| Fetal non-stress test | CPT | 59025 | 23 | $503.93 |
| Colonoscopy with biopsy | CPT | 45380 | 23 | $2,332.24 |
| Abdominal ultrasound limited | CPT | 76705 | 23 | $430.51 |
| Obstetric ultrasound first trimester | CPT | 76801 | 23 | $500.45 |
| Transvaginal ultrasound | CPT | 76830 | 23 | $439.02 |
| Colonoscopy with polyp removal | CPT | 45385 | 23 | $2,383.71 |
| Colonoscopy diagnostic | CPT | 45378 | 23 | $1,908.66 |
| Upper GI endoscopy diagnostic | CPT | 43235 | 23 | $1,564.9 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 23 | $1,735.66 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 23 | $1,382.95 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 23 | $1,898.55 |
| MRI brain without contrast | CPT | 70551 | 22 | $1,168.23 |
| CT chest without contrast | CPT | 71250 | 22 | $864.85 |
| CT chest with and without contrast | CPT | 71270 | 22 | $864.84 |
| CT cervical spine without contrast | CPT | 72125 | 22 | $953.68 |
| CT thoracic spine without contrast | CPT | 72128 | 22 | $867.44 |
| CT lumbar spine without contrast | CPT | 72131 | 22 | $880.64 |
| Chest X-ray single view | CPT | 71045 | 22 | $215.79 |
| Chest X-ray 2 views | CPT | 71046 | 22 | $214.15 |
| CT neck with contrast | CPT | 70491 | 22 | $1,051.06 |
| MRI brain with and without contrast | CPT | 70553 | 22 | $1,977.28 |
| MRI lumbar spine without contrast | CPT | 72148 | 22 | $1,298.03 |
| Vaginal delivery only | CPT | 59409 | 22 | $2,213.8 |
| MRI brain with contrast | CPT | 70552 | 22 | $1,843.03 |
| MRI chest without contrast | CPT | 71550 | 22 | $989.11 |
| MRI chest with and without contrast | CPT | 71552 | 22 | $1,162.49 |
| MRI cervical spine without contrast | CPT | 72141 | 22 | $1,375.09 |
| MRI thoracic spine without contrast | CPT | 72146 | 22 | $1,333.78 |
| CT head without contrast | CPT | 70450 | 22 | $966.79 |
| CT head with and without contrast | CPT | 70470 | 22 | $959.06 |