| Hepatitis C antibody test CPT Code: 86803 | $59 | — | — | — |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $11 | — | — | — |
| CT scan, neck (cervical spine) CPT Code: 72125 | $364 | — | — | — |
| Blood test, magnesium CPT Code: 83735 | $28 | — | — | — |
| CT scan, head (with and without contrast) CPT Code: 70470 | $425 | — | — | — |
| X-ray, foot CPT Code: 73630 | $95 | — | — | — |
| MRI, lower back (no contrast) CPT Code: 72148 | $860 | — | — | — |
| X-ray, lower back CPT Code: 72110 | $73 | — | — | — |
| Blood test, cholesterol (lipid panel) CPT Code: 80061 | $55 | — | — | — |
| Blood test, calcium CPT Code: 82310 | $53 | — | — | — |
| Blood test, glucose (blood sugar) CPT Code: 82947 | $16 | — | — | — |
| Prosthetic fitting and training CPT Code: 97761 | $28 | — | — | — |
| Blood test, clotting time (PTT) CPT Code: 85730 | $45 | — | — | — |
| X-ray, hip CPT Code: 73502 | $95 | — | — | — |
| CT scan, pelvis CPT Code: 72192 | $701 | — | — | — |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $65 | — | — | — |
| Inguinal hernia repair CPT Code: 49505 | $2,500 | — | — | — |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $12 | — | — | — |
| X-ray, pelvis CPT Code: 72170 | $36 | — | — | — |
| MRI, brain (no contrast) CPT Code: 70551 | $860 | — | — | — |
| X-ray, hand CPT Code: 73130 | $95 | — | — | — |
| CT scan, head (with contrast) CPT Code: 70460 | $425 | — | — | — |
| Blood transfusion CPT Code: 36430 | $150 | — | — | — |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $364 | — | — | — |
| Blood test, amylase CPT Code: 82150 | $68 | — | — | — |
| New patient office visit (30-44 min) CPT Code: 99203 | $200 | — | — | — |
| Blood test, lipase CPT Code: 83690 | $28 | — | — | — |
| Blood test, sodium CPT Code: 84295 | $20 | — | — | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $19 | — | — | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $73 | — | — | — |
| CT scan, head (no contrast) CPT Code: 70450 | $364 | — | — | — |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $100 | — | — | — |
| Screening mammogram (both breasts) CPT Code: 77067 | $206 | — | — | — |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $500 | — | — | — |
| Blood test, vitamin B12 CPT Code: 82607 | $62 | — | — | — |
| X-ray, ankle CPT Code: 73610 | $95 | — | — | — |
| Blood test, PSA (prostate screen) CPT Code: 84153 | $76 | — | — | — |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $188 | — | — | — |
| Occupational therapy (self-care training) CPT Code: 97535 | $11 | — | — | — |
| Ultrasound, pelvis CPT Code: 76856 | $206 | — | — | — |
| X-ray, chest (two views) CPT Code: 71046 | $95 | — | — | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $575 | — | — | — |
| Blood test, clotting time (PT/INR) CPT Code: 85610 | $16 | — | — | — |
| Culture, bacterial CPT Code: 87070 | $53 | — | — | — |
| Breast lump removal CPT Code: 19120 | $513 | — | — | — |
| Blood test, creatinine (kidney) CPT Code: 82565 | $21 | — | — | — |
| Blood test, vitamin D CPT Code: 82306 | $122 | — | — | — |
| Blood test, hemoglobin CPT Code: 85018 | $8 | — | — | — |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $11 | — | — | — |
| Blood test, potassium CPT Code: 84132 | $19 | — | — | — |
| X-ray, chest (single view) CPT Code: 71045 | $95 | — | — | — |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $40 | — | — | — |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $597 | — | — | — |
| Ultrasound, thyroid and neck CPT Code: 76536 | $216 | — | — | — |
| Physical therapy (manual therapy) CPT Code: 97140 | $11 | — | — | — |
| Colonoscopy with biopsy CPT Code: 45380 | $398 | — | — | — |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $28 | — | — | — |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $43 | — | — | — |
| Physical therapy (gait training) CPT Code: 97116 | $28 | — | — | — |
| Blood test, urea nitrogen (BUN, kidney) CPT Code: 84520 | $16 | — | — | — |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $17 | — | — | — |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $122 | — | — | — |
| MRI, knee or other leg joint CPT Code: 73721 | $1,656 | — | — | — |
| X-ray, shoulder CPT Code: 73030 | $95 | — | — | — |
| Blood test, liver function panel CPT Code: 80076 | $53 | — | — | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $95 | — | — | — |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $249 | — | — | — |
| CT scan, chest (no contrast) CPT Code: 71250 | $364 | — | — | — |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $304 | — | — | — |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $216 | — | — | — |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $2,500 | — | — | — |
| MRI, brain (with and without contrast) CPT Code: 70553 | $993 | — | — | — |
| Blood antibody screen CPT Code: 86850 | $25 | — | — | — |
| Colonoscopy (diagnostic) CPT Code: 45378 | $471 | — | — | — |
| Blood test, thyroid (TSH) CPT Code: 84443 | $104 | — | — | — |
| CT scan, sinuses CPT Code: 70486 | $364 | — | — | — |
| Blood test, basic metabolic panel CPT Code: 80048 | $35 | — | — | — |