| Allergen specific IgE each allergen CPT 86003 • Allergy | $3 | $5 | $8 |
| Allergen specific IgE qualitative multi-allergen CPT 86005 • Allergy | $4 | $15 | $34 |
| Percutaneous allergy skin test each allergen CPT 95004 • Allergy | $5 | $8 | $12 |
| Allergy testing insect venoms CPT 95017 • Allergy | $4 | $11 | $15 |
| Allergy testing drugs or biologicals CPT 95018 • Allergy | $8 | $24 | $32 |
| Intracutaneous allergy test each allergen CPT 95024 • Allergy | $2 | $8 | $13 |
| Allergen immunotherapy injection single CPT 95115 • Allergy | $11 | $13 | $16 |
| Allergen immunotherapy injection multiple CPT 95117 • Allergy | $15 | $18 | $20 |
| Allergen immunotherapy antigen preparation multi-dose CPT 95165 • Allergy | $5 | $12 | $17 |
| Anesthesia for salivary gland procedures CPT 00100 • Anesthesia | $68 | $284 | $421 |
| Anesthesia for eye procedures CPT 00140 • Anesthesia | $68 | $284 | $421 |
| Anesthesia for head and neck procedures CPT 00300 • Anesthesia | $68 | $335 | $611 |
| Anesthesia for chest wall procedures CPT 00400 • Anesthesia | $68 | $202 | $281 |
| Anesthesia for chest procedures CPT 00520 • Anesthesia | $68 | $588 | $1,079 |
| Anesthesia for lumbar region procedures CPT 00630 • Anesthesia | $68 | $510 | $917 |
| Anesthesia for upper GI endoscopy CPT 00740 • Anesthesia | $240 | $240 | $240 |
| Anesthesia for lower GI endoscopy CPT 00810 • Anesthesia | $240 | $240 | $240 |
| Anesthesia for abdominal wall surgery CPT 00840 • Anesthesia | $68 | $528 | $1,079 |
| Anesthesia for inguinal hernia repair CPT 00902 • Anesthesia | $68 | $284 | $421 |
| Anesthesia for total hip replacement CPT 01214 • Anesthesia | $68 | $433 | $632 |
| Anesthesia for total knee replacement CPT 01402 • Anesthesia | $68 | $623 | $1,048 |
| Anesthesia for hand and wrist procedures CPT 01630 • Anesthesia | $68 | $335 | $611 |
| Anesthesia for cesarean delivery CPT 01961 • Anesthesia | $68 | $638 | $1,286 |
| Anesthesia for epidural or spinal labor analgesia CPT 01967 • Anesthesia | $68 | $705 | $1,682 |
| Permanent pacemaker insertion CPT 33208 • Cardiology | $492 | $14,453 | $69,550 |
| Implantable defibrillator insertion CPT 33249 • Cardiology | $220 | $15,099 | $71,412 |
| Coronary artery bypass graft (CABG) single CPT 33533 • Cardiology | $451 | $3,455 | $6,982 |
| Coronary artery bypass graft (CABG) two grafts CPT 33534 • Cardiology | $464 | $3,340 | $6,982 |
| Coronary artery bypass graft (CABG) three grafts CPT 33535 • Cardiology | $589 | $3,239 | $6,982 |
| Percutaneous coronary angioplasty single vessel CPT 92920 • Cardiology | $599 | $8,549 | $39,452 |
| Percutaneous coronary stent single vessel CPT 92928 • Cardiology | $658 | $8,506 | $39,452 |
| Electrocardiogram (ECG) 12-lead CPT 93000 • Cardiology | $15 | $19 | $22 |
| Electrocardiogram tracing only CPT 93005 • Cardiology | $7 | $13 | $21 |
| Electrocardiogram interpretation only CPT 93010 • Cardiology | $9 | $12 | $15 |
| Cardiovascular stress test CPT 93015 • Cardiology | $108 | $123 | $159 |
| Cardiovascular stress test tracing only CPT 93017 • Cardiology | $58 | $72 | $100 |
| Holter monitor up to 48 hours CPT 93224 • Cardiology | $111 | $139 | $175 |
| External ECG recording up to 7 days CPT 93241 • Cardiology | $88 | $235 | $397 |
| Echocardiography transthoracic limited CPT 93303 • Cardiology | $185 | $261 | $387 |
| Echocardiography transthoracic complete CPT 93306 • Cardiology | $103 | $217 | $337 |
| Echocardiography transesophageal CPT 93312 • Cardiology | $103 | $253 | $407 |
| Stress echocardiography CPT 93350 • Cardiology | $179 | $279 | $437 |
| Left and right heart catheterization CPT 93452 • Cardiology | $273 | $6,719 | $29,462 |
| Left heart catheterization CPT 93458 • Cardiology | $335 | $6,561 | $29,462 |
| Left heart catheterization with ventriculography CPT 93459 • Cardiology | $378 | $6,633 | $29,462 |
| Duplex scan extracranial arteries CPT 93880 • Cardiology | $46 | $214 | $324 |
| Non-invasive physiologic study extremity arteries CPT 93922 • Cardiology | $22 | $98 | $138 |
| Duplex scan lower extremity arteries CPT 93925 • Cardiology | $57 | $259 | $414 |
| Duplex scan extremity veins complete CPT 93970 • Cardiology | $50 | $155 | $319 |
| Paring or cutting benign hyperkeratotic lesion single CPT 11055 • Dermatology | $24 | $144 | $502 |