| CT scan, head (with and without contrast) CPT Code: 70470 | $5,086 | — | $1,386 | — |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $798 | — | $671 | — |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $64 | — | $52 | — |
| Prostate cancer screening (blood test) HCPCS Code: G0103 | $129 | — | $96 | — |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $68 | — | $16 | — |
| Blood test, sodium CPT Code: 84295 | $79 | — | $31 | — |
| Culture, blood CPT Code: 87040 | $267 | — | $76 | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $715 | — | $151 | — |
| Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: 90715 | $261 | — | $108 | — |
| MMR vaccine (measles, mumps, rubella) HCPCS Code: 90707 | $501 | — | $252 | — |
| Blood test, PSA (prostate screen) CPT Code: 84153 | $117 | — | $88 | — |
| X-ray, chest (two views) CPT Code: 71046 | $734 | — | $336 | — |
| Varicella (chickenpox) vaccine HCPCS Code: 90716 | $766 | — | $300 | — |
| Blood test, basic metabolic panel CPT Code: 80048 | $48 | — | $65 | — |
| Psychotherapy session (45 minutes) CPT Code: 90834 | $200 | — | $353 | — |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $5,210 | — | $1,470 | — |
| Speech therapy (group session) CPT Code: 92508 | $165 | — | $82 | — |
| Pneumococcal vaccine HCPCS Code: 90732 | $596 | — | $244 | — |
| Hepatitis B immune globulin HCPCS Code: 90371 | $1,874 | — | $578 | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $1,628 | — | $280 | — |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $2,114 | — | $928 | — |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,636 | — | $979 | — |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $15 | — | $56 | — |
| Typhoid vaccine HCPCS Code: 90675 | $1,770 | — | $1,019 | — |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $335 | — | $341 | — |
| Hospital observation (per hour) HCPCS Code: G0378 | $151 | — | $148 | — |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $5,479 | — | $1,703 | — |
| X-ray, lower back CPT Code: 72110 | $1,031 | — | $432 | — |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $210 | — | $116 | — |
| Ultrasound, pelvis CPT Code: 76856 | $1,619 | — | $792 | — |
| Physical therapy (manual therapy) CPT Code: 97140 | $210 | — | $95 | — |
| Blood test, glucose (blood sugar) CPT Code: 82947 | $36 | — | $22 | — |
| X-ray, hip CPT Code: 73502 | $727 | — | $409 | — |
| Bunion correction surgery CPT Code: 28296 | $11,950 | — | $8,647 | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $715 | — | $354 | — |
| MRI, lower back (no contrast) CPT Code: 72148 | $3,847 | — | $1,679 | — |
| Group therapy session CPT Code: 90853 | $191 | — | $227 | — |
| Electrical stimulation therapy HCPCS Code: G0283 | $126 | — | $34 | — |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $206 | — | $186 | — |
| New patient office visit (30-44 min) CPT Code: 99203 | $309 | — | $320 | — |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $140 | — | $488 | — |
| Blood test, clotting time (PTT) CPT Code: 85730 | $47 | — | $48 | — |
| Review of medical records for care CPT Code: 90889 | $544 | — | $405 | — |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $652 | — | $402 | — |
| MRI, brain (with and without contrast) CPT Code: 70553 | $5,550 | — | $2,199 | — |
| X-ray, ankle CPT Code: 73610 | $792 | — | $357 | — |
| Rabies immune globulin HCPCS Code: 90375 | $4,349 | — | $1,040 | — |
| CT scan, sinuses CPT Code: 70486 | $1,507 | — | $951 | — |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $67 | — | $64 | — |
| Diagnostic procedure preparation HCPCS Code: G0279 | $156 | — | $99 | — |
| X-ray, foot CPT Code: 73630 | $727 | — | $334 | — |
