| emergency |
| ED visit level 1 | CPT | 99281 | 34 | $480 | $144 | $110.4 | $336.72 | 2.4× | $480 |
| ED visit level 2 | CPT | 99282 | 7 | $960 | $288 | $220.8 | $220.8 | 0.93× | $475.2 |
| ED visit level 3 | CPT | 99283 | 7 | $1,411 | $423.3 | $324.53 | $324.53 | 0.80× | $698.45 |
| ED visit level 4 | CPT | 99284 | 34 | $2,026 | $607.8 | $465.98 | $1,421.24 | 2.1× | $2,026 |
| ED visit level 5 | CPT | 99285 | 34 | $2,706 | $811.8 | $622.38 | $1,898.26 | 1.8× | $2,706 |
| Critical care, first hour | CPT | 99291 | 7 | $3,489 | $1,046.7 | $802.47 | $802.47 | 0.75× | $1,727.06 |
| imaging |
| CT head without contrast | CPT | 70450 | 20 | $2,856 | $856.8 | $714 | $853.94 | 4.1× | $2,856 |
| CT head with contrast | CPT | 70460 | 20 | $2,962 | $888.6 | $740.5 | $885.64 | 3.8× | $2,962 |
| CT head with and without contrast | CPT | 70470 | 20 | $3,147 | $944.1 | $786.75 | $940.95 | 3.5× | $3,147 |
| CT neck with contrast | CPT | 70491 | 20 | $2,629 | $788.7 | $657.25 | $786.07 | 2.9× | $2,629 |
| MRI brain without contrast | CPT | 70551 | 20 | $3,330 | $999 | $832.5 | $995.67 | 2.5× | $3,330 |
| MRI brain with contrast | CPT | 70552 | 20 | $5,467 | $1,640.1 | $1,366.75 | $1,634.63 | 3.4× | $5,467 |
| MRI brain with and without contrast | CPT | 70553 | 20 | $4,963 | $1,488.9 | $1,240.75 | $1,483.94 | 2.5× | $4,963 |
| Chest X-ray single view | CPT | 71045 | 37 | $424 | $127.2 | $106 | $262.88 | 2.8× | $424 |
| Chest X-ray 2 views | CPT | 71046 | 37 | $678 | $203.4 | $169.5 | $420.36 | 4.3× | $678 |
| Chest X-ray 3 views | CPT | 71047 | 37 | $745 | $223.5 | $186.25 | $461.9 | 4.8× | $745 |
| CT chest without contrast | CPT | 71250 | 20 | $3,206 | $961.8 | $801.5 | $958.59 | 4.5× | $3,206 |
| CT chest with contrast | CPT | 71260 | 20 | $3,708 | $1,112.4 | $927 | $1,108.69 | 3.9× | $3,708 |
| CT chest with and without contrast | CPT | 71270 | 20 | $4,171 | $1,251.3 | $1,042.75 | $1,247.13 | 4.3× | $4,171 |
| Lumbosacral spine X-ray | CPT | 72100 | 37 | $968 | $290.4 | $242 | $600.16 | 5.8× | $968 |
| CT cervical spine without contrast | CPT | 72125 | 20 | $3,367 | $1,010.1 | $841.75 | $1,006.73 | 5.0× | $3,367 |
| CT thoracic spine without contrast | CPT | 72128 | 20 | $3,196 | $958.8 | $799 | $955.6 | 4.8× | $3,196 |
| CT lumbar spine without contrast | CPT | 72131 | 20 | $3,314 | $994.2 | $828.5 | $990.89 | 4.9× | $3,314 |
| MRI cervical spine without contrast | CPT | 72141 | 20 | $4,611 | $1,383.3 | $1,152.75 | $1,378.69 | 3.5× | $4,611 |
| MRI thoracic spine without contrast | CPT | 72146 | 20 | $4,372 | $1,311.6 | $1,093 | $1,307.23 | 3.5× | $4,372 |
| MRI lumbar spine without contrast | CPT | 72148 | 20 | $4,550 | $1,365 | $1,137.5 | $1,360.45 | 3.6× | $4,550 |
| MRI cervical spine with and without contrast | CPT | 72156 | 20 | $5,432 | $1,629.6 | $1,358 | $1,624.17 | 3.0× | $5,432 |
| MRI lumbar spine with contrast | CPT | 72158 | 20 | $5,833 | $1,749.9 | $1,458.25 | $1,744.07 | 3.2× | $5,833 |
| CT pelvis without contrast | CPT | 72192 | 20 | $3,096 | $928.8 | $774 | $925.7 | 4.6× | $3,096 |
