| Flu vaccine injection HCPCS Code: G0008 | $62 | — | — | — |
| Flu vaccine (high dose) HCPCS Code: 90656 | $36 | — | — | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $162 | — | — | — |
| Electrical stimulation therapy HCPCS Code: G0283 | $77 | — | — | — |
| Blood test, liver function panel CPT Code: 80076 | $163 | — | — | — |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,159 | — | — | — |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $184 | — | — | — |
| Blood test, glucose (blood sugar) CPT Code: 82947 | $84 | — | — | — |
| Inguinal hernia repair CPT Code: 49505 | $5,438 | — | — | — |
| Varicella (chickenpox) vaccine HCPCS Code: 90716 | $262 | — | — | — |
| MMR vaccine (measles, mumps, rubella) HCPCS Code: 90707 | $133 | — | — | — |
| Ultrasound, pelvis CPT Code: 76856 | $731 | — | — | — |
| Screening mammogram (both breasts) CPT Code: 77067 | $381 | — | — | — |
| Total hip replacement CPT Code: 27130 | $7,641 | — | — | — |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $659 | — | — | — |
| Total knee replacement CPT Code: 27447 | $10,520 | — | — | — |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,190 | — | — | — |
| Ultrasound, thyroid and neck CPT Code: 76536 | $559 | — | — | — |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,158 | — | — | — |
| X-ray, foot CPT Code: 73630 | $220 | — | — | — |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $3,754 | — | — | — |
| Typhoid vaccine HCPCS Code: 90675 | $474 | — | — | — |
| Prostate cancer screening (blood test) HCPCS Code: G0103 | $119 | — | — | — |
| X-ray, ankle CPT Code: 73610 | $218 | — | — | — |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $92 | — | — | — |
| X-ray, hand CPT Code: 73130 | $128 | — | — | — |
| Blood test, magnesium CPT Code: 83735 | $115 | — | — | — |
| Pneumococcal vaccine HCPCS Code: 90732 | $213 | — | — | — |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $102 | — | — | — |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $131 | — | — | — |
| Blood test, basic metabolic panel CPT Code: 80048 | $167 | — | — | — |
| X-ray, shoulder CPT Code: 73030 | $155 | — | — | — |
| MRI, lower back (no contrast) CPT Code: 72148 | $3,014 | — | — | — |
| Hepatitis C antibody test CPT Code: 86803 | $120 | — | — | — |
| X-ray, pelvis CPT Code: 72170 | $164 | — | — | — |
| Blood test, sodium CPT Code: 84295 | $85 | — | — | — |
| CT scan, head (with contrast) CPT Code: 70460 | $2,051 | — | — | — |
| Vaginal delivery (full package) CPT Code: 59400 | $2,795 | — | — | — |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $855 | — | — | — |
| Colonoscopy with biopsy CPT Code: 45380 | $2,389 | — | — | — |
| CT scan, sinuses CPT Code: 70486 | $1,705 | — | — | — |
| Physical therapy (manual therapy) CPT Code: 97140 | $97 | — | — | — |
| Occupational therapy (self-care training) CPT Code: 97535 | $90 | — | — | — |
| X-ray, hip CPT Code: 73502 | $284 | — | — | — |
| Blood test, potassium CPT Code: 84132 | $83 | — | — | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $152 | — | — | — |
| Blood test, clotting time (PTT) CPT Code: 85730 | $102 | — | — | — |
| Speech therapy (language evaluation) CPT Code: 92507 | $292 | — | — | — |
| Neurobehavioral status check CPT Code: 96116 | $277 | — | — | — |
| Blood test, calcium CPT Code: 82310 | $85 | — | — | — |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $58 | — | — | — |
| Breast lump removal CPT Code: 19120 | $2,831 | — | — | — |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,652 | — | — | — |
| Hepatitis B vaccine HCPCS Code: 90744 | $39 | — | — | — |
| Blood test, PSA (prostate screen) CPT Code: 84153 | $120 | — | — | — |
| Blood test, creatinine (kidney) CPT Code: 82565 | $88 | — | — | — |
| Prosthetic fitting and training CPT Code: 97761 | $82 | — | — | — |
| Orthotic fitting and training CPT Code: 97760 | $106 | — | — | — |
| Blood test, lipase CPT Code: 83690 | $143 | — | — | — |
| X-ray, chest (single view) CPT Code: 71045 | $110 | — | — | — |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $440 | — | — | — |
| Rabies immune globulin HCPCS Code: 90375 | $784 | — | — | — |
| Blood test, amylase CPT Code: 82150 | $110 | — | — | — |
| MRI, brain (no contrast) CPT Code: 70551 | $3,363 | — | — | — |
| Blood test, hemoglobin CPT Code: 85018 | $71 | — | — | — |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $170 | — | — | — |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,164 | — | — | — |
| CT scan, chest (no contrast) CPT Code: 71250 | $2,270 | — | — | — |
| X-ray, lower back CPT Code: 72110 | $275 | — | — | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $231 | — | — | — |
| CT scan, pelvis CPT Code: 72192 | $2,112 | — | — | — |
| Blood antibody screen CPT Code: 86850 | $126 | — | — | — |
| Blood test, vitamin B12 CPT Code: 82607 | $159 | — | — | — |
| Physical therapy (gait training) CPT Code: 97116 | $92 | — | — | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $4,157 | — | — | — |
| Bunion correction surgery CPT Code: 28296 | $3,377 | — | — | — |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $150 | — | — | — |
| Blood test, clotting time (PT/INR) CPT Code: 85610 | $89 | — | — | — |
| Hospital observation (per hour) HCPCS Code: G0378 | $48 | — | — | — |
| MRI, brain (with and without contrast) CPT Code: 70553 | $3,728 | — | — | — |
| MRI, knee or other leg joint CPT Code: 73721 | $2,397 | — | — | — |
| Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: 90715 | $61 | — | — | — |
| Culture, blood CPT Code: 87040 | $371 | — | — | — |
| Electrocardiogram (ECG/EKG) CPT Code: 93000 | $230 | — | — | — |
| Blood transfusion CPT Code: 36430 | $795 | — | — | — |
| CT scan, neck (cervical spine) CPT Code: 72125 | $2,335 | — | — | — |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $93 | — | — | — |
| DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: 90700 | $45 | — | — | — |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,275 | — | — | — |
| Pneumonia vaccine injection HCPCS Code: G0009 | $37 | — | — | — |
| Blood test, cholesterol (lipid panel) CPT Code: 80061 | $153 | — | — | — |
| Culture, bacterial CPT Code: 87070 | $120 | — | — | — |
| Group therapy session CPT Code: 90853 | $446 | — | — | — |
| Trauma team activation HCPCS Code: G0390 | $1,699 | — | — | — |
| Blood test, vitamin D CPT Code: 82306 | $171 | — | — | — |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,272 | — | — | — |
| New patient office visit (30-44 min) CPT Code: 99203 | $167 | — | — | — |
| Colorectal cancer screening (alternative) HCPCS Code: G0145 | $141 | — | — | — |
| Blood test, thyroid (TSH) CPT Code: 84443 | $133 | — | — | — |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $93 | — | — | — |
| Blood test, urea nitrogen (BUN, kidney) CPT Code: 84520 | $85 | — | — | — |
| CT scan, head (no contrast) CPT Code: 70450 | $1,752 | — | — | — |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $258 | — | — | — |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $128 | — | — | — |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,584 | — | — | — |
| Family therapy session CPT Code: 90847 | $263 | — | — | — |
| X-ray, chest (two views) CPT Code: 71046 | $128 | — | — | — |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,349 | — | — | — |