| HC LA PSYCHOTHERAPY PATIENT&/ FAMILY PER MIN | 90832 | $2 – $3 |
| HC LA PSYCHOTHERAPY PATIENT &/ FAMILY PER MIN | 90834 | $2 – $3 |
| Psychotherapy (60 min) | 90837 | $2 – $3 |
| HC LA PSYCHIATRIC DIAGNOSTIC EVALUATION PER MIN | 90791 | $2 – $3 |
| HC LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY LAB | 88300 | $6 – $101 |
| Blood Glucose Test | 82947 | $11 – $85 |
| HC ASSAY BLD/SERUM CHOLESTEROL | 82465 | $12 – $91 |
| HC LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88302 | $13 – $151 |
| Complete Blood Count (CBC) | 85025 | $16 – $94 |
| HC LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88304 | $16 – $218 |
| HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88305 | $18 – $283 |
| HC MICROSLIDE CONSULTATION W/ SLIDE PREP | 88323 | $20 – $93 |
| HC SPECIAL STAIN GROUP 1 MICROORGANISMS I&R | 88312 | $23 |
| HC IMMUNIZATION ADMIN CDM | 90471 | $23 |
| HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | 81001 | $25 – $96 |
| HC PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC LAB | 88331 | $28 – $283 |
| Comprehensive Metabolic Panel | 80053 | $28 – $194 |
| Hemoglobin A1c | 83036 | $29 – $78 |
| Lipid Panel | 80061 | $31 – $130 |
| TSH Thyroid Test | 84443 | $39 – $190 |
| HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | 84153 | $42 – $174 |
| HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ LAB | 87591 | $53 |
| HC IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ LAB | 87491 | $53 |
| HC LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88309 | $100 – $495 |
| HC LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88307 | $105 – $396 |
| HC ED EYE EXAM NEW PATIENT CDM | 92002 | $113 |
| Therapeutic Injection | 96372 | $133 |
| HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM | 12001 | $168 |
| HC ED FAC E&M VISIT LEVEL 1 CDM | 99281 | $183 |
| HC SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM CDM | 11301 | $219 |
| HC ED DESTRUCT PREMALG LESION FIRST LESION CDM | 17000 | $257 |
| Mammogram (Screening) | 77067 | $281 |
| HC ED SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM OR LESS CDM | 11305 | $298 |
| Knee X-Ray | 73560 | $306 |
| HC IV HYDRATION INITIAL HR CDM | 96360 | $318 |
| DEXA Bone Density Scan | 77080 | $328 |
| HC XR CHEST 1 VIEW | 71045 | $332 |
| HC ED INCISION OF EARDRUM W/O GENERAL ANESTHESIA CDM | 69420 | $348 |
| HC ED EXCISION CHALAZION SINGLE CDM | 67800 | $351 |
| HC REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 | 11200 | $358 |
| HC ED FAC E&M VISIT LEVEL 2 CDM | 99282 | $358 |
| HC DESTRUCT BENIGN LESIONS UP TO 14 LESIONS CDM | 17110 | $364 |
| HC XR SHOULDER COMPLETE MIN 2 VIEWS | 73030 | $383 |
| Chest X-Ray (2 Views) | 71046 | $398 |
| HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | 10060 | $473 |
| Upper Endoscopy with Biopsy | 43239 | $587 |
| HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | 43235 | $587 |
| HC ED FAC E&M VISIT LEVEL 3 CDM | 99283 | $602 |
| Colonoscopy | 45378 | $611 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM | 11400 | $772 |
| HC EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM | 11401 | $772 |
| HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | 20610 | $867 |
| HC SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/OR LESS | 11300 | $959 |
| HC ED FAC E&M VISIT LEVEL 4 CDM | 99284 | $1,030 |
| Epidural Steroid Injection | 64483 | $1,199 |
| HC BX BREAST PERCUT W/O IMAGE | 19100 | $1,289 |
| Echocardiogram | 93306 | $1,374 |
| Head CT Scan | 70450 | $1,532 |
| HC ED FAC E&M VISIT LEVEL 5 CDM | 99285 | $1,540 |
| HC ED ABLATE INF TURBINATE SUPERFICIAL CDM | 30801 | $1,658 |
| HC ED CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ CDM | 27238 | $1,707 |
| Knee MRI | 73721 | $1,790 |
| HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM | 11440 | $2,022 |
| Lumbar Spine MRI | 72148 | $2,228 |
| Cervical Spine MRI | 72141 | $2,272 |
| HC ED REPAIR OF NASAL SEPTUM CDM | 30520 | $2,858 |
| Brain MRI with Contrast | 70553 | $2,967 |
| HC BIOPSY OF PROSTATE | 55700 | $3,584 |