| Abdominal Hysterectomy | $2,654$1.7k$5.1k | — | — |
| ACL Reconstruction (Arthroscopic) | $7,223$1.3k$15k | — | — |
| Allergy Skin Testing | $894$855$1.7k | — | — |
| Basic Metabolic Panel | $12$8$21 | $449 | $449 |
| Bone Marrow Biopsy | $1,711$964$3.3k | — | — |
| Breast Biopsy (Ultrasound-guided) | $1,711$964$3.3k | $6,964 | $6,964 |
| Bunion Correction Surgery | $3,257$1.3k$6.6k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $26,814$3.3k$53k | — | — |
| Cardiac Catheterization (Left Heart) | $3,359$1.3k$6.5k | $25,653 | $25,653 |
| Carpal Tunnel Release Surgery | $2,043$964$3.9k | — | — |
| Cataract Surgery with Lens Implant | $2,452$2.3k$4.6k | — | — |
| Cervical Spinal Fusion (Anterior) | $13,040$2.5k$26k | — | — |
| Cesarean Delivery (Global Package) | $1,922$1.3k$5.1k | — | — |
| Chemotherapy Infusion (First Hour) | $344$329$665 | $1,493 | $1,493 |
| Chest X-ray (2 Views) | $90$52$175 | $954 | $954 |
| Colonoscopy with Biopsy | $1,650$964$2.4k | — | — |
| Complete Abdominal Ultrasound | $159$104$210 | $945 | $945 |
| Complete Blood Count (CBC) with Differential | $11$8$19 | $327 | $327 |
| Comprehensive Metabolic Panel | $14$10$26 | $610 | $610 |
| Coronary Angioplasty with Stent | $11,843$2.5k$23k | $35,501 | $35,501 |
| Critical Care, First Hour | $860$822$1.7k | $9,200 | $9,200 |
| CT Abdomen and Pelvis with Contrast | $363$347$702 | $7,152 | $7,152 |
| CT Cardiac Calcium Scoring | $91$87$175 | $125 | $125 |
| CT Chest without Contrast | $134$104$621 | $2,199 | $2,199 |
| CT Head without Contrast | $134$104$496 | $2,777 | $2,777 |
| DEXA Bone Density Scan | $108$64$210 | $439 | $439 |
| Diagnostic Colonoscopy | $1,417$926$2.2k | — | — |
| Diagnostic Mammogram (Both Breasts) | $102$97$485 | $612 | $612 |
| Ear Tube Placement (Tympanostomy) | $1,922$1.3k$3.1k | — | — |
| Echocardiogram (Complete with Doppler) | $569$544$1.1k | $5,763 | $5,763 |
| Emergency Room Visit (Level 3) | $284$272$550 | $1,455 | $1,455 |
| Hemoglobin A1c (Diabetes Test) | $13$10$24 | $197 | $197 |
| HIV Antibody Test | $12$9$22 | $231 | $231 |
| Home Sleep Study | $225$215$435 | $4,113 | $4,113 |
| Inguinal Hernia Repair (Open) | $3,564$1.4k$7.2k | — | — |
| Initial Psychiatric Diagnostic Evaluation | — | $1,123 | $1,123 |
| Initial Psychiatric Evaluation with Medication Management | — | $1,122 | $1,122 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | — | $3,503 | $3,503 |
| IUD Insertion | $1,244$791$1.7k | — | — |
| IUD Removal | $464$303$1.7k | $1,876 | $1,876 |
| Knee Arthroscopy with Meniscectomy | $3,257$1.4k$6.6k | — | — |
| Laparoscopic Appendectomy | $6,141$3.3k$12k | — | — |
| Laparoscopic Gallbladder Removal | $6,141$3.3k$12k | — | — |
| Laparoscopic Tubal Ligation | $6,141$1.7k$12k | — | — |
| Lipid Panel (Cholesterol Test) | $18$13$33 | $266 | $266 |
| Lumbar Epidural Steroid Injection | $791$703$5.1k | $3,488 | $3,488 |
