| emergency |
| ED visit level 1 | CPT | 99281 | 1 | $793 | $237.9 | $325.13 | $325.13 | 2.3× | $325.13 |
| ED visit level 2 | CPT | 99282 | 1 | $1,019 | $305.7 | $417.79 | $417.79 | 1.8× | $417.79 |
| ED visit level 3 | CPT | 99283 | 1 | $1,778 | $533.4 | $728.98 | $728.98 | 1.8× | $728.98 |
| ED visit level 4 | CPT | 99284 | 1 | $2,397 | $719.1 | $982.77 | $982.77 | 1.5× | $982.77 |
| ED visit level 5 | CPT | 99285 | 1 | $2,871 | $861.3 | $1,177.11 | $1,177.11 | 1.1× | $1,177.11 |
| Critical care, first hour | CPT | 99291 | 1 | $3,044 | $913.2 | $1,248.04 | $1,248.04 | 1.2× | $1,248.04 |
| imaging |
| CT head without contrast | CPT | 70450 | 10 | $5,291 | $1,587.3 | $1,068.78 | $3,042.33 | 14.7× | $3,632.27 |
| CT head with contrast | CPT | 70460 | 10 | $5,557 | $1,667.1 | $1,122.51 | $3,195.28 | 13.7× | $3,814.88 |
| CT head with and without contrast | CPT | 70470 | 10 | $6,058 | $1,817.4 | $1,223.72 | $3,483.35 | 13.0× | $4,158.82 |
| CT neck with contrast | CPT | 70491 | 10 | $3,305 | $991.5 | $667.61 | $1,900.38 | 6.9× | $2,268.88 |
| MRI brain without contrast | CPT | 70551 | 10 | $5,798 | $1,739.4 | $1,171.2 | $3,333.85 | 8.3× | $3,980.33 |
| MRI brain with contrast | CPT | 70552 | 10 | $5,970 | $1,791 | $1,205.94 | $3,432.75 | 7.2× | $4,098.41 |
| MRI brain with and without contrast | CPT | 70553 | 10 | $7,905 | $2,371.5 | $1,596.81 | $4,545.38 | 7.7× | $5,426.78 |
| Chest X-ray single view | CPT | 71045 | 28 | $712 | $213.6 | $143.82 | $640.8 | 6.8× | $640.8 |
| Chest X-ray 2 views | CPT | 71046 | 28 | $758 | $227.4 | $153.12 | $682.2 | 6.9× | $682.2 |
| Chest X-ray 3 views | CPT | 71047 | 28 | $834 | $250.2 | $168.47 | $750.6 | 7.8× | $750.6 |
| CT chest without contrast | CPT | 71250 | 10 | $5,039 | $1,511.7 | $1,017.88 | $2,897.43 | 13.5× | $3,459.27 |
| CT chest with contrast | CPT | 71260 | 10 | $2,894 | $868.2 | $584.59 | $1,664.05 | 5.9× | $1,986.73 |
| CT chest with and without contrast | CPT | 71270 | 10 | $3,024 | $907.2 | $610.85 | $1,738.8 | 6.0× | $2,075.98 |
| MRI chest without contrast | CPT | 71550 | 10 | $3,755 | $1,126.5 | $758.51 | $2,159.13 | 5.0× | $2,577.81 |
| Lumbosacral spine X-ray | CPT | 72100 | 28 | $739 | $221.7 | $149.28 | $665.1 | 6.4× | $665.1 |
| CT cervical spine without contrast | CPT | 72125 | 10 | $9,193 | $2,757.9 | $1,856.99 | $5,285.98 | 26.2× | $6,310.99 |
| CT thoracic spine without contrast | CPT | 72128 | 10 | $4,526 | $1,357.8 | $914.25 | $2,602.45 | 13.1× | $3,107.1 |
| CT lumbar spine without contrast | CPT | 72131 | 10 | $5,200 | $1,560 | $1,050.4 | $2,990 | 14.7× | $3,569.8 |
| MRI cervical spine without contrast | CPT | 72141 | 10 | $9,520 | $2,856 | $1,923.04 | $5,474 | 13.8× | $6,535.48 |
| MRI thoracic spine without contrast | CPT | 72146 | 10 | $9,466 | $2,839.8 | $1,912.13 | $5,442.95 | 14.6× | $6,498.41 |
| MRI lumbar spine without contrast | CPT | 72148 | 10 | $7,253 | $2,175.9 | $1,465.11 | $4,170.48 | 11.1× | $4,979.18 |
| MRI cervical spine with and without contrast | CPT | 72156 | 10 | $11,518 | $3,455.4 | $2,326.64 | $6,622.85 | 12.3× | $7,907.11 |
| MRI lumbar spine with contrast | CPT | 72158 | 10 | $9,832 | $2,949.6 | $1,986.06 | $5,653.4 | 10.3× | $6,749.67 |
| CT pelvis without contrast | CPT | 72192 | 10 | $7,396 | $2,218.8 | $1,493.99 | $4,252.7 | 21.3× | $5,077.35 |
