| ACL Reconstruction (Arthroscopic) | $8,087$7.8k$8.2k3 plansshared rate · 2 | — | — |
| Allergy Skin Testing | $957$920$9663 plansshared rate · 2 | — | — |
| Basic Metabolic Panel | $9$8$93 plans | $107 | $195 |
| Bone Marrow Biopsy | $1,841$1.8k$1.9k3 plansshared rate · 3 | $1,400 | $2,546 |
| Breast Biopsy (Ultrasound-guided) | $1,841$1.8k$1.9k3 plansshared rate · 3 | $2,335 | $4,246 |
| Bunion Correction Surgery | $3,647$3.5k$3.7k3 plansshared rate · 2 | — | — |
| Cardiac Arrhythmia (with Complications) Inpatient | $6,297$6.2k$14k5 plans | — | — |
| Cardiac Arrhythmia (with Major Complications) Inpatient | $9,995$9.8k$22k5 plans | — | — |
| Cardiac Arrhythmia (without Complications) Inpatient | $4,958$4.9k$10k5 plans | — | — |
| Cardiac Catheterization (Left Heart) | — | $17,070 | $31,036 |
| Carpal Tunnel Release Surgery | $2,176$2.1k$2.2k3 plans | — | — |
| Cellulitis (with Major Complications) Inpatient | $11,711$11k$27k5 plans | — | — |
| Cellulitis (without Major Complications) Inpatient | $7,365$7.2k$16k5 plans | — | — |
| Cervical Spinal Fusion (Anterior) | $14,309$14k$14k3 plansshared rate · 3 | — | — |
| Chemotherapy Infusion (First Hour) | $368$354$3723 plans | $446 | $810 |
| Chest Pain Inpatient | $6,174$6.1k$13k5 plans | — | — |
| Chest X-ray (2 Views) | $97$93$983 plansshared rate · 2 | $391 | $711 |
| Colonoscopy with Biopsy | $1,334$1.3k$1.3k3 plans | — | — |
| Complete Abdominal Ultrasound | $117$112$1183 plansshared rate · 5 | $1,272 | $2,312 |
| Complete Blood Count (CBC) with Differential | $8$8$83 plans | $81 | $148 |
| Comprehensive Metabolic Panel | $11$11$113 plans | $149 | $270 |
| COPD (with Complications) Inpatient | $7,145$7.0k$16k5 plans | — | — |
| COPD (with Major Complications) Inpatient | $9,235$9.1k$21k5 plans | — | — |
| COPD (without Complications) Inpatient | $5,558$5.4k$12k5 plans | — | — |
| Coronary Angioplasty with Stent | — | $15,937 | $28,976 |
| Coronary Stent (Drug-eluting, without Major Complications) Inpatient | $35,4161 plan | — | — |
| Critical Care, First Hour | $921$885$9293 plans | $2,988 | $5,433 |
| CT Abdomen and Pelvis with Contrast | $389$374$3933 plansshared rate · 4 | $4,334 | $7,880 |
| CT Cardiac Calcium Scoring | $97$93$983 plansshared rate · 2 | $96 | $174 |
| CT Chest without Contrast | $117$112$1183 plansshared rate · 5 | $1,997 | $3,630 |
| CT Head without Contrast | $117$112$1183 plansshared rate · 5 | $1,888 | $3,432 |
| DEXA Bone Density Scan | $117$112$1183 plansshared rate · 5 | $538 | $979 |
| Diabetes (with Complications) Inpatient | $7,565$7.4k$17k5 plans | — | — |
| Diabetes (with Major Complications) Inpatient | $11,832$12k$27k5 plans | — | — |
| Diabetes (without Complications) Inpatient | $5,393$5.3k$12k5 plans | — | — |
| Diagnostic Colonoscopy | $1,036$997$1.0k3 plans | — | — |
| Diagnostic Mammogram (Both Breasts) | $116$112$1183 plans | $580 | $1,055 |
| Digestive Disorders, E.g. Gastroenteritis (with Major Complications) Inpatient | $10,503$10k$24k5 plans | — | — |
| Digestive Disorders, E.g. Gastroenteritis (without Major Complications) Inpatient | $6,644$6.5k$14k5 plans | — | — |
| Echocardiogram (Complete with Doppler) | $609$586$6153 plans | $2,502 | $4,549 |
| Emergency Room Visit (Level 3) | $304$293$3073 plans | $939 | $1,708 |
| GI Hemorrhage (with Complications) Inpatient | $8,232$8.1k$18k5 plans | — | — |
| GI Hemorrhage (with Major Complications) Inpatient | $14,922$15k$34k5 plans | — | — |
| GI Hemorrhage (without Complications) Inpatient | $5,466$5.4k$12k5 plans | — | — |
| Group Therapy Session | $113$109$1143 plans | $211 | $383 |
| Heart Attack, Discharged Alive (with Complications) Inpatient | $7,746$7.6k$17k5 plans | — | — |
