| Complete Blood Count (CBC) | 85025 | $3 |
| Comprehensive Metabolic Panel | 80053 | $3 |
| Urinalysis | 81001 | $3 |
| Lipid Panel | 80061 | $4 |
| Chemistry | 82465 | $4 |
| Chemistry | 84153 | $5 |
| Prev Visit, Est, Age 18-39 | 99395 | $7 |
| Prev Visit, Est, Age 40-64 | 99396 | $7 |
| Hemoglobin A1c | 83036 | $10 |
| Blood Glucose Test | 82947 | $11 |
| TB Skin Test, Intradermal | 86580 | $12 |
| Surgical Pathology study | 88302 | $12 |
| TSH Thyroid Test | 84443 | $12 |
| Surgical Pathology study | 88300 | $16 |
| Microslide Consult W Slide Prep | 88323 | $16 |
| Determine Refractive State | 92015 | $18 |
| Surgical Pathology study | 88305 | $20 |
| Immunization administration | 90471 | $21 |
| Visual Field Examination | 92083 | $21 |
| Office Visit | 99211 | $22 |
| Surgical Pathology study | 88304 | $23 |
| Prev Visit, New, Age 40-64 | 99386 | $25 |
| Prev Visit, New, Age 18-39 | 99385 | $25 |
| Psychotherapy (60 min) | 90837 | $27 |
| Emergency Room visit | 99281 | $27 |
| Office Visit | 99212 | $30 |
| Hpv, High Risk, Anal | 87624 | $34 |
| Microbiology | 87591 | $35 |
| Chlamydia Trachomatis Rna, Tma, Urogenital | 87491 | $35 |
| Office Visit | 99202 | $35 |
| Psychotherapy; 30 minutes | 90832 | $36 |
| Office Visit (Established Patient) | 99213 | $37 |
| Special Stain Group 1 Microorganisms I&R | 88312 | $39 |
| Office Visit (New Patient) | 99203 | $40 |
| Bone Density | 77081 | $40 |
| Psychiatric diagnostic evaluation | 90791 | $47 |
| Emergency Room visit | 99282 | $49 |
| Surgical Pathology study | 88307 | $49 |
| Eye Exam Established Pat | 92012 | $50 |
| Office Visit (Complex) | 99214 | $53 |
| Office Visit (New, Complex) | 99204 | $55 |
| Path Consult in Surg,W Frz Sec | 88331 | $59 |
| Surgical Pathology study | 88309 | $61 |
| Therapeutic Injection | 96372 | $69 |
| Office Visit | 99215 | $70 |
| Office/Outpatient Visit New | 99205 | $71 |
| Psytx W Pt 45 Minutes | 90834 | $72 |
| Eye Exam & Treatment | 92014 | $75 |
| Emergency Room visit | 99283 | $80 |
| IV Therapy | 96360 | $80 |
| Shave skin lesion | 11301 | $88 |
| Drainage/injection major joint | 20610 | $88 |
| Removal of skin tags | 11200 | $94 |
| Repair superficial wound | 12001 | $95 |
| Mammogram (Screening) | 77067 | $99 |
| Eye Exam, New Patient | 92004 | $100 |
| Destruct B9 Lesion, 1-14 | 17110 | $101 |
| Destruct Premalg Lesion | 17000 | $118 |
| Destruction of benign lesions, 15 or more | 17111 | $119 |
| Drainage of skin abscess | 10060 | $121 |
| DEXA Bone Density Scan | 77080 | $125 |
| Exc Tr-Ext B9+Marg 0.5 < | 11400 | $127 |
| Knee X-Ray | 73560 | $132 |
| X-ray; shoulder | 73030 | $132 |
| X-ray chest | 71045 | $132 |
| Chest X-Ray (2 Views) | 71046 | $132 |
| Remove Eyelid Lesion | 67800 | $134 |
| Colonoscopy | 45378 | $144 |
| Emergency Room visit | 99284 | $145 |
| Exc Face-Mm B9+Marg 0.5 | 11440 | $146 |
| Exc Tr-Ext B9+Marg 0.6-1 | 11401 | $148 |
| Shaving of skin lesion, single lesion | 11300 | $148 |
| Tympanostomy | 69436 | $152 |
| Bx Breast Percut W/O Ima | 19100 | $161 |
| Incision of Eardrum | 69420 | $200 |
| Emergency Room visit | 99285 | $216 |
| Removal of Tonsils | 42826 | $291 |
| Remove tonsils and adenoids | 42820 | $301 |
| Remove tonsils and adenoids | 42821 | $326 |
| Esophagogastroduodenoscopy, diagnostic | 43235 | $338 |
| Nasal/Sinus Endoscopy, S | 31237 | $368 |
| Upper Endoscopy with Biopsy | 43239 | $383 |
| Head CT Scan | 70450 | $428 |
| Echocardiogram | 93306 | $449 |
| Colonoscopy with Biopsy | 45380 | $522 |
| Colonoscopy with lesion removal | 45385 | $532 |
| Treatment of thigh fracture | 27238 | $548 |
| Repair of Nasal Septum | 30520 | $558 |
| Epidural Steroid Injection | 64483 | $575 |
| Appendectomy | 44950 | $680 |
| Knee MRI | 73721 | $753 |
| Lumbar Spine MRI | 72148 | $753 |
| Cervical Spine MRI | 72141 | $753 |
| Laparoscopic Cholecystectomy | 47562 | $761 |
| Appendectomy | 44960 | $839 |
| Brain MRI with Contrast | 70553 | $1,060 |
| Total hysterectomy | 58150 | $1,067 |
| Sleep study | 95810 | $1,229 |
| Total Knee Replacement | 27447 | $1,732 |