| CT pelvis with contrast | CPT | 72193 | 20 | $3,404 | $1,021.2 | $851 | $1,017.8 | 3.6× | $3,404 |
| Shoulder X-ray | CPT | 73030 | 37 | $1,342.5 | $402.75 | $223.75 | $656.48 | 7.1× | $1,342.5 |
| Humerus X-ray | CPT | 73060 | 37 | $910 | $273 | $227.5 | $564.2 | 6.3× | $910 |
| Hand X-ray 3 views | CPT | 73130 | 37 | $1,516.5 | $454.95 | $252.75 | $741.57 | 8.0× | $1,516.5 |
| MRI upper extremity joint without contrast | CPT | 73221 | 20 | $7,392 | $2,217.6 | $1,232 | $2,210.21 | 5.3× | $7,392 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 20 | $5,995 | $1,798.5 | $1,498.75 | $1,792.51 | 2.9× | $5,995 |
| Knee X-ray 1-2 views | CPT | 73560 | 37 | $1,449 | $434.7 | $241.5 | $708.56 | 7.6× | $1,449 |
| Ankle X-ray 3 views | CPT | 73610 | 37 | $1,533 | $459.9 | $255.5 | $749.64 | 8.1× | $1,533 |
| MRI lower extremity joint without contrast | CPT | 73721 | 20 | $6,267 | $1,880.1 | $1,044.5 | $1,873.83 | 4.0× | $6,267 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 20 | $5,973 | $1,791.9 | $1,493.25 | $1,785.93 | 2.8× | $5,973 |
| CT abdomen without contrast | CPT | 74150 | 20 | $3,050 | $915 | $762.5 | $911.95 | 4.8× | $3,050 |
| CT abdomen with contrast | CPT | 74160 | 20 | $3,355 | $1,006.5 | $838.75 | $1,003.15 | 3.5× | $3,355 |
| CT abdomen with and without contrast | CPT | 74170 | 20 | $4,433 | $1,329.9 | $1,108.25 | $1,325.47 | 4.0× | $4,433 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 20 | $3,060 | $918 | $765 | $914.94 | 2.5× | $3,060 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 20 | $4,567 | $1,370.1 | $1,141.75 | $1,365.53 | 2.5× | $4,567 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 20 | $6,655 | $1,996.5 | $1,663.75 | $1,989.85 | 3.5× | $6,655 |
| MRI abdomen without contrast | CPT | 74181 | 20 | $4,619 | $1,385.7 | $1,154.75 | $1,381.08 | 3.5× | $4,619 |
| MRI abdomen with and without contrast | CPT | 74183 | 20 | $5,590 | $1,677 | $1,397.5 | $1,671.41 | 2.9× | $5,590 |
| Abdominal ultrasound complete | CPT | 76700 | 23 | $1,787 | $536.1 | $446.75 | $784.49 | 5.3× | $1,787 |
| Abdominal ultrasound limited | CPT | 76705 | 23 | $1,348 | $404.4 | $337 | $591.77 | 4.0× | $1,348 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 23 | $1,606 | $481.8 | $401.5 | $705.03 | 4.9× | $1,606 |
| Obstetric ultrasound first trimester | CPT | 76801 | 37 | $1,281 | $384.3 | $320.25 | $794.22 | 5.6× | $1,281 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 37 | $1,654 | $496.2 | $413.5 | $1,025.48 | 6.7× | $1,654 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 37 | $413 | $123.9 | $103.25 | $256.06 | 1.1× | $413 |
| Transvaginal ultrasound | CPT | 76830 | 37 | $1,168 | $350.4 | $292 | $724.16 | 4.9× | $1,168 |
| Pelvic ultrasound complete | CPT | 76856 | 23 | $1,481 | $444.3 | $370.25 | $650.16 | 4.5× | $1,481 |
| Scrotal ultrasound | CPT | 76870 | 23 | $1,383 | $414.9 | $345.75 | $607.14 | 4.6× | $1,383 |
| Diagnostic mammography unilateral | CPT | 77065 | 34 | $416 | $124.8 | $104 | $288.29 | 1.9× | $416 |
| Diagnostic mammography bilateral | CPT | 77066 | 34 | $570 | $171 | $142.5 | $395.01 | 2.1× | $570 |
