| emergency |
| ED visit level 1 | CPT | 99281 | 8 | $412.5 | $412.5 | $288.75 | $319.69 | 2.3× | $371.25 |
| Critical care, first hour | CPT | 99291 | 8 | $4,466.63 | $4,466.63 | $3,126.64 | $3,461.64 | 3.2× | $4,019.97 |
| imaging |
| CT head without contrast | CPT | 70450 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 13.4× | $3,209.22 |
| CT head with contrast | CPT | 70460 | 8 | $5,509.35 | $5,509.35 | $3,856.55 | $4,269.75 | 18.2× | $4,958.42 |
| CT head with and without contrast | CPT | 70470 | 8 | $6,136.8 | $6,136.8 | $4,295.76 | $4,756.02 | 17.8× | $5,523.12 |
| CT neck with contrast | CPT | 70491 | 8 | $5,509.35 | $5,509.35 | $3,856.55 | $4,269.75 | 15.6× | $4,958.42 |
| MRI brain without contrast | CPT | 70551 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 12.1× | $5,674.59 |
| MRI brain with contrast | CPT | 70552 | 8 | $4,023.2 | $4,023.2 | $2,816.24 | $3,117.98 | 6.5× | $3,620.88 |
| MRI brain with and without contrast | CPT | 70553 | 8 | $9,794.35 | $9,794.35 | $6,856.05 | $7,590.62 | 12.9× | $8,814.92 |
| Chest X-ray single view | CPT | 71045 | 8 | $308.5 | $308.5 | $215.95 | $239.09 | 2.5× | $277.65 |
| Chest X-ray 2 views | CPT | 71046 | 8 | $549.75 | $549.75 | $384.83 | $426.06 | 4.3× | $494.78 |
| Chest X-ray 3 views | CPT | 71047 | 8 | $203.5 | $203.5 | $142.45 | $157.72 | 1.6× | $183.15 |
| CT chest without contrast | CPT | 71250 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 12.9× | $3,209.22 |
| CT chest with contrast | CPT | 71260 | 8 | $5,509.35 | $5,509.35 | $3,856.55 | $4,269.75 | 15.2× | $4,958.42 |
| CT chest with and without contrast | CPT | 71270 | 8 | $6,136.8 | $6,136.8 | $4,295.76 | $4,756.02 | 16.3× | $5,523.12 |
| MRI chest without contrast | CPT | 71550 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 11.4× | $5,674.59 |
| MRI chest with and without contrast | CPT | 71552 | 8 | $9,794.35 | $9,794.35 | $6,856.05 | $7,590.62 | 12.6× | $8,814.92 |
| Lumbosacral spine X-ray | CPT | 72100 | 8 | $497.55 | $497.55 | $348.29 | $385.6 | 3.7× | $447.8 |
| CT cervical spine without contrast | CPT | 72125 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 13.7× | $3,209.22 |
| CT thoracic spine without contrast | CPT | 72128 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 13.9× | $3,209.22 |
| CT lumbar spine without contrast | CPT | 72131 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 13.6× | $3,209.22 |
| MRI cervical spine without contrast | CPT | 72141 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 12.3× | $5,674.59 |
| MRI thoracic spine without contrast | CPT | 72146 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 13.1× | $5,674.59 |
| MRI lumbar spine without contrast | CPT | 72148 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 13.0× | $5,674.59 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 10.8× | $5,674.59 |
| MRI cervical spine with and without contrast | CPT | 72156 | 8 | $9,794.35 | $9,794.35 | $6,856.05 | $7,590.62 | 14.0× | $8,814.92 |
| MRI lumbar spine with contrast | CPT | 72158 | 8 | $9,794.35 | $9,794.35 | $6,856.05 | $7,590.62 | 13.9× | $8,814.92 |
| CT pelvis without contrast | CPT | 72192 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 13.8× | $3,209.22 |
| CT pelvis with contrast | CPT | 72193 | 8 | $5,509.35 | $5,509.35 | $3,856.55 | $4,269.75 | 15.2× | $4,958.42 |
| Shoulder X-ray | CPT | 73030 | 8 | $733.45 | $733.45 | $284.9 | $439.86 | 4.7× | $660.11 |
| Humerus X-ray | CPT | 73060 | 8 | $369.85 | $369.85 | $258.9 | $286.64 | 3.2× | $332.87 |
| Hand X-ray 3 views | CPT | 73130 | 8 | $347.85 | $347.85 | $243.5 | $269.59 | 2.9× | $313.07 |
| MRI upper extremity joint without contrast | CPT | 73221 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 11.7× | $5,674.59 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 8 | $6,354.18 | $6,354.18 | $4,447.93 | $4,924.49 | 8.1× | $5,718.76 |
| Knee X-ray 1-2 views | CPT | 73560 | 8 | $427.6 | $427.6 | $221.59 | $288.75 | 3.1× | $384.84 |
| Ankle X-ray 3 views | CPT | 73610 | 8 | $456.05 | $456.05 | $142.45 | $251.2 | 2.7× | $410.45 |
