| Ground mileage, per statute mile | $25.18 | $9.58 | 2.6x | 0.95x |
| Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $242.68 | $109.02 | 2.2x | 0.88x |
| Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $164.79 | $77.09 | 2.1x | 0.87x |
| Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $62.51 | $21.30 | 2.9x | 0.90x |
| Insertion of needle into vein for collection of blood sample | $17.20 | $8.55 | 2.0x | 0.79x |
| Therapy procedure using functional activities | $64.24 | $29.05 | 2.2x | 0.86x |
| Blood test, comprehensive group of blood chemicals | $34.02 | $10.31 | 3.3x | 0.55x |
| Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $25.51 | $7.58 | 3.4x | 0.69x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $199.26 | $71.05 | 2.8x | 0.98x |
| Therapy procedure using manual technique, each 15 minutes | $55.60 | $19.30 | 2.9x | 0.82x |
| Pathology examination of tissue using a microscope, intermediate complexity | $176.17 | $49.07 | 3.6x | 0.95x |
| Blood test, lipids (cholesterol and triglycerides) | $54.50 | $13.05 | 4.2x | 0.57x |
| Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $57.92 | $24.70 | 2.3x | 0.80x |
| 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 | $47.89 | $14.79 | 3.2x | 1.10x |
| Destruction of precancer skin growth, 2-14 growths | $15.39 | $5.56 | 2.8x | 0.70x |
| Blood test, thyroid stimulating hormone (tsh) | $65.61 | $16.43 | 4.0x | 0.68x |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $316.99 | $107.95 | 2.9x | 0.97x |
| Hemoglobin a1c level | $41.11 | $9.45 | 4.3x | 0.71x |
| Removal of cataract with insertion of prosthetic lens | $585.66 | $133.40 | 4.4x | 0.57x |
| X-ray of chest, 1 view | $48.81 | $8.32 | 5.9x | 0.93x |
| Injection of drug or substance under skin or into muscle | $47.96 | $12.20 | 3.9x | 0.87x |
| Professional service for preparation and provision of 1 or more antigens | $26.49 | $12.70 | 2.1x | 0.90x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | $37.24 | $7.53 | 4.9x | 0.83x |
| Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $228.07 | $86.90 | 2.6x | 1.08x |
| New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $367.96 | $145.29 | 2.5x | 0.90x |
| 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 | $1.67 | $1.10 | 1.5x | 0.96x |
| Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $52.65 | $12.62 | 4.2x | 0.76x |
| Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | $252.65 | $112.54 | 2.2x | 0.91x |
| Automated urinalysis test | $11.39 | $2.18 | 5.2x | 0.75x |
| Chiropractic manipulative treatment, 3-4 spinal regions | $54.46 | $36.27 | 1.5x | 0.90x |
| Administration of influenza virus vaccine | $33.62 | $26.51 | 1.3x | 0.82x |
| Test for allergy using allergenic extract | $12.03 | $3.00 | 4.0x | 0.91x |
| Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | $349.42 | $151.76 | 2.3x | 0.86x |
| Injection, bupivacaine liposome, 1 mg | $4.00 | $1.40 | 2.9x | 0.82x |
| Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $565.95 | $155.86 | 3.6x | 1.00x |
| Vitamin d-3 level | $110.62 | $28.88 | 3.8x | 0.60x |
| Established patient complete exam of visual system | $208.70 | $115.54 | 1.8x | 0.92x |
| Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $137.75 | $60.99 | 2.3x | 0.89x |
| Emergency department visit with high level of medical decision making | $1,455.54 | $159.37 | 9.1x | 1.18x |
| Creatinine level to test for kidney function or muscle injury | $26.98 | $5.04 | 5.4x | 0.59x |