| Hemoglobin A1c | 83036 | $2 – $478 |
| Complete Blood Count (CBC) | 85025 | $2 – $179 |
| HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | 84153 | $4 – $380 |
| TSH Thyroid Test | 84443 | $4 – $380 |
| HC CHOLESTEROL SERUM/WHOLE BLOOD TOTAL | 82465 | $5 |
| HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | 87591 | $6 – $531 |
| HC CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE | 87491 | $6 |
| Lipid Panel | 80061 | $7 – $221 |
| Comprehensive Metabolic Panel | 80053 | $15 – $581 |
| HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM | 82270 | $23 – $77 |
| HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | 81001 | $30 – $232 |
| Blood Glucose Test | 82947 | $36 – $114 |
| HC HIV-1/HIV-2 SINGLE ASSAY - REFLEXIVE | 86703 | $42 |
| HC LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY LAB | 88300 | $65 – $88 |
| HC LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88302 | $77 – $167 |
| HC PR RX INFLUENZA QUADRIVALENT (IIV4) PF IM 0.5 ML | 90686 | $84 |
| HC IMMUNIZATION ADMIN CDM | 90471 | $103 |
| HC SPECIAL STAIN GROUP 1 MICROORGANISMS I&R LAB | 88312 | $108 |
| HC LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88304 | $119 – $216 |
| Knee X-Ray | 73560 | $121 – $828 |
| HC XR SHOULDER COMPLETE MIN 2 VIEWS | 73030 | $133 – $1,081 |
| HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88305 | $148 – $379 |
| HC ED OB FAC E&M VISIT LEVEL 1 CDM | 99281 | $159 |
| Therapeutic Injection | 96372 | $176 |
| HC XR CHEST 1 VIEW | 71045 | $184 – $784 |
| Chest X-Ray (2 Views) | 71046 | $184 – $1,027 |
| HC ED EYE EXAM NEW PATIENT CDM | 92002 | $236 |
| HC IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES LAB | 87624 | $255 – $382 |
| HC ED OB FAC E&M VISIT LEVEL 2 CDM | 99282 | $296 |
| HC BONE DENSITY PERIPHERAL SKELETON | 77081 | $352 – $630 |
| HC PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC LAB | 88331 | $364 |
| HC ED SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM OR LESS CDM | 11305 | $407 |
| HC ED DESTRUCT PREMALG LESION FIRST LESION CDM | 17000 | $407 |
| HC REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15 | 11200 | $407 |
| HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM | 17110 | $407 |
| Mammogram (Screening) | 77067 | $467 |
| HC ED INCISION OF EARDRUM W/O GENERAL ANESTHESIA CDM | 69420 | $468 |
| HC ED OB FAC E&M VISIT LEVEL 3 CDM | 99283 | $519 |
| HC LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88307 | $611 – $614 |
| HC IV HYDRATION INITIAL HR CDM | 96360 | $661 |
| DEXA Bone Density Scan | 77080 | $662 – $1,018 |
| HC ED EXCISION CHALAZION SINGLE CDM | 67800 | $669 |
| HC ED OB FAC E&M VISIT LEVEL 4 CDM | 99284 | $807 |
| HC ED SHAVE SKIN LESION 0.5 CM OR LESS TRNK ARM LEG CDM | 11300 | $840 |
| Head CT Scan | 70450 | $1,004 – $2,400 |
| HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM | 12001 | $1,146 |
| HC ED OB FAC E&M VISIT LEVEL 5 CDM | 99285 | $1,160 |
| HC LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88309 | $1,375 – $1,408 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM | 11400 | $1,461 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM CDM | 11401 | $1,461 |
| HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | 10060 | $1,554 |
| HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | 43235 | $1,602 |
| Upper Endoscopy with Biopsy | 43239 | $1,602 |
| Colonoscopy | 45378 | $1,613 |
| HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM | 11440 | $1,890 |
| HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | 20610 | $2,007 |
| Knee MRI | 73721 | $2,188 – $6,729 |
| Lumbar Spine MRI | 72148 | $2,188 – $9,042 |
| Cervical Spine MRI | 72141 | $2,201 – $3,949 |
| HC BIOPSY OF PROSTATE | 55700 | $2,609 |
| HC ED ABLATE INF TURBINATE SUPERFICIAL CDM | 30801 | $3,125 |
| Echocardiogram | 93306 | $3,127 |
| HC ED CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ CDM | 27238 | $3,229 |
| Brain MRI with Contrast | 70553 | $5,595 – $7,893 |
| Epidural Steroid Injection | 64483 | $6,021 |
| HC ED REPAIR OF NASAL SEPTUM CDM | 30520 | $6,404 |