| MRI lower extremity joint without contrast | CPT | 73721 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 10.4× | $5,674.59 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 7.7× | $5,674.59 |
| CT abdomen without contrast | CPT | 74150 | 8 | $3,565.8 | $3,565.8 | $2,496.06 | $2,763.5 | 14.7× | $3,209.22 |
| CT abdomen with contrast | CPT | 74160 | 8 | $5,509.35 | $5,509.35 | $3,856.55 | $4,269.75 | 14.9× | $4,958.42 |
| CT abdomen with and without contrast | CPT | 74170 | 8 | $6,136.8 | $6,136.8 | $4,295.76 | $4,756.02 | 14.2× | $5,523.12 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 8 | $5,348.7 | $5,348.7 | $3,744.09 | $4,145.25 | 11.4× | $4,813.83 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 8 | $8,264 | $8,264 | $5,784.8 | $6,404.6 | 11.7× | $7,437.6 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 8 | $9,205.2 | $9,205.2 | $6,443.64 | $7,134.03 | 12.4× | $8,284.68 |
| MRI abdomen without contrast | CPT | 74181 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 12.5× | $5,674.59 |
| MRI abdomen with and without contrast | CPT | 74183 | 8 | $6,305.1 | $6,305.1 | $4,413.57 | $4,886.46 | 8.6× | $5,674.59 |
| Abdominal ultrasound complete | CPT | 76700 | 8 | $1,130.75 | $1,130.75 | $791.53 | $876.33 | 5.9× | $1,017.68 |
| Abdominal ultrasound limited | CPT | 76705 | 8 | $978.85 | $978.85 | $685.2 | $758.61 | 5.2× | $880.97 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 8 | $1,415.51 | $1,415.51 | $714.6 | $954.82 | 6.6× | $1,273.96 |
| Transvaginal ultrasound | CPT | 76830 | 8 | $662.2 | $662.2 | $463.54 | $513.21 | 3.5× | $595.98 |
| Pelvic ultrasound complete | CPT | 76856 | 8 | $1,130.75 | $1,130.75 | $791.53 | $876.33 | 6.1× | $1,017.68 |
| Scrotal ultrasound | CPT | 76870 | 8 | $446.8 | $446.8 | $312.76 | $346.27 | 2.6× | $402.12 |
| Screening mammography bilateral | CPT | 77067 | 8 | $1,628.79 | $1,628.79 | $1,140.15 | $1,262.31 | 8.0× | $1,465.91 |
| EKG tracing only | CPT | 93005 | 8 | $349.05 | $349.05 | $244.34 | $270.52 | 2.3× | $314.15 |
| Transthoracic echocardiogram complete | CPT | 93306 | 8 | $1,063.7 | $1,063.7 | $744.59 | $824.37 | 1.4× | $957.33 |
| Transthoracic echocardiogram | CPT | 93307 | 8 | $1,063.7 | $1,063.7 | $744.59 | $824.37 | 3.3× | $957.33 |
| Stress echocardiogram | CPT | 93350 | 8 | $2,270 | $2,270 | $1,589 | $1,759.25 | 3.5× | $2,043 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 8 | $449.25 | $449.25 | $314.48 | $348.17 | 10.7× | $404.33 |
| Electrolyte panel | CPT | 80051 | 8 | $284.75 | $284.75 | $199.33 | $220.68 | 9.3× | $256.28 |
| Comprehensive metabolic panel | CPT | 80053 | 8 | $585.95 | $585.95 | $410.17 | $454.11 | 10.2× | $527.36 |
| Lipid panel | CPT | 80061 | 8 | $234.35 | $234.35 | $164.05 | $181.62 | 4.8× | $210.92 |
| Renal function panel | CPT | 80069 | 8 | $572.45 | $572.45 | $400.72 | $443.65 | 16.3× | $515.21 |
| Hepatic function panel | CPT | 80076 | 8 | $375.25 | $375.25 | $262.68 | $290.82 | 10.9× | $337.73 |
| Urinalysis automated | CPT | 81003 | 8 | $82.75 | $82.75 | $54.92 | $62.41 | 4.5× | $74.48 |
| Glucose quantitative | CPT | 82947 | 8 | $418.55 | $418.55 | $292.99 | $324.38 | 18.4× | $376.7 |
| Hemoglobin A1c | CPT | 83036 | 8 | $147.2 | $147.2 | $103.04 | $114.08 | 4.2× | $132.48 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 8 | $219.8 | $219.8 | $153.86 | $170.35 | 3.6× | $197.82 |
| Complete blood count with automated differential | CPT | 85025 | 8 | $135.7 | $135.7 | $94.99 | $105.17 | 4.0× | $122.13 |
| Complete blood count without differential | CPT | 85027 | 8 | $139.7 | $139.7 | $97.79 | $108.27 | 5.0× | $125.73 |
| Urine culture bacterial | CPT | 87086 | 8 | $231.05 | $231.05 | $161.74 | $179.07 | 7.7× | $207.95 |
| Urine culture identification | CPT | 87088 | 8 | $1,197.45 | $1,197.45 | $838.22 | $928.03 | 41.7× | $1,077.71 |
| Tissue exam by pathologist level IV | CPT | 88305 | 8 | $490.75 | $490.75 | $343.53 | $380.33 | 3.7× | $441.68 |
| preventive |
| Upper GI endoscopy with biopsy | CPT | 43239 | 8 | $2,503.44 | $2,503.44 | $1,752.41 | $1,940.17 | 2.0× | $2,253.1 |