| Hemoglobin A1c | 83036 | $2 – $142 |
| Complete Blood Count (CBC) | 85025 | $2 – $212 |
| HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | 84153 | $4 – $191 |
| TSH Thyroid Test | 84443 | $4 – $276 |
| HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL | 82465 | $5 |
| HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE | 87491 | $6 |
| HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | 87591 | $6 – $320 |
| Lipid Panel | 80061 | $7 – $325 |
| Comprehensive Metabolic Panel | 80053 | $15 – $453 |
| HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM | 82270 | $21 – $92 |
| HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY CDM | 81001 | $24 – $138 |
| Blood Glucose Test | 82947 | $33 – $156 |
| HC HIV-1/HIV-2 SINGLE ASSAY - REFLEXIVE | 86703 | $42 |
| HC LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY LAB | 88300 | $49 – $90 |
| HC LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88302 | $49 – $129 |
| HC ADMIN INFLUENZA VIRUS VAC CDM | 90471 | $69 – $82 |
| HC PR RX INFLUENZA QUADRIVALENT (IIV4) PF IM 0.5 ML | 90686 | $84 |
| HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88305 | $84 – $339 |
| HC SPECIAL STAIN GROUP 1 MICROORGANISMS I&R LAB | 88312 | $91 – $147 |
| HC LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88304 | $91 – $185 |
| Therapeutic Injection | 96372 | $119 |
| HC XR CHEST 1 VIEW | 71045 | $187 – $742 |
| Chest X-Ray (2 Views) | 71046 | $210 – $853 |
| HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB | 87624 | $218 – $265 |
| HC PSYCH DIAG EVAL PHP/IOP CDM | 90791 | $226 |
| HC ED EYE EXAM NEW PATIENT CDM | 92002 | $235 |
| Knee X-Ray | 73560 | $279 – $807 |
| HC BONE DENSITY PERIPHERAL SKELETON | 77081 | $280 – $311 |
| Mammogram (Screening) | 77067 | $281 – $684 |
| HC UC SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/OR LESS CDM | 12001 | $291 |
| HC PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC LAB | 88331 | $307 – $326 |
| HC UC REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 CDM | 11200 | $309 |
| HC PSYTX W PT 30 MIN PHP/IOP CDM | 90832 | $323 |
| HC IV HYDRATION INITIAL HR CDM | 96360 | $392 |
| HC ED DESTRUCT PREMALG LESION FIRST LESION CDM | 17000 | $392 |
| HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM | 17110 | $392 |
| HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | 10060 | $405 |
| HC LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88307 | $406 – $419 |
| HC ED INCISION OF EARDRUM W/O GENERAL ANESTHESIA CDM | 69420 | $450 |
| HC XR SHOULDER COMPLETE MIN 2 VIEWS | 73030 | $462 – $1,143 |
| HC SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/OR LESS | 11300 | $486 |
| HC ED SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM OR LESS CDM | 11305 | $494 |
| HC ED FAC E&M VISIT LEVEL 1 CDM | 99281 | $503 |
| HC PSYTX W PT 45 MIN PHP/IOP CDM | 90834 | $513 |
| DEXA Bone Density Scan | 77080 | $607 – $618 |
| HC UC ARTHROCENTESIS JNT MAJ | 20610 | $622 |
| Psychotherapy (60 min) | 90837 | $704 |
| HC ED EXCISION CHALAZION SINGLE CDM | 67800 | $803 |
| HC ED SEXUAL ASSAULT EXAM CDM | 99284 | $817 |
| HC LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88309 | $914 |
| HC ED FAC E&M VISIT LEVEL 2 CDM | 99282 | $1,015 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM | 11400 | $1,359 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM CDM | 11401 | $1,359 |
| HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM | 11440 | $1,406 |
| Upper Endoscopy with Biopsy | 43239 | $1,602 |
| HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | 43235 | $1,602 |
| Colonoscopy | 45378 | $1,613 |
| Head CT Scan | 70450 | $1,650 – $2,395 |
| HC ED FAC E&M VISIT LEVEL 3 CDM | 99283 | $1,666 |
| HC POLYSOMNOGRAPHY 4 OR MORE | 95810 | $2,083 |
| Echocardiogram | 93306 | $2,253 |
| Knee MRI | 73721 | $2,337 – $4,281 |
| Cervical Spine MRI | 72141 | $2,350 – $5,336 |
| Lumbar Spine MRI | 72148 | $2,468 – $4,765 |
| Epidural Steroid Injection | 64483 | $2,985 |
| HC ED ABLATE INF TURBINATE SUPERFICIAL CDM | 30801 | $3,007 |
| HC NASAL/SINUS ENDOSCOPY SURG W/ BIOPSY | 31237 | $3,080 |
| HC ED CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ CDM | 27238 | $3,107 |
| Brain MRI with Contrast | 70553 | $3,763 – $7,324 |
| HC ED FAC E&M VISIT LEVEL 5 CDM | 99285 | $4,132 |
| HC ED REPAIR OF NASAL SEPTUM CDM | 30520 | $6,162 |