| Allergen specific IgE each allergen CPT 86003 • Allergy | $2 | $4 | $6 |
| Allergen specific IgE qualitative multi-allergen CPT 86005 • Allergy | $4 | $6 | $7 |
| Percutaneous allergy skin test each allergen CPT 95004 • Allergy | $4 | $5 | $6 |
| Allergy testing insect venoms CPT 95017 • Allergy | $9 | $10 | $12 |
| Allergy testing drugs or biologicals CPT 95018 • Allergy | $20 | $25 | $30 |
| Intracutaneous allergy test each allergen CPT 95024 • Allergy | $8 | $11 | $13 |
| Allergen immunotherapy injection single CPT 95115 • Allergy | $9 | $12 | $14 |
| Allergen immunotherapy injection multiple CPT 95117 • Allergy | $15 | $18 | $21 |
| Allergen immunotherapy antigen preparation multi-dose CPT 95165 • Allergy | $4 | $8 | $13 |
| Permanent pacemaker insertion CPT 33208 • Cardiology | $739 | $900 | $1,060 |
| Implantable defibrillator insertion CPT 33249 • Cardiology | $1,303 | $1,606 | $1,909 |
| Coronary artery bypass graft (CABG) single CPT 33533 • Cardiology | $2,648 | $3,171 | $3,693 |
| Coronary artery bypass graft (CABG) two grafts CPT 33534 • Cardiology | $1,986 | $2,547 | $3,109 |
| Coronary artery bypass graft (CABG) three grafts CPT 33535 • Cardiology | $3,465 | $4,124 | $4,783 |
| Percutaneous coronary angioplasty single vessel CPT 92920 • Cardiology | $749 | $812 | $875 |
| Percutaneous coronary stent single vessel CPT 92928 • Cardiology | $569 | $701 | $834 |
| Electrocardiogram (ECG) 12-lead CPT 93000 • Cardiology | $8 | $17 | $23 |
| Electrocardiogram tracing only CPT 93005 • Cardiology | $9 | $12 | $18 |
| Electrocardiogram interpretation only CPT 93010 • Cardiology | $8 | $13 | $19 |
| Cardiovascular stress test CPT 93015 • Cardiology | $62 | $90 | $109 |
| Cardiovascular stress test tracing only CPT 93017 • Cardiology | $47 | $59 | $77 |
| Holter monitor up to 48 hours CPT 93224 • Cardiology | $62 | $98 | $121 |
| External ECG recording up to 7 days CPT 93241 • Cardiology | $160 | $204 | $248 |
| Echocardiography transthoracic limited CPT 93303 • Cardiology | $236 | $272 | $308 |
| Echocardiography transthoracic complete CPT 93306 • Cardiology | $140 | $213 | $314 |
| Echocardiography transesophageal CPT 93312 • Cardiology | $181 | $264 | $347 |
| Stress echocardiography CPT 93350 • Cardiology | $65 | $211 | $298 |
| Left and right heart catheterization CPT 93452 • Cardiology | $335 | $387 | $439 |
| Left heart catheterization CPT 93458 • Cardiology | $604 | $1,145 | $1,703 |
| Left heart catheterization with ventriculography CPT 93459 • Cardiology | $690 | $943 | $1,196 |
| Duplex scan extracranial arteries CPT 93880 • Cardiology | $139 | $241 | $306 |
| Non-invasive physiologic study extremity arteries CPT 93922 • Cardiology | $23 | $91 | $130 |
| Duplex scan lower extremity arteries CPT 93925 • Cardiology | $59 | $267 | $389 |
| Duplex scan extremity veins complete CPT 93970 • Cardiology | $224 | $259 | $300 |
| Paring or cutting benign hyperkeratotic lesion single CPT 11055 • Dermatology | $22 | $23 | $23 |
| Paring or cutting benign hyperkeratotic lesions 2-4 CPT 11056 • Dermatology | $29 | $70 | $112 |
| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $53 | $103 | $160 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $163 | $182 | $201 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $82 | $190 | $245 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $53 | $119 | $159 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $80 | $149 | $193 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $54 | $94 | $168 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $65 | $104 | $183 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $116 | $147 | $199 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $134 | $199 | $243 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $138 | $216 | $268 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $142 | $189 | $223 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $134 | $206 | $312 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $189 | $252 | $360 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $170 | $260 | $384 |