| Heart Attack, Discharged Alive (with Major Complications) Inpatient | $13,154$13k$30k5 plans | — | — |
| Heart Attack, Discharged Alive (without Complications) Inpatient | $6,198$6.1k$13k5 plans | — | — |
| Heart Failure and Shock (with Complications) Inpatient | $7,192$7.1k$16k5 plans | — | — |
| Heart Failure and Shock (with Major Complications) Inpatient | $10,625$10k$24k5 plans | — | — |
| Heart Failure and Shock (without Complications) Inpatient | $4,958$4.9k$10k5 plans | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$10$103 plans | $37 | $67 |
| Hip and Femur Procedures (with Complications) Inpatient | $17,026$17k$38k5 plans | — | — |
| Hip and Femur Procedures (with Major Complications) Inpatient | $23,483$23k$55k5 plans | — | — |
| Hip and Femur Procedures (without Complications) Inpatient | $13,367$13k$29k5 plans | — | — |
| Hip or Knee Replacement (with Major Complications) Inpatient | $24,438$24k$61k5 plans | — | — |
| Hip or Knee Replacement (without Major Complications) Inpatient | $15,719$15k$35k5 plans | — | — |
| HIV Antibody Test | $9$9$93 plans | $174 | $317 |
| Home Sleep Study | $241$231$2433 plansshared rate · 2 | $563 | $1,023 |
| Individual Therapy Session (45 Minutes) | $198$190$2003 plansshared rate · 3 | $265 | $482 |
| Inguinal Hernia Repair (Open) | $3,990$3.8k$4.0k3 plans | — | — |
| Initial Psychiatric Diagnostic Evaluation | $198$190$2003 plansshared rate · 3 | $294 | $534 |
| Initial Psychiatric Evaluation with Medication Management | $198$190$2003 plansshared rate · 3 | $317 | $576 |
| Inpatient Rehabilitation (with Complications) Inpatient | $12,716$12k$28k5 plans | — | — |
| Inpatient Rehabilitation (without Complications) Inpatient | $9,543$9.4k$21k5 plans | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | — | $2,128 | $3,869 |
| IUD Removal | $340$327$3433 plans | $331 | $601 |
| Kidney Failure (with Complications) Inpatient | $7,404$7.3k$16k5 plans | — | — |
| Kidney Failure (with Major Complications) Inpatient | $12,182$12k$28k5 plans | — | — |
| Kidney Failure (without Complications) Inpatient | $5,228$5.1k$11k5 plans | — | — |
| Kidney or Urinary Tract Infection (with Major Complications) Inpatient | $9,650$9.5k$22k5 plans | — | — |
| Kidney or Urinary Tract Infection (without Major Complications) Inpatient | $6,880$6.7k$15k5 plans | — | — |
| Knee Arthroscopy with Meniscectomy | $3,647$3.5k$3.7k3 plansshared rate · 2 | — | — |
| Laparoscopic Appendectomy | $6,738$6.5k$6.8k3 plansshared rate · 3 | — | — |
| Laparoscopic Gallbladder Removal | $6,738$6.5k$6.8k3 plansshared rate · 3 | — | — |
| Laparoscopic Gallbladder Removal (with Complications) Inpatient | $13,845$14k$31k5 plans | — | — |
| Laparoscopic Gallbladder Removal (with Major Complications) Inpatient | $19,331$19k$44k5 plans | — | — |
| Laparoscopic Gallbladder Removal (without Complications) Inpatient | $11,273$11k$24k5 plans | — | — |
| Laparoscopic Tubal Ligation | $6,738$6.5k$6.8k3 plansshared rate · 3 | — | — |
| Lipid Panel (Cholesterol Test) | $14$13$143 plans | $136 | $248 |
| Lumbar Epidural Steroid Injection | $787$756$7943 plansshared rate · 2 | — | — |
| Lumbar Puncture (Spinal Tap) | $787$756$7943 plansshared rate · 2 | $1,192 | $2,168 |
| Lumbar Spinal Fusion (Posterior) | $19,541$19k$20k3 plans | — | — |
| Lumpectomy (Partial Mastectomy) | $4,364$4.2k$4.4k3 plans | — | — |
| Major Bowel Procedure (with Complications) Inpatient | $19,416$19k$44k5 plans | — | — |
| Major Bowel Procedure (with Major Complications) Inpatient | $36,781$36k$85k5 plans | — | — |
| Major Bowel Procedure (without Complications) Inpatient | $13,776$14k$31k5 plans | — | — |
