| Hepatitis B immune globulin HCPCS Code: 90371 | $613 | — | $157 | — |
| Screening mammogram (both breasts) CPT Code: 77067 | $384 | — | $111 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $3,082 | — | $217 | unverified |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $420 | — | $126 | — |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $49 | — | $6 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $762 | — | $123 | unverified |
| X-ray, neck (cervical spine) CPT Code: 72040 | $343 | — | $74 | unverified |
| Blood test, lipase CPT Code: 83690 | $123 | — | $14 | unverified |
| Blood test, amylase CPT Code: 82150 | $102 | — | $13 | unverified |
| Flu vaccine (high dose) HCPCS Code: 90656 | $82 | — | $25 | — |
| Blood test, potassium CPT Code: 84132 | $50 | — | $9 | unverified |
| Blood antibody screen CPT Code: 86850 | $81 | — | $34 | — |
| Trauma team activation HCPCS Code: G0390 | $2,533 | — | $1,208 | — |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,207 | — | $137 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,206 | — | $189 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $3,854 | — | $193 | unverified |
| Hepatitis B vaccine HCPCS Code: 90744 | $69 | — | $37 | — |
| Blood test, hemoglobin CPT Code: 85018 | $32 | — | $4 | unverified |
| Hospital observation (per hour) HCPCS Code: G0378 | $94 | — | $73 | — |
| Blood test, liver function panel CPT Code: 80076 | $53 | — | $19 | — |
| Flu vaccine injection HCPCS Code: G0008 | $61 | — | $53 | — |
| Blood test, thyroid (TSH) CPT Code: 84443 | $135 | — | $31 | unverified |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $85 | — | $17 | unverified |
| Blood test, vitamin B12 CPT Code: 82607 | $152 | — | $30 | unverified |
| Blood test, urea nitrogen (BUN, kidney) CPT Code: 84520 | $63 | — | $7 | unverified |
| Pneumococcal vaccine HCPCS Code: 90732 | $187 | — | $141 | — |
| Hepatitis C antibody test CPT Code: 86803 | $124 | — | $28 | unverified |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $112 | — | $20 | unverified |
| X-ray, chest (two views) CPT Code: 71046 | $374 | — | $76 | unverified |
| Diagnostic procedure preparation HCPCS Code: G0279 | $120 | — | $45 | — |
| Culture, bacterial CPT Code: 87070 | $98 | — | $20 | — |
| Drug screening test HCPCS Code: G0480 | $140 | — | $85 | — |
| Ultrasound, pelvis CPT Code: 76856 | $852 | — | $119 | unverified |
| Prostate cancer screening (blood test) HCPCS Code: G0103 | $93 | — | $32 | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $4,331 | — | $282 | unverified |
| Blood test, clotting time (PTT) CPT Code: 85730 | $91 | — | $12 | unverified |
| Culture, blood CPT Code: 87040 | $200 | — | $24 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $2,207 | — | $137 | unverified |
| Rabies immune globulin HCPCS Code: 90375 | $1,738 | — | $351 | — |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $155 | — | $25 | unverified |
| Pneumonia vaccine injection HCPCS Code: G0009 | $41 | — | $52 | — |
| Colorectal cancer screening HCPCS Code: G0010 | $66 | — | $51 | — |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,725 | — | $601 | unverified |
| MMR vaccine (measles, mumps, rubella) HCPCS Code: 90707 | $155 | — | $93 | — |
| Blood test, PSA (prostate screen) CPT Code: 84153 | $108 | — | $33 | unverified |
| X-ray, pelvis CPT Code: 72170 | $348 | — | $68 | unverified |
| CT scan, head (no contrast) CPT Code: 70450 | $1,726 | — | $136 | unverified |
| Blood test, vitamin D CPT Code: 82306 | $235 | — | $46 | unverified |
| X-ray, lower back CPT Code: 72110 | $565 | — | $86 | unverified |
| New patient office visit (30-44 min) CPT Code: 99203 | $199 | — | $113 | — |
| X-ray, chest (single view) CPT Code: 71045 | $351 | — | $68 | unverified |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $135 | — | $96 | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $243 | — | $61 | unverified |
| Blood test, calcium CPT Code: 82310 | $49 | — | $10 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,744 | — | $134 | unverified |
| DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: 90700 | $68 | — | $43 | — |
| Blood test, clotting time (PT/INR) CPT Code: 85610 | $59 | — | $9 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $681 | — | $111 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $1,761 | — | $176 | unverified |
| Blood test, creatinine (kidney) CPT Code: 82565 | $60 | — | $9 | unverified |
| Blood test, magnesium CPT Code: 83735 | $115 | — | $14 | unverified |
| CT scan, sinuses CPT Code: 70486 | $2,008 | — | $131 | unverified |
| Blood test, sodium CPT Code: 84295 | $42 | — | $9 | — |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,089 | — | $185 | unverified |
| MRI, brain (with and without contrast) CPT Code: 70553 | $4,189 | — | $326 | unverified |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $121 | — | $28 | unverified |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $205 | — | $118 | — |
| MRI, lower back (no contrast) CPT Code: 72148 | $3,103 | — | $217 | unverified |
| Varicella (chickenpox) vaccine HCPCS Code: 90716 | $273 | — | $173 | — |
| Blood transfusion CPT Code: 36430 | $1,000 | — | $287 | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $119 | — | $63 | — |
| Blood test, basic metabolic panel CPT Code: 80048 | $124 | — | $20 | unverified |
| Blood test, cholesterol (lipid panel) CPT Code: 80061 | $79 | — | $27 | — |
| Blood test, glucose (blood sugar) CPT Code: 82947 | $44 | — | $7 | unverified |
| Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: 90715 | $93 | — | $58 | — |
| Injection procedure for pain management HCPCS Code: G0260 | $1,486 | — | $492 | — |
| CT scan, pelvis CPT Code: 72192 | $1,897 | — | $141 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,439 | — | $255 | unverified |
| Typhoid vaccine HCPCS Code: 90675 | $533 | — | $323 | — |