| CT pelvis with contrast | CPT | 72193 | 10 | $7,767 | $2,330.1 | $1,568.93 | $4,466.03 | 15.9× | $5,332.05 |
| Shoulder X-ray | CPT | 73030 | 28 | $883.5 | $265.05 | $118.98 | $530.1 | 5.7× | $795.15 |
| Humerus X-ray | CPT | 73060 | 28 | $1,242 | $372.6 | $167.26 | $745.2 | 8.3× | $1,117.8 |
| Hand X-ray 3 views | CPT | 73130 | 28 | $937.5 | $281.25 | $126.25 | $562.5 | 6.0× | $843.75 |
| MRI upper extremity joint without contrast | CPT | 73221 | 10 | $13,265 | $3,979.35 | $1,786.29 | $5,909.34 | 14.2× | $9,106.08 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 10 | $8,228 | $2,468.4 | $1,662.06 | $4,731.1 | 7.7× | $5,648.52 |
| Knee X-ray 1-2 views | CPT | 73560 | 28 | $1,579.5 | $473.85 | $212.71 | $947.7 | 10.2× | $1,421.55 |
| Ankle X-ray 3 views | CPT | 73610 | 28 | $1,351.5 | $405.45 | $182 | $810.9 | 8.8× | $1,216.35 |
| MRI lower extremity joint without contrast | CPT | 73721 | 10 | $10,205 | $3,061.35 | $1,374.21 | $4,546.11 | 9.7× | $7,005.39 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 10 | $8,264 | $2,479.2 | $1,669.33 | $4,751.8 | 7.5× | $5,673.24 |
| CT abdomen without contrast | CPT | 74150 | 10 | $9,319 | $2,795.7 | $1,882.44 | $5,358.43 | 28.5× | $6,397.49 |
| CT abdomen with contrast | CPT | 74160 | 10 | $10,829 | $3,248.7 | $2,187.46 | $6,226.68 | 21.7× | $7,434.11 |
| CT abdomen with and without contrast | CPT | 74170 | 10 | $13,610 | $4,083 | $2,749.22 | $7,825.75 | 23.4× | $9,343.27 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 10 | $9,319 | $2,795.7 | $1,882.44 | $5,358.43 | 14.7× | $6,397.49 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 10 | $8,918 | $2,675.4 | $1,801.44 | $5,127.85 | 9.3× | $6,122.21 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 10 | $17,693 | $5,307.9 | $3,573.99 | $10,173 | 17.7× | $12,146 |
| MRI abdomen without contrast | CPT | 74181 | 10 | $5,443 | $1,632.9 | $1,099.49 | $3,129.73 | 8.0× | $3,736.62 |
| MRI abdomen with and without contrast | CPT | 74183 | 10 | $9,184 | $2,755.2 | $1,855.17 | $5,280.8 | 9.3× | $6,304.82 |
| Abdominal ultrasound complete | CPT | 76700 | 10 | $2,493 | $747.9 | $503.59 | $1,433.48 | 9.6× | $1,711.44 |
| Abdominal ultrasound limited | CPT | 76705 | 10 | $1,748 | $524.4 | $353.1 | $1,005.1 | 6.9× | $1,200 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 10 | $2,729 | $818.7 | $551.26 | $1,569.18 | 10.9× | $1,873.46 |
| Obstetric ultrasound first trimester | CPT | 76801 | 28 | $594 | $178.2 | $119.99 | $534.6 | 3.8× | $534.6 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 28 | $1,720 | $516 | $347.44 | $1,548 | 10.1× | $1,548 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 28 | $1,615 | $484.5 | $326.23 | $1,453.5 | 6.2× | $1,453.5 |
| Transvaginal ultrasound | CPT | 76830 | 28 | $2,025 | $607.5 | $409.05 | $1,822.5 | 12.3× | $1,822.5 |
| Pelvic ultrasound complete | CPT | 76856 | 10 | $2,034 | $610.2 | $410.87 | $1,169.55 | 8.2× | $1,396.34 |
| Scrotal ultrasound | CPT | 76870 | 10 | $2,251 | $675.3 | $454.7 | $1,294.33 | 9.9× | $1,545.31 |
| Diagnostic mammography unilateral | CPT | 77065 | 28 | $617 | $185.1 | $124.63 | $555.3 | 3.7× | $555.3 |
| Diagnostic mammography bilateral | CPT | 77066 | 28 | $947 | $284.1 | $191.29 | $852.3 | 4.5× | $852.3 |
| Screening mammography bilateral | CPT | 77067 | 28 | $729 | $218.7 | $147.26 | $656.1 | 4.2× | $656.1 |
