| Abdominal Hysterectomy | $899$899$950 | — | — |
| ACL Reconstruction (Arthroscopic) | $9,333$675$14k | — | — |
| Allergy Skin Testing | $1,104$4$1.7k | — | — |
| Basic Metabolic Panel | $134$7$172 | $134 | $191 |
| Bone Marrow Biopsy | $2,124$196$3.3k | — | — |
| Breast Biopsy (Ultrasound-guided) | $2,124$614$3.3k | — | — |
| Bunion Correction Surgery | $4,208$401$6.5k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $33,618$880$52k | — | — |
| Cardiac Catheterization (Left Heart) | $4,170$950$6.4k | — | — |
| Cardiac Stress Test (Treadmill) | $96$96$101 | — | — |
| Carpal Tunnel Release Surgery | $2,512$317$3.9k | — | — |
| Cataract Surgery with Lens Implant | $2,968$1.0k$4.6k | — | — |
| Cervical Spinal Fusion (Anterior) | $16,513$1.4k$25k | — | — |
| Cesarean Delivery (Global Package) | $2,298$2.3k$2.4k | — | — |
| Chemotherapy Infusion (First Hour) | $425$29$654 | $382 | $545 |
| Chest X-ray (2 Views) | $245$27$316 | $224 | $320 |
| Colonoscopy with Biopsy | $1,539$330$2.4k | — | — |
| Complete Abdominal Ultrasound | $728$83$936 | $728 | $1,040 |
| Complete Blood Count (CBC) with Differential | $76$7$97 | $76 | $108 |
| Comprehensive Metabolic Panel | $152$9$195 | $152 | $217 |
| Coronary Angioplasty with Stent | $14,848$483$23k | — | — |
| Critical Care, First Hour | $1,413$128$5.0k | $3,861 | $5,516 |
| CT Abdomen and Pelvis with Contrast | $1,743$282$2.4k | $1,877 | $2,682 |
| CT Cardiac Calcium Scoring | $232$81$299 | $232 | $332 |
| CT Chest without Contrast | $1,663$127$2.3k | $1,791 | $2,559 |
| CT Head without Contrast | $1,118$101$1.5k | $1,204 | $1,721 |
| DEXA Bone Density Scan | $243$34$313 | $243 | $348 |
| Diagnostic Colonoscopy | $1,196$295$1.8k | — | — |
| Diagnostic Mammogram (Both Breasts) | $266$106$341 | $266 | $379 |
| Ear Tube Placement (Tympanostomy) | $1,996$121$3.1k | — | — |
| Echocardiogram (Complete with Doppler) | $1,071$240$1.5k | $1,153 | $1,647 |
| EKG (Electrocardiogram, 12-lead) | $29$29$30 | — | — |
| Emergency Room Visit (Level 3) | $429$47$552 | $429 | $613 |
| Group Therapy Session | $131$24$201 | — | — |
| Hemodialysis Treatment | $153$153$162 | — | — |
| Hemoglobin A1c (Diabetes Test) | $14$2$61 | $14 | $20 |
| HIV Antibody Test | $8$3$14 | $7 | $10 |
| Holter Monitor (24-48 Hour Heart Monitor) | $111$111$117 | — | — |
| Home Sleep Study | $278$83$428 | — | — |
| Individual Therapy Session (45 Minutes) | $228$90$352 | — | — |
| Inguinal Hernia Repair (Open) | $4,605$344$7.1k | — | — |
| Initial Hospital Admission (Level 1) | $34$34$36 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $228$163$352 | — | — |
| Initial Psychiatric Evaluation with Medication Management | $228$176$352 | — | — |
| IUD Insertion | $979$168$1.2k | $958 | $1,369 |
| IUD Removal | $470$49$959 | $746 | $1,065 |
| Knee Arthroscopy with Meniscectomy | $4,208$551$6.5k | — | — |
| Laparoscopic Appendectomy | $7,776$273$12k | — | — |
| Laparoscopic Gallbladder Removal | $7,776$466$12k | — | — |
