| Abdominal Hysterectomy | $2,143$792$50k | $2,318 | $3,090 |
| ACL Reconstruction (Arthroscopic) | $10,128$2.5k$50k | — | — |
| Anesthesia for Screening Colonoscopy | $62$15$116 | $96 | $129 |
| Anesthesia for Upper Endoscopy | $62$15$116 | $96 | $129 |
| Basic Metabolic Panel | $223$7$446 | $335 | $446 |
| Bone Marrow Biopsy | $3,137$208$50k | $3,906 | $5,208 |
| Breast Biopsy (Ultrasound-guided) | $3,658$587$50k | $4,988 | $6,651 |
| Bunion Correction Surgery | $6,053$2.2k$50k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $24,484$775$52k | $39,071 | $52,094 |
| Cardiac Catheterization (Left Heart) | $7,967$684$38k | $17,012 | $22,683 |
| Carpal Tunnel Release Surgery | $3,137$1.1k$50k | — | — |
| Cataract Surgery with Lens Implant | $4,274$696$50k | — | — |
| Cervical Spinal Fusion (Anterior) | $5,305$1.5k$50k | $3,906 | $5,208 |
| Cesarean Delivery (Global Package) | $3,137$2.2k$50k | $6,075 | $8,100 |
| Chemotherapy Infusion (First Hour) | $773$101$1.2k | $920 | $1,227 |
| Chest X-ray (2 Views) | $400$17$843 | $632 | $843 |
| Colonoscopy with Biopsy | $713$182$50k | $450 | $600 |
| Complete Abdominal Ultrasound | $316$75$1.7k | $1,305 | $1,740 |
| Complete Blood Count (CBC) with Differential | $123$6$308 | $231 | $308 |
| Comprehensive Metabolic Panel | $347$8$694 | $521 | $694 |
| Coronary Angioplasty with Stent | $17,858$481$50k | $27,164 | $36,218 |
| Critical Care, First Hour | $826$163$6.0k | $2,498 | $3,331 |
| CT Abdomen and Pelvis with Contrast | $1,269$213$7.1k | $5,336 | $7,115 |
| CT Cardiac Calcium Scoring | $1,053$72$1.5k | $1,131 | $1,508 |
| CT Chest without Contrast | $1,135$82$4.2k | $3,113 | $4,150 |
| CT Head without Contrast | $1,135$66$4.0k | $2,993 | $3,990 |
| DEXA Bone Density Scan | $592$29$1.2k | $888 | $1,184 |
| Diagnostic Colonoscopy | $578$168$50k | $414 | $552 |
| Diagnostic Mammogram (Both Breasts) | $401$85$1.3k | $945 | $1,260 |
| Ear Tube Placement (Tympanostomy) | $4,152$209$50k | — | — |
| Echocardiogram (Complete with Doppler) | $2,710$122$4.4k | $3,332 | $4,442 |
| Emergency Room Visit (Level 3) | $277$55$2.7k | $721 | $961 |
| Group Therapy Session | $153$18$411 | $206 | $274 |
| Hemoglobin A1c (Diabetes Test) | $59$4$344 | $136 | $181 |
| HIV Antibody Test | $179$7$358 | $269 | $358 |
| Home Sleep Study | $143$42$3.7k | $209 | $279 |
| Individual Therapy Session (45 Minutes) | $297$68$457 | $343 | $457 |
| Inguinal Hernia Repair (Open) | $1,577$364$50k | $1,200 | $1,600 |
| Initial Hospital Admission (Level 1) | $103$60$310 | $188 | $251 |
| Initial Psychiatric Diagnostic Evaluation | $402$105$649 | $487 | $649 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $3,465$552$6.9k | $5,198 | $6,930 |
| IUD Insertion | $219$41$50k | $159 | $212 |
| IUD Removal | $221$59$50k | $254 | $338 |
| Knee Arthroscopy with Meniscectomy | $4,895$1.4k$50k | — | — |
| Laparoscopic Appendectomy | $1,820$450$50k | $1,379 | $1,839 |
| Laparoscopic Gallbladder Removal | $1,995$597$50k | $1,509 | $2,012 |
| Laparoscopic Tubal Ligation | $1,575$574$50k | $1,493 | $1,991 |
