| imaging |
| CT head without contrast | CPT | 70450 | 0 | $864.28 | — | — | — | — |
| CT head with and without contrast | CPT | 70470 | 0 | $1,362.52 | — | — | — | — |
| CT neck with contrast | CPT | 70491 | 0 | $1,361.2 | — | — | — | — |
| MRI brain without contrast | CPT | 70551 | 0 | $1,824.96 | — | — | — | — |
| MRI brain with and without contrast | CPT | 70553 | 0 | $2,852.72 | — | — | — | — |
| Chest X-ray single view | CPT | 71045 | 0 | $104.16 | — | — | — | — |
| Chest X-ray 2 views | CPT | 71046 | 0 | $136.36 | — | — | — | — |
| CT chest without contrast | CPT | 71250 | 0 | $709.88 | — | — | — | — |
| CT chest with contrast | CPT | 71260 | 0 | $1,367 | — | — | — | — |
| CT chest with and without contrast | CPT | 71270 | 0 | $1,231.8 | — | — | — | — |
| MRI chest with contrast | CPT | 71551 | 0 | $2,017.8 | — | — | — | — |
| Lumbosacral spine X-ray | CPT | 72100 | 0 | $179.92 | — | — | — | — |
| CT cervical spine without contrast | CPT | 72125 | 0 | $1,072.48 | — | — | — | — |
| CT thoracic spine without contrast | CPT | 72128 | 0 | $1,072.48 | — | — | — | — |
| CT lumbar spine without contrast | CPT | 72131 | 0 | $1,072.48 | — | — | — | — |
| MRI cervical spine without contrast | CPT | 72141 | 0 | $1,851.72 | — | — | — | — |
| MRI thoracic spine without contrast | CPT | 72146 | 0 | $1,851.72 | — | — | — | — |
| MRI lumbar spine without contrast | CPT | 72148 | 0 | $1,826.32 | — | — | — | — |
| MRI cervical spine with and without contrast | CPT | 72156 | 0 | $2,900.44 | — | — | — | — |
| MRI lumbar spine with contrast | CPT | 72158 | 0 | $2,855.64 | — | — | — | — |
| CT pelvis without contrast | CPT | 72192 | 0 | $1,068.15 | — | — | — | — |
| CT pelvis with contrast | CPT | 72193 | 0 | $1,294.04 | — | — | — | — |
| Shoulder X-ray | CPT | 73030 | 0 | $273.52 | — | — | — | — |
| Humerus X-ray | CPT | 73060 | 0 | $258.8 | — | — | — | — |
| Hand X-ray 3 views | CPT | 73130 | 0 | $141.28 | — | — | — | — |
| MRI upper extremity joint without contrast | CPT | 73221 | 0 | $1,802.4 | — | — | — | — |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 0 | $2,081.36 | — | — | — | — |
| Knee X-ray 1-2 views | CPT | 73560 | 0 | $187.2 | — | — | — | — |
| Ankle X-ray 3 views | CPT | 73610 | 0 | $285.61 | — | — | — | — |
| MRI lower extremity joint without contrast | CPT | 73721 | 0 | $1,800.92 | — | — | — | — |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 0 | $2,805.04 | — | — | — | — |
| CT abdomen without contrast | CPT | 74150 | 0 | $1,085.96 | — | — | — | — |
| CT abdomen with contrast | CPT | 74160 | 0 | $1,468.04 | — | — | — | — |
| CT abdomen with and without contrast | CPT | 74170 | 0 | $1,769.88 | — | — | — | — |
| CT abdomen and pelvis without contrast | CPT | 74176 | 0 | $880.92 | — | — | — | — |
| CT abdomen and pelvis with contrast | CPT | 74177 | 0 | $1,572.5 | — | — | — | — |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 0 | $1,362.9 | — | — | — | — |
| MRI abdomen without contrast | CPT | 74181 | 0 | $4,819.04 | — | — | — | — |
| MRI abdomen with and without contrast | CPT | 74183 | 0 | $2,827.44 | — | — | — | — |
| Abdominal ultrasound limited | CPT | 76705 | 0 | $470.16 | — | — | — | — |
| Retroperitoneal ultrasound complete | CPT | 76770 | 0 | $581.76 | — | — | — | — |
| Pelvic ultrasound complete | CPT | 76856 | 0 | $549.04 | — | — | — | — |
| Scrotal ultrasound | CPT | 76870 | 0 | $545.96 | — | — | — | — |
| Diagnostic mammography unilateral | CPT | 77065 | 0 | $305 | — | — | — | — |
| Diagnostic mammography bilateral | CPT | 77066 | 0 | $389 | — | — | — | — |
| EKG complete | CPT | 93000 | 0 | $91.96 | — | — | — | — |
| EKG tracing only | CPT | 93005 | 0 | $196 | — | — | — | — |
| Transthoracic echocardiogram | CPT | 93307 | 0 | $764.36 | — | — | — | — |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 0 | $80.45 | — | — | — | — |
| Electrolyte panel | CPT | 80051 | 0 | $66.7 | — | — | — | — |
| Comprehensive metabolic panel | CPT | 80053 | 0 | $100.5 | — | — | — | — |
| Lipid panel | CPT | 80061 | 0 | $78.28 | — | — | — | — |
| Renal function panel | CPT | 80069 | 0 | $82.55 | — | — | — | — |
| Hepatic function panel | CPT | 80076 | 0 | $77.65 | — | — | — | — |
| Urinalysis non-automated | CPT | 81002 | 0 | $36 | — | — | — | — |
| Urinalysis automated | CPT | 81003 | 0 | $21.35 | — | — | — | — |
| Hemoglobin A1c | CPT | 83036 | 0 | $92.3 | — | — | — | — |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 0 | $159.75 | — | — | — | — |
| Complete blood count with automated differential | CPT | 85025 | 0 | $73.95 | — | — | — | — |
| Complete blood count without differential | CPT | 85027 | 0 | $61.55 | — | — | — | — |
| Urine culture bacterial | CPT | 87086 | 0 | $76.75 | — | — | — | — |
| Urine culture identification | CPT | 87088 | 0 | $77 | — | — | — | — |
| Tissue exam by pathologist level IV | CPT | 88305 | 0 | $409 | — | — | — | — |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 0 | $2,834 | — | — | — | — |