| MRI Abdomen with and without Contrast | $389$374$3933 plansshared rate · 4 | $4,158 | $7,560 |
| MRI Brain with and without Contrast | $389$374$3933 plansshared rate · 4 | $3,729 | $6,780 |
| MRI Brain with Contrast | $389$374$3933 plansshared rate · 4 | $3,552 | $6,458 |
| MRI Brain without Contrast | $266$256$2683 plansshared rate · 5 | $3,079 | $5,598 |
| MRI Cervical Spine (Neck) without Contrast | $266$256$2683 plansshared rate · 5 | $3,530 | $6,418 |
| MRI Knee without Contrast | $266$256$2683 plansshared rate · 5 | $3,015 | $5,482 |
| MRI Lower Back (Lumbar Spine) without Contrast | $266$256$2683 plansshared rate · 5 | $2,595 | $4,719 |
| MRI Thoracic Spine (Mid-back) without Contrast | $266$256$2683 plansshared rate · 5 | $3,093 | $5,623 |
| Newborn Circumcision | — | $1,997 | $3,630 |
| Nuclear Cardiac Stress Test | $1,443$1.4k$1.5k3 plans | $4,736 | $8,610 |
| Office Visit, Established Patient (Level 3) | — | $138 | $250 |
| Office Visit, New Patient (Level 3) | — | $149 | $270 |
| Pacemaker Insertion (Dual Chamber) | — | $19,374 | $35,226 |
| PET/CT Scan, Whole Body | $1,594$1.5k$1.6k3 plans | $4,386 | $7,974 |
| Pneumonia and Pleurisy (with Complications) Inpatient | $6,852$6.7k$15k5 plans | — | — |
| Pneumonia and Pleurisy (with Major Complications) Inpatient | $10,867$11k$24k5 plans | — | — |
| Pneumonia and Pleurisy (without Complications) Inpatient | $5,451$5.3k$12k5 plans | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $117$112$1183 plansshared rate · 5 | $1,333 | $2,423 |
| Prostate Biopsy | — | $1,727 | $3,140 |
| PSA Prostate Cancer Screening | $19$18$193 plans | $137 | $249 |
| Psychiatric Admission (Psychoses) Inpatient | $11,517$11k$26k5 plans | — | — |
| Pulmonary Edema and Respiratory Failure Inpatient | $10,243$10k$23k5 plans | — | — |
| Pulmonary Function Test with Bronchodilator | $416$400$4203 plans | $848 | $1,541 |
| Rotator Cuff Repair (Arthroscopic) | $8,087$7.8k$8.2k3 plansshared rate · 2 | — | — |
| Screening Mammogram | $96$92$973 plans | $261 | $475 |
| Sepsis (with Major Complications) Inpatient | $15,826$16k$36k5 plans | — | — |
| Sepsis (without Major Complications) Inpatient | $8,568$8.4k$19k5 plans | — | — |
| Skin Biopsy (Tangential) | $453$436$4573 plans | $327 | $595 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,841$1.8k$1.9k3 plansshared rate · 3 | $1,515 | $2,755 |
| Sleep Study (In-lab Polysomnography) | $957$920$9663 plansshared rate · 2 | $3,961 | $7,201 |
| Spinal Cord Stimulator Trial | $7,103$6.8k$7.2k3 plans | — | — |
| Spinal Fusion, Except Cervical (without Major Complications) Inpatient | $67,8431 plan | — | — |
| Spirometry (Breathing Test) | $241$231$2433 plansshared rate · 2 | $317 | $577 |
| Stroke (with Complications) Inpatient | $8,466$8.3k$19k5 plans | — | — |
| Stroke (with Major Complications) Inpatient | $16,367$16k$37k5 plans | — | — |
| Stroke (without Complications) Inpatient | $5,892$5.8k$13k5 plans | — | — |
| Syncope and Collapse Inpatient | $7,371$7.2k$16k5 plans | — | — |
| Total Hip Replacement | $14,309$14k$14k3 plansshared rate · 3 | — | — |
| Total Knee Replacement | $14,309$14k$14k3 plansshared rate · 3 | — | — |
| Total Mastectomy | $7,400$7.1k$7.5k3 plans | — | — |
| TSH Thyroid Function Test | $17$17$183 plans | $147 | $268 |
| Upper GI Endoscopy (EGD) | $1,011$972$1.0k3 plans | $1,152 | $2,094 |
| Urinalysis with Microscopy | $3$3$33 plans | $106 | $193 |
| Uterine and Adnexa Surgery, Non-cancer (without Complications) Inpatient | $10,285$10k$22k5 plans | — | — |
| Vaginal Hysterectomy | $5,575$5.4k$5.6k3 plans | — | — |
| Vitamin D Blood Test | $31$30$313 plans | $100 | $182 |