| Abdominal Hysterectomy | $7,380$4.4k$14k | $1,551 | $2,386 |
| ACL Reconstruction (Arthroscopic) | $10,097$5.0k$14k | $1,551 | $2,386 |
| Allergy Skin Testing | $18$18$23 | — | — |
| Basic Metabolic Panel | $64$21$9.7k | $206 | $318 |
| Bone Marrow Biopsy | $2,831$1.4k$9.7k | $3,583 | $5,513 |
| Breast Biopsy (Ultrasound-guided) | $4,173$2.0k$5.9k | $3,583 | $5,513 |
| Bunion Correction Surgery | $6,796$5.0k$7.5k | $1,551 | $2,386 |
| Cardiac Ablation for Atrial Fibrillation | $13,265$11k$19k | $1,551 | $2,386 |
| Cardiac Catheterization (Left Heart) | $13,265$8.2k$19k | $1,551 | $2,386 |
| Cardiac Stress Test (Treadmill) | $677$677$885 | — | — |
| Carpal Tunnel Release Surgery | $4,592$3.0k$5.9k | $1,551 | $2,386 |
| Cataract Surgery with Lens Implant | $9,116$4.6k$13k | $1,551 | $2,386 |
| Cervical Spinal Fusion (Anterior) | $10,097$6.8k$19k | $1,551 | $2,386 |
| Cesarean Delivery (Global Package) | $7,268$4.8k$11k | $1,551 | $2,386 |
| Chemotherapy Infusion (First Hour) | $638$638$843 | — | — |
| Chest X-ray (2 Views) | $137$58$9.7k | $957 | $1,473 |
| Colonoscopy with Biopsy | $4,038$1.5k$5.9k | $1,551 | $2,386 |
| Complete Abdominal Ultrasound | $323$132$9.7k | $1,965 | $3,024 |
| Complete Blood Count (CBC) with Differential | $59$19$9.7k | $319 | $490 |
| Comprehensive Metabolic Panel | $81$26$9.7k | $411 | $633 |
| Coronary Angioplasty with Stent | $10,097$9.6k$19k | $1,551 | $2,386 |
| Critical Care, First Hour | $6,003$1.0k$9.7k | $5,124 | $7,883 |
| CT Abdomen and Pelvis with Contrast | $1,180$445$9.7k | $7,818 | $12,027 |
| CT Cardiac Calcium Scoring | $188$110$2.2k | $197 | $303 |
| CT Chest without Contrast | $661$132$9.7k | $3,448 | $5,305 |
| CT Head without Contrast | $565$132$9.7k | $3,952 | $6,080 |
| DEXA Bone Density Scan | $467$71$611 | — | — |
| Diagnostic Colonoscopy | $4,038$1.1k$5.9k | $1,551 | $2,386 |
| Diagnostic Mammogram (Both Breasts) | $578$278$2.2k | $715 | $1,100 |
| Ear Tube Placement (Tympanostomy) | $4,173$3.0k$6.8k | $1,551 | $2,386 |
| Echocardiogram (Complete with Doppler) | $1,365$683$9.7k | $4,259 | $6,552 |
| EKG (Electrocardiogram, 12-lead) | $164$164$215 | — | — |
| Emergency Room Visit (Level 3) | $1,936$345$9.7k | $1,252 | $1,925 |
| Hemoglobin A1c (Diabetes Test) | $74$24$9.7k | $203 | $312 |
| HIV Antibody Test | $51$22$69 | — | — |
| Holter Monitor (24-48 Hour Heart Monitor) | $982$982$1.3k | — | — |
| Home Sleep Study | $932$932$1.2k | — | — |
| Inguinal Hernia Repair (Open) | $7,380$5.6k$8.4k | $5,204 | $8,006 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,803$1.4k$3.7k | — | — |
| IUD Insertion | $2,136$214$2.9k | $302 | $464 |
| IUD Removal | $2,831$1.4k$3.9k | $975 | $1,500 |
| Knee Arthroscopy with Meniscectomy | $7,380$5.6k$8.4k | $1,551 | $2,386 |
| Laparoscopic Appendectomy | $8,777$5.4k$11k | $1,551 | $2,386 |
| Laparoscopic Gallbladder Removal | $13,265$10k$19k | $1,551 | $2,386 |
| Laparoscopic Tubal Ligation | $9,553$5.9k$11k | $1,551 | $2,386 |
| Lipid Panel (Cholesterol Test) | $102$33$9.7k | $196 | $301 |
| Lumbar Epidural Steroid Injection | $3,362$2.6k$4.4k | $1,942 | $2,987 |
