| HC REFRACTIVE STATE,DETERMINATION | 92015 | $5 |
| Lipid Panel | 80061 | $24 |
| TSH Thyroid Test | 84443 | $36 |
| HC TB INTRADERMAL | 86580 | $45 |
| HC VACC,IMMUN ADM,</=18YR - 1ST VAC | 90460 | $46 |
| HC OCCULT BLOOD, BY PEROXIDASE, FECES, COLORECTAL SCREEN | 82270 | $46 |
| Blood Glucose Test | 82947 | $49 |
| HC CHOLESTEROL, TOTAL BLOOD | 82465 | $52 |
| HC IMMUNIZATION ADMINISTRATION | 90471 | $62 |
| Complete Blood Count (CBC) | 85025 | $62 |
| HC URINALYSIS, AUTO, W/SCOPE | 81001 | $72 |
| HC SANE EXAM OUTSIDE OF HOSPITAL (CAC) | 99211 | $75 |
| HC HPV HIGH RISK TYPES | 87624 | $77 |
| HC SURG PATH, GROSS, LEVEL I | 88300 | $105 |
| Hemoglobin A1c | 83036 | $115 |
| HC INFECTIVE AGENT DETECTION, DNA/RNA | 87491 | $117 |
| EKG (Electrocardiogram) | 93000 | $130 |
| HC ANTIBODY - HIV-1 & HIV-2,SINGLE | 86703 | $137 |
| HC SCAN COMP/OPHTH/DIAG IMG POST SEGM - RETINA | 92134 | $150 |
| HC PSA,TOTAL | 84153 | $157 |
| HC N.GONORRHOEAE DNA AMP PROB | 87591 | $158 |
| HC SPECIAL STAINS, GROUP I, EACH | 88312 | $159 |
| HC SURGICAL PATH,GROSS, LEVEL II | 88302 | $169 |
| HC VIDEO VISIT PSYCHOTHERAPY, 30 MIN WITH PATIENT | 90832 | $175 |
| HC EYE EXAM, NEW PATIENT,INTERMED | 92002 | $175 |
| HC COMP CORNEAL TOPOGRAPHY,W/INT | 92025 | $178 |
| HC OPHTHAL.SERVICE,INTERMED/EST.P | 92012 | $182 |
| Therapeutic Injection | 96372 | $183 |
| HC PATH CONSLTN SURG 1ST BLK FROZEN SCTN SINGLE SPECIMEN, | 88331 | $195 |
| Comprehensive Metabolic Panel | 80053 | $198 |
| HC VIDEO VISIT PSYCHOTHERAPY, 45 MIN WITH PATIENT | 90834 | $201 |
| Psychotherapy (60 min) | 90837 | $201 |
| HC SURGICAL PATH, GROSS, LEVEL III | 88304 | $201 |
| HC SURGICAL PATH, LEVEL IV, GROSS | 88305 | $202 |
| HC REMOVE PREMALIGNANT LESION | 17000 | $212 |
| HC OPHTHAL.SERVICE,COMPREHEN/EST. | 92014 | $217 |
| HC XR DXA PERIPHERAL APPENDICULAR SKELETON | 77081 | $218 |
| Mammogram (Screening) | 77067 | $221 |
| HC EST PT PREV EXAM 40-64 YRS | 99396 | $222 |
| HC CONSLTN&REPRT MATERIAL REQUIRING PREPN SLIDES | 88323 | $230 |
| HC SHAVE SKIN LES - TRNK/ARM/LEG, < 0.5 CM | 11300 | $239 |
| HC EYE EXAM, NEW PATIENT,COMPREHESV | 92004 | $251 |
| HC SHV 1 LES S/H/F/G 0.5 CM OR LESS | 11305 | $266 |
| HC DESTRUCT BENIGN LESION 1-14 | 17110 | $272 |
| HC VISUAL FIELD EXAM, EXTENDED | 92083 | $277 |
| HC SHAVE SKIN LES - TRNK/ARM/LEG, 0.6 - 1.0 CM | 11301 | $277 |
| HC VIDEO VISIT, PSYCHIATRIC DIAGNOSTIC EVALUATION | 90791 | $317 |
| HC X-RAY EXAM CHEST 1 VIEW | 71045 | $324 |
| DEXA Bone Density Scan | 77080 | $343 |
| HC EMERGENCY DEPT LEVEL I | 99281 | $347 |
| Knee X-Ray | 73560 | $352 |
