| Stool analysis for blood to screen for colon tumors | 82270 | $19 |
| Skin test for tuberculosis | 86580 | $19 |
| Blood Glucose Test | 82947 | $31 |
| Cholesterol level | 82465 | $32 |
| Established patient periodic preventive medicine examination (40-64 years) | 99396 | $33 |
| Established patient periodic preventive medicine examination (18-39 years) | 99395 | $34 |
| Manual urinalysis test with examination using microscope, automated | 81001 | $39 |
| Initial new patient preventive medicine evaluation (40-64 years) | 99386 | $43 |
| Initial new patient preventive medicine evaluation (18-39 years) | 99385 | $44 |
| Hemoglobin A1c | 83036 | $52 |
| Complete Blood Count (CBC) | 85025 | $56 |
| Pathology examination of tissue using a microscope, limited examination | 88300 | $61 |
| Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | 87591 | $63 |
| Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | 87491 | $63 |
| Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | 99211 | $75 |
| Analysis for antibody to HIV-1 and HIV-2 virus | 86703 | $75 |
| TSH Thyroid Test | 84443 | $80 |
| Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | 99212 | $82 |
| New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | 99202 | $83 |
| Detection test by nucleic acid for Human Papillomavirus (HPV), high-risk types | 87624 | $84 |
| Lipid Panel | 80061 | $85 |
| PSA (prostate specific antigen) measurement, total | 84153 | $88 |
| Administration of vaccine | 90471 | $93 |
| Office Visit (Established Patient) | 99213 | $93 |
| Surgical pathology consultation and report on referred material requiring preparation of slides | 88323 | $104 |
| Office Visit (New Patient) | 99203 | $107 |
| Influenza vaccine, quadrivalent, preservative free, 0.5 mL dosage | 90686 | $108 |
| Pathology examination of tissue using a microscope, intermediate complexity | 88305 | $112 |
| Special stained specimen slides to identify organisms including interpretation and report | 88312 | $113 |
| Pathology examination of tissue using a microscope | 88302 | $115 |
| Therapeutic Injection | 96372 | $116 |
| Comprehensive Metabolic Panel | 80053 | $117 |
| Office Visit (Complex) | 99214 | $122 |
| Office Visit (New, Complex) | 99204 | $125 |
| Pathology examination of tissue using a microscope, moderately low complexity | 88304 | $125 |
| Psychotherapy, 30 minutes | 90832 | $127 |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 99215 | $132 |
| New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | 99205 | $138 |
| Pathology examination of specimen during surgery, first tissue block | 88331 | $139 |
| Psychotherapy, 45 minutes | 90834 | $146 |
| Psychotherapy (60 min) | 90837 | $168 |
| X-ray of chest, 1 view | 71045 | $199 |
| Emergency department visit for problem that may not require health care professional | 99281 | $245 |
| DXA bone density measurement of forearm, finger, hand, or foot | 77081 | $246 |
| Pathology examination of tissue using a microscope, moderately high complexity | 88307 | $263 |
| Knee X-Ray | 73560 | $272 |
| Shaving of skin growth of scalp, neck, hands, feet, or genitals, 0.5 cm or less | 11305 | $275 |
| Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.5 cm or less | 12001 | $284 |
| Chest X-Ray (2 Views) | 71046 | $284 |
| Destruction of skin growth, 1-14 growths | 17110 | $297 |
| DEXA Bone Density Scan | 77080 | $321 |
| Removal of skin tag, 1-15 skin tags | 11200 | $322 |
| Psychiatric diagnostic evaluation | 90791 | $349 |
| X-ray of shoulder, minimum of 2 views | 73030 | $364 |
| Infusion into a vein for hydration, 31-60 minutes | 96360 | $386 |
| Simple or single drainage of skin abscess | 10060 | $399 |
| Pathology examination of tissue using a microscope, high complexity | 88309 | $425 |
| Mammogram (Screening) | 77067 | $427 |
| Emergency department visit with straightforward medical decision making | 99282 | $487 |
| Removal of noncancer skin growth of body, arms, or legs, 0.5 cm or less | 11400 | $550 |
| Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm | 11401 | $600 |
| Aspiration and/or injection of fluid from large joint | 20610 | $612 |
| Head CT Scan | 70450 | $901 |
| Emergency department visit with low level of medical decision making | 99283 | $938 |
| Epidural Steroid Injection | 64483 | $1,248 |
| Knee MRI | 73721 | $1,296 |
| Needle biopsy of breast | 19100 | $1,438 |
| Emergency department visit with moderate level of medical decision making | 99284 | $1,499 |
| Cervical Spine MRI | 72141 | $1,538 |
| Closed treatment of broken below neck of thigh bone | 27238 | $1,665 |
| Emergency department visit with high level of medical decision making | 99285 | $1,726 |
| Lumbar Spine MRI | 72148 | $1,764 |
| Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope | 43235 | $1,897 |
| Echocardiogram | 93306 | $2,137 |
| Brain MRI with Contrast | 70553 | $2,384 |
| Upper Endoscopy with Biopsy | 43239 | $2,387 |
| Colonoscopy with Biopsy | 45380 | $2,522 |
| Colonoscopy | 45378 | $2,758 |
| Removal of polyps or growths of large bowel using an endoscope with mechanical snare | 45385 | $3,168 |
| Sleep study in sleep lab (6 years or older) | 95810 | $3,382 |