| Abdominal Hysterectomy | $896 | — | — |
| ACL Reconstruction (Arthroscopic) | $7,171$882$7.9k | $7,171 | — |
| Allergy Skin Testing | $1,021$5$1.1k | $1,021 | — |
| Basic Metabolic Panel | $9$7$269 | $8 | $336 |
| Bone Marrow Biopsy | $1,626$65$1.8k | $1,626 | — |
| Breast Biopsy (Ultrasound-guided) | $1,626$67$3.9k | $1,626 | $4,206 |
| Bunion Correction Surgery | $3,257$445$3.6k | $3,257 | — |
| Cardiac Ablation for Atrial Fibrillation | $24,625$991$32k | $24,625 | — |
| Cardiac Catheterization (Left Heart) | $3,229$260$13k | $3,229 | — |
| Cardiac Stress Test (Treadmill) | $61 | — | — |
| Carpal Tunnel Release Surgery | $1,960$377$4.4k | $1,960 | — |
| Cataract Surgery with Lens Implant | $2,289$423$2.5k | $2,289 | — |
| Cervical Spinal Fusion (Anterior) | $12,915$1.6k$14k | $12,915 | — |
| Cesarean Delivery (Global Package) | $2,500 | — | — |
| Chemotherapy Infusion (First Hour) | $333$122$1.2k | $333 | — |
| Chest X-ray (2 Views) | $93$7$486 | $88 | $247 |
| Colonoscopy with Biopsy | $1,185$67$3.5k | $1,184 | $2,370 |
| Complete Abdominal Ultrasound | $107$27$1.5k | $107 | $1,045 |
| Complete Blood Count (CBC) with Differential | $8$6$215 | $8 | $151 |
| Comprehensive Metabolic Panel | $11$9$362 | $11 | $453 |
| Coronary Angioplasty with Stent | $11,383$524$21k | $11,383 | — |
| Critical Care, First Hour | $846$67$2.0k | $846 | $1,936 |
| CT Abdomen and Pelvis with Contrast | $376$51$5.0k | $358 | $3,255 |
| CT Cardiac Calcium Scoring | $88$51$171 | $88 | — |
| CT Chest without Contrast | $112$51$2.3k | $107 | $1,747 |
| CT Head without Contrast | $112$51$2.3k | $107 | $1,375 |
| DEXA Bone Density Scan | $107$7$431 | $107 | $406 |
| Diagnostic Colonoscopy | $961$67$2.5k | $915 | $2,493 |
| Diagnostic Mammogram (Both Breasts) | $208$51$308 | $208 | $168 |
| Ear Tube Placement (Tympanostomy) | $1,487$143$1.6k | $1,487 | — |
| Echocardiogram (Complete with Doppler) | $578$51$2.0k | $550 | $2,182 |
| EKG (Electrocardiogram, 12-lead) | $406$14$406 | — | — |
| Emergency Room Visit (Level 3) | $292$67$659 | $508 | $508 |
| Group Therapy Session | $93$49$102 | $93 | — |
| Hemodialysis Treatment | $2,369$83$4.6k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$8$215 | $10 | $219 |
| HIV Antibody Test | $9$7$215 | $9 | $49 |
| Holter Monitor (24-48 Hour Heart Monitor) | $72 | — | — |
| Home Sleep Study | $157$49$1.4k | $157 | — |
| Individual Therapy Session (45 Minutes) | $161$69$177 | $161 | — |
| Inguinal Hernia Repair (Open) | $3,542$505$14k | $3,542 | — |
| Initial Hospital Admission (Level 1) | $87 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $161$93$270 | $161 | — |
| Initial Psychiatric Evaluation with Medication Management | $161$93$200 | $161 | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $581$252$2.0k | $581 | — |
| IUD Insertion | $47 | — | — |
| IUD Removal | $305$59$336 | $305 | — |
| Knee Arthroscopy with Meniscectomy | $3,257$481$3.6k | $3,257 | — |
| Laparoscopic Appendectomy | $5,856$67$6.4k | $3,228 | $3,006 |
| Laparoscopic Gallbladder Removal | $5,856$67$10k | $5,856 | $12,900 |
