| Office Visit - Basic | $79 | N/A | $79 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $210 | N/A | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $221 | N/A | $221 |
| Office Visit - Established Patient, High Complexity | $242 | N/A | $242 |
| Office Visit - Established Patient, Low Complexity | $126 | N/A | $126 |
| Office Visit - Established Patient, Moderate Complexity | $179 | N/A | $179 |
| Office Visit - New Patient, Low Complexity | $179 | N/A | $179 |
| Office Visit - New Patient, Moderate Complexity | $273 | N/A | $273 |
| Physical Therapy - Application of Blood Vessel Compression or Decompression Device | $53 | 
Above Average
State Average: 3 | $53 |
| Physical Therapy - Application of Mechanical Traction | $53 | 
Below Average
State Average: 3 | $53 |
| Physical Therapy - Electrical Stimulation Therapy | $53 |
Above Average
State Average: 3 | $53 |
| Physical Therapy - High Complexity Evaluation | $210 | 
Near Average
State Average: 1 | $210 |
| Physical Therapy - Low Complexity Evaluation | $210 |
Near Average
State Average: 1 | $210 |
| Physical Therapy - Manual Therapy | $74 |
Above Average
State Average: 4 | $74 |
| Physical Therapy - Moderate Complexity Evaluation | $210 |
Near Average
State Average: 1 | $210 |
| Physical Therapy - Neuromuscular Reeducation | $89 |
Near Average
State Average: 4 | $89 |
| Physical Therapy - Re-Evaluation | $95 |
Near Average
State Average: 1 | $95 |
| Physical Therapy - Self-care or Home Management Training | $79 |
Near Average
State Average: 1 | $79 |
| Physical Therapy - Therapeutic Activities | $79 |
Near Average
State Average: 3 | $79 |
| Physical Therapy - Therapeutic Exercises | $91 |
Above Average
State Average: 4 | $91 |
| Physical Therapy - Ultrasound Therapy | $42 |
Above Average
State Average: 3 | $42 |
| Vaccine - Influenza for Injection into Muscle | $32 | N/A | $32 |
