| Ground mileage, per statute mile | $17.38 | $9.67 | 1.8x | 0.66x |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $198.29 | $108.59 | 1.8x | 0.72x |
| Insertion of needle into vein for collection of blood sample | $19.03 | $8.42 | 2.3x | 0.87x |
| Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled | $1.27 | $1.11 | 1.1x | 0.73x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $139.21 | $76.94 | 1.8x | 0.74x |
| Blood test, comprehensive group of blood chemicals | $43.29 | $10.32 | 4.2x | 0.70x |
| Rotary wing air mileage, per statute mile | $458.12 | $37.92 | 12.1x | 1.28x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $59.80 | $20.61 | 2.9x | 0.86x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $28.45 | $7.59 | 3.8x | 0.77x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $154.06 | $71.29 | 2.2x | 0.76x |
| Blood test, lipids (cholesterol and triglycerides) | $75.56 | $13.07 | 5.8x | 0.79x |
| Therapy procedure using functional activities | $63.41 | $28.94 | 2.2x | 0.85x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $57.36 | $24.34 | 2.4x | 0.79x |
| Blood test, thyroid stimulating hormone (tsh) | $83.07 | $16.43 | 5.1x | 0.87x |
| Hemoglobin a1c level | $49.41 | $9.47 | 5.2x | 0.85x |
| Therapy procedure using manual technique, each 15 minutes | $50.51 | $18.77 | 2.7x | 0.75x |
| Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | $27.98 | $14.85 | 1.9x | 0.64x |
| Removal of cataract with insertion of prosthetic lens | $278.71 | $72.56 | 3.8x | 0.27x |
| Injection of drug or substance under skin or into muscle | $38.86 | $12.06 | 3.2x | 0.70x |
| Destruction of precancer skin growth, 2-14 growths | $29.42 | $5.48 | 5.4x | 1.34x |
| Pathology examination of tissue using a microscope, intermediate complexity | $176.31 | $54.00 | 3.3x | 0.95x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $233.86 | $107.32 | 2.2x | 0.72x |
| Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | $35.54 | $7.95 | 4.5x | 0.91x |
| Fixed wing air mileage, per statute mile | $239.80 | $13.88 | 17.3x | 1.73x |
| X-ray of chest, 1 view | $35.71 | $8.15 | 4.4x | 0.68x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $40.47 | $7.46 | 5.4x | 0.90x |
| Vitamin d-3 level | $180.64 | $28.92 | 6.2x | 0.98x |
| Thyroxine (thyroid chemical), free | $62.89 | $8.81 | 7.1x | 0.72x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $283.20 | $143.22 | 2.0x | 0.69x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $55.61 | $12.43 | 4.5x | 0.81x |
| Creatinine level to test for kidney function or muscle injury | $46.04 | $5.06 | 9.1x | 1.01x |
| Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | $87.38 | $56.54 | 1.5x | 0.77x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $203.17 | $114.55 | 1.8x | 0.73x |
| Cyanocobalamin (vitamin b-12) level | $72.45 | $14.72 | 4.9x | 0.82x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $428.44 | $155.36 | 2.8x | 0.75x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $273.21 | $151.11 | 1.8x | 0.67x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $47.62 | $35.76 | 1.3x | 0.78x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $193.88 | $88.25 | 2.2x | 0.92x |
| Urine microalbumin (protein) level | $54.30 | $5.64 | 9.6x | 0.95x |
| Bacterial colony count, urine | $46.34 | $7.90 | 5.9x | 0.91x |