| EKG tracing only | CPT | 93005 | 30 | $629 | $188.7 | $127.06 | $566.1 | 4.8× | $566.1 |
| Transthoracic echocardiogram complete | CPT | 93306 | 30 | $5,074 | $1,522.2 | $1,024.95 | $4,566.6 | 7.6× | $4,566.6 |
| Transthoracic echocardiogram | CPT | 93307 | 30 | $1,189 | $356.7 | $240.18 | $1,070.1 | 4.3× | $1,070.1 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 28 | $310 | $93 | $62 | $279 | 8.6× | $279 |
| General health panel | CPT | 80050 | 2 | $3,462 | $1,038.6 | $1,038.6 | $1,038.6 | 9.7× | $1,038.6 |
| Electrolyte panel | CPT | 80051 | 28 | $223 | $66.9 | $44.6 | $200.7 | 8.4× | $200.7 |
| Comprehensive metabolic panel | CPT | 80053 | 28 | $325 | $97.5 | $65 | $292.5 | 6.6× | $292.5 |
| Lipid panel | CPT | 80061 | 28 | $385 | $115.5 | $77 | $346.5 | 9.1× | $346.5 |
| Renal function panel | CPT | 80069 | 28 | $324 | $97.2 | $64.8 | $291.6 | 10.7× | $291.6 |
| Hepatic function panel | CPT | 80076 | 28 | $496 | $148.8 | $99.2 | $446.4 | 16.8× | $446.4 |
| Urinalysis non-automated | CPT | 81002 | 28 | $31 | $9.3 | $6.2 | $27.9 | 4.0× | $27.9 |
| Urinalysis automated | CPT | 81003 | 28 | $26 | $7.8 | $5.2 | $23.4 | 1.7× | $23.4 |
| Glucose quantitative | CPT | 82947 | 28 | $152 | $45.6 | $30.4 | $136.8 | 7.8× | $136.8 |
| Hemoglobin A1c | CPT | 83036 | 28 | $266 | $79.8 | $53.2 | $239.4 | 8.9× | $239.4 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 28 | $940 | $282 | $188 | $846 | 17.9× | $846 |
| Complete blood count with automated differential | CPT | 85025 | 28 | $328 | $98.4 | $65.6 | $295.2 | 11.1× | $295.2 |
| Complete blood count without differential | CPT | 85027 | 28 | $404 | $121.2 | $80.8 | $363.6 | 16.8× | $363.6 |
| Urine culture bacterial | CPT | 87086 | 28 | $219 | $65.7 | $43.8 | $197.1 | 8.5× | $197.1 |
| Tissue exam by pathologist level IV | CPT | 88305 | 28 | $918 | $275.4 | $183.6 | $826.2 | 8.1× | $826.2 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 13 | $3,124 | $937.2 | $631.05 | $1,562 | 8.3× | $2,144.63 |
| office |
| Office visit, established patient, 5 min | CPT | 99211 | 30 | $938 | $281.4 | $189.48 | $844.2 | 13.1× | $844.2 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 9 | $5,935 | $1,780.5 | $1,198.87 | $3,857.75 | 4.2× | $4,074.38 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 9 | $6,531 | $1,959.3 | $1,319.26 | $4,245.15 | 4.4× | $4,483.53 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 10 | $1,710 | $513 | $345.42 | $855 | 1.0× | $1,173.92 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 9 | $1,710 | $513 | $345.42 | $1,111.5 | 1.2× | $1,173.92 |
| Colonoscopy diagnostic | CPT | 45378 | 9 | $7,779 | $2,333.7 | $1,571.36 | $5,056.35 | 5.8× | $5,340.28 |
| Colonoscopy with biopsy | CPT | 45380 | 9 | $9,992 | $2,997.6 | $2,018.38 | $6,494.8 | 5.4× | $6,859.51 |
| Colonoscopy with polyp removal | CPT | 45385 | 9 | $9,992 | $2,997.6 | $2,018.38 | $6,494.8 | 5.4× | $6,859.51 |
| surgery |
| PCI single major coronary artery | CPT | 92920 | 30 | $27,100 | $8,130 | $5,474.2 | $24,390 | 4.3× | $24,390 |
| PCI with drug-eluting stent | CPT | 92928 | 2 | $41,159 | $12,348 | $16,669 | $18,563 | 1.9× | $23,831 |
| Left heart catheterization | CPT | 93452 | 30 | $30,615 | $9,184.5 | $6,184.23 | $27,554 | 8.9× | $27,554 |
| Coronary angiography with bypass cath | CPT | 93458 | 30 | $38,270 | $11,481 | $7,730.54 | $34,443 | 11.1× | $34,443 |