| Abdominal Hysterectomy | $975$882$995 | — | — |
| ACL Reconstruction (Arthroscopic) | $7,776$912$7.9k | — | — |
| Allergy Skin Testing | $160$3$939 | