| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $255.11 | $111.33 | 2.3x | 0.93x |
| Ground mileage, per statute mile | $15.74 | $9.73 | 1.6x | 0.60x |
| Insertion of needle into vein for collection of blood sample | $23.02 | $8.60 | 2.7x | 1.06x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $176.00 | $78.76 | 2.2x | 0.93x |
| Blood test, comprehensive group of blood chemicals | $49.68 | $10.33 | 4.8x | 0.81x |
| 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 | $1.28 | $1.10 | 1.2x | 0.73x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $33.07 | $7.60 | 4.4x | 0.89x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $63.27 | $21.80 | 2.9x | 0.92x |
| Blood test, lipids (cholesterol and triglycerides) | $88.47 | $13.10 | 6.8x | 0.92x |
| Therapy procedure using functional activities | $67.31 | $29.56 | 2.3x | 0.90x |
| Hemoglobin a1c level | $61.19 | $9.50 | 6.4x | 1.05x |
| Blood test, thyroid stimulating hormone (tsh) | $96.17 | $16.45 | 5.8x | 1.00x |
| 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 | $39.81 | $15.00 | 2.7x | 0.92x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $65.32 | $25.75 | 2.5x | 0.90x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $210.31 | $72.56 | 2.9x | 1.03x |
| Therapy procedure using manual technique, each 15 minutes | $60.70 | $19.70 | 3.1x | 0.90x |
| Removal of cataract with insertion of prosthetic lens | $365.60 | $79.68 | 4.6x | 0.36x |
| Destruction of precancer skin growth, 2-14 growths | $22.02 | $5.83 | 3.8x | 1.00x |
| Pathology examination of tissue using a microscope, intermediate complexity | $156.32 | $52.14 | 3.0x | 0.84x |
| Vitamin d-3 level | $202.35 | $28.98 | 7.0x | 1.10x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $314.97 | $109.49 | 2.9x | 0.97x |
| Measurement of antibody (ige) to allergic substance, crude allergen extract, each | $36.57 | $5.11 | 7.2x | 1.20x |
| Creatinine level to test for kidney function or muscle injury | $52.66 | $5.07 | 10.4x | 1.15x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $212.09 | $89.93 | 2.4x | 1.01x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $42.65 | $7.58 | 5.6x | 0.95x |
| Thyroxine (thyroid chemical), free | $82.81 | $8.83 | 9.4x | 0.95x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $355.09 | $150.74 | 2.4x | 0.87x |
| Manual urinalysis test with examination using microscope, automated | $30.52 | $3.10 | 9.8x | 0.96x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $377.84 | $147.89 | 2.6x | 0.93x |
| Injection, bupivacaine liposome, 1 mg | $4.70 | $1.39 | 3.4x | 0.96x |
| X-ray of chest, 1 view | $50.47 | $8.25 | 6.1x | 0.97x |
| Urine microalbumin (protein) level | $64.02 | $5.65 | 11.3x | 1.12x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $257.11 | $117.94 | 2.2x | 0.92x |
| Administration of influenza virus vaccine | $39.49 | $27.69 | 1.4x | 0.97x |
| Cyanocobalamin (vitamin b-12) level | $92.75 | $14.77 | 6.3x | 1.05x |
| Blood test, basic group of blood chemicals (calcium, total) | $41.24 | $8.28 | 5.0x | 0.86x |
| Bacterial colony count, urine | $52.30 | $7.90 | 6.6x | 1.02x |
| Emergency department visit with high level of medical decision making | $1,126.20 | $160.68 | 7.0x | 0.91x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $58.06 | $36.93 | 1.6x | 0.96x |
| Automated urinalysis test | $18.21 | $2.19 | 8.3x | 1.20x |