| Blood transfusion CPT Code: 36430 | $770 | — | — | — |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,379 | — | — | — |
| X-ray, foot CPT Code: 73630 | $220 | — | — | — |
| Ultrasound, pelvis CPT Code: 76856 | $541 | — | — | — |
| Orthotic fitting and training CPT Code: 97760 | $91 | — | — | — |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $238 | — | — | — |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $88 | — | — | — |
| New patient office visit (30-44 min) CPT Code: 99203 | $228 | — | — | — |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $962 | — | — | — |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $88 | — | — | — |
| Typhoid vaccine HCPCS Code: 90675 | $946 | — | — | — |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,404 | — | — | — |
| X-ray, lower back CPT Code: 72110 | $331 | — | — | — |
| CT scan, head (no contrast) CPT Code: 70450 | $1,656 | — | — | — |
| CT scan, sinuses CPT Code: 70486 | $1,475 | — | — | — |
| X-ray, pelvis CPT Code: 72170 | $182 | — | — | — |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $868 | — | — | — |
| X-ray, chest (two views) CPT Code: 71046 | $208 | — | — | — |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,865 | — | — | — |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $374 | — | — | — |
| Physical therapy (gait training) CPT Code: 97116 | $80 | — | — | — |
| X-ray, hip CPT Code: 73502 | $208 | — | — | — |
| Physical therapy (functional capacity test) CPT Code: 97750 | $75 | — | — | — |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $90 | — | — | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $209 | — | — | — |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $2,445 | — | — | — |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $677 | — | — | — |
| X-ray, ankle CPT Code: 73610 | $262 | — | — | — |
| Occupational therapy (self-care training) CPT Code: 97535 | $82 | — | — | — |
| Hospital observation (per hour) HCPCS Code: G0378 | $57 | — | — | — |
| Extended office visit (prolonged) HCPCS Code: G2212 | $72 | — | — | — |
| Speech therapy (group session) CPT Code: 92508 | $149 | — | — | — |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $494 | — | — | — |
| CT scan, pelvis CPT Code: 72192 | $1,353 | — | — | — |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,656 | — | — | — |
| Group therapy session CPT Code: 90853 | $828 | — | — | — |
| X-ray, hand CPT Code: 73130 | $220 | — | — | — |
| Speech therapy (language evaluation) CPT Code: 92507 | $205 | — | — | — |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $186 | — | — | — |
| X-ray, shoulder CPT Code: 73030 | $229 | — | — | — |
| CT scan, head (with contrast) CPT Code: 70460 | $1,878 | — | — | — |
| MRI, knee or other leg joint CPT Code: 73721 | $2,209 | — | — | — |
| Screening mammogram (both breasts) CPT Code: 77067 | $320 | — | — | — |
| Family therapy session CPT Code: 90847 | $952 | — | — | — |
| Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: 90715 | $182 | — | — | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $153 | — | — | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $285 | — | — | — |
| Psychotherapy session (45 minutes) CPT Code: 90834 | $851 | — | — | — |
| Ultrasound, thyroid and neck CPT Code: 76536 | $458 | — | — | — |
| Physical therapy (manual therapy) CPT Code: 97140 | $88 | — | — | — |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,095 | — | — | — |
| MRI, lower back (no contrast) CPT Code: 72148 | $2,425 | — | — | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $2,913 | — | — | — |
| MRI, brain (no contrast) CPT Code: 70551 | $2,289 | — | — | — |
| MRI, brain (with and without contrast) CPT Code: 70553 | $4,075 | — | — | — |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,717 | — | — | — |
| X-ray, chest (single view) CPT Code: 71045 | $172 | — | — | — |