| Abdominal Hysterectomy | $6,860$3.1k$9.5k | — | — |
| ACL Reconstruction (Arthroscopic) | $7,518$5.4k$16k | $11,309 | $11,309 |
| Allergy Skin Testing | $898$872$1.8k | — | — |
| Basic Metabolic Panel | $9$6$18 | $206 | $206 |
| Bone Marrow Biopsy | $2,987$1.7k$5.1k | $5,759 | $5,759 |
| Breast Biopsy (Ultrasound-guided) | $3,295$1.7k$5.5k | $2,731 | $2,731 |
| Bunion Correction Surgery | $5,405$3.3k$7.9k | $6,653 | $6,653 |
| Cardiac Ablation for Atrial Fibrillation | $14,089$6.6k$56k | $16,666 | $16,666 |
| Cardiac Catheterization (Left Heart) | $5,498$3.1k$9.5k | $10,710 | $10,710 |
| Carpal Tunnel Release Surgery | $3,826$2.0k$5.3k | $5,174 | $5,174 |
| Cataract Surgery with Lens Implant | $4,455$2.3k$11k | $10,558 | $10,558 |
| Cervical Spinal Fusion (Anterior) | $11,403$6.3k$28k | — | — |
| Cesarean Delivery (Global Package) | $5,498$3.1k$7.2k | $13,051 | $13,051 |
| Chemotherapy Infusion (First Hour) | $346$336$711 | $1,634 | $1,634 |
| Chest X-ray (2 Views) | $51$34$200 | $260 | $260 |
| Colonoscopy with Biopsy | $3,051$1.2k$5.3k | $3,732 | $3,732 |
| Complete Abdominal Ultrasound | $139$106$280 | $2,352 | $2,352 |
| Complete Blood Count (CBC) with Differential | $8$6$16 | $114 | $114 |
| Comprehensive Metabolic Panel | $11$8$22 | $287 | $287 |
| Coronary Angioplasty with Stent | $11,403$6.3k$25k | $8,687 | $8,687 |
| Critical Care, First Hour | $864$839$1.8k | $3,026 | $3,026 |
| CT Abdomen and Pelvis with Contrast | $383$354$955 | $3,563 | $3,563 |
| CT Cardiac Calcium Scoring | $141$88$711 | $90 | $90 |
| CT Chest without Contrast | $160$106$711 | $1,160 | $1,160 |
| CT Head without Contrast | $129$106$711 | $1,160 | $1,160 |
| DEXA Bone Density Scan | $64$44$280 | $804 | $804 |
| Diagnostic Colonoscopy | $3,051$945$5.3k | $3,650 | $3,650 |
| Diagnostic Mammogram (Both Breasts) | $161$99$301 | $551 | $551 |
| Ear Tube Placement (Tympanostomy) | $3,341$1.6k$6.3k | $4,327 | $4,327 |
| Echocardiogram (Complete with Doppler) | $572$555$1.2k | $4,390 | $4,390 |
| Emergency Room Visit (Level 3) | $286$277$588 | $1,513 | $1,513 |
| Group Therapy Session | — | $351 | $351 |
| Hemoglobin A1c (Diabetes Test) | $10$7$21 | $146 | $146 |
| HIV Antibody Test | $9$7$19 | $214 | $214 |
| Home Sleep Study | $226$219$465 | $2,220 | $2,220 |
| Individual Therapy Session (45 Minutes) | — | $628 | $628 |
| Inguinal Hernia Repair (Open) | $5,153$3.5k$7.9k | $8,405 | $8,405 |
| Initial Psychiatric Diagnostic Evaluation | — | $628 | $628 |
| Initial Psychiatric Evaluation with Medication Management | — | $628 | $628 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $736$577$1.1k | $3,389 | $3,389 |
| IUD Insertion | $2,987$1.3k$4.8k | $4,544 | $4,544 |
| IUD Removal | $2,572$310$4.8k | $3,041 | $3,041 |
| Knee Arthroscopy with Meniscectomy | $5,153$3.3k$7.9k | $11,309 | $11,309 |
| Laparoscopic Appendectomy | $6,509$5.0k$13k | $10,651 | $10,651 |
| Laparoscopic Gallbladder Removal | $6,654$5.0k$13k | $16,385 | $16,385 |
| Laparoscopic Tubal Ligation | $6,654$5.0k$13k | $9,383 | $9,383 |
| Lipid Panel (Cholesterol Test) | $14$10$28 | $122 | $122 |
| Lumbar Epidural Steroid Injection | $2,572$717$4.8k | $4,107 | $4,107 |
