| emergency |
| ED visit level 1 | CPT | 99281 | 37 | $426 | $255.6 | $90.27 | $283.29 | 2.0× | $1,898 |
| ED visit level 2 | CPT | 99282 | 11 | $834 | $500.4 | $452.03 | $542.1 | 2.3× | $1,011 |
| ED visit level 3 | CPT | 99283 | 11 | $1,474 | $884.4 | $798.91 | $958.1 | 2.4× | $1,291.22 |
| ED visit level 4 | CPT | 99284 | 11 | $1,967 | $1,180.2 | $1,011 | $1,249.05 | 1.9× | $1,723.09 |
| ED visit level 5 | CPT | 99285 | 37 | $2,894 | $1,736.4 | $628.54 | $1,898 | 1.8× | $2,535.14 |
| Critical care, first hour | CPT | 99291 | 37 | $3,774 | $2,264.4 | $863.83 | $2,453.1 | 2.3× | $3,306.02 |
| imaging |
| CT head without contrast | CPT | 70450 | 36 | $1,466 | $879.6 | $109.02 | $952.9 | 4.6× | $1,725 |
| CT head with contrast | CPT | 70460 | 36 | $1,754 | $1,052.4 | $182.5 | $1,192.72 | 5.1× | $1,725 |
| CT head with and without contrast | CPT | 70470 | 36 | $2,528 | $1,516.8 | $182.5 | $1,643.2 | 6.2× | $2,214.53 |
| CT neck with contrast | CPT | 70491 | 36 | $2,301 | $1,380.6 | $182.5 | $1,495.65 | 5.5× | $2,015.68 |
| MRI brain without contrast | CPT | 70551 | 36 | $2,364 | $1,418.4 | $247.81 | $1,536.6 | 3.8× | $2,250 |
| MRI brain with contrast | CPT | 70552 | 36 | $4,138 | $2,482.8 | $366.12 | $2,689.7 | 5.6× | $3,624.89 |
| MRI brain with and without contrast | CPT | 70553 | 36 | $5,534 | $3,320.4 | $366.12 | $3,597.1 | 6.1× | $4,847.78 |
| Chest X-ray single view | CPT | 71045 | 36 | $236 | $141.6 | $29.26 | $153.4 | 1.6× | $449 |
| Chest X-ray 2 views | CPT | 71046 | 36 | $491 | $294.6 | $42.11 | $319.15 | 3.2× | $449 |
| Chest X-ray 3 views | CPT | 71047 | 34 | $545 | $327 | $68.15 | $346.62 | 3.6× | $463.25 |
| CT chest without contrast | CPT | 71250 | 36 | $1,524 | $914.4 | $109.02 | $990.6 | 4.6× | $1,725 |
| CT chest with contrast | CPT | 71260 | 36 | $2,143 | $1,285.8 | $182.5 | $1,392.95 | 4.9× | $1,877.27 |
| CT chest with and without contrast | CPT | 71270 | 36 | $2,627 | $1,576.2 | $182.5 | $1,707.55 | 5.9× | $2,301.25 |
| MRI chest without contrast | CPT | 71550 | 36 | $2,317 | $1,390.2 | $247.81 | $1,506.05 | 3.5× | $2,250 |
| MRI chest with and without contrast | CPT | 71552 | 36 | $3,563 | $2,137.8 | $366.12 | $2,315.95 | 3.9× | $3,121.19 |
| Lumbosacral spine X-ray | CPT | 72100 | 36 | $604 | $362.4 | $53.09 | $392.6 | 3.8× | $529.1 |
| CT cervical spine without contrast | CPT | 72125 | 36 | $1,684 | $1,010.4 | $109.02 | $1,094.6 | 5.4× | $1,725 |
| CT thoracic spine without contrast | CPT | 72128 | 36 | $1,489 | $893.4 | $109.02 | $967.85 | 4.9× | $1,725 |
| CT lumbar spine without contrast | CPT | 72131 | 36 | $1,623 | $973.8 | $109.02 | $1,054.95 | 5.2× | $1,725 |
| MRI cervical spine without contrast | CPT | 72141 | 36 | $3,695 | $2,217 | $247.03 | $2,401.75 | 6.0× | $3,236.82 |
| MRI thoracic spine without contrast | CPT | 72146 | 36 | $2,456 | $1,473.6 | $247.03 | $1,596.4 | 4.3× | $2,250 |
| MRI lumbar spine without contrast | CPT | 72148 | 36 | $3,824 | $2,294.4 | $247.65 | $2,485.6 | 6.6× | $3,349.82 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 36 | $4,507 | $2,704.2 | $366.12 | $2,929.55 | 6.5× | $3,948.13 |
| MRI cervical spine with and without contrast | CPT | 72156 | 36 | $4,267 | $2,560.2 | $366.12 | $2,773.55 | 5.1× | $3,737.89 |
| MRI lumbar spine with contrast | CPT | 72158 | 36 | $4,732 | $2,839.2 | $366.12 | $3,075.8 | 5.6× | $4,145.23 |
| CT pelvis without contrast | CPT | 72192 | 36 | $1,200 | $720 | $109.02 | $780 | 3.9× | $1,725 |
