| ACL Reconstruction (Arthroscopic) | $8,032$7.6k$20k | $20,422 | $20,422 |
| Allergy Skin Testing | $951$897$2.4k | — | — |
| Basic Metabolic Panel | $9$8$22 | $285 | $285 |
| Bone Marrow Biopsy | $1,828$1.7k$4.6k | $5,059 | $5,059 |
| Breast Biopsy (Ultrasound-guided) | $1,828$1.7k$4.6k | $11,720 | $11,720 |
| Bunion Correction Surgery | $3,622$3.4k$9.1k | $16,136 | $16,136 |
| Cardiac Ablation for Atrial Fibrillation | $28,933$27k$72k | $49,885 | $49,885 |
| Cardiac Catheterization (Left Heart) | $3,589$3.4k$9.0k | $25,771 | $25,771 |
| Carpal Tunnel Release Surgery | $2,162$2.0k$5.4k | $12,087 | $12,087 |
| Cataract Surgery with Lens Implant | $2,555$2.4k$6.4k | $9,892 | $9,892 |
| Cervical Spinal Fusion (Anterior) | $14,212$13k$36k | $19,516 | $19,516 |
| Chemotherapy Infusion (First Hour) | $366$345$914 | $1,416 | $1,416 |
| Chest X-ray (2 Views) | $106$91$241 | $777 | $777 |
| Colonoscopy with Biopsy | $1,325$1.2k$3.3k | $3,914 | $3,914 |
| Complete Abdominal Ultrasound | $195$109$328 | $2,465 | $2,465 |
| Complete Blood Count (CBC) with Differential | $8$8$21 | $299 | $299 |
| Comprehensive Metabolic Panel | $11$11$28 | $414 | $414 |
| Coronary Angioplasty with Stent | $12,779$12k$32k | $39,451 | $39,451 |
| Critical Care, First Hour | $914$863$2.3k | $7,214 | $7,214 |
| CT Abdomen and Pelvis with Contrast | $430$364$965 | $12,149 | $12,149 |
| CT Cardiac Calcium Scoring | $96$35$241 | $8,713 | $8,713 |
| CT Chest without Contrast | $195$109$308 | $4,806 | $4,806 |
| CT Head without Contrast | $195$109$308 | $4,178 | $4,178 |
| DEXA Bone Density Scan | $189$109$289 | $1,749 | $1,749 |
| Diagnostic Colonoscopy | $1,029$971$2.6k | $2,996 | $2,996 |
| Diagnostic Mammogram (Both Breasts) | $193$113$298 | $1,510 | $1,510 |
| Ear Tube Placement (Tympanostomy) | $1,718$1.6k$4.3k | $7,768 | $7,768 |
| Echocardiogram (Complete with Doppler) | $605$571$1.5k | $5,002 | $5,002 |
| Emergency Room Visit (Level 3) | $302$285$755 | $1,455 | $1,455 |
| Group Therapy Session | — | $439 | $439 |
| Hemodialysis Treatment | — | $3,297 | $3,297 |
| Hemoglobin A1c (Diabetes Test) | $10$10$26 | $518 | $518 |
| HIV Antibody Test | $9$9$24 | $507 | $507 |
| Home Sleep Study | $239$225$598 | $4,308 | $4,308 |
| Individual Therapy Session (45 Minutes) | $196$185$491 | $388 | $388 |
| Inguinal Hernia Repair (Open) | $3,963$3.7k$9.9k | $22,786 | $22,786 |
| Initial Psychiatric Diagnostic Evaluation | $196$185$491 | $972 | $972 |
| Initial Psychiatric Evaluation with Medication Management | $196$185$491 | $971 | $971 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | — | $7,171 | $7,171 |
| IUD Insertion | — | $6,221 | $6,221 |
| IUD Removal | $337$318$843 | $1,065 | $1,065 |
| Knee Arthroscopy with Meniscectomy | $3,622$3.4k$9.1k | $18,284 | $18,284 |
| Laparoscopic Appendectomy | $6,692$6.3k$17k | — | — |
| Laparoscopic Gallbladder Removal | $6,692$6.3k$17k | $19,100 | $19,100 |
| Laparoscopic Tubal Ligation | $6,692$6.3k$17k | $29,577 | $29,577 |