| Laparoscopic Tubal Ligation | $5,856$570$6.4k | $5,856 | — |
| Lipid Panel (Cholesterol Test) | $14$11$237 | $13 | $55 |
| Lumbar Epidural Steroid Injection | $695$88$2.2k | $695 | — |
| Lumbar Puncture (Spinal Tap) | $695$67$2.5k | $695 | $1,186 |
| Lumbar Spinal Fusion (Posterior) | $18,460$1.5k$20k | $18,460 | — |
| Lumpectomy (Partial Mastectomy) | $3,844$594$4.2k | $3,844 | — |
| MRI Abdomen with and without Contrast | $376$63$4.5k | $358 | $3,472 |
| MRI Brain with and without Contrast | $376$63$4.0k | $358 | $3,858 |
| MRI Brain with Contrast | $376$63$3.5k | $358 | $1,105 |
| MRI Brain without Contrast | $255$63$2.7k | $243 | $1,600 |
| MRI Cervical Spine (Neck) without Contrast | $255$63$2.6k | $243 | $3,038 |
| MRI Knee without Contrast | $255$63$2.6k | $243 | $1,948 |
| MRI Lower Back (Lumbar Spine) without Contrast | $255$63$2.8k | $243 | $3,038 |
| MRI Thoracic Spine (Mid-back) without Contrast | $255$63$2.7k | $243 | $3,038 |
| Newborn Circumcision | $2,056$87$2.3k | $2,056 | — |
| Nuclear Cardiac Stress Test | $1,310$52$3.9k | $1,310 | $3,517 |
| Office Visit, Established Patient (Level 3) | $140$43$273 | — | $341 |
| Office Visit, New Patient (Level 3) | $279$66$279 | — | — |
| Pacemaker Insertion (Dual Chamber) | $10,505$483$12k | $10,505 | — |
| PET/CT Scan, Whole Body | $1,464$119$1.6k | $1,464 | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $112$33$999 | $107 | $381 |
| Prostate Biopsy | $2,056$116$2.3k | $2,056 | — |
| PSA Prostate Cancer Screening | $19$8$215 | $17 | $45 |
| Pulmonary Function Test with Bronchodilator | $313$10$522 | $313 | $400 |
| Rotator Cuff Repair (Arthroscopic) | $7,171$934$12k | $7,171 | — |
| Screening Mammogram | $169$39$308 | $169 | $126 |
| Septoplasty (Deviated Septum Repair) | $3,255$541$3.6k | $3,255 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,949$357$7.6k | $6,949 | — |
| Skin Biopsy (Tangential) | $199$35$219 | $199 | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,626$71$1.8k | $1,626 | — |
| Sleep Study (In-lab Polysomnography) | $1,021$97$1.1k | $1,021 | — |
| Spinal Cord Stimulator Trial | $6,588$357$7.2k | $6,588 | — |
| Spirometry (Breathing Test) | $157$7$334 | $157 | $418 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,255$282$3.6k | $3,255 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,938$270$6.5k | $5,938 | — |
| Total Hip Replacement | $12,915$1.2k$14k | $12,915 | — |
| Total Knee Replacement | $12,915$1.2k$14k | $12,915 | — |
| Total Mastectomy | $6,546$922$7.2k | $6,546 | — |
| TSH Thyroid Function Test | $18$14$215 | $17 | $139 |
| TURP (Transurethral Prostate Resection) | $5,103$784$5.6k | $5,103 | — |
| Umbilical Hernia Repair | $7,238 | — | — |
| Upper GI Endoscopy (EGD) | $988$67$2.5k | $941 | $2,235 |
| Urinalysis with Microscopy | $3$3$215 | $3 | $129 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,500 | — | — |
| Vaginal Delivery (Global Package) | $2,500 | — | — |
| Vaginal Hysterectomy | $4,955$715$5.5k | $4,955 | — |
| Vasectomy | $2,056$199$2.3k | $2,056 | — |
| Vitamin D Blood Test | $30$12$215 | $27 | $24 |