| CT pelvis with contrast | CPT | 72193 | 36 | $2,571 | $1,542.6 | $182.5 | $1,671.15 | 5.9× | $2,252.2 |
| Shoulder X-ray | CPT | 73030 | 36 | $587 | $352.2 | $54.55 | $381.55 | 4.1× | $514.21 |
| Humerus X-ray | CPT | 73060 | 36 | $383 | $229.8 | $43.94 | $238.23 | 2.7× | $449 |
| Hand X-ray 3 views | CPT | 73130 | 36 | $538 | $322.8 | $63.28 | $349.7 | 3.8× | $471.29 |
| MRI upper extremity joint without contrast | CPT | 73221 | 36 | $3,711 | $2,226.6 | $247.81 | $2,412.15 | 5.8× | $3,250.84 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 36 | $4,868 | $2,920.8 | $366.12 | $3,164.2 | 5.2× | $4,264.37 |
| Knee X-ray 1-2 views | CPT | 73560 | 36 | $541 | $324.6 | $47.59 | $351.65 | 3.8× | $473.92 |
| Ankle X-ray 3 views | CPT | 73610 | 36 | $583 | $349.8 | $62.32 | $378.95 | 4.1× | $510.71 |
| MRI lower extremity joint without contrast | CPT | 73721 | 36 | $2,741 | $1,644.6 | $247.81 | $1,781.65 | 3.8× | $2,401.12 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 36 | $3,374 | $2,024.4 | $366.12 | $2,193.1 | 3.5× | $2,955.62 |
| CT abdomen without contrast | CPT | 74150 | 36 | $1,770 | $1,062 | $109.02 | $1,150.5 | 6.1× | $1,725 |
| CT abdomen with contrast | CPT | 74160 | 36 | $2,036 | $1,221.6 | $182.5 | $1,323.4 | 4.6× | $1,783.54 |
| CT abdomen with and without contrast | CPT | 74170 | 36 | $2,286 | $1,371.6 | $182.5 | $1,485.9 | 4.4× | $2,002.54 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 36 | $3,247 | $1,948.2 | $221.33 | $2,086.2 | 5.7× | $2,844.37 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 36 | $4,663 | $2,797.8 | $366.12 | $3,030.95 | 5.5× | $4,084.79 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 36 | $5,260 | $3,156 | $366.12 | $3,419 | 5.9× | $4,607.76 |
| MRI abdomen without contrast | CPT | 74181 | 36 | $2,824 | $1,694.4 | $247.81 | $1,835.6 | 4.7× | $2,473.82 |
| MRI abdomen with and without contrast | CPT | 74183 | 36 | $4,043 | $2,425.8 | $366.12 | $2,627.95 | 4.6× | $3,541.67 |
| Abdominal ultrasound complete | CPT | 76700 | 36 | $1,536 | $921.6 | $109.02 | $998.4 | 6.7× | $1,345.54 |
| Abdominal ultrasound limited | CPT | 76705 | 36 | $1,304 | $782.4 | $109.02 | $847.6 | 5.8× | $1,142.3 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 36 | $1,328 | $796.8 | $109.02 | $863.2 | 6.0× | $1,163.33 |
| Obstetric ultrasound first trimester | CPT | 76801 | 36 | $1,019 | $611.4 | $109.02 | $662.35 | 4.7× | $892.64 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 36 | $1,501 | $900.6 | $109.02 | $975.65 | 6.4× | $1,314.88 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 36 | $1,727 | $1,036.2 | $236.43 | $1,122.55 | 4.8× | $1,512.85 |
| Transvaginal ultrasound | CPT | 76830 | 36 | $1,015 | $609 | $109.02 | $659.75 | 4.5× | $889.14 |
| Pelvic ultrasound complete | CPT | 76856 | 36 | $1,284 | $770.4 | $109.02 | $834.6 | 5.8× | $1,124.78 |
| Scrotal ultrasound | CPT | 76870 | 36 | $1,287 | $772.2 | $99.26 | $836.55 | 6.4× | $1,127.41 |
| Diagnostic mammography unilateral | CPT | 77065 | 36 | $377 | $226.2 | $73.15 | $245.05 | 1.6× | $330.25 |
| Diagnostic mammography bilateral | CPT | 77066 | 34 | $578 | $346.8 | $93.16 | $348.53 | 1.8× | $491.3 |
| Screening mammography bilateral | CPT | 77067 | 36 | $411 | $246.6 | $38.5 | $251.74 | 1.6× | $360.04 |
| EKG tracing only | CPT | 93005 | 36 | $306 | $183.6 | $60.9 | $201.2 | 1.7× | $268.06 |
| Transthoracic echocardiogram complete | CPT | 93306 | 36 | $5,537 | $3,322.2 | $562.11 | $3,618.43 | 6.0× | $4,850.41 |