| Lipid Panel (Cholesterol Test) | $14$13$35 | $97 | $97 |
| Lumbar Epidural Steroid Injection | $781$737$2.0k | $2,632 | $2,632 |
| Lumbar Puncture (Spinal Tap) | $781$737$2.0k | $1,154 | $1,154 |
| Lumbar Spinal Fusion (Posterior) | $19,409$18k$49k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,334$4.1k$11k | — | — |
| MRI Abdomen with and without Contrast | $776$364$1.2k | $6,936 | $6,936 |
| MRI Brain with and without Contrast | $776$364$1.2k | $9,027 | $9,027 |
| MRI Brain with Contrast | $430$364$1.0k | $7,432 | $7,432 |
| MRI Brain without Contrast | $395$249$718 | $6,534 | $6,534 |
| MRI Cervical Spine (Neck) without Contrast | $395$249$718 | $7,772 | $7,772 |
| MRI Knee without Contrast | $395$249$718 | $7,481 | $7,481 |
| MRI Lower Back (Lumbar Spine) without Contrast | $395$249$718 | $7,374 | $7,374 |
| MRI Thoracic Spine (Mid-back) without Contrast | $395$249$718 | $6,964 | $6,964 |
| Newborn Circumcision | $2,314$2.2k$5.8k | $6,759 | $6,759 |
| Nuclear Cardiac Stress Test | $2,045$1.4k$3.6k | $6,238 | $6,238 |
| Office Visit, Established Patient (Level 3) | — | $396 | $396 |
| Office Visit, New Patient (Level 3) | — | $1,088 | $1,088 |
| Pacemaker Insertion (Dual Chamber) | $11,570$11k$29k | $27,737 | $27,737 |
| PET/CT Scan, Whole Body | $2,341$1.5k$4.0k | $7,135 | $7,135 |
| Pregnancy Ultrasound (Second or Third Trimester) | $195$109$328 | $1,257 | $1,257 |
| Prostate Biopsy | — | $10,241 | $10,241 |
| PSA Prostate Cancer Screening | $19$18$49 | $385 | $385 |
| Pulmonary Function Test with Bronchodilator | $413$390$1.0k | $1,252 | $1,252 |
| Rotator Cuff Repair (Arthroscopic) | $8,032$7.6k$20k | $16,817 | $16,817 |
| Screening Mammogram | $160$87$232 | $784 | $784 |
| Septoplasty (Deviated Septum Repair) | $3,670$3.5k$9.2k | $9,459 | $9,459 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,812$7.4k$20k | $7,552 | $7,552 |
| Skin Biopsy (Tangential) | $450$425$1.1k | $699 | $699 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,828$1.7k$4.6k | $6,901 | $6,901 |
| Sleep Study (In-lab Polysomnography) | $951$897$2.4k | $8,626 | $8,626 |
| Spinal Cord Stimulator Trial | $7,055$6.7k$18k | $23,503 | $23,503 |
| Spirometry (Breathing Test) | $239$225$598 | $832 | $832 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,670$3.5k$9.2k | $10,326 | $10,326 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,553$6.2k$16k | $19,198 | $19,198 |
| Total Hip Replacement | $14,212$13k$36k | — | — |
| Total Knee Replacement | $14,212$13k$36k | — | — |
| Total Mastectomy | $7,350$6.9k$18k | — | — |
| TSH Thyroid Function Test | $18$17$45 | $520 | $520 |
| TURP (Transurethral Prostate Resection) | $5,935$5.6k$15k | — | — |
| Upper GI Endoscopy (EGD) | $1,004$947$2.5k | $3,055 | $3,055 |
| Urinalysis with Microscopy | $3$3$8 | $292 | $292 |
| Vaginal Hysterectomy | $5,537$5.2k$14k | — | — |
| Vasectomy | $2,314$2.2k$5.8k | $5,140 | $5,140 |
| Vitamin D Blood Test | $31$30$78 | $143 | $143 |