| Screening mammography bilateral | CPT | 77067 | 34 | $496 | $148.8 | $124 | $343.73 | 2.2× | $496 |
| EKG tracing only | CPT | 93005 | 37 | $511 | $153.3 | $127.75 | $316.82 | 2.7× | $511 |
| Transthoracic echocardiogram complete | CPT | 93306 | 37 | $2,269 | $680.7 | $567.25 | $1,406.78 | 2.3× | $2,269 |
| Stress echocardiogram | CPT | 93350 | 37 | $1,629 | $488.7 | $407.25 | $1,009.98 | 2.0× | $1,629 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 34 | $467 | $140.1 | $116.75 | $327.6 | 10.1× | $467 |
| General health panel | CPT | 80050 | 38 | $2,345 | $703.5 | $586.25 | $1,453.9 | 13.5× | $2,345 |
| Electrolyte panel | CPT | 80051 | 34 | $45 | $13.5 | $11.25 | $31.57 | 1.3× | $45 |
| Comprehensive metabolic panel | CPT | 80053 | 34 | $579 | $173.7 | $144.75 | $406.17 | 9.1× | $579 |
| Lipid panel | CPT | 80061 | 34 | $588 | $176.4 | $147 | $412.48 | 10.8× | $588 |
| Renal function panel | CPT | 80069 | 34 | $465 | $139.5 | $116.25 | $326.2 | 12.0× | $465 |
| Hepatic function panel | CPT | 80076 | 34 | $356 | $106.8 | $89 | $249.74 | 9.4× | $356 |
| Urinalysis non-automated | CPT | 81002 | 34 | $14 | $4.2 | $3.5 | $9.82 | 1.4× | $14 |
| Urinalysis automated | CPT | 81003 | 34 | $172 | $51.6 | $43 | $120.66 | 8.7× | $172 |
| Glucose quantitative | CPT | 82947 | 34 | $106 | $31.8 | $26.5 | $74.36 | 4.2× | $106 |
| Hemoglobin A1c | CPT | 83036 | 34 | $162 | $48.6 | $8 | $36.25 | 1.3× | $162 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 34 | $265 | $79.5 | $66.25 | $185.9 | 3.9× | $265 |
| Complete blood count with automated differential | CPT | 85025 | 34 | $473 | $141.9 | $118.25 | $331.81 | 12.5× | $473 |
| Complete blood count without differential | CPT | 85027 | 34 | $211 | $63.3 | $52.75 | $148.02 | 6.8× | $211 |
| Urine culture bacterial | CPT | 87086 | 34 | $256 | $76.8 | $64 | $179.59 | 7.7× | $256 |
| Urine culture identification | CPT | 87088 | 34 | $37 | $11.1 | $9.25 | $25.96 | 1.2× | $37 |
| Tissue exam by pathologist level IV | CPT | 88305 | 34 | $412 | $123.6 | $103 | $289.02 | 2.8× | $412 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 37 | $895 | $268.5 | $223.75 | $554.9 | 3.0× | $895 |
| office |
| Office visit, established patient, 5 min | CPT | 99211 | 37 | $430 | $129 | $107.5 | $239.73 | 3.7× | $430 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 18 | $5,385 | $1,615.5 | $1,346.25 | $2,633.27 | 2.9× | $5,385 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 18 | $5,734 | $1,720.2 | $1,433.5 | $2,803.93 | 2.9× | $5,734 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 18 | $2,201 | $660.3 | $550.25 | $1,076.29 | 1.3× | $2,201 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 18 | $2,901 | $870.3 | $725.25 | $1,418.59 | 1.6× | $2,901 |
| Colonoscopy diagnostic | CPT | 45378 | 18 | $4,861 | $1,458.3 | $1,215.25 | $2,377.03 | 2.7× | $4,861 |
| Colonoscopy with biopsy | CPT | 45380 | 18 | $5,306 | $1,591.8 | $1,326.5 | $2,594.63 | 2.1× | $5,306 |
| Colonoscopy with polyp removal | CPT | 45385 | 18 | $5,767 | $1,730.1 | $1,441.75 | $2,820.06 | 2.3× | $5,767 |