| HC Fecal Occult Blood Single Determ | 82270 | $16 |
| HC Urinalysis W Microscopic | 81001 | $31 |
| HC Hepatitis B Vac Admin | 90471 | $34 |
| HC Immunization Admin 1st Vaccine Thru 18yrs | 90460 | $41 |
| HC Total Psa Mayo | 84153 | $41 |
| Blood Glucose Test | 82947 | $45 |
| Complete Blood Count (CBC) | 85025 | $49 |
| HC Level I Surg Path Gross Only | 88300 | $55 |
| Hemoglobin A1c | 83036 | $61 |
| HC Cholesterol | 82465 | $62 |
| HC Iadna Hpv High Risk Types Yale | 87624 | $79 |
| HC Supplemental Hiv 1/2 Rapid Test | 86703 | $81 |
| HC Established Patient Level 2 | 99212 | $86 |
| Office Visit (New Patient) | 99203 | $89 |
| Office Visit (Established Patient) | 99213 | $105 |
| HC Nurse Visit Estab Patient Lvl1 | 99211 | $105 |
| HC Chlamydia by Pcr | 87491 | $108 |
| HC Gonorrhoeae by Pcr | 87591 | $108 |
| HC Level III Surg Path Gross and Micro | 88304 | $118 |
| TSH Thyroid Test | 84443 | $119 |
| HC Level II Surg Path Gross and Micro | 88302 | $125 |
| HC ED Visit Level 1 | 99281 | $128 |
| Therapeutic Injection | 96372 | $140 |
| Office Visit (Complex) | 99214 | $142 |
| HC ASC Arthrocentesis Maj Joint Bursa | 20610 | $147 |
| Comprehensive Metabolic Panel | 80053 | $157 |
| HC Special Stains Grp 1 | 88312 | $160 |
| Lipid Panel | 80061 | $168 |
| HC New Patient Level 2 | 99202 | $176 |
| HC Frozen Section First Block | 88331 | $197 |
| DEXA Bone Density Scan | 77080 | $199 |
| HC Addtl Bn Marrow Bx Smear Prep and Int | 88305 | $203 |
| HC Chest 1 View | 71045 | $205 |
| HC ASC Incision and Drainage Abscess Simple or Single | 10060 | $220 |
| Mammogram (Screening) | 77067 | $222 |
| HC Dexa Appendicular Skeleton | 77081 | $223 |
| HC ED Visit Level 2 | 99282 | $235 |
| HC Simple Repair Superfcl Wnd Rpr Sc Nk Gen Ext 2.5 Cm or Less | 12001 | $251 |
| HC ASC Excision Benign Lesion Trunk Arm Leg 0.5cm Or< | 11400 | $263 |
| ADJUVANT AS01B (PF), COMPONENT VIAL 1 OF 2 INTRAMUSCULAR SUSPENSION | 90750 | $281 |
| Office Visit (New, Complex) | 99204 | $299 |
| HC ASC Excision Benign Lesion Trunk Arm Leg 0.6cm-1.0cm | 11401 | $301 |
| Chest X-Ray (2 Views) | 71046 | $305 |
| HC Established Patient Level 5 | 99215 | $308 |
| HC New Patient Level 5 | 99205 | $308 |
| HC Hydration IV Initial 31min-1hr | 96360 | $319 |
| Knee X-Ray | 73560 | $320 |
| HC ED Visit Level 3 | 99283 | $330 |
| HC Level V Surg Path or Cyto Gross and Micro | 88307 | $340 |
| HC Shoulder Comp 2 Vws | 73030 | $374 |
| HC Level VI Surg Path Gross and Micro | 88309 | $493 |
| HC ED Visit Level 4 | 99284 | $575 |
| Epidural Steroid Injection | 64483 | $896 |
| HC ED Visit Level 5 | 99285 | $1,065 |
| Colonoscopy | 45378 | $1,110 |
| HC ASC Egd Incl Specimen Flexible Transoral | 43235 | $1,132 |
| Upper Endoscopy with Biopsy | 43239 | $1,132 |
| Head CT Scan | 70450 | $1,271 |
| Echocardiogram | 93306 | $1,390 |
| HC ASC Bil Micro Tympanostomy W Tube | 69436 | $1,421 |
| HC ASC Colonoscopy With Lesion Removal | 45385 | $1,450 |
| Colonoscopy with Biopsy | 45380 | $1,450 |
| HC ASC Nasal Sinus Endoscopy Surg W/Bx Polypectomy or Debide | 31237 | $1,776 |
| HC Polysom Less Than 6 Hrs and 6 Yrs Old or More | 95810 | $2,180 |
| Knee MRI | 73721 | $2,666 |
| Lumbar Spine MRI | 72148 | $2,717 |
| Cervical Spine MRI | 72141 | $2,944 |
| HC ASC Rec Submucous Inferior Turbinate Part or Complete Any Method | 30140 | $2,996 |
| HC ASC Tonsillectomy 12yrs or Over | 42826 | $2,996 |
| HC ASC Tonsillectomy and Adenoidectomy 12yrs or Over | 42821 | $2,996 |
| HC ASC Septoplasty or Submucous Resection W/WO Cartilage Scoring | 30520 | $2,996 |
| Brain MRI with Contrast | 70553 | $3,054 |
| HC ASC 2 Arthroscopy Knee W Meniscectomy Medial or Lateral W Shaving | 29881 | $3,677 |
| Laparoscopic Cholecystectomy | 47562 | $6,382 |
| HC ASC Tonsillectomy and Adenoidectomy Under 12yrs | 42820 | $6,603 |