| Allergen specific IgE each allergen CPT 86003 • Allergy | $4 | $4 | $4 |
| Allergen specific IgE qualitative multi-allergen CPT 86005 • Allergy | $5 | $5 | $5 |
| Percutaneous allergy skin test each allergen CPT 95004 • Allergy | $6 | $8 | $9 |
| Allergy testing insect venoms CPT 95017 • Allergy | $9 | $10 | $11 |
| Allergy testing drugs or biologicals CPT 95018 • Allergy | $8 | $21 | $27 |
| Intracutaneous allergy test each allergen CPT 95024 • Allergy | $7 | $9 | $10 |
| Allergen immunotherapy injection single CPT 95115 • Allergy | $9 | $11 | $12 |
| Allergen immunotherapy injection multiple CPT 95117 • Allergy | $11 | $13 | $14 |
| Allergen immunotherapy antigen preparation multi-dose CPT 95165 • Allergy | $3 | $8 | $17 |
| Permanent pacemaker insertion CPT 33208 • Cardiology | $547 | $742 | $840 |
| Implantable defibrillator insertion CPT 33249 • Cardiology | $950 | $1,289 | $1,459 |
| Coronary artery bypass graft (CABG) single CPT 33533 • Cardiology | $1,922 | $2,649 | $3,012 |
| Coronary artery bypass graft (CABG) two grafts CPT 33534 • Cardiology | $2,255 | $3,113 | $3,542 |
| Coronary artery bypass graft (CABG) three grafts CPT 33535 • Cardiology | $2,512 | $3,470 | $3,949 |
| Percutaneous coronary angioplasty single vessel CPT 92920 • Cardiology | $565 | $696 | $761 |
| Percutaneous coronary stent single vessel CPT 92928 • Cardiology | $627 | $772 | $845 |
| Electrocardiogram (ECG) 12-lead CPT 93000 • Cardiology | $20 | $22 | $23 |
| Electrocardiogram tracing only CPT 93005 • Cardiology | $10 | $11 | $11 |
| Electrocardiogram interpretation only CPT 93010 • Cardiology | $9 | $11 | $12 |
| Cardiovascular stress test CPT 93015 • Cardiology | $92 | $99 | $103 |
| Cardiovascular stress test tracing only CPT 93017 • Cardiology | $51 | $52 | $52 |
| Holter monitor up to 48 hours CPT 93224 • Cardiology | $103 | $117 | $123 |
| Echocardiography transthoracic limited CPT 93303 • Cardiology | $202 | $282 | $322 |
| Echocardiography transthoracic complete CPT 93306 • Cardiology | $72 | $230 | $309 |
| Echocardiography transesophageal CPT 93312 • Cardiology | $30 | $281 | $450 |
| Stress echocardiography CPT 93350 • Cardiology | $80 | $244 | $326 |
| Left and right heart catheterization CPT 93452 • Cardiology | $875 | $1,082 | $1,185 |
| Left heart catheterization CPT 93458 • Cardiology | $1,007 | $1,181 | $1,448 |
| Left heart catheterization with ventriculography CPT 93459 • Cardiology | $374 | $1,191 | $1,600 |
| Duplex scan extracranial arteries CPT 93880 • Cardiology | $42 | $176 | $257 |
| Non-invasive physiologic study extremity arteries CPT 93922 • Cardiology | $114 | $117 | $119 |
| Duplex scan lower extremity arteries CPT 93925 • Cardiology | $259 | $292 | $309 |
| Duplex scan extremity veins complete CPT 93970 • Cardiology | $35 | $112 | $253 |
| Paring or cutting benign hyperkeratotic lesion single CPT 11055 • Dermatology | $21 | $38 | $73 |
| Paring or cutting benign hyperkeratotic lesions 2-4 CPT 11056 • Dermatology | $53 | $78 | $90 |
| Tangential biopsy of skin single lesion CPT 11102 • Dermatology | $99 | $99 | $99 |
| Punch biopsy of skin single lesion CPT 11104 • Dermatology | $123 | $124 | $124 |
| Incisional biopsy of skin single lesion CPT 11106 • Dermatology | $62 | $62 | $62 |
| Shaving skin lesion trunk/arms/legs 0.5cm or less CPT 11300 • Dermatology | $30 | $67 | $147 |
| Shaving skin lesion trunk/arms/legs 0.6-1.0cm CPT 11301 • Dermatology | $85 | $149 | $181 |
| Shaving skin lesion scalp/neck/hands/feet 0.5cm or less CPT 11305 • Dermatology | $63 | $92 | $151 |
| Shaving skin lesion face 0.5cm or less CPT 11310 • Dermatology | $42 | $129 | $172 |
| Excision benign lesion trunk/arms/legs 0.5cm or less CPT 11400 • Dermatology | $71 | $149 | $188 |
| Excision benign lesion trunk/arms/legs 0.6-1.0cm CPT 11401 • Dermatology | $130 | $173 | $228 |
| Excision benign lesion trunk/arms/legs 1.1-2.0cm CPT 11402 • Dermatology | $145 | $217 | $253 |
| Excision benign lesion face 0.5cm or less CPT 11440 • Dermatology | $117 | $162 | $208 |
| Excision malignant lesion trunk/arms/legs 0.5cm or less CPT 11600 • Dermatology | $165 | $252 | $296 |
| Excision malignant lesion trunk/arms/legs 0.6-1.0cm CPT 11601 • Dermatology | $138 | $202 | $234 |
| Excision malignant lesion trunk/arms/legs 1.1-2.0cm CPT 11602 • Dermatology | $152 | $304 | $380 |
| Excision malignant lesion face 0.5cm or less CPT 11640 • Dermatology | $115 | $243 | $308 |