopic cholecystectomy | CPT | 47562 | 15 | — | $7,367.33 | $2,335.27 | $5,208.87 | 2.9× | $11,596 |
| Open umbilical hernia repair | CPT | 49560 | 15 | — | $3,301.4 | $1,017.7 | $2,758 | 1.4× | $5,196.4 |
| Lap inguinal hernia repair | CPT | 49650 | 15 | — | $1,555.25 | $1,147.77 | $2,335.99 | 2.1× | $4,167.27 |
| Lap incisional hernia repair | CPT | 49652 | 15 | — | $7,599 | $1,544.82 | $4,186.5 | 1.6× | $11,961 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 15 | — | $8,703.64 | $3,438.64 | $6,626.67 | 3.0× | $13,700 |
| Lap salpingo-oophorectomy | CPT | 58661 | 15 | — | $5,678.3 | $2,307.08 | $4,859.77 | 2.4× | $8,937.64 |
| PCI single major coronary artery | CPT | 92920 | 15 | — | $2,158.7 | $364.87 | $2,683.82 | 0.47× | $4,151.3 |
| PCI with drug-eluting stent | CPT | 92928 | 15 | — | $3,857 | $404.59 | $4,795.28 | 0.48× | $7,417.3 |
| PCI bypass graft | CPT | 92937 | 15 | — | $3,857 | $403.53 | $4,795.28 | 0.44× | $7,417.3 |
| Left heart catheterization | CPT | 93452 | 15 | — | $4,616.8 | $1,768.4 | $5,327.1 | 1.7× | $6,987.38 |
| Coronary angiography with cath | CPT | 93455 | 15 | — | $4,061.4 | $1,768.4 | $4,686.24 | 1.5× | $6,146.78 |
| Coronary angiography with bypass cath | CPT | 93458 | 15 | — | $4,664.4 | $1,768.4 | $5,340.74 | 1.7× | $7,059.39 |