| Arthrocentesis (outpatient) | $739 | 0% | $739 | 
Medium |
| MRI - Back (outpatient) | $3,419 | 0% | $3,419 |
Medium |
| MRI - Knee (outpatient) | $3,231 | 0% | $3,231 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $3,213 | 0% | $3,213 |
Medium |
| Office Visit - Basic | $129 | 0% | $129 |
Medium |
| Office Visit - Established Patient, High Complexity | $384 | 0% | $384 |
Medium |
| Office Visit - Established Patient, Low Complexity | $167 | 0% | $167 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $242 | 0% | $242 |
Medium |
| Office Visit - New Patient, Low Complexity | $274 | 0% | $274 |
Medium |
| Office Visit - New Patient, Minor | $210 | 0% | $210 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $57 | 0% | $57 |
Medium |
| Physical Therapy - High Complexity Evaluation | $282 | 0% | $282 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $282 | 0% | $282 |
Medium |
| Physical Therapy - Manual Therapy | $72 | 0% | $72 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $282 | 0% | $282 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $91 | 0% | $91 |
Medium |
| Physical Therapy - Re-Evaluation | $159 | 0% | $159 |
Medium |
| Physical Therapy - Therapeutic Activities | $114 | 0% | $114 |
Medium |
| Physical Therapy - Therapeutic Exercises | $95 | 0% | $95 |
Medium |
| Physical Therapy - Ultrasound Therapy | $76 | 0% | $76 |
Medium |
| X-Ray - Ankle (outpatient) | $449 | 0% | $449 |
Medium |
| X-Ray - Foot (outpatient) | $413 | 0% | $413 |
Medium |
| X-Ray - Hand | $553 | 0% | $553 |
Medium |
| X-Ray - Hip | $490 | 0% | $490 |
Medium |
| X-Ray - Knee (outpatient) | $661 | 0% | $661 |
Medium |
| X-Ray - Middle Back, Thoracic Spine | $415 | 0% | $415 | 
High |
| X-Ray - Neck, Cervical Spine | $483 | 0% | $483 |
Medium |
| X-Ray - Pelvis | $525 | 0% | $525 |
Medium |
| X-Ray - Shoulder (outpatient) | $485 | 0% | $485 |
Medium |
| X-Ray - Spine (outpatient) | $456 | 0% | $456 |
Medium |
| X-Ray - Wrist (outpatient) | $452 | 0% | $452 |
Medium |
