| Abdominal Hysterectomy | $4,575$800$12k | — | — |
| ACL Reconstruction (Arthroscopic) | $6,359$975$29k | — | — |
| Allergy Skin Testing | $50$5$98 | — | — |
| Basic Metabolic Panel | $83$8$982 | $1,068 | $1,068 |
| Bone Marrow Biopsy | $1,950$1.4k$12k | — | — |
| Breast Biopsy (Ultrasound-guided) | $1,950$452$12k | — | — |
| Bunion Correction Surgery | $4,575$1.1k$12k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $23,125$1.3k$45k | — | — |
| Cardiac Catheterization (Left Heart) | $11,825$780$29k | — | — |
| Cardiac Stress Test (Treadmill) | $413$99$740 | — | — |
| Carpal Tunnel Release Surgery | $4,058$1.3k$12k | — | — |
| Cataract Surgery with Lens Implant | $4,096$1.3k$12k | — | — |
| Cervical Spinal Fusion (Anterior) | $6,596$975$35k | — | — |
| Cesarean Delivery (Global Package) | $1,950$1.6k$12k | — | — |
| Chemotherapy Infusion (First Hour) | $606$143$1.1k | — | — |
| Chest X-ray (2 Views) | $446$182$456 | — | — |
| Colonoscopy with Biopsy | $2,418$1.5k$12k | — | — |
| Complete Abdominal Ultrasound | $1,074$180$3.5k | $3,836 | $3,836 |
| Complete Blood Count (CBC) with Differential | $38$8$450 | $489 | $489 |
| Comprehensive Metabolic Panel | $12$1$1.0k | $555 | $555 |
| Coronary Angioplasty with Stent | $23,125$675$45k | — | — |
| Critical Care, First Hour | $1,871$240$9.2k | $3,742 | $3,742 |
| CT Abdomen and Pelvis with Contrast | $1,968$382$7.5k | $8,132 | $8,132 |
| CT Cardiac Calcium Scoring | $1,780$110$13k | — | — |
| CT Chest without Contrast | $1,404$176$3.4k | $3,740 | $3,740 |
| CT Head without Contrast | $1,404$158$3.1k | $3,352 | $3,352 |
| DEXA Bone Density Scan | $211$35$695 | $755 | $755 |
| Diagnostic Colonoscopy | $2,012$1.2k$12k | — | — |
| Diagnostic Mammogram (Both Breasts) | $263 | — | — |
| Ear Tube Placement (Tympanostomy) | $2,594$1.4k$12k | — | — |
| Echocardiogram (Complete with Doppler) | $547$107$2.1k | $2,280 | $2,280 |
| EKG (Electrocardiogram, 12-lead) | $199$25$381 | — | — |
| Emergency Room Visit (Level 3) | $1,109$70$5.5k | $1,479 | $1,479 |
| Group Therapy Session | $130$30$233 | — | — |
| Hemodialysis Treatment | $2,232$215$4.3k | — | — |
| Hemoglobin A1c (Diabetes Test) | $12$1$150 | $89 | $89 |
| HIV Antibody Test | $20$1$230 | $132 | $132 |
| Holter Monitor (24-48 Hour Heart Monitor) | $342$151$540 | — | — |
| Home Sleep Study | $1,250$130$1.9k | — | — |
| Individual Therapy Session (45 Minutes) | $160$89$233 | — | — |
| Inguinal Hernia Repair (Open) | $4,575$975$13k | — | — |
| Initial Hospital Admission (Level 1) | $110$110$113 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $192$134$253 | — | — |
| Initial Psychiatric Evaluation with Medication Management | $168$150$187 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,794$1.8k$1.8k | — | — |
| IUD Insertion | $3,950$1.3k$12k | — | — |
| IUD Removal | $3,897$1.3k$12k | — | — |
| Knee Arthroscopy with Meniscectomy | $4,575$1.1k$29k | — | — |
| Laparoscopic Appendectomy | $9,081$975$29k | — | — |
| Laparoscopic Gallbladder Removal | $4,575$239$25k | — | — |