| Lipid Panel (Cholesterol Test) | $207$7$376 | $282 | $376 |
| Lumbar Epidural Steroid Injection | $2,813$329$50k | $2,482 | $3,309 |
| Lumbar Puncture (Spinal Tap) | $727$61$50k | $882 | $1,176 |
| Lumbar Spinal Fusion (Posterior) | $5,304$1.3k$50k | $3,629 | $4,839 |
| Lumpectomy (Partial Mastectomy) | $1,901$305$50k | $1,511 | $2,015 |
| MRI Abdomen with and without Contrast | $1,589$231$7.6k | $5,735 | $7,647 |
| MRI Brain with and without Contrast | $1,589$209$7.6k | $5,735 | $7,647 |
| MRI Brain with Contrast | $1,678$185$7.0k | $3,943 | $5,257 |
| MRI Brain without Contrast | $1,581$126$6.2k | $4,665 | $6,220 |
| MRI Cervical Spine (Neck) without Contrast | $1,581$120$6.2k | $4,665 | $6,220 |
| MRI Knee without Contrast | $1,678$138$12k | $6,999 | $9,332 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,581$120$6.2k | $4,665 | $6,220 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,581$120$6.2k | $4,665 | $6,220 |
| Newborn Circumcision | $300$86$50k | $331 | $441 |
| Nuclear Cardiac Stress Test | $5,591$336$11k | $8,386 | $11,181 |
| Office Visit, Established Patient (Level 3) | $82$58$218 | $205 | $273 |
| Office Visit, New Patient (Level 3) | $107$73$271 | $254 | $339 |
| Pacemaker Insertion (Dual Chamber) | $10,916$660$50k | $24,332 | $32,442 |
| PET/CT Scan, Whole Body | $4,618$960$11k | $7,997 | $10,662 |
| Pregnancy Ultrasound (Second or Third Trimester) | $311$84$1.7k | $1,285 | $1,713 |
| Prostate Biopsy | $3,137$311$50k | $3,941 | $5,254 |
| PSA Prostate Cancer Screening | $96$14$479 | $224 | $299 |
| Pulmonary Function Test with Bronchodilator | $677$28$1.1k | $806 | $1,075 |
| Rotator Cuff Repair (Arthroscopic) | $8,339$2.7k$50k | — | — |
| Screening Mammogram | $243$44$998 | $682 | $910 |
| Septoplasty (Deviated Septum Repair) | $4,274$872$50k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,342$417$50k | — | — |
| Skin Biopsy (Tangential) | $3,035$122$50k | $566 | $754 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $3,137$164$50k | — | — |
| Sleep Study (In-lab Polysomnography) | $881$112$7.3k | $2,874 | $3,833 |
| Spinal Cord Stimulator Trial | $9,044$2.0k$50k | — | — |
| Spirometry (Breathing Test) | $336$19$534 | $401 | $534 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,274$400$50k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,211$383$50k | — | — |
| Total Hip Replacement | $12,464$2.2k$50k | — | — |
| Total Knee Replacement | $12,464$2.2k$50k | — | — |
| Total Mastectomy | $2,401$580$50k | $3,285 | $4,380 |
| TSH Thyroid Function Test | $93$13$494 | $226 | $302 |
| TURP (Transurethral Prostate Resection) | $6,858$943$50k | — | — |
| Umbilical Hernia Repair | $7,706$3.0k$50k | — | — |
| Upper GI Endoscopy (EGD) | $4,046$368$50k | — | — |
| Urinalysis with Microscopy | $100$2$200 | $150 | $200 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $3,137$2.1k$50k | $5,751 | $7,668 |
| Vaginal Delivery (Global Package) | $4,229$2.1k$38k | $5,489 | $7,319 |
| Vaginal Hysterectomy | $5,668$1.1k$50k | — | — |
| Vasectomy | $4,274$432$50k | — | — |
| Vitamin D Blood Test | $265$23$529 | $397 | $529 |