| Hc Urinalysis Auto W/Scope | 81001 | $4 |
| Hc Blood Occult Peroxidase Actv Qual Feces 1 Deter | 82270 | $7 |
| Comprehensive Metabolic Panel | 80053 | $8 |
| Blood Glucose Test | 82947 | $8 |
| Hc Cholesterol Serum/Whole Blood Total | 82465 | $9 |
| Hc Vaccine Admin - Initial Injection Sngl Or Combo | 90471 | $10 |
| Lipid Panel | 80061 | $10 |
| Complete Blood Count (CBC) | 85025 | $13 |
| Hemoglobin A1c | 83036 | $14 |
| Hc Iadna Chlamydia Trachomatis Amplified Probe Tq | 87491 | $16 |
| TSH Thyroid Test | 84443 | $19 |
| Hc Surg Path Gross Tech Adm | 88300 | $22 |
| Hc Assay Of Prostate Specific Antigen Total | 84153 | $22 |
| Tb Skin Test | 86580 | $25 |
| Hc Xr Chest 1Vw | 71045 | $25 |
| Hc Xr Shoulder Complete 2 Plus Vw | 73030 | $25 |
| Knee X-Ray | 73560 | $25 |
| Chest X-Ray (2 Views) | 71046 | $25 |
| Hc Hiv1/Hiv2 Antibody | 86703 | $45 |
| Hc Surg Path Ltd Tech Adm | 88302 | $47 |
| Hc Path Consultation Surgery 1St Block Frozen Section 1 Spec | 88331 | $53 |
| DEXA Bone Density Scan | 77080 | $59 |
| Hc Bd Dexa Forearm/Appendicular Skeleton | 77081 | $59 |
| Mammogram (Screening) | 77067 | $59 |
| Hc Surg Path Inter Tech/Adm | 88304 | $60 |
| Hc Neisseria Gonorrhoeae Amplified Probe Technique | 87591 | $62 |
| Hc Human Papillomavirus Hpv High-Risk Types | 87624 | $63 |
| Hc Consult Sendout Tech Adm | 88323 | $65 |
| Hc Visual Field Exam Extended | 92083 | $78 |
| Therapeutic Injection | 96372 | $79 |
| Hc Cmptr Opth Imaging Retina Uni/Bi | 92134 | $80 |
| Hc Level Iv Surgical Pathology Gross And Microscopic Exam | 88305 | $81 |
| Hc Destruction Premalignant Lesion 1St | 17000 | $90 |
| Hc Special Stain Group 1 Microorganisms I And R | 88312 | $94 |
| Head CT Scan | 70450 | $107 |
| Hc Computerized Corneal Topography Uni/Bi | 92025 | $112 |
| Hc Oph Svcs Medical Exam And Eval Compre Est Pt 1 Or More | 92014 | $113 |
| Cl Visit Estab Pt Level 4 | 99212 | $128 |
| Hc Shaving Skin Lesion 1 Scalp Neck Hands Feet Genitalia 0.5 Cm Or Less | 11305 | $139 |
| Hc Shave Lesion 1 Trunk Arm Leg 0.6 To 1.0 Cm | 11301 | $139 |
| Hc Eye Exam New Pt 1 Or More Visits | 92004 | $147 |
| Hc Shave Skin Lesion Trunk/Arm/Leg 0.5 Cm Diam Or Less | 11300 | $159 |
| Hc Oph Svcs Medical Exam And Eval Intermediate Est Pt | 92012 | $161 |
| Hc Oph Svcs Medical Exam And Eval Intermediate New Pt | 92002 | $162 |
| Office Visit (Complex) | 99214 | $168 |
| Echocardiogram | 93306 | $172 |
| Hc Destruction Benign Lesions 15 Or More | 17111 | $173 |
| Office Visit (New, Complex) | 99204 | $185 |
| Cl Visit Estab Level 5 | 99215 | $194 |
| Knee MRI | 73721 | $203 |
| Cervical Spine MRI | 72141 | $203 |
| Lumbar Spine MRI | 72148 | $203 |
| Hc Er Service Level I | 99281 | $224 |
| Hc Surg Path Complex Tech Adm | 88307 | $240 |
| Cl Visit New Pt Level 5 | 99205 | $240 |
| Iv Inf Hydrat Init 31Min-1Hr | 96360 | $290 |
| Hc Therapy Ind And Family 30 Mins | 90832 | $308 |
| Hc Surg Path Compre Tech Adm | 88309 | $334 |
| Hc Er Service Level Ii | 99282 | $341 |
| Hc Therapy Ind And Family 45 Mins | 90834 | $389 |
| Hc Removal Of Skin Tags 15 Or Less Any Area | 11200 | $401 |
| Brain MRI with Contrast | 70553 | $419 |
| Hc Polysom 6Yrs Or Over Sleep 4 Or Over Addl Param Attnd | 95810 | $468 |
| Hc Psychiatric Diagnostic Evaluation | 90791 | $536 |
| Hc Exc Benign Lesion Mrgn Xcp Sk Tg Face Ears Eyelids Nose Lips Muc Memb 0.5Cm Or Less | 11440 | $578 |
| Hc Myringotomy Aspir And/Or Eustachian Tube Nfltj | 69420 | $615 |
| Hc Exc Benign Lesion Mrgn Xcp Sk Tg Trunk Arms Legs 0.5 Cm Or Less | 11400 | $625 |
| Hc Er Service Level Iii | 99283 | $644 |
| Hc Repair Simple Scalp/Neck/Ax/Genit/Trunk 2.5Cm Or Less | 12001 | $741 |
| Psychotherapy (60 min) | 90837 | $759 |
| Hc Trabeculoplasty By Laser Surgery | 65855 | $773 |
| Hc I And D Abscess-Simple Or Sing | 10060 | $795 |
| Hc Er Service Level Iv | 99284 | $875 |
| Hc Inj/Asp/Drn Bursa Major Joint Wo Us Guidance | 20610 | $905 |
| Hc Prostate Needle Biopsy Any Approach | 55700 | $950 |
| Hc Excision Chalazion Multiple Different Lids | 67805 | $1,108 |
| Hc Polysom Any Age Sleep Stage 1-3 Addl Param Attnd | 95808 | $1,204 |
| Hc Er Service Level V | 99285 | $1,205 |
| Hc Excision Chalazion Single | 67800 | $1,394 |
| Upper Endoscopy with Biopsy | 43239 | $1,406 |
| Hc Exc Lesion Trunk/Arms/Legs Benign Marg 0.6-1 Cm | 11401 | $1,955 |
| Hc Nasal/Sinus Ndsc Surg W/Bx Polypc/Dbrdmt Spx | 31237 | $2,341 |
| Hc Destruction Of Benign Lesions 1-14 | 17110 | $2,690 |
| Hc Femoralfx Int/Per/Sub Wo Manip | 27238 | $3,447 |
| Epidural Steroid Injection | 64483 | $4,176 |
| Hc Cautery Simple Inner Nose | 30801 | $6,287 |