| Lumbar Puncture (Spinal Tap) | $3,096$862$9.7k | $3,621 | $5,571 |
| Lumbar Spinal Fusion (Posterior) | $10,097$7.7k$13k | $1,551 | $2,386 |
| Lumpectomy (Partial Mastectomy) | $4,990$4.6k$7.5k | $1,551 | $2,386 |
| MRI Abdomen with and without Contrast | $2,134$445$9.7k | $4,551 | $7,002 |
| MRI Brain with and without Contrast | $2,134$445$9.7k | $5,068 | $7,797 |
| MRI Brain with Contrast | $2,096$445$9.7k | $4,815 | $7,407 |
| MRI Brain without Contrast | $1,811$301$9.7k | $4,561 | $7,017 |
| MRI Cervical Spine (Neck) without Contrast | $1,812$301$9.7k | $3,675 | $5,654 |
| MRI Knee without Contrast | $1,804$301$9.7k | $3,675 | $5,654 |
| MRI Lower Back (Lumbar Spine) without Contrast | $2,008$301$9.7k | $3,675 | $5,654 |
| MRI Thoracic Spine (Mid-back) without Contrast | $2,010$301$9.7k | $3,675 | $5,654 |
| Newborn Circumcision | $4,443$2.6k$4.6k | $1,551 | $2,386 |
| Nuclear Cardiac Stress Test | $2,027$903$9.7k | $3,933 | $6,051 |
| Office Visit, Established Patient (Level 3) | — | $233 | $358 |
| Office Visit, New Patient (Level 3) | — | $233 | $358 |
| Pacemaker Insertion (Dual Chamber) | $12,994$6.5k$21k | $1,807 | $2,780 |
| PET/CT Scan, Whole Body | $4,092$2.0k$5.4k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $335$132$9.7k | $1,957 | $3,010 |
| Prostate Biopsy | $4,173$3.0k$5.9k | $2,455 | $3,777 |
| PSA Prostate Cancer Screening | $140$45$9.7k | $45 | $69 |
| Pulmonary Function Test with Bronchodilator | $199$199$261 | $1,347 | $2,073 |
| Rotator Cuff Repair (Arthroscopic) | $9,553$5.9k$13k | $1,551 | $2,386 |
| Screening Mammogram | $477$230$2.2k | $390 | $601 |
| Septoplasty (Deviated Septum Repair) | $5,561$4.6k$13k | $1,551 | $2,386 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,380$5.4k$9.6k | $1,551 | $2,386 |
| Skin Biopsy (Tangential) | $2,900$214$5.9k | $678 | $1,044 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $3,362$2.6k$4.4k | $1,551 | $2,386 |
| Sleep Study (In-lab Polysomnography) | $1,132$1.1k$1.5k | — | — |
| Spinal Cord Stimulator Trial | $10,097$3.0k$12k | $1,551 | $2,386 |
| Spirometry (Breathing Test) | $90$90$118 | $919 | $1,413 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $5,917$4.6k$9.6k | $1,551 | $2,386 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $4,990$4.6k$8.4k | $1,551 | $2,386 |
| Total Hip Replacement | $10,589$6.8k$12k | $1,551 | $2,386 |
| Total Knee Replacement | $12,329$6.8k$19k | $1,551 | $2,386 |
| Total Mastectomy | $7,380$5.6k$8.4k | $1,551 | $2,386 |
| TSH Thyroid Function Test | $128$42$9.7k | $323 | $497 |
| TURP (Transurethral Prostate Resection) | $8,191$5.4k$9.5k | $1,551 | $2,386 |
| Umbilical Hernia Repair | $6,116$6.1k$8.4k | — | — |
| Upper GI Endoscopy (EGD) | $4,140$1.2k$4.4k | $1,551 | $2,386 |
| Urinalysis with Microscopy | $24$8$9.7k | $256 | $394 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $6,220$4.8k$9.3k | $1,551 | $2,386 |
| Vaginal Delivery (Global Package) | $6,844$4.8k$11k | $1,551 | $2,386 |
| Vaginal Hysterectomy | $7,380$4.4k$14k | $1,551 | $2,386 |
| Vasectomy | $4,592$3.0k$5.9k | $1,551 | $2,386 |
| Vitamin D Blood Test | $225$72$9.7k | $206 | $317 |