| Blood Glucose Test | 82947 | $17 – $34 |
| Cholesterol Panel (Lipids) | 80061 | $19 – $33 |
| PSA (Prostate Screening) | 84153 | $24 – $40 |
| Fecal Occult Blood Test | 82270 | $32 – $54 |
| Cholesterol Test | 82465 | $32 – $54 |
| Surgical Pathology (level 1) | 88300 | $38 – $65 |
| TB Skin Test (PPD) | 86580 | $45 – $90 |
| Annual Preventive Visit Est. (18-39) | 99395 | $47 – $80 |
| HIV Test | 86703 | $47 – $93 |
| Urinalysis | 81001 | $47 – $81 |
| Vaccine Administration | 90471 | $51 – $183 |
| Annual Preventive Visit Est. (40-64) | 99396 | $51 – $88 |
| Annual Preventive Visit (18-39) | 99385 | $52 – $129 |
| Annual Preventive Visit (40-64) | 99386 | $62 – $106 |
| Gonorrhea Test | 87591 | $77 – $132 |
| Surgical Pathology (level 2) | 88302 | $78 – $240 |
| Hemoglobin A1c | 83036 | $78 – $157 |
| Complete Blood Count (CBC) | 85025 | $84 – $168 |
| Pathology Consultation | 88323 | $93 – $159 |
| Surgical Pathology (level 3) | 88304 | $94 – $285 |
| Thyroid Stimulating Hormone (TSH) | 84443 | $102 – $204 |
| HPV Test | 87624 | $103 – $176 |
| Surgical Pathology (level 4) | 88305 | $112 – $321 |
| Bone Density Scan (DEXA) | 77080 | $114 – $751 |
| Special Stain | 88312 | $116 – $198 |
| Psychotherapy (30 min) | 90832 | $134 – $268 |
| Frozen Section | 88331 | $144 – $247 |
| Psychotherapy (45 min) | 90834 | $152 – $305 |
| Therapeutic Injection | 96372 | $154 – $5,932 |
| Chlamydia/Gonorrhea Test | 87491 | $157 – $269 |
| Psychiatric Evaluation | 90791 | $162 – $1,635 |
| Psychotherapy (60 min) | 90837 | $162 – $393 |
| Destroy Premalignant Lesion (1st) | 17000 | $163 – $280 |
| Shave Removal (1.1-2.0cm) | 11305 | $171 – $293 |
| Shingles Vaccine | 90750 | $172 – $512 |
| Shave Removal (0.5cm or less) | 11300 | $173 – $5,932 |
| Comprehensive Metabolic Panel | 80053 | $174 – $298 |
| Shave Removal (0.6-1.0cm) | 11301 | $180 – $308 |
| OCT Eye Scan | 92134 | $182 – $643 |
| Surgical Pathology (level 5) | 88307 | $197 – $1,869 |
| Eye Exam New Patient (comprehensive) | 92004 | $207 – $354 |
| Eye Exam Established (comprehensive) | 92014 | $207 – $354 |
| Destroy Wart/Lesion (up to 14) | 17110 | $216 – $371 |
| Contact Lens Fitting | 92310 | $235 – $470 |
| Skin Tag Removal | 11200 | $239 – $409 |
| Corneal Topography | 92025 | $250 – $643 |
| Destroy Wart/Lesion (15 or more) | 17111 | $251 – $430 |
| X-Ray Knee (2 views) | 73560 | $276 – $751 |
| Surgical Pathology (level 6) | 88309 | $296 – $2,599 |
| PT Evaluation – Low Complexity | 97161 | $298 – $596 |
| PT Evaluation – Moderate Complexity | 97162 | $307 – $527 |
| Chest X-Ray (1 view) | 71045 | $316 – $542 |
| Abscess Incision & Drainage | 10060 | $319 – $546 |
| X-Ray Shoulder | 73030 | $321 – $551 |
| PT Evaluation – High Complexity | 97163 | $323 – $553 |
| Visual Field Test | 92083 | $341 – $681 |
| Simple Laceration Repair | 12001 | $341 – $584 |
| Screening Mammogram | 77067 | $368 – $631 |
| Myringotomy | 69420 | $418 – $716 |
| Joint Injection (large) | 20610 | $433 – $6,317 |
| Chest X-Ray (2 views) | 71046 | $436 – $872 |
| IV Infusion (first hour) | 96360 | $463 – $925 |
| Excision Benign Lesion (0.5cm or less) | 11400 | $465 – $1,270 |
| Eyelid Cyst Removal | 67800 | $486 – $1,270 |
| Excision Benign Lesion (0.6-1.0cm) | 11401 | $581 – $6,317 |
| Excision Benign Face Lesion (0.5cm) | 11440 | $635 – $1,088 |
| Multiple Eyelid Cysts | 67805 | $819 – $1,637 |
| Glaucoma Laser Treatment | 65855 | $866 – $1,485 |
| Turbinate Ablation | 30801 | $1,025 – $2,050 |
| Breast Biopsy | 19100 | $1,167 – $2,335 |
| Epidural Steroid Injection | 64483 | $1,355 – $6,317 |
| Upper GI Endoscopy | 43235 | $1,425 – $6,317 |
| MRI Knee | 73721 | $1,599 – $3,198 |
| Endoscopy with Biopsy | 43239 | $1,601 – $2,744 |
| Vasectomy | 55250 | $1,789 – $3,066 |
| Colonoscopy (screening) | 45378 | $1,854 – $3,178 |
| Colonoscopy with Biopsy | 45380 | $2,016 – $3,457 |
| CT Head/Brain | 70450 | $2,050 – $3,514 |
| Submucous Turbinate Resection | 30140 | $2,245 – $3,849 |
| Sinus Surgery (FESS) | 31237 | $2,291 – $3,927 |
| Cervical Spine MRI | 72141 | $2,422 – $4,845 |
| Cataract Surgery (unspecified) | 66999 | $2,462 – $6,317 |
| Colonoscopy with Polyp Removal | 45385 | $2,541 – $4,355 |
| Lumbar Spine MRI | 72148 | $2,577 – $5,153 |
| Echocardiogram | 93306 | $2,770 – $5,541 |
| Photorefractive Keratectomy | S0812 | $2,813 – $5,626 |
| Septoplasty (Deviated Septum Repair) | 30520 | $2,933 – $5,916 |
| Brain MRI with/without contrast | 70553 | $3,549 – $7,098 |
| Sleep Study (Polysomnography) | 95810 | $3,799 – $6,513 |