| Abdominal Hysterectomy | $1,002$811$2.6k | $2,561 | $3,201 |
| ACL Reconstruction (Arthroscopic) | $973$675$2.5k | $2,485 | $3,106 |
| Basic Metabolic Panel | $19$5$32 | $29 | $36 |
| Bone Marrow Biopsy | $3,684$185$5.6k | $4,941 | $6,176 |
| Breast Biopsy (Ultrasound-guided) | $3,625$182$5.5k | $4,862 | $6,077 |
| Bunion Correction Surgery | $899$401$1.2k | $1,186 | $1,483 |
| Cardiac Catheterization (Left Heart) | $6,706$1.6k$11k | $9,808 | $12,260 |
| Carpal Tunnel Release Surgery | $459$63$1.1k | $1,097 | $1,372 |
| Cataract Surgery with Lens Implant | $545$201$1.3k | $1,346 | $1,682 |
| Cervical Spinal Fusion (Anterior) | $1,654$284$4.2k | $4,233 | $5,292 |
| Cesarean Delivery (Global Package) | $2,489$125$3.8k | $3,338 | $4,173 |
| Chemotherapy Infusion (First Hour) | $643$165$1.8k | $1,016 | $1,269 |
| Chest X-ray (2 Views) | $178$44$307 | $273 | $341 |
| Colonoscopy with Biopsy | $438$330$511 | $511 | $639 |
| Complete Abdominal Ultrasound | $284$71$490 | $435 | $544 |
| Complete Blood Count (CBC) with Differential | $17$4$30 | $26 | $33 |
| Comprehensive Metabolic Panel | $23$6$40 | $36 | $45 |
| Critical Care, First Hour | $3,076$255$7.6k | $6,789 | $8,487 |
| CT Abdomen and Pelvis with Contrast | $2,816$702$4.9k | $4,319 | $5,399 |
| CT Chest without Contrast | $740$184$1.3k | $1,135 | $1,419 |
| CT Head without Contrast | $884$220$1.5k | $1,356 | $1,695 |
| DEXA Bone Density Scan | $215$54$371 | $330 | $412 |
| Diagnostic Colonoscopy | $349$295$471 | $471 | $589 |
| Diagnostic Mammogram (Both Breasts) | $192$48$332 | $295 | $369 |
| Ear Tube Placement (Tympanostomy) | $2,376$120$3.6k | $3,187 | $3,983 |
| Echocardiogram (Complete with Doppler) | $1,411$272$2.7k | $2,036 | $2,546 |
| Emergency Room Visit (Level 3) | $878$58$1.7k | $1,542 | $1,928 |
| Hemodialysis Treatment | $2,047$149$4.5k | $3,979 | $4,973 |
| Hemoglobin A1c (Diabetes Test) | $22$5$37 | $33 | $41 |
| HIV Antibody Test | $7$2$11 | $10 | $13 |
| Individual Therapy Session (45 Minutes) | $252$18$551 | $490 | $612 |
| Inguinal Hernia Repair (Open) | $516$344$1.3k | $1,315 | $1,644 |
| Initial Hospital Admission (Level 1) | $81$34$254 | $254 | $318 |
| Initial Psychiatric Diagnostic Evaluation | $172$128$371 | $371 | $464 |
| Initial Psychiatric Evaluation with Medication Management | $179$13$390 | $347 | $434 |
| IUD Insertion | $301$15$454 | $404 | $505 |
| IUD Removal | $717$36$1.1k | $962 | $1,202 |
| Knee Arthroscopy with Meniscectomy | $606$551$1.4k | $1,376 | $1,720 |
| Laparoscopic Appendectomy | $4,587$599$19k | $17,302 | $21,628 |
| Laparoscopic Gallbladder Removal | $7,382$504$15k | $13,442 | $16,802 |
| Laparoscopic Tubal Ligation | $640$98$1.6k | $1,649 | $2,062 |
| Lipid Panel (Cholesterol Test) | $30$7$51 | $46 | $57 |
| Lumbar Epidural Steroid Injection | $1,352$337$2.3k | $2,074 | $2,592 |
