| hepatitis b vaccine (Engerix-B) 10 MCG/0.5ML injection *Commercially Insured / Private Pay* 0.5 mL | 90471 | $20 |
| Therapeutic Injection | 96372 | $20 – $147 |
| Blood Glucose Test | 82947 | $32 – $55 |
| HC 88300 LEVEL I; GROSS EXAM ONLY | 88300 | $36 – $39 |
| HC 20610 ASP/INJ MJR JNT/BURSA W/O US GDE | 20610 | $37 – $2,209 |
| Office Visit (Established Patient) | 99213 | $43 – $448 |
| HC 17110 DEST B9 LESIONS UP TO 14 | 17110 | $47 – $116 |
| HC 99211 ED NURSE ONLY WND CK/DRSG CHANGE | 99211 | $47 |
| HC 86580 TB INTRADERMAL TEST | 86580 | $51 |
| HC 99212 OFC/OUTPATIENT VISIT, EST 2 | 99212 | $53 – $311 |
| HC 88302 LEVEL II; GROSS AND MICRO EXAM | 88302 | $54 – $67 |
| HC 99202 OFC/OUTPATIENT VISIT,NEW 2 | 99202 | $59 – $391 |
| HC 82270 OCCULT BLOOD FECAL SCRN 2 | 82270 | $61 |
| HC 82465 ASSAY, BLD/SERUM CHOLESTEROL | 82465 | $67 – $69 |
| HC 87624 HPV, DNA, AMP PROBE | 87624 | $71 |
| HC 71045 DX- CHEST 1VW | 71045 | $75 – $324 |
| HC 88304 LEVEL III; GROSS AND MICRO EXA | 88304 | $77 – $89 |
| Office Visit (New Patient) | 99203 | $79 – $448 |
| Office Visit (Complex) | 99214 | $79 – $506 |
| HC 88312 SPECIAL STAINS | 88312 | $82 |
| HC 10060 I&D ABSCESS,SIMPLE/SINGLE | 10060 | $85 – $441 |
| HC 77081 BONE DENS PERIPH SITE (FOREARM | 77081 | $94 – $301 |
| Lipid Panel | 80061 | $102 |
| Hemoglobin A1c | 83036 | $105 |
| Office Visit (New, Complex) | 99204 | $108 – $506 |
| HC 99215 OFC/OUTPATIENT VISIT, EST 5 | 99215 | $109 – $565 |
| HC 88331 PATH CONSULT INTRAOP, 1 BLOC | 88331 | $110 – $136 |
| HC 73030 DX- SHOULDER COMPL MIN 2VW | 73030 | $111 – $1,475 |
| TSH Thyroid Test | 84443 | $123 – $125 |
| HC 88305 LEVEL IV; GROSS AND MICRO EXAM | 88305 | $123 |
| HC 86703 HIV COMBO SNGL RESULT | 86703 | $126 |
| HC 88323 MICROSLIDE CONSULTATION | 88323 | $128 |
| HC 99205 OFC/OUTPATIENT VISIT,NEW 5 | 99205 | $130 – $565 |
| HC 84153 ASSAY OF PSA, TOTAL | 84153 | $135 – $219 |
| Complete Blood Count (CBC) | 85025 | $140 – $147 |
| Knee X-Ray | 73560 | $153 – $1,087 |
| Comprehensive Metabolic Panel | 80053 | $155 – $156 |
| HC FN: 99285 SANE FACILITY COMPREHENSIVE | 99285 | $182 |
| HC FN: 99283 BASIC SANE PT EVAL | 99283 | $182 |
| HC 81001 URINALYSIS, AUTO W/SCOPE | 81001 | $184 – $257 |
| HC 99281 EMERGENCY VISIT LEVEL 1 | 99281 | $207 – $242 |
| HC 88307 SURGICAL PATH LEVEL 5 | 88307 | $208 |
| Mammogram (Screening) | 77067 | $221 – $330 |
| HC 88309 LEVEL VI; GROSS AND MICRO EXAM | 88309 | $233 – $288 |
| HC 17000 DEST PREMALIGNANT LESION 1ST | 17000 | $234 |
| HC 87591 N.GONORRHOEAE, DNA, AMP PROB | 87591 | $235 |
| HC 87491 CHYLMD TRACH, DNA, AMP PROBE | 87491 | $265 |
| HC 27238 CLSD TX THIGH FX W/O MANIPULATION | 27238 | $269 – $482 |
| HC 99282 EMERGENCY VISIT LEVEL 2 | 99282 | $278 – $349 |
| HC 12001 SMPL REP S/N/AX/G/TR; 2.5CM/< | 12001 | $334 – $558 |
| Chest X-Ray (2 Views) | 71046 | $344 – $362 |
| HC 43235 EGD FLXORL SCOPE FOR DIAGNOSIS | 43235 | $396 |
| HC 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR | 96360 | $409 |
| Head CT Scan | 70450 | $417 |
| Upper Endoscopy with Biopsy | 43239 | $496 |
| DEXA Bone Density Scan | 77080 | $508 – $1,139 |
| HC 11400 EXC LES B9MARG T/A/L; 0.5 < CM | 11400 | $730 |
| Brain MRI with Contrast | 70553 | $797 – $1,036 |
| Knee MRI | 73721 | $825 – $1,350 |
| Epidural Steroid Injection | 64483 | $837 |
| HC 11200 REMOVAL SKIN TAGS, <=15 LES | 11200 | $970 |
| HC 69420 MRGT ASPIR&/EUSTACHIAN TUBE NFLTJ | 69420 | $975 |
| HC 45385 COLSC FLX PROX SPLENIC FLXR RMVL LES SNARE TQ | 45385 | $999 |
| Colonoscopy | 45378 | $999 |
| HC 19100 BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX | 19100 | $1,021 |
| Colonoscopy with Biopsy | 45380 | $1,033 |
| HC 92012 OPH MEDICAL XM&EVAL INTRM EST PT | 92012 | $1,047 |
| HC 99284 EMERGENCY VISIT LEVEL 4 | 99284 | $1,065 |
| Lumbar Spine MRI | 72148 | $1,693 – $2,641 |
| Cervical Spine MRI | 72141 | $1,905 – $2,162 |
| Echocardiogram | 93306 | $2,628 – $2,954 |
| HC 55700 PROSTATE NEEDLE BIOPSY, ANY APPROACH | 55700 | $2,895 – $3,444 |