| HC DESTROY LESION, >15 | 17111 | $364 |
| HC SHOULDER -2 OR MORE VIEWS | 73030 | $370 |
| Chest X-Ray (2 Views) | 71046 | $382 |
| HC REMOVE SKIN TAGS - 1-15 LESIONS | 11200 | $438 |
| HC SURGICAL PATH, GROSS, LEVEL V | 88307 | $455 |
| HC INCISION OF EARDRUM | 69420 | $469 |
| HC IV INFUSION HYDRATION, INITIAL 31MIN - 1HR | 96360 | $509 |
| HC EMERGENCY CARE LEVEL II | 99282 | $546 |
| HC SURGICAL PATH, GROSS, LEVEL VI | 88309 | $627 |
| HC REMOVE EYELID LESION - MULTIPLE DIFF LID | 67805 | $746 |
| HC REMOVE EYELID LESION - SINGLE | 67800 | $777 |
| HC SMPL RPR WND FACE/NCK/TRUNK < 2.5 CM | 12001 | $821 |
| HC DRAINAGE OF SKIN ABSCESS - SIMPLE | 10060 | $841 |
| HC EMERGENCY CARE LEVEL III | 99283 | $960 |
| HC EXC TR-EXT B9+MARG 0.6 - 1.0 CM | 11401 | $963 |
| HC BIOPSY BREAST PERCUT W/O | 19100 | $1,078 |
| HC EXC FACE-MM B9+MARG - 0.5CM OR LESS | 11440 | $1,088 |
| HC ARTHR ASP INJ MJ JNT BURS | 20610 | $1,125 |
| HC EXC TR-EXT B9+MARG 0.5 CM OR LESS | 11400 | $1,246 |
| HC ABLATE INF TURBINATE | 30801 | $1,355 |
| HC TREAT INT/PER/SUBTROCH FS | 27238 | $1,417 |
| HC EMERGENCY CARE LEVEL IV | 99284 | $1,552 |
| HC LASER SURGERY OF EYE | 65855 | $1,668 |
| Head CT Scan | 70450 | $1,828 |
| Lumbar Spine MRI | 72148 | $1,913 |
| Knee MRI | 73721 | $2,090 |
| Epidural Steroid Injection | 64483 | $2,115 |
| HC EMERGENCY CARE LEVEL V | 99285 | $2,201 |
| Cervical Spine MRI | 72141 | $2,351 |
| Echocardiogram | 93306 | $2,590 |
| HC NASAL/SINUS ENDOSCOP | 31237 | $2,622 |
| HC POLYSOMNOGRAPHY - 1-3 ADD.PARAME | 95808 | $2,737 |
| HC EXCISE INFERIOR TURB | 30130 | $2,823 |
| HC BIOPSY OF PROSTATE | 55700 | $2,907 |
| HC RESECT INFERIOR TURB | 30140 | $2,945 |
| HC CREATE EARDRUM OPENI (GENERAL ANES) | 69436 | $3,341 |
| HC REMOVE TONSILS/ADENO | 42821 | $3,638 |
| HC REPAIR NASAL SEPTUM | 30520 | $3,652 |
| Brain MRI with Contrast | 70553 | $3,675 |
| HC POLYSOMNOGRAPHY 4OR MORE | 95810 | $4,314 |
| HC REMOVAL OF TONSILS | 42826 | $4,424 |
| HC REMOVAL OF TONSILS | 42825 | $4,556 |
| HC REMOVE TONSILS/ADENO | 42820 | $4,556 |
| Shoulder Arthroscopy | 29827 | $4,881 |
| HC PARTICAL MASTECTOMY | 19301 | $5,128 |
| HC P-MASTECTMY W/LN REM | 19302 | $5,429 |
| HC APPENDECTOMY | 44950 | $5,682 |
| HC MAST, SIMPLE, COMPLE | 19303 | $6,052 |
| HC PROSTATECTOMY (TURP) | 52601 | $7,000 |
| HC LAPARO-VAG HYST INCL | 58552 | $8,067 |
| HC MAST, MOD RAD | 19307 | $8,079 |
| HC KNEE ARTHROSCOPY/SUR - W/MENISCECTOMY | 29881 | $8,187 |
| HC VAGINAL HYSTERECTOMY | 58260 | $8,216 |
| HC KNEE ARTHROSCOPY/SUR | 29888 | $8,358 |
| HC TLH W/T/O 250 G OR LE | 58571 | $10,721 |