| emergency |
| ED visit level 1 | CPT | 99281 | 31 | $1,836 | $550.8 | $422.28 | $1,081.4 | 7.7× | $1,468.8 |
| ED visit level 2 | CPT | 99282 | 5 | $1,462 | $438.6 | $336.26 | $336.26 | 1.4× | $336.26 |
| ED visit level 3 | CPT | 99283 | 5 | $2,101 | $630.3 | $483.23 | $483.23 | 1.2× | $483.23 |
| ED visit level 4 | CPT | 99284 | 31 | $3,134 | $940.2 | $720.82 | $1,845.93 | 2.8× | $2,507.2 |
| ED visit level 5 | CPT | 99285 | 31 | $4,384 | $1,315.2 | $1,008.32 | $2,582.18 | 2.5× | $3,507.2 |
| Critical care, first hour | CPT | 99291 | 5 | $6,040 | $1,812 | $1,389.2 | $1,389.2 | 1.3× | $1,389.2 |
| imaging |
| CT head without contrast | CPT | 70450 | 15 | $4,675 | $1,402.5 | $1,168.75 | $1,841.95 | 8.9× | $2,753.58 |
| CT head with contrast | CPT | 70460 | 15 | $4,744 | $1,423.2 | $1,186 | $1,869.14 | 8.0× | $2,794.22 |
| CT head with and without contrast | CPT | 70470 | 15 | $5,706 | $1,711.8 | $1,426.5 | $2,248.16 | 8.4× | $3,360.83 |
| CT neck with contrast | CPT | 70491 | 15 | $3,774 | $1,132.2 | $943.5 | $1,486.96 | 5.4× | $2,222.89 |
| MRI brain without contrast | CPT | 70551 | 15 | $3,343 | $1,002.9 | $835.75 | $1,317.14 | 3.3× | $1,969.03 |
| MRI brain with contrast | CPT | 70552 | 15 | $3,677 | $1,103.1 | $919.25 | $1,448.74 | 3.0× | $2,165.75 |
| MRI brain with and without contrast | CPT | 70553 | 15 | $4,587 | $1,376.1 | $1,146.75 | $1,807.28 | 3.1× | $2,701.74 |
| Chest X-ray single view | CPT | 71045 | 35 | $682 | $204.6 | $170.5 | $299.4 | 3.2× | $545.6 |
| Chest X-ray 2 views | CPT | 71046 | 35 | $750 | $225 | $187.5 | $329.25 | 3.3× | $600 |
| Chest X-ray 3 views | CPT | 71047 | 35 | $787 | $236.1 | $196.75 | $345.49 | 3.6× | $629.6 |
| CT chest without contrast | CPT | 71250 | 15 | $3,024 | $907.2 | $756 | $1,191.46 | 5.5× | $1,781.14 |
| CT chest with contrast | CPT | 71260 | 15 | $3,928 | $1,178.4 | $982 | $1,547.63 | 5.5× | $2,313.59 |
| CT chest with and without contrast | CPT | 71270 | 15 | $3,210 | $963 | $802.5 | $1,264.74 | 4.3× | $1,890.69 |
| MRI chest without contrast | CPT | 71550 | 15 | $798 | $239.4 | $199.5 | $314.41 | 0.73× | $470.02 |
| MRI chest with and without contrast | CPT | 71552 | 15 | $5,040 | $1,512 | $1,260 | $1,985.76 | 3.3× | $2,968.56 |
| Lumbosacral spine X-ray | CPT | 72100 | 35 | $911 | $273.3 | $227.75 | $399.93 | 3.9× | $728.8 |
| CT cervical spine without contrast | CPT | 72125 | 15 | $3,655 | $1,096.5 | $913.75 | $1,440.07 | 7.1× | $2,152.8 |
| CT thoracic spine without contrast | CPT | 72128 | 15 | $3,738 | $1,121.4 | $934.5 | $1,472.77 | 7.4× | $2,201.68 |
| CT lumbar spine without contrast | CPT | 72131 | 15 | $3,719 | $1,115.7 | $929.75 | $1,465.29 | 7.2× | $2,190.49 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | $3,692 | $1,107.6 | $923 | $1,454.65 | 3.7× | $2,174.59 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | $3,641 | $1,092.3 | $910.25 | $1,434.55 | 3.8× | $2,144.55 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | $3,686 | $1,105.8 | $921.5 | $1,452.28 | 3.9× | $2,171.05 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 15 | $4,915 | $1,474.5 | $1,228.75 | $1,936.51 | 4.3× | $2,894.94 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | $5,573 | $1,671.9 | $1,393.25 | $2,195.76 | 4.1× | $3,282.5 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | $5,855 | $1,756.5 | $1,463.75 | $2,306.87 | 4.2× | $3,448.6 |
| CT pelvis without contrast | CPT | 72192 | 15 | $2,479 | $743.7 | $619.75 | $976.73 | 4.9× | $1,460.13 |