| Blood test, calcium CPT Code: 82310 | $52 | — | $33 | — |
| X-ray, chest (single view) CPT Code: 71045 | $667 | — | $275 | — |
| Occupational therapy (self-care training) CPT Code: 97535 | $210 | — | $105 | — |
| Trauma team activation HCPCS Code: G0390 | $10,311 | — | $5,258 | — |
| Ultrasound, thyroid and neck CPT Code: 76536 | $1,273 | — | $763 | — |
| X-ray, hand CPT Code: 73130 | $668 | — | $368 | — |
| Blood transfusion CPT Code: 36430 | $1,108 | — | $1,283 | — |
| CT scan, chest (no contrast) CPT Code: 71250 | $2,812 | — | $935 | — |
| Culture, bacterial CPT Code: 87070 | $53 | — | $66 | — |
| Physical therapy (gait training) CPT Code: 97116 | $210 | — | $101 | — |
| Blood test, clotting time (PT/INR) CPT Code: 85610 | $32 | — | $26 | — |
| Blood test, hemoglobin CPT Code: 85018 | $29 | — | $13 | — |
| CT scan, head (with contrast) CPT Code: 70460 | $4,378 | — | $1,188 | — |
| CT scan, pelvis CPT Code: 72192 | $2,462 | — | $957 | — |
| Blood test, thyroid (TSH) CPT Code: 84443 | $81 | — | $82 | — |
| Community mental health services HCPCS Code: H0038 | $30 | — | $58 | — |
| Speech therapy (language evaluation) CPT Code: 92507 | $642 | — | $256 | — |
| CT scan, head (no contrast) CPT Code: 70450 | $3,366 | — | $920 | — |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $1,233 | — | $831 | — |
| Blood test, cholesterol (lipid panel) CPT Code: 80061 | $38 | — | $75 | — |
| MRI, brain (no contrast) CPT Code: 70551 | $4,386 | — | $1,701 | — |
| Flu vaccine (high dose) HCPCS Code: 90656 | $119 | — | $53 | — |
| Blood test, potassium CPT Code: 84132 | $101 | — | $31 | — |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $210 | — | $106 | — |
| Blood test, liver function panel CPT Code: 80076 | $29 | — | $63 | — |
| Blood antibody screen CPT Code: 86850 | $22 | — | $69 | — |
| Family therapy session CPT Code: 90847 | $244 | — | $386 | — |
| Hepatitis B vaccine HCPCS Code: 90744 | $21 | — | $84 | — |
| Prosthetic fitting and training CPT Code: 97761 | $210 | — | $118 | — |
| Orthotic fitting and training CPT Code: 97760 | $210 | — | $138 | — |
| Blood test, magnesium CPT Code: 83735 | $58 | — | $48 | — |
| Screening mammogram (both breasts) CPT Code: 77067 | $537 | — | $366 | — |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $122 | — | $79 | — |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,608 | — | $3,022 | — |
| Colorectal cancer screening (alternative) HCPCS Code: G0145 | $144 | — | $104 | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $5,892 | — | $2,064 | — |
| X-ray, pelvis CPT Code: 72170 | $715 | — | $306 | — |
| Blood test, vitamin D CPT Code: 82306 | $81 | — | $100 | — |
| DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: 90700 | $145 | — | $83 | — |
| Hepatitis C antibody test CPT Code: 86803 | $30 | — | $80 | — |
| Physical therapy (functional capacity test) CPT Code: 97750 | $210 | — | $109 | — |
| Blood test, amylase CPT Code: 82150 | $48 | — | $49 | — |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $210 | — | $97 | — |
| Blood test, lipase CPT Code: 83690 | $147 | — | $67 | — |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $293 | — | $506 | — |
| X-ray, shoulder CPT Code: 73030 | $752 | — | $298 | — |
| Blood test, vitamin B12 CPT Code: 82607 | $65 | — | $83 | — |
| Blood test, creatinine (kidney) CPT Code: 82565 | $57 | — | $34 | — |
| Mental health services (assessment) HCPCS Code: H0031 | $699 | — | $397 | — |
| MRI, knee or other leg joint CPT Code: 73721 | $3,833 | — | $1,512 | — |
| CT scan, neck (cervical spine) CPT Code: 72125 | $3,469 | — | $945 | — |
| Blood test, urea nitrogen (BUN, kidney) CPT Code: 84520 | $60 | — | $24 | — |