| Lumbar Puncture (Spinal Tap) | $1,075$703$1.7k | $3,253 | $3,253 |
| Lumbar Spinal Fusion (Posterior) | $17,809$2.5k$35k | — | — |
| Lumpectomy (Partial Mastectomy) | $3,897$1.3k$7.9k | — | — |
| MRI Abdomen with and without Contrast | $448$347$2.6k | $5,734 | $5,734 |
| MRI Brain with and without Contrast | $448$347$2.6k | $6,436 | $6,436 |
| MRI Brain with Contrast | $448$347$1.4k | $5,718 | $5,718 |
| MRI Brain without Contrast | $307$238$1.2k | $5,007 | $5,007 |
| MRI Cervical Spine (Neck) without Contrast | $307$238$1.2k | $5,638 | $5,638 |
| MRI Knee without Contrast | $307$238$1.2k | $5,932 | $5,932 |
| MRI Lower Back (Lumbar Spine) without Contrast | $307$238$1.3k | $6,182 | $6,182 |
| MRI Thoracic Spine (Mid-back) without Contrast | $307$238$1.3k | $5,820 | $5,820 |
| Newborn Circumcision | $2,123$791$4.2k | — | — |
| Nuclear Cardiac Stress Test | $1,341$812$2.6k | $9,213 | $9,213 |
| Office Visit, Established Patient (Level 3) | — | $824 | $824 |
| Office Visit, New Patient (Level 3) | — | $944 | $944 |
| Pacemaker Insertion (Dual Chamber) | $10,616$1.7k$21k | — | — |
| PET/CT Scan, Whole Body | $1,481$277$2.9k | $10,843 | $10,843 |
| Pregnancy Ultrasound (Second or Third Trimester) | $159$104$221 | $1,143 | $1,143 |
| Prostate Biopsy | $2,234$964$2.2k | — | — |
| PSA Prostate Cancer Screening | $25$18$46 | $355 | $355 |
| Pulmonary Function Test with Bronchodilator | — | $704 | $704 |
| Rotator Cuff Repair (Arthroscopic) | $7,370$1.7k$15k | — | — |
| Screening Mammogram | $95$91$383 | $366 | $366 |
| Septoplasty (Deviated Septum Repair) | $3,300$1.4k$6.7k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,168$1.7k$14k | — | — |
| Skin Biopsy (Tangential) | $619$405$5.1k | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,711$791$3.3k | — | — |
| Sleep Study (In-lab Polysomnography) | $894$855$1.7k | $9,173 | $9,173 |
| Spinal Cord Stimulator Trial | $6,344$964$13k | — | — |
| Spirometry (Breathing Test) | $225$215$435 | $487 | $487 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,368$1.7k$6.7k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,893$1.3k$12k | — | — |
| Total Hip Replacement | $13,040$2.4k$26k | — | — |
| Total Knee Replacement | $13,040$2.5k$26k | — | — |
| Total Mastectomy | $6,610$1.4k$13k | — | — |
| TSH Thyroid Function Test | $23$16$42 | $319 | $319 |
| TURP (Transurethral Prostate Resection) | $5,337$1.4k$11k | — | — |
| Umbilical Hernia Repair | $3,093$1.4k$3.1k | — | — |
| Upper GI Endoscopy (EGD) | $1,244$791$2.2k | — | — |
| Urinalysis with Microscopy | $4$3$8 | $189 | $189 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $1,922$1.3k$5.1k | — | — |
| Vaginal Delivery (Global Package) | $1,922$1.3k$5.1k | — | — |
| Vaginal Hysterectomy | $5,081$1.7k$10k | — | — |
| Vasectomy | $2,187$964$4.2k | — | — |
| Vitamin D Blood Test | $40$29$74 | $100 | $100 |