| TB Skin Test, Intradermal | 86580 | $8 |
| Flu vaccine | 90686 | $10 |
| Im Admin 1st/Only Component | 90460 | $22 |
| Urinalysis | 81001 | $22 |
| Chemistry | 84153 | $23 |
| Blood Glucose Test | 82947 | $24 |
| Chemistry | 82465 | $25 |
| Occult Blood, Feces | 82270 | $26 |
| Surgical Pathology study | 88300 | $28 |
| Office/Outpatient Visit Est | 99211 | $39 |
| Lipid Panel | 80061 | $42 |
| Immunization administration | 90471 | $42 |
| Path Consult in Surg,W Frz Sec | 88331 | $42 |
| Hemoglobin A1c | 83036 | $44 |
| Psychotherapy; 30 minutes | 90832 | $46 |
| Complete Blood Count (CBC) | 85025 | $49 |
| Therapeutic Injection | 96372 | $58 |
| Psytx W Pt 45 Minutes | 90834 | $61 |
| Surgical Pathology study | 88302 | $62 |
| Surgical Pathology study | 88312 | $68 |
| Microbiology | 87591 | $69 |
| Shaving of skin lesion, single lesion | 11300 | $72 |
| Shave skin lesion 0.5cm/less | 11305 | $72 |
| Bone Density | 77081 | $78 |
| TSH Thyroid Test | 84443 | $78 |
| Surgical Pathology study | 88304 | $79 |
| Hpv Genotyping Pcr | 87624 | $83 |
| Prev Visit, Est, Age 18-39 | 99395 | $84 |
| Office Visit | 99212 | $86 |
| Microbiology | 87491 | $86 |
| Shaving skin lesion, single lesion | 11301 | $88 |
| Prev Visit, Est, Age 40-64 | 99396 | $88 |
| Psychotherapy (60 min) | 90837 | $89 |
| Exc Tr-Ext B9+Marg 0.5 < | 11400 | $91 |
| Prev Visit, New, Age 18-39 | 99385 | $93 |
| Psychiatric diagnostic evaluation | 90791 | $97 |
| Exc Face-Mm B9+Marg 0.5 | 11440 | $99 |
| Destruct Premalg Lesion | 17000 | $102 |
| Surgical Pathology study | 88307 | $106 |
| Prev Visit, New, Age 40-64 | 99386 | $108 |
| Surgical Pathology study | 88305 | $108 |
| Exc Tr-Ext B9+Marg 0.6-1 | 11401 | $109 |
| Emergency Room visit | 99282 | $115 |
| ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR | 90750 | $119 |
| Drainage/injection major joint | 20610 | $119 |
| Office/Outpatient Visit New | 99202 | $126 |
| Knee X-Ray | 73560 | $128 |
| IV Therapy | 96360 | $132 |
| Surgical Pathology study | 88309 | $136 |
| Office Visit (Established Patient) | 99213 | $139 |
| Destruct B9 Lesion, 1-14 | 17110 | $147 |
| Emergency Room visit | 99281 | $149 |
| Incision of Eardrum | 69420 | $152 |
| Drainage of skin abscess | 10060 | $155 |
| Repair superficial wound | 12001 | $159 |
| X-ray chest | 71045 | $161 |
| Office Visit (New Patient) | 99203 | $162 |
| Destruct Lesion, 15 or M | 17111 | $164 |
| Removal of skin tags | 11200 | $181 |
| Comprehensive Metabolic Panel | 80053 | $181 |
| Emergency Room visit | 99283 | $183 |
| Chest X-Ray (2 Views) | 71046 | $184 |
| Office Visit (Complex) | 99214 | $204 |
| Office Visit (New, Complex) | 99204 | $219 |
| DEXA Bone Density Scan | 77080 | $237 |
| Office/Outpatient Visit Est | 99215 | $281 |
| Office/Outpatient Visit New | 99205 | $283 |
| X-ray; shoulder | 73030 | $286 |
| Emergency Room visit | 99284 | $326 |
| Upper Endoscopy with Biopsy | 43239 | $330 |
| Mammogram (Screening) | 77067 | $340 |
| Tympanostomy | 69436 | $375 |
| Epidural Steroid Injection | 64483 | $406 |
| Emergency Room visit | 99285 | $472 |
| Nasal/Sinus Endoscopy, S | 31237 | $539 |
| Ablate Inf Turbinate, Su | 30801 | $556 |
| Removal of Tonsils | 42826 | $577 |
| Resect Inferior Turbinat | 30140 | $658 |
| EGD | 43235 | $661 |
| Remove tonsils and adenoids | 42820 | $689 |
| Echocardiogram | 93306 | $702 |
| Remove tonsils and adenoids | 42821 | $715 |
| Head CT Scan | 70450 | $828 |
| Colonoscopy | 45378 | $874 |
| Colonoscopy with Biopsy | 45380 | $1,045 |
| Colonoscopy with lesion removal | 45385 | $1,174 |
| Knee Arthroscopy/Surgery | 29881 | $1,292 |
| Appendectomy | 44970 | $1,334 |
| Repair of Nasal Septum | 30520 | $1,371 |
| Appendectomy | 44950 | $1,420 |
| Cervical Spine MRI | 72141 | $1,521 |
| Partial Mastectomy | 19301 | $1,565 |
| Laparoscopic Cholecystectomy | 47562 | $1,583 |
| Lumbar Spine MRI | 72148 | $1,685 |
| Appendectomy | 44960 | $1,934 |
| Brain MRI with Contrast | 70553 | $1,957 |
| Knee MRI | 73721 | $2,029 |
| Masectomy; simple complete | 19303 | $2,299 |
| Laparo-Vag Hyst Incl T/O | 58552 | $2,329 |
| Knee Arthroscopy/Surgery | 29888 | $2,353 |
| Total hysterectomy | 58150 | $2,415 |
| Shoulder Arthroscopy | 29827 | $2,520 |
| Sleep study | 95810 | $2,809 |
| Treat thigh fracture | 27236 | $2,863 |
| Masectomy; radical | 19307 | $2,873 |
| Total Knee Replacement | 27447 | $3,244 |
| Total Hip Replacement | 27130 | $3,245 |
| Revision of total knee replacement | 27486 | $3,365 |
| Revision of total knee replacement | 27487 | $4,211 |