| emergency |
| ED visit level 3 | CPT | 99283 | 3 | $1,870 | $561 | $751.37 | $766.7 | 1.9× | $766.7 |
| ED visit level 4 | CPT | 99284 | 3 | $2,993 | $897.9 | $1,202.59 | $1,227.13 | 1.8× | $1,227.13 |
| ED visit level 5 | CPT | 99285 | 3 | $4,705 | $1,411.5 | $1,890.47 | $1,929.05 | 1.8× | $1,929.05 |
| imaging |
| CT head without contrast | CPT | 70450 | 6 | $4,078 | $1,223.4 | $787.05 | $2,039 | 9.9× | $3,792.54 |
| CT head with contrast | CPT | 70460 | 6 | $4,323 | $1,296.9 | $834.34 | $2,161.5 | 9.2× | $4,020.39 |
| CT head with and without contrast | CPT | 70470 | 6 | $6,250 | $1,875 | $1,206.25 | $3,125 | 11.7× | $5,812.5 |
| CT neck with contrast | CPT | 70491 | 6 | $4,297 | $1,289.1 | $829.32 | $2,148.5 | 7.9× | $3,996.21 |
| MRI brain without contrast | CPT | 70551 | 6 | $3,468 | $1,040.4 | $669.32 | $1,734 | 4.3× | $3,225.24 |
| MRI brain with contrast | CPT | 70552 | 6 | $5,667 | $1,700.1 | $1,093.73 | $2,833.5 | 5.9× | $5,270.31 |
| MRI brain with and without contrast | CPT | 70553 | 6 | $8,333 | $2,499.9 | $1,608.27 | $4,166.5 | 7.1× | $7,749.69 |
| Chest X-ray single view | CPT | 71045 | 23 | $325 | $97.5 | $62.73 | $292.5 | 3.1× | $302.25 |
| Chest X-ray 2 views | CPT | 71046 | 23 | $577 | $173.1 | $111.36 | $519.3 | 5.3× | $536.61 |
| CT chest without contrast | CPT | 71250 | 6 | $2,614 | $784.2 | $504.5 | $1,307 | 6.1× | $2,431.02 |
| CT chest with contrast | CPT | 71260 | 6 | $4,429 | $1,328.7 | $854.8 | $2,214.5 | 7.9× | $4,118.97 |
| CT chest with and without contrast | CPT | 71270 | 6 | $5,111 | $1,533.3 | $986.42 | $2,555.5 | 8.8× | $4,753.23 |
| MRI chest without contrast | CPT | 71550 | 6 | $4,390 | $1,317 | $847.27 | $2,195 | 5.1× | $4,082.7 |
| MRI chest with and without contrast | CPT | 71552 | 6 | $4,939 | $1,481.7 | $953.23 | $2,469.5 | 4.1× | $4,593.27 |
| Lumbosacral spine X-ray | CPT | 72100 | 23 | $881 | $264.3 | $170.03 | $792.9 | 7.7× | $819.33 |
| CT cervical spine without contrast | CPT | 72125 | 6 | $4,326 | $1,297.8 | $834.92 | $2,163 | 10.7× | $4,023.18 |
| CT thoracic spine without contrast | CPT | 72128 | 6 | $3,938 | $1,181.4 | $760.03 | $1,969 | 9.9× | $3,662.34 |
| CT lumbar spine without contrast | CPT | 72131 | 6 | $3,950 | $1,185 | $762.35 | $1,975 | 9.7× | $3,673.5 |
| MRI cervical spine without contrast | CPT | 72141 | 6 | $4,194 | $1,258.2 | $809.44 | $2,097 | 5.3× | $3,900.42 |
| MRI thoracic spine without contrast | CPT | 72146 | 6 | $4,401 | $1,320.3 | $849.39 | $2,200.5 | 5.9× | $4,092.93 |
| MRI lumbar spine without contrast | CPT | 72148 | 6 | $4,562 | $1,368.6 | $880.47 | $2,281 | 6.1× | $4,242.66 |
| MRI cervical spine with and without contrast | CPT | 72156 | 6 | $6,872 | $2,061.6 | $1,326.3 | $3,436 | 6.4× | $6,390.96 |
| MRI lumbar spine with contrast | CPT | 72158 | 6 | $6,932 | $2,079.6 | $1,337.88 | $3,466 | 6.3× | $6,446.76 |
| CT pelvis without contrast | CPT | 72192 | 6 | $3,953 | $1,185.9 | $762.93 | $1,976.5 | 9.9× | $3,676.29 |
| CT pelvis with contrast | CPT | 72193 | 6 | $4,617 | $1,385.1 | $891.08 | $2,308.5 | 8.2× | $4,293.81 |
| Shoulder X-ray | CPT | 73030 | 23 | $781 | $234.3 | $150.73 | $702.9 | 7.6× | $726.33 |
| Humerus X-ray | CPT | 73060 | 23 | $763 | $228.9 | $147.26 | $686.7 | 7.7× | $709.59 |
| Hand X-ray 3 views | CPT | 73130 | 23 | $675 | $202.5 | $130.28 | $607.5 | 6.5× | $627.75 |
| MRI upper extremity joint without contrast | CPT | 73221 | 6 | $6,046.5 | $1,813.95 | $777.98 | $2,899.3 | 7.0× | $5,623.25 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 6 | $4,779 | $1,433.7 | $922.35 | $2,389.5 | 3.9× | $4,444.47 |
| Knee X-ray 1-2 views | CPT | 73560 | 23 | $1,015.5 | $304.65 | $130.66 | $609.3 | 6.5× | $944.42 |
| Ankle X-ray 3 views | CPT | 73610 | 23 | $1,119 | $335.7 | $143.98 | $671.4 | 7.3× | $1,040.67 |
| MRI lower extremity joint without contrast | CPT | 73721 | 6 | $4,191 | $1,257.3 | $808.86 | $2,095.5 | 4.5× | $3,897.63 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 6 | $4,858 | $1,457.4 | $937.59 | $2,429 | 3.8× | $4,517.94 |