| Laparoscopic Tubal Ligation | $9,081$975$15k | — | — |
| Lipid Panel (Cholesterol Test) | $41$13$480 | $522 | $522 |
| Lumbar Epidural Steroid Injection | $2,059$1.6k$12k | — | — |
| Lumbar Puncture (Spinal Tap) | $1,950$900$8.0k | — | — |
| Lumbar Spinal Fusion (Posterior) | $6,783$975$57k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,575$975$29k | — | — |
| MRI Abdomen with and without Contrast | $2,062$359$7.0k | $7,639 | $7,639 |
| MRI Brain with and without Contrast | $2,466$407$8.0k | $8,651 | $8,651 |
| MRI Brain with Contrast | $1,826$247$4.8k | $5,263 | $5,263 |
| MRI Brain without Contrast | $1,826$247$4.8k | $5,263 | $5,263 |
| MRI Cervical Spine (Neck) without Contrast | $1,826$261$5.1k | $5,558 | $5,558 |
| MRI Knee without Contrast | $1,887$312$6.8k | $7,399 | $7,399 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,826$247$4.8k | $5,249 | $5,249 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,826$262$5.1k | $5,571 | $5,571 |
| Newborn Circumcision | $2,100$1.3k$12k | — | — |
| Nuclear Cardiac Stress Test | $2,492$418$8.2k | $8,899 | $8,899 |
| Office Visit, Established Patient (Level 3) | $85$17$324 | $352 | $352 |
| Office Visit, New Patient (Level 3) | $96$19$367 | $399 | $399 |
| Pacemaker Insertion (Dual Chamber) | $11,047$975$60k | — | — |
| PET/CT Scan, Whole Body | $4,381$2.1k$6.7k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $454$76$1.5k | $1,621 | $1,621 |
| Prostate Biopsy | $4,367$1.3k$4.9k | — | — |
| PSA Prostate Cancer Screening | $22$1$268 | $169 | $169 |
| Pulmonary Function Test with Bronchodilator | $252$47$1.0k | $1,116 | $1,116 |
| Rotator Cuff Repair (Arthroscopic) | $9,081$975$29k | — | — |
| Screening Mammogram | $217 | — | — |
| Septoplasty (Deviated Septum Repair) | $4,575$547$12k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $4,575$453$29k | — | — |
| Skin Biopsy (Tangential) | $2,100$1.3k$12k | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,950$1.3k$12k | — | — |
| Sleep Study (In-lab Polysomnography) | $954$168$5.5k | $4,292 | $4,292 |
| Spinal Cord Stimulator Trial | $4,763$975$49k | — | — |
| Spirometry (Breathing Test) | $35$2$492 | $287 | $287 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $2,100$1.1k$12k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $2,100$975$12k | — | — |
| Total Hip Replacement | $10,100$975$44k | — | — |
| Total Knee Replacement | $11,000$975$44k | — | — |
| Total Mastectomy | $4,575$975$29k | — | — |
| TSH Thyroid Function Test | $27$16$319 | $347 | $347 |
| TURP (Transurethral Prostate Resection) | $8,976$975$29k | — | — |
| Umbilical Hernia Repair | $6,648$975$9.5k | — | — |
| Upper GI Endoscopy (EGD) | $1,950$1.6k$12k | — | — |
| Urinalysis with Microscopy | $5$2$231 | $131 | $131 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $1,950$1.6k$12k | — | — |
| Vaginal Delivery (Global Package) | $1,950$1.6k$12k | — | — |
| Vaginal Hysterectomy | $4,575$975$12k | — | — |
| Vasectomy | $2,100$1.3k$12k | — | — |
| Vitamin D Blood Test | $30$2$202 | $95 | $95 |