| Ground mileage, per statute mile | $25.29 | $9.91 | 2.6x | 0.96x |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $234.43 | $95.61 | 2.5x | 0.85x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $168.42 | $68.68 | 2.5x | 0.89x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $74.60 | $23.23 | 3.2x | 1.08x |
| 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 | $2.63 | $1.11 | 2.4x | 1.51x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $226.81 | $73.54 | 3.1x | 1.12x |
| Therapy procedure using functional activities | $83.88 | $30.15 | 2.8x | 1.13x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $71.18 | $38.14 | 1.9x | 1.17x |
| Therapy procedure using manual technique, each 15 minutes | $67.60 | $20.80 | 3.3x | 1.00x |
| Fixed wing air mileage, per statute mile | $107.29 | $14.14 | 7.6x | 0.77x |
| Pathology examination of tissue using a microscope, intermediate complexity | $136.31 | $38.88 | 3.5x | 0.73x |
| Insertion of needle into vein for collection of blood sample | $19.88 | $8.60 | 2.3x | 0.91x |
| 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 | $47.35 | $15.18 | 3.1x | 1.09x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $71.96 | $27.29 | 2.6x | 0.99x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $45.36 | $7.68 | 5.9x | 1.01x |
| Chiropractic manipulative treatment, 1-2 spinal regions | $52.91 | $26.31 | 2.0x | 1.08x |
| Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg | $3.23 | $0.73 | 4.4x | 1.37x |
| Injection, bupivacaine liposome, 1 mg | $3.74 | $1.41 | 2.6x | 0.76x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $46.65 | $7.59 | 6.1x | 1.26x |
| Blood test, comprehensive group of blood chemicals | $71.36 | $10.33 | 6.9x | 1.16x |
| Destruction of precancer skin growth, 2-14 growths | $19.72 | $3.97 | 5.0x | 0.90x |
| Established patient complete exam of visual system | $229.40 | $116.01 | 2.0x | 1.01x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $308.39 | $135.15 | 2.3x | 0.76x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $348.31 | $111.06 | 3.1x | 1.07x |
| Screening mammography | $173.02 | $47.36 | 3.7x | 0.70x |
| Screening 3d breast mammography | $78.78 | $26.21 | 3.0x | 0.57x |
| Administration of influenza virus vaccine | $38.97 | $29.65 | 1.3x | 0.96x |
| Imaging of retina | $106.73 | $35.31 | 3.0x | 0.86x |
| Blood test, lipids (cholesterol and triglycerides) | $71.13 | $13.09 | 5.4x | 0.74x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $319.04 | $134.81 | 2.4x | 0.78x |
| X-ray of chest, 1 view | $53.38 | $8.12 | 6.6x | 1.02x |
| Hemoglobin a1c level | $42.26 | $9.49 | 4.5x | 0.73x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $596.73 | $162.84 | 3.7x | 1.05x |
| Admn sarscov2 vacc 1 dose | $55.50 | $36.02 | 1.5x | 1.10x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $318.12 | $102.96 | 3.1x | 1.14x |
| Blood test, thyroid stimulating hormone (tsh) | $64.19 | $16.43 | 3.9x | 0.67x |
| New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $225.35 | $84.98 | 2.7x | 0.85x |
| Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $287.80 | $71.09 | 4.0x | 0.61x |
| Emergency department visit with high level of medical decision making | $723.50 | $163.51 | 4.4x | 0.59x |
| Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | $128.88 | $45.41 | 2.8x | 1.07x |