| CT pelvis with contrast | CPT | 72193 | 15 | $2,819 | $845.7 | $704.75 | $1,110.69 | 3.9× | $1,660.39 |
| Shoulder X-ray | CPT | 73030 | 35 | $1,191 | $357.3 | $198.5 | $522.85 | 5.6× | $952.8 |
| Humerus X-ray | CPT | 73060 | 35 | $1,330.5 | $399.15 | $221.75 | $584.09 | 6.5× | $1,064.4 |
| Hand X-ray 3 views | CPT | 73130 | 35 | $1,450.5 | $435.15 | $241.75 | $636.77 | 6.8× | $1,160.4 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | $5,577 | $1,673.1 | $929.5 | $1,598.74 | 3.8× | $3,284.85 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $4,017 | $1,205.1 | $1,004.25 | $1,582.7 | 2.6× | $2,366.01 |
| Knee X-ray 1-2 views | CPT | 73560 | 35 | $1,225.5 | $367.65 | $204.25 | $537.99 | 5.8× | $980.4 |
| Ankle X-ray 3 views | CPT | 73610 | 35 | $1,416 | $424.8 | $236 | $621.62 | 6.7× | $1,132.8 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | $8,244 | $2,473.2 | $1,374 | $2,363.28 | 5.1× | $4,855.72 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | $5,341 | $1,602.3 | $1,335.25 | $2,104.35 | 3.3× | $3,145.85 |
| CT abdomen without contrast | CPT | 74150 | 15 | $3,264 | $979.2 | $816 | $1,286.02 | 6.8× | $1,922.5 |
| CT abdomen with contrast | CPT | 74160 | 15 | $3,604 | $1,081.2 | $901 | $1,419.98 | 5.0× | $2,122.76 |
| CT abdomen with and without contrast | CPT | 74170 | 15 | $4,749 | $1,424.7 | $1,187.25 | $1,871.11 | 5.6× | $2,797.16 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 15 | $6,566 | $1,969.8 | $1,641.5 | $2,587 | 7.1× | $3,867.37 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 15 | $7,360 | $2,208 | $1,840 | $2,899.84 | 5.3× | $4,335.04 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 15 | $8,986 | $2,695.8 | $2,246.5 | $3,540.48 | 6.2× | $5,292.75 |
| MRI abdomen without contrast | CPT | 74181 | 15 | $3,602 | $1,080.6 | $900.5 | $1,419.19 | 3.6× | $2,121.58 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | $6,970 | $2,091 | $1,742.5 | $2,746.18 | 4.8× | $4,105.33 |
| Abdominal ultrasound complete | CPT | 76700 | 19 | $2,076 | $622.8 | $519 | $892.68 | 6.0× | $1,222.76 |
| Abdominal ultrasound limited | CPT | 76705 | 19 | $1,227 | $368.1 | $306.75 | $527.61 | 3.6× | $722.7 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 19 | $1,539 | $461.7 | $384.75 | $661.77 | 4.6× | $906.47 |
| Obstetric ultrasound first trimester | CPT | 76801 | 35 | $1,141 | $342.3 | $285.25 | $500.9 | 3.5× | $912.8 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 35 | $1,491 | $447.3 | $372.75 | $654.55 | 4.3× | $1,192.8 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 35 | $437 | $131.1 | $109.25 | $191.84 | 0.81× | $349.6 |
| Transvaginal ultrasound | CPT | 76830 | 35 | $979 | $293.7 | $244.75 | $429.78 | 2.9× | $783.2 |
| Pelvic ultrasound complete | CPT | 76856 | 19 | $1,835 | $550.5 | $458.75 | $789.05 | 5.5× | $1,080.82 |
| Scrotal ultrasound | CPT | 76870 | 19 | $1,209 | $362.7 | $302.25 | $519.87 | 4.0× | $712.1 |
| Diagnostic mammography unilateral | CPT | 77065 | 31 | $969 | $290.7 | $242.25 | $570.74 | 3.8× | $775.2 |
| Diagnostic mammography bilateral | CPT | 77066 | 31 | $1,133 | $339.9 | $283.25 | $667.34 | 3.5× | $906.4 |
| Screening mammography bilateral | CPT | 77067 | 31 | $914 | $274.2 | $228.5 | $538.35 | 3.4× | $731.2 |
| EKG tracing only | CPT | 93005 | 35 | $508 | $152.4 | $127 | $218.44 | 1.9× | $406.4 |
| Transthoracic echocardiogram complete | CPT | 93306 | 35 | $3,668 | $1,100.4 | $917 | $1,577.24 | 2.6× | $2,934.4 |
| Transthoracic echocardiogram | CPT | 93307 | 35 | $1,980 | $594 | $495 | $851.4 | 3.4× | $1,584 |
