| ACL Reconstruction (Arthroscopic) | $9,077$3.0k$32k | $19,956 | $19,956 |
| Allergy Skin Testing | $1,293$639$4.5k | — | — |
| Basic Metabolic Panel | $23$8$183 | $244 | $244 |
| Bone Marrow Biopsy | $2,059$963$7.2k | — | — |
| Breast Biopsy (Ultrasound-guided) | $2,059$912$7.2k | $6,077 | $6,077 |
| Bunion Correction Surgery | $4,123$1.8k$14k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $31,171$13k$109k | — | — |
| Cardiac Catheterization (Left Heart) | $4,087$2.0k$14k | — | — |
| Carpal Tunnel Release Surgery | $2,481$1.1k$8.7k | — | — |
| Cataract Surgery with Lens Implant | $2,898$1.3k$10k | $12,304 | $12,304 |
| Cervical Spinal Fusion (Anterior) | $16,349$7.5k$57k | — | — |
| Cesarean Delivery (Global Package) | $6,371 | — | — |
| Chemotherapy Infusion (First Hour) | $421$202$1.5k | — | — |
| Chest X-ray (2 Views) | $197$75$740 | $987 | $987 |
| Colonoscopy with Biopsy | $1,498$686$5.2k | — | — |
| Complete Abdominal Ultrasound | $224$135$840 | $1,120 | $1,120 |
| Complete Blood Count (CBC) with Differential | $21$8$144 | $191 | $191 |
| Comprehensive Metabolic Panel | $29$10$227 | $186 | $186 |
| Coronary Angioplasty with Stent | $14,409$6.8k$50k | — | — |
| Critical Care, First Hour | $1,759$518$6.6k | $8,660 | $8,660 |
| CT Abdomen and Pelvis with Contrast | $697$454$2.6k | $3,484 | $3,484 |
| CT Cardiac Calcium Scoring | $112$75$391 | — | — |
| CT Chest without Contrast | $473$135$2.3k | $3,009 | $3,009 |
| CT Head without Contrast | $473$135$1.8k | $2,406 | $2,406 |
| DEXA Bone Density Scan | $180$128$639 | $852 | $852 |
| Diagnostic Colonoscopy | $1,158$478$4.1k | $3,189 | $3,189 |
| Diagnostic Mammogram (Both Breasts) | $534$118$806 | $1,075 | $1,075 |
| Ear Tube Placement (Tympanostomy) | $1,882$895$6.6k | — | — |
| Echocardiogram (Complete with Doppler) | $762$348$2.9k | $3,811 | $3,811 |
| Emergency Room Visit (Level 3) | $611$156$2.3k | $3,055 | $3,055 |
| Group Therapy Session | $118$53$411 | — | — |
| Hemoglobin A1c (Diabetes Test) | $26$10$209 | $278 | $278 |
| HIV Antibody Test | $16$9$24 | — | — |
| Home Sleep Study | $199$95$696 | — | — |
| Individual Therapy Session (45 Minutes) | $204$89$714 | — | — |
| Inguinal Hernia Repair (Open) | $4,484$2.1k$16k | — | — |
| Initial Hospital Admission (Level 1) | $1,097$331$1.7k | $2,209 | $2,209 |
| Initial Psychiatric Diagnostic Evaluation | $204$89$714 | — | — |
| Initial Psychiatric Evaluation with Medication Management | $204$89$714 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $832$624$2.6k | — | — |
| IUD Insertion | $545$165$823 | $1,097 | $1,097 |
| IUD Removal | $473$116$1.8k | $1,937 | $1,937 |
| Knee Arthroscopy with Meniscectomy | $4,123$1.8k$14k | — | — |
| Laparoscopic Appendectomy | $5,947$1.2k$26k | $8,329 | $8,329 |
| Laparoscopic Gallbladder Removal | $7,413$2.4k$26k | $15,725 | $15,725 |
| Laparoscopic Tubal Ligation | $7,413$3.2k$26k | — | — |
| Lipid Panel (Cholesterol Test) | $36$7$287 | $88 | $88 |
| Lumbar Epidural Steroid Injection | $880$419$3.1k | — | — |
| Lumbar Puncture (Spinal Tap) | $880$419$3.1k | $3,053 | $3,053 |
| Lumbar Spinal Fusion (Posterior) | $23,366$7.5k$82k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,865$2.0k$17k | — | — |
| MRI Abdomen with and without Contrast | $1,313$454$4.9k | $6,566 | $6,566 |
| MRI Brain with and without Contrast | $1,162$454$4.4k | $5,808 | $5,808 |
| MRI Brain with Contrast | $706$454$2.6k | $3,532 | $3,532 |
| MRI Brain without Contrast | $590$277$2.2k | $2,950 | $2,950 |
| MRI Cervical Spine (Neck) without Contrast | $590$277$2.2k | $2,951 | $2,951 |
| MRI Knee without Contrast | $588$277$2.2k | $2,939 | $2,939 |
| MRI Lower Back (Lumbar Spine) without Contrast | $654$277$2.5k | $3,269 | $3,269 |
| MRI Thoracic Spine (Mid-back) without Contrast | $654$277$2.5k | $3,271 | $3,271 |
| Newborn Circumcision | $1,731$346$9.1k | $2,308 | $2,308 |
| Nuclear Cardiac Stress Test | $2,134$922$8.0k | $8,407 | $8,407 |
| Office Visit, Established Patient (Level 3) | $173$81$648 | $743 | $743 |
| Office Visit, New Patient (Level 3) | $184$81$689 | $892 | $892 |
| Pacemaker Insertion (Dual Chamber) | $13,297$6.9k$47k | — | — |
| PET/CT Scan, Whole Body | $2,201$1.7k$6.5k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $257$135$965 | $1,286 | $1,286 |
| Prostate Biopsy | $2,603$1.2k$9.1k | — | — |
| PSA Prostate Cancer Screening | $41$4$396 | $122 | $122 |
| Pulmonary Function Test with Bronchodilator | $396$177$1.4k | $1,824 | $1,824 |
| Rotator Cuff Repair (Arthroscopic) | $9,077$4.0k$32k | — | — |
| Screening Mammogram | $349$83$527 | $627 | $627 |
| Septoplasty (Deviated Septum Repair) | $4,121$1.6k$14k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $8,796$3.6k$31k | — | — |
| Skin Biopsy (Tangential) | $252$124$883 | $890 | $890 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,059$963$7.2k | — | — |
| Sleep Study (In-lab Polysomnography) | $1,293$639$4.5k | — | — |
| Spinal Cord Stimulator Trial | $8,339$4.2k$29k | — | — |
| Spirometry (Breathing Test) | $225$95$843 | $1,125 | $1,125 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,121$1.6k$14k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $7,516$3.1k$26k | — | — |
| Total Hip Replacement | $57,202$16k$57k | — | — |
| Total Knee Replacement | $16,349$7.5k$57k | — | — |
| Total Mastectomy | $8,286$3.4k$29k | — | — |
| TSH Thyroid Function Test | $30$10$83 | $100 | $100 |
| TURP (Transurethral Prostate Resection) | $6,459$2.8k$23k | — | — |
| Umbilical Hernia Repair | $2,800$2.1k$3.5k | — | — |
| Upper GI Endoscopy (EGD) | $1,191$533$4.2k | — | — |
| Urinalysis with Microscopy | $9$3$68 | $90 | $90 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $3,929 | — | — |
| Vaginal Delivery (Global Package) | $3,929 | — | — |
| Vaginal Hysterectomy | $6,272$2.9k$22k | — | — |
| Vasectomy | $2,603$1.2k$9.1k | — | — |
| Vitamin D Blood Test | $39$2$157 | $196 | $196 |