| emergency |
| ED visit level 4 | CPT | 99284 | 12 | $2,495 | $249.5 | $623.75 | $623.75 | 0.93× | $1,671.65 |
| ED visit level 5 | CPT | 99285 | 17 | $2,745 | $274.5 | $686.25 | $1,133.69 | 1.1× | $1,839.15 |
| imaging |
| CT head without contrast | CPT | 70450 | 11 | $4,120 | $412 | $1,030 | $1,030 | 5.0× | $2,105.32 |
| CT head with and without contrast | CPT | 70470 | 11 | $8,717 | $871.7 | $2,179.25 | $2,179.25 | 8.2× | $4,454.39 |
| CT neck with contrast | CPT | 70491 | 11 | $7,688 | $768.8 | $1,922 | $1,922 | 7.0× | $3,928.57 |
| MRI brain without contrast | CPT | 70551 | 11 | $4,521 | $452.1 | $1,130.25 | $1,130.25 | 2.8× | $2,310.23 |
| MRI brain with and without contrast | CPT | 70553 | 11 | $6,117 | $611.7 | $1,529.25 | $1,529.25 | 2.6× | $3,125.79 |
| Chest X-ray single view | CPT | 71045 | 17 | $789 | $78.9 | $197.25 | $320.73 | 3.4× | $528.63 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $1,035 | $103.5 | $258.75 | $420.73 | 4.3× | $693.45 |
| CT chest without contrast | CPT | 71250 | 11 | $4,272 | $427.2 | $1,068 | $1,068 | 5.0× | $2,182.99 |
| CT chest with contrast | CPT | 71260 | 11 | $7,973 | $797.3 | $1,993.25 | $1,993.25 | 7.1× | $4,074.2 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $983 | $98.3 | $245.75 | $405.98 | 3.9× | $658.61 |
| CT thoracic spine without contrast | CPT | 72128 | 11 | $6,103 | $610.3 | $1,525.75 | $1,525.75 | 7.7× | $3,118.63 |
| CT lumbar spine without contrast | CPT | 72131 | 11 | $6,103 | $610.3 | $1,525.75 | $1,525.75 | 7.5× | $3,118.63 |
| MRI thoracic spine without contrast | CPT | 72146 | 11 | $9,105 | $910.5 | $2,276.25 | $2,276.25 | 6.1× | $4,652.66 |
| MRI lumbar spine without contrast | CPT | 72148 | 11 | $9,105 | $910.5 | $2,276.25 | $2,276.25 | 6.0× | $4,652.66 |
| MRI cervical spine with and without contrast | CPT | 72156 | 11 | $6,117 | $611.7 | $1,529.25 | $1,529.25 | 2.8× | $3,125.79 |
| MRI lumbar spine with contrast | CPT | 72158 | 11 | $12,317 | $1,231.7 | $3,079.25 | $3,079.25 | 5.6× | $6,293.99 |
| CT pelvis without contrast | CPT | 72192 | 11 | $6,103 | $610.3 | $1,525.75 | $1,525.75 | 7.6× | $3,118.63 |
| CT pelvis with contrast | CPT | 72193 | 11 | $7,973 | $797.3 | $1,993.25 | $1,993.25 | 7.1× | $4,074.2 |
| Shoulder X-ray | CPT | 73030 | 17 | $983 | $98.3 | $245.75 | $405.98 | 4.4× | $658.61 |
| Humerus X-ray | CPT | 73060 | 17 | $983 | $98.3 | $245.75 | $405.98 | 4.5× | $658.61 |
| Hand X-ray 3 views | CPT | 73130 | 17 | $1,088 | $108.8 | $272 | $449.34 | 4.8× | $728.96 |
| Knee X-ray 1-2 views | CPT | 73560 | 17 | $861 | $86.1 | $215.25 | $355.59 | 3.8× | $576.87 |
| MRI lower extremity joint without contrast | CPT | 73721 | 11 | $6,374 | $637.4 | $1,593.5 | $1,593.5 | 3.4× | $3,257.11 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 11 | $8,544 | $854.4 | $2,136 | $2,136 | 5.9× | $4,365.98 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 11 | $11,163 | $1,116.3 | $2,790.75 | $2,790.75 | 5.1× | $5,704.29 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 11 | $18,084 | $1,808.4 | $4,521 | $4,521 | 7.9× | $9,240.92 |