| CT abdomen without contrast | CPT | 74150 | 6 | $3,983 | $1,194.9 | $768.72 | $1,991.5 | 10.6× | $3,704.19 |
| CT abdomen with contrast | CPT | 74160 | 6 | $4,607 | $1,382.1 | $889.15 | $2,303.5 | 8.0× | $4,284.51 |
| CT abdomen with and without contrast | CPT | 74170 | 6 | $5,574 | $1,672.2 | $1,075.78 | $2,787 | 8.3× | $5,183.82 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 6 | $5,553 | $1,665.9 | $1,071.73 | $2,776.5 | 7.6× | $5,164.29 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 6 | $6,456 | $1,936.8 | $1,246.01 | $3,228 | 5.9× | $6,004.08 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 6 | $11,210 | $3,363 | $2,163.53 | $5,605 | 9.7× | $10,425 |
| MRI abdomen without contrast | CPT | 74181 | 6 | $4,147 | $1,244.1 | $800.37 | $2,073.5 | 5.3× | $3,856.71 |
| MRI abdomen with and without contrast | CPT | 74183 | 6 | $4,437 | $1,331.1 | $856.34 | $2,218.5 | 3.9× | $4,126.41 |
| Abdominal ultrasound complete | CPT | 76700 | 6 | $1,590 | $477 | $306.87 | $795 | 5.3× | $1,478.7 |
| Abdominal ultrasound limited | CPT | 76705 | 6 | $1,316 | $394.8 | $253.99 | $658 | 4.5× | $1,223.88 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 6 | $1,402 | $420.6 | $270.59 | $701 | 4.9× | $1,303.86 |
| Obstetric ultrasound first trimester | CPT | 76801 | 23 | $1,269 | $380.7 | $244.92 | $1,142.1 | 8.1× | $1,180.17 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 23 | $1,219 | $365.7 | $235.27 | $1,097.1 | 7.2× | $1,133.67 |
| Transvaginal ultrasound | CPT | 76830 | 23 | $1,140 | $342 | $220.02 | $1,026 | 6.9× | $1,060.2 |
| Pelvic ultrasound complete | CPT | 76856 | 6 | $1,288 | $386.4 | $248.58 | $644 | 4.5× | $1,197.84 |
| Scrotal ultrasound | CPT | 76870 | 6 | $1,224 | $367.2 | $236.23 | $612 | 4.7× | $1,138.32 |
| EKG tracing only | CPT | 93005 | 26 | $632 | $189.6 | $121.98 | $568.8 | 4.8× | $587.76 |
| Transthoracic echocardiogram complete | CPT | 93306 | 26 | $2,414 | $724.2 | $465.9 | $2,172.6 | 3.6× | $2,245.02 |
| Stress echocardiogram | CPT | 93350 | 26 | $2,606 | $781.8 | $502.96 | $2,345.4 | 4.6× | $2,423.58 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 23 | $405 | $121.5 | $78.17 | $364.5 | 11.3× | $376.65 |
| General health panel | CPT | 80050 | 3 | $1,543 | $462.9 | $462.9 | $462.9 | 4.3× | $462.9 |
| Electrolyte panel | CPT | 80051 | 23 | $385 | $115.5 | $74.31 | $346.5 | 14.6× | $358.05 |
| Comprehensive metabolic panel | CPT | 80053 | 23 | $695 | $208.5 | $134.14 | $625.5 | 14.1× | $646.35 |
| Lipid panel | CPT | 80061 | 23 | $492 | $147.6 | $94.96 | $442.8 | 11.6× | $457.56 |
| Renal function panel | CPT | 80069 | 23 | $377 | $113.1 | $72.76 | $339.3 | 12.4× | $350.61 |
| Hepatic function panel | CPT | 80076 | 23 | $599 | $179.7 | $115.61 | $539.1 | 20.3× | $557.07 |
| Urinalysis non-automated | CPT | 81002 | 23 | $45 | $13.5 | $8.69 | $40.5 | 5.8× | $41.85 |
| Urinalysis automated | CPT | 81003 | 23 | $85 | $25.5 | $16.41 | $76.5 | 5.5× | $79.05 |
| Glucose quantitative | CPT | 82947 | 23 | $326 | $97.8 | $62.92 | $293.4 | 16.7× | $303.18 |
| Hemoglobin A1c | CPT | 83036 | 23 | $277 | $83.1 | $53.46 | $249.3 | 9.3× | $257.61 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 23 | $491 | $147.3 | $94.76 | $441.9 | 9.3× | $456.63 |
| Complete blood count with automated differential | CPT | 85025 | 23 | $327 | $98.1 | $63.11 | $294.3 | 11.1× | $304.11 |
| Complete blood count without differential | CPT | 85027 | 23 | $166 | $49.8 | $32.04 | $149.4 | 6.9× | $154.38 |
| Urine culture bacterial | CPT | 87086 | 23 | $434 | $130.2 | $83.76 | $390.6 | 16.7× | $403.62 |
| Tissue exam by pathologist level IV | CPT | 88305 | 23 | $963 | $288.9 | $185.86 | $866.7 | 8.5× | $895.59 |
| office |
| Office visit, established patient, 5 min | CPT | 99211 | 26 | $891 | $267.3 | $114.64 | $534.6 | 8.3× | $828.63 |