| Lumbar Puncture (Spinal Tap) | $1,575$79$2.4k | $2,112 | $2,640 |
| Lumbar Spinal Fusion (Posterior) | $1,548$1.2k$4.0k | $3,972 | $4,965 |
| Lumpectomy (Partial Mastectomy) | $648$67$1.7k | $1,651 | $2,063 |
| MRI Abdomen with and without Contrast | $1,154$288$2.0k | $1,770 | $2,212 |
| MRI Brain with and without Contrast | $1,154$288$2.0k | $1,770 | $2,212 |
| MRI Brain with Contrast | $1,154$288$2.0k | $1,770 | $2,212 |
| MRI Brain without Contrast | $704$176$1.2k | $1,080 | $1,350 |
| MRI Cervical Spine (Neck) without Contrast | $704$176$1.2k | $1,080 | $1,350 |
| MRI Knee without Contrast | $704$176$1.2k | $1,080 | $1,350 |
| MRI Lower Back (Lumbar Spine) without Contrast | $704$176$1.2k | $1,080 | $1,350 |
| MRI Thoracic Spine (Mid-back) without Contrast | $704$176$1.2k | $1,080 | $1,350 |
| Newborn Circumcision | $4,630$234$7.0k | $6,247 | $7,809 |
| Nuclear Cardiac Stress Test | $2,776$692$4.8k | $4,258 | $5,322 |
| Office Visit, Established Patient (Level 3) | $93$24$162 | $162 | $203 |
| Office Visit, New Patient (Level 3) | $117$101$203 | $203 | $254 |
| Pacemaker Insertion (Dual Chamber) | $8,132$3.5k$36k | $32,020 | $40,025 |
| Pregnancy Ultrasound (Second or Third Trimester) | $240$60$414 | $368 | $460 |
| Prostate Biopsy | $3,540$178$5.3k | $4,748 | $5,935 |
| PSA Prostate Cancer Screening | $10$2$70 | $33 | $41 |
| Pulmonary Function Test with Bronchodilator | $601$154$1.1k | $950 | $1,187 |
| Rotator Cuff Repair (Arthroscopic) | $1,067$494$2.7k | $2,712 | $3,390 |
| Screening Mammogram | $159$40$274 | $244 | $305 |
| Septoplasty (Deviated Septum Repair) | $683$372$1.7k | $1,653 | $2,067 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $363$316$808 | $808 | $1,010 |
| Skin Biopsy (Tangential) | $452$23$682 | $606 | $757 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $3,684$185$5.6k | $4,941 | $6,176 |
| Spinal Cord Stimulator Trial | $1,676$87$2.6k | $1,056 | $1,320 |
| Spirometry (Breathing Test) | $295$18$537 | $477 | $596 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $308$203$756 | $756 | $945 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $295$169$732 | $732 | $915 |
| Total Hip Replacement | $1,476$1.3k$3.4k | $3,426 | $4,282 |
| Total Knee Replacement | $1,271$298$3.4k | $3,422 | $4,277 |
| Total Mastectomy | $939$153$2.4k | $2,409 | $3,011 |
| TSH Thyroid Function Test | $15$3$64 | $37 | $46 |
| TURP (Transurethral Prostate Resection) | $7,361$441$13k | $11,768 | $14,710 |
| Upper GI Endoscopy (EGD) | $1,483$107$3.2k | $2,859 | $3,574 |
| Urinalysis with Microscopy | $7$2$12 | $11 | $13 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,488$125$3.8k | $3,336 | $4,170 |
| Vaginal Delivery (Global Package) | $2,112$542$3.8k | $3,336 | $4,170 |
| Vaginal Hysterectomy | $900$811$2.1k | $2,121 | $2,652 |
| Vasectomy | $3,540$178$5.3k | $4,748 | $5,935 |
| Vitamin D Blood Test | $66$16$113 | $101 | $126 |