| HC ED SEXUAL ASSAULT EXAM CDM | 99284 | $0 |
| HC BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER CDM | 82270 | $32 |
| Blood Glucose Test | 82947 | $77 |
| HC IMMUNIZATION ADMIN CDM | 90471 | $124 |
| HC CHLAMYDIA TRACHOMATIS PCR | 87491 | $141 |
| HC IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ | 87591 | $141 |
| HC URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY LAB | 81001 | $149 |
| HC LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY LAB | 88300 | $162 |
| HC CHOLESTEROL | 82465 | $180 |
| HC ED EYE EXAM NEW PATIENT CDM | 92002 | $185 |
| HC PSYCHOTH IND 30 MIN IOP CD/SA | 90832 | $218 |
| Complete Blood Count (CBC) | 85025 | $227 |
| HC ED REMOVAL OF SKIN TAGS CDM | 11200 | $235 |
| Therapeutic Injection | 96372 | $236 |
| TSH Thyroid Test | 84443 | $242 |
| HC ED DESTRUCT PREMALG LESION FIRST LESION CDM | 17000 | $255 |
| HC ED SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM OR LESS CDM | 11305 | $255 |
| HC ED DESTRUCTION BENIGN LESIONS UP TO 14 CDM | 17110 | $255 |
| HC ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL CDM | 84153 | $288 |
| HC ED INCISION OF EARDRUM W/O GENERAL ANESTHESIA CDM | 69420 | $293 |
| HC PSYCHOTH IND 45 MIN IOP CD/SA | 90834 | $297 |
| Psychotherapy (60 min) | 90837 | $297 |
| Hemoglobin A1c | 83036 | $316 |
| HC ED FAC E&M VISIT LEVEL 1 CDM | 99281 | $325 |
| Mammogram (Screening) | 77067 | $337 |
| HC HIV-1/HIV-2 SINGLE ASSAY | 86703 | $341 |
| HC ED EXCISION CHALAZION SINGLE CDM | 67800 | $353 |
| HC LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88302 | $365 |
| HC SPECIAL STAIN GROUP 1 MICROORGANISMS I&R LAB | 88312 | $422 |
| HC IV HYDRATION INITIAL HR CDM | 96360 | $433 |
| HC XR CHEST 1 VIEW | 71045 | $468 |
| HC LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88304 | $504 |
| Knee X-Ray | 73560 | $512 |
| Comprehensive Metabolic Panel | 80053 | $519 |
| Chest X-Ray (2 Views) | 71046 | $524 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM CDM | 11401 | $525 |
| HC ED SHAVE SKIN LESION 0.5 CM OR LESS TRNK ARM LEG CDM | 11300 | $525 |
| HC ED FAC E&M VISIT LEVEL 2 CDM | 99282 | $542 |
| HC MICROSLIDE CONSULTATION W/ SLIDE PREP | 88323 | $610 |
| HC XR SHOULDER COMPLETE MIN 2 VIEWS | 73030 | $612 |
| HC PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC LAB | 88331 | $615 |
| HC INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE | 10060 | $620 |
| HC ED REPAIR SUPERFIC WOUND(S)LT/2.5CM SLP NK AX EXGEN TRNK EXTR HND FT CDM | 12001 | $695 |
| HC ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US | 20610 | $717 |
| HC LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88305 | $825 |
| DEXA Bone Density Scan | 77080 | $910 |
| HC ED EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM OR LESS CDM | 11400 | $914 |
| HC ED EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM OR LESS CDM | 11440 | $914 |
| HC ED FAC E&M VISIT LEVEL 3 CDM | 99283 | $938 |
| HC LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88307 | $975 |
| Upper Endoscopy with Biopsy | 43239 | $1,040 |
| HC ED ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC CDM | 43235 | $1,040 |
| Colonoscopy | 45378 | $1,047 |
| Lipid Panel | 80061 | $1,047 |
| HC LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM LAB | 88309 | $1,830 |
| HC ED ABLATE INF TURBINATE SUPERFICIAL CDM | 30801 | $1,955 |
| HC ED CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ CDM | 27238 | $2,021 |
| Knee MRI | 73721 | $2,408 |
| Head CT Scan | 70450 | $2,421 |
| Cervical Spine MRI | 72141 | $2,620 |
| Echocardiogram | 93306 | $2,851 |
| HC ED FAC E&M VISIT LEVEL 5 CDM | 99285 | $3,231 |
| HC ED REPAIR OF NASAL SEPTUM CDM | 30520 | $4,007 |
| Brain MRI with Contrast | 70553 | $4,187 |
| Lumbar Spine MRI | 72148 | $5,611 |
| HC POLYSOMNOGRAM REDUCED SERVICE | 95810 | $8,020 |