| Stress echocardiogram | CPT | 93350 | 35 | $3,155 | $946.5 | $788.75 | $1,356.65 | 2.7× | $2,524 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 31 | $366 | $109.8 | $91.5 | $215.57 | 6.7× | $292.8 |
| General health panel | CPT | 80050 | 35 | $1,046 | $313.8 | $261.5 | $523 | 4.9× | $836.8 |
| Electrolyte panel | CPT | 80051 | 31 | $276 | $82.8 | $69 | $162.56 | 6.8× | $220.8 |
| Comprehensive metabolic panel | CPT | 80053 | 31 | $392 | $117.6 | $98 | $230.89 | 5.2× | $313.6 |
| Lipid panel | CPT | 80061 | 31 | $325 | $97.5 | $81.25 | $191.43 | 5.0× | $260 |
| Renal function panel | CPT | 80069 | 31 | $369 | $110.7 | $92.25 | $217.34 | 8.0× | $295.2 |
| Hepatic function panel | CPT | 80076 | 31 | $206 | $61.8 | $51.5 | $121.33 | 4.6× | $164.8 |
| Urinalysis non-automated | CPT | 81002 | 31 | $16 | $4.8 | $4 | $9.42 | 1.4× | $12.8 |
| Urinalysis automated | CPT | 81003 | 31 | $115 | $34.5 | $28.75 | $67.74 | 4.9× | $92 |
| Glucose quantitative | CPT | 82947 | 31 | $262 | $78.6 | $65.5 | $154.32 | 8.8× | $209.6 |
| Hemoglobin A1c | CPT | 83036 | 31 | $224 | $67.2 | $8 | $40.8 | 1.5× | $179.2 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 31 | $623 | $186.9 | $155.75 | $366.95 | 7.8× | $498.4 |
| Complete blood count with automated differential | CPT | 85025 | 31 | $377 | $113.1 | $94.25 | $222.05 | 8.4× | $301.6 |
| Complete blood count without differential | CPT | 85027 | 31 | $264 | $79.2 | $66 | $155.5 | 7.2× | $211.2 |
| Urine culture bacterial | CPT | 87086 | 31 | $419 | $125.7 | $104.75 | $246.79 | 10.6× | $335.2 |
| Urine culture identification | CPT | 87088 | 31 | $171 | $51.3 | $42.75 | $100.72 | 4.5× | $136.8 |
| Tissue exam by pathologist level IV | CPT | 88305 | 31 | $710 | $213 | $177.5 | $418.19 | 4.1× | $568 |
| maternity |
| Fetal non-stress test | CPT | 59025 | 35 | $1,560 | $468 | $390 | $684.84 | 3.6× | $1,248 |
| office |
| Office visit, established patient, 5 min | CPT | 99211 | 35 | $691 | $207.3 | $172.75 | $303.35 | 4.7× | $552.8 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | $3,732 | $1,119.6 | $933 | $1,604.76 | 1.8× | $2,198.15 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | $3,774 | $1,132.2 | $943.5 | $1,622.82 | 1.7× | $2,222.89 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 13 | $3,185 | $955.5 | $796.25 | $1,369.55 | 1.6× | $1,875.97 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 13 | $4,458 | $1,337.4 | $1,114.5 | $1,916.94 | 2.1× | $2,625.76 |
| Colonoscopy diagnostic | CPT | 45378 | 13 | $4,187 | $1,256.1 | $1,046.75 | $1,800.41 | 2.1× | $2,466.14 |
| Colonoscopy with biopsy | CPT | 45380 | 13 | $5,121 | $1,536.3 | $1,280.25 | $2,202.03 | 1.8× | $3,016.27 |
| Colonoscopy with polyp removal | CPT | 45385 | 13 | $5,121 | $1,536.3 | $1,280.25 | $2,202.03 | 1.8× | $3,016.27 |
| surgery |
| PCI single major coronary artery | CPT | 92920 | 31 | $13,912 | $4,173.6 | $3,478 | $8,194.17 | 1.4× | $11,130 |
| PCI with drug-eluting stent | CPT | 92928 | 31 | $21,127 | $6,338.1 | $5,281.75 | $12,444 | 1.2× | $16,902 |
| PCI bypass graft | CPT | 92937 | 31 | $21,127 | $6,338.1 | $5,281.75 | $12,444 | 1.1× | $16,902 |
| Left heart catheterization | CPT | 93452 | 35 | $9,781 | $2,934.3 | $2,445.25 | $4,293.86 | 1.4× | $7,824.8 |
| Coronary angiography with cath | CPT | 93455 | 35 | $15,519 | $4,655.7 | $3,879.75 | $6,812.84 | 2.2× | $12,415 |
| Coronary angiography with bypass cath | CPT | 93458 | 35 | $16,818 | $5,045.4 | $4,204.5 | $7,383.1 | 2.4× | $13,454 |