| Lumbar Puncture (Spinal Tap) | $2,572$717$4.8k | $3,352 | $3,352 |
| Lumbar Spinal Fusion (Posterior) | $9,172$6.3k$38k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,557$3.5k$8.4k | $7,906 | $7,906 |
| MRI Abdomen with and without Contrast | $458$354$965 | $3,431 | $3,431 |
| MRI Brain with and without Contrast | $412$354$965 | $3,431 | $3,431 |
| MRI Brain with Contrast | $376$354$965 | $2,961 | $2,961 |
| MRI Brain without Contrast | $257$242$965 | $2,067 | $2,067 |
| MRI Cervical Spine (Neck) without Contrast | $257$237$965 | $2,067 | $2,067 |
| MRI Knee without Contrast | $271$242$965 | $2,067 | $2,067 |
| MRI Lower Back (Lumbar Spine) without Contrast | $257$238$965 | $2,067 | $2,067 |
| MRI Thoracic Spine (Mid-back) without Contrast | $257$236$965 | $2,067 | $2,067 |
| Newborn Circumcision | $3,590$2.1k$5.1k | $2,404 | $2,404 |
| Nuclear Cardiac Stress Test | $777$527$3.2k | $5,897 | $5,897 |
| Office Visit, Established Patient (Level 3) | — | $399 | $399 |
| Office Visit, New Patient (Level 3) | — | $796 | $796 |
| Pacemaker Insertion (Dual Chamber) | $10,829$6.3k$23k | $8,442 | $8,442 |
| PET/CT Scan, Whole Body | $2,599$1.5k$4.0k | $9,918 | $9,918 |
| Pregnancy Ultrasound (Second or Third Trimester) | $157$106$280 | $983 | $983 |
| Prostate Biopsy | $4,038$2.9k$5.3k | $7,220 | $7,220 |
| PSA Prostate Cancer Screening | $19$14$39 | $244 | $244 |
| Pulmonary Function Test with Bronchodilator | $390$379$804 | $1,438 | $1,438 |
| Rotator Cuff Repair (Arthroscopic) | $7,739$5.7k$16k | $15,061 | $15,061 |
| Screening Mammogram | $147$93$250 | $230 | $230 |
| Septoplasty (Deviated Septum Repair) | $4,455$3.0k$7.2k | $8,354 | $8,354 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,383$5.1k$15k | $9,445 | $9,445 |
| Skin Biopsy (Tangential) | $1,462$413$4.8k | $780 | $780 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $3,051$1.7k$5.1k | $4,862 | $4,862 |
| Sleep Study (In-lab Polysomnography) | $898$872$1.8k | $9,509 | $9,509 |
| Spinal Cord Stimulator Trial | $6,797$3.3k$14k | $11,423 | $11,423 |
| Spirometry (Breathing Test) | $226$219$465 | $848 | $848 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,455$3.0k$8.4k | $11,148 | $11,148 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,133$3.6k$13k | $7,906 | $7,906 |
| Total Hip Replacement | $9,969$3.1k$28k | $12,866 | $12,866 |
| Total Knee Replacement | $10,091$3.1k$28k | $12,866 | $12,866 |
| Total Mastectomy | $6,879$4.8k$14k | $9,791 | $9,791 |
| TSH Thyroid Function Test | $17$13$36 | $202 | $202 |
| TURP (Transurethral Prostate Resection) | $5,773$4.4k$12k | $9,791 | $9,791 |
| Umbilical Hernia Repair | $6,393$4.7k$7.2k | $8,241 | $8,241 |
| Upper GI Endoscopy (EGD) | $2,912$921$4.8k | $1,879 | $1,879 |
| Urinalysis with Microscopy | $3$2$7 | $74 | $74 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $5,498$3.1k$7.2k | $12,187 | $12,187 |
| Vaginal Delivery (Global Package) | $5,843$3.5k$7.2k | — | — |
| Vaginal Hysterectomy | $5,386$3.1k$11k | $13,654 | $13,654 |
| Vasectomy | $3,826$2.1k$5.3k | $10,780 | $10,780 |
| Vitamin D Blood Test | $30$22$63 | $262 | $262 |