| MRI abdomen without contrast | CPT | 74181 | 11 | $9,105 | $910.5 | $2,276.25 | $2,276.25 | 5.8× | $4,652.66 |
| MRI abdomen with and without contrast | CPT | 74183 | 11 | $10,265 | $1,026.5 | $2,566.25 | $2,566.25 | 4.5× | $5,245.42 |
| Abdominal ultrasound complete | CPT | 76700 | 13 | $1,468 | $146.8 | $367 | $431.59 | 2.9× | $750.15 |
| Abdominal ultrasound limited | CPT | 76705 | 13 | $971 | $97.1 | $242.75 | $285.48 | 2.0× | $496.18 |
| EKG tracing only | CPT | 93005 | 17 | $864 | $86.4 | $216 | $351.22 | 3.0× | $578.88 |
| Transthoracic echocardiogram complete | CPT | 93306 | 17 | $4,502 | $450.2 | $1,125.5 | $1,830.07 | 3.1× | $3,016.34 |
| lab |
| Basic metabolic panel (BMP) | CPT | 80048 | 17 | $198 | $19.8 | $49.5 | $81.77 | 2.5× | $132.66 |
| Electrolyte panel | CPT | 80051 | 17 | $713 | $71.3 | $178.25 | $294.47 | 12.4× | $477.71 |
| Comprehensive metabolic panel | CPT | 80053 | 17 | $290 | $29 | $72.5 | $119.77 | 2.7× | $194.3 |
| Lipid panel | CPT | 80061 | 17 | $638 | $63.8 | $159.5 | $263.49 | 6.9× | $427.46 |
| Renal function panel | CPT | 80069 | 17 | $290 | $29 | $72.5 | $119.77 | 4.4× | $194.3 |
| Hepatic function panel | CPT | 80076 | 17 | $390 | $39 | $97.5 | $161.07 | 6.1× | $261.3 |
| Urinalysis automated | CPT | 81003 | 17 | $152 | $15.2 | $38 | $62.78 | 4.5× | $101.84 |
| Glucose quantitative | CPT | 82947 | 17 | $95 | $9.5 | $23.75 | $39.24 | 2.2× | $63.65 |
| Hemoglobin A1c | CPT | 83036 | 17 | $165 | $16.5 | $41.25 | $68.15 | 2.5× | $110.55 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 17 | $445 | $44.5 | $111.25 | $183.79 | 3.9× | $298.15 |
| Complete blood count with automated differential | CPT | 85025 | 17 | $266 | $26.6 | $66.5 | $109.86 | 4.1× | $178.22 |
| Complete blood count without differential | CPT | 85027 | 17 | $487 | $48.7 | $121.75 | $201.13 | 9.3× | $326.29 |
| Urine culture bacterial | CPT | 87086 | 17 | $316 | $31.6 | $79 | $130.51 | 5.6× | $211.72 |
| Urine culture identification | CPT | 87088 | 12 | $631 | $63.1 | $157.75 | $157.75 | 7.1× | $422.77 |
| Tissue exam by pathologist level IV | CPT | 88305 | 17 | $1,124 | $112.4 | $281 | $464.21 | 4.5× | $753.08 |
| office |
| Office visit, established patient, 5 min | CPT | 99211 | 21 | $149 | $14.9 | $37.25 | $66.45 | 1.0× | $99.83 |
| preventive |
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | $3,211 | $321.1 | $802.75 | $944.04 | 1.0× | $1,640.82 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | $3,532 | $353.2 | $883 | $1,038.41 | 1.1× | $1,804.85 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 13 | $4,882 | $488.2 | $1,220.5 | $1,435.31 | 1.7× | $2,494.7 |
| Colonoscopy with biopsy | CPT | 45380 | 13 | $6,050 | $605 | $1,512.5 | $1,778.7 | 1.5× | $3,091.55 |
| Colonoscopy with polyp removal | CPT | 45385 | 13 | $6,381 | $638.1 | $1,595.25 | $1,876.02 | 1.6× | $3,260.69 |
| surgery |
| Coronary angiography with bypass cath | CPT | 93458 | 17 | $35,016 | $3,501.6 | $8,754 | $14,234 | 4.6× | $23,461 |