| Transthoracic echocardiogram | CPT | 93307 | 36 | $1,464 | $878.4 | $247.81 | $956.73 | 3.9× | $1,282.46 |
| Stress echocardiogram | CPT | 93350 | 36 | $4,673 | $2,803.8 | $562.11 | $3,053.81 | 6.0× | $4,093.55 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 37 | $161 | $96.6 | $8.46 | $102.4 | 3.2× | $141.04 |
| General health panel | CPT | 80050 | 32 | $349 | $209.4 | $46.97 | $226.85 | 2.1× | $305.72 |
| Electrolyte panel | CPT | 80051 | 37 | $60 | $36 | $7.01 | $39 | 1.6× | $52.56 |
| Comprehensive metabolic panel | CPT | 80053 | 37 | $311 | $186.6 | $10.56 | $193.44 | 4.4× | $272.44 |
| Lipid panel | CPT | 80061 | 37 | $182 | $109.2 | $13.39 | $115.75 | 3.0× | $159.43 |
| Renal function panel | CPT | 80069 | 37 | $77 | $46.2 | $8.68 | $48.97 | 1.8× | $67.45 |
| Hepatic function panel | CPT | 80076 | 37 | $279 | $167.4 | $8.17 | $181.35 | 6.8× | $244.4 |
| Urinalysis non-automated | CPT | 81002 | 37 | $14 | $8.4 | $3.48 | $9.1 | 1.3× | $12.26 |
| Urinalysis automated | CPT | 81003 | 37 | $35 | $21 | $2.25 | $21.77 | 1.6× | $30.66 |
| Glucose quantitative | CPT | 82947 | 37 | $105 | $63 | $3.93 | $66.78 | 3.8× | $91.98 |
| Hemoglobin A1c | CPT | 83036 | 37 | $133 | $79.8 | $9.71 | $84.59 | 3.1× | $116.51 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 37 | $244 | $146.4 | $16.8 | $155.19 | 3.3× | $213.74 |
| Complete blood count with automated differential | CPT | 85025 | 37 | $123 | $73.8 | $7.77 | $75.34 | 2.8× | $107.75 |
| Complete blood count without differential | CPT | 85027 | 37 | $139 | $83.4 | $6.47 | $88.41 | 4.1× | $121.76 |
| Urine culture bacterial | CPT | 87086 | 37 | $187 | $112.2 | $8.07 | $116.31 | 5.0× | $163.81 |
| Tissue exam by pathologist level IV | CPT | 88305 | 36 | $642 | $385.2 | $40.88 | $417.3 | 4.1× | $562.39 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 36 | $754 | $452.4 | $206.24 | $490.1 | 2.6× | $660.5 |
| Vaginal delivery only | CPT | 59409 | 17 | $2,430 | $1,458 | $342 | $1,606.23 | 0.73× | $2,128.68 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 37 | $4,356.95 | $2,614.17 | $25 | $80 | 0.09× | $4,402 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 36 | $9,025.61 | $5,415.37 | $45.6 | $911.72 | 0.94× | $4,402 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 36 | $3,475.55 | $2,085.33 | $45.6 | $80 | 0.09× | $4,402 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 36 | $4,601.44 | $2,760.86 | $45.6 | $610.16 | 0.68× | $4,402 |
| Colonoscopy diagnostic | CPT | 45378 | 37 | $11,330 | $6,797.74 | $25 | $277.47 | 0.32× | $4,402 |
| Colonoscopy with biopsy | CPT | 45380 | 37 | $14,101 | $8,460.5 | $25 | $1,208.77 | 1.00× | $4,402 |
| Colonoscopy with polyp removal | CPT | 45385 | 36 | $12,740 | $7,643.81 | $45.6 | $604.39 | 0.50× | $4,659.44 |
| surgery |
| PCI single major coronary artery | CPT | 92920 | 37 | $66,909 | $40,145 | $25 | $75.5 | 0.01× | $20,564 |
| PCI with drug-eluting stent | CPT | 92928 | 37 | $70,518 | $42,311 | $25 | $75 | 0.01× | $20,564 |
| PCI bypass graft | CPT | 92937 | 3 | $16,089 | $9,653.4 | $9,331.62 | $9,331.62 | 0.86× | $10,458 |
| Left heart catheterization | CPT | 93452 | 37 | $67,751 | $40,650 | $25 | $75 | 0.02× | $18,409 |
| Coronary angiography with cath | CPT | 93455 | 37 | $15,817 | $9,490.47 | $25 | $75 | 0.02× | $14,309 |
| Coronary angiography with bypass cath | CPT | 93458 | 37 | $56,221 | $33,733 | $25 | $3,297.41 | 1.1× | $20,564 |