| Laparoscopic Tubal Ligation | $7,776$489$12k | — | — |
| Lipid Panel (Cholesterol Test) | $17$4$111 | $51 | $73 |
| Lumbar Epidural Steroid Injection | $908$220$1.4k | — | — |
| Lumbar Puncture (Spinal Tap) | $908$122$1.4k | — | — |
| Lumbar Spinal Fusion (Posterior) | $22,551$1.2k$35k | — | — |
| Lumpectomy (Partial Mastectomy) | $5,036$334$7.8k | — | — |
| MRI Abdomen with and without Contrast | $2,174$334$3.3k | $2,553 | $3,647 |
| MRI Brain with and without Contrast | $2,174$311$4.0k | $3,128 | $4,468 |
| MRI Brain with Contrast | $2,111$264$2.9k | $2,273 | $3,247 |
| MRI Brain without Contrast | $2,008$190$2.8k | $2,163 | $3,090 |
| MRI Cervical Spine (Neck) without Contrast | $2,174$186$3.2k | $2,484 | $3,549 |
| MRI Knee without Contrast | $2,133$307$3.2k | $2,225 | $3,178 |
| MRI Lower Back (Lumbar Spine) without Contrast | $2,174$186$3.2k | $2,484 | $3,549 |
| MRI Thoracic Spine (Mid-back) without Contrast | $2,174$185$3.2k | $2,484 | $3,549 |
| Newborn Circumcision | $2,689$2.4k$4.1k | — | — |
| Nuclear Cardiac Stress Test | $1,665$348$2.6k | — | — |
| Office Visit, Established Patient (Level 3) | $221$58$632 | $214 | $305 |
| Office Visit, New Patient (Level 3) | $224$66$632 | $204 | $292 |
| Pacemaker Insertion (Dual Chamber) | $13,443$745$21k | — | — |
| PET/CT Scan, Whole Body | $2,246$1.0k$3.5k | $2,746 | $3,923 |
| Pregnancy Ultrasound (Second or Third Trimester) | $425$128$936 | $728 | $1,040 |
| PSA Prostate Cancer Screening | $9$2$169 | $8 | $11 |
| Pulmonary Function Test with Bronchodilator | $463$45$739 | $372 | $532 |
| Rotator Cuff Repair (Arthroscopic) | $9,333$494$14k | — | — |
| Screening Mammogram | $252$83$330 | $257 | $367 |
| Septoplasty (Deviated Septum Repair) | $4,264$372$6.6k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $9,077$359$14k | — | — |
| Skin Biopsy (Tangential) | $523$95$805 | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,124$119$3.3k | — | — |
| Sleep Study (In-lab Polysomnography) | $1,104$348$1.7k | — | — |
| Spinal Cord Stimulator Trial | $8,197$436$13k | — | — |
| Spirometry (Breathing Test) | $226$25$646 | $204 | $291 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,264$203$6.6k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $7,614$169$12k | — | — |
| Total Hip Replacement | $16,513$1.5k$25k | — | — |
| Total Knee Replacement | $16,513$1.5k$25k | — | — |
| Total Mastectomy | $8,540$763$13k | — | — |
| TSH Thyroid Function Test | $23$2$102 | $79 | $113 |
| TURP (Transurethral Prostate Resection) | $6,896$745$11k | — | — |
| Upper GI Endoscopy (EGD) | $1,167$224$1.8k | — | — |
| Urinalysis with Microscopy | $25$3$82 | $64 | $91 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,174$2.2k$2.3k | — | — |
| Vaginal Delivery (Global Package) | $2,091$2.1k$2.2k | — | — |
| Vaginal Hysterectomy | $6,434$811$9.9k | — | — |
| Vasectomy | $2,689$261$4.1k | — | — |
| Vitamin D Blood Test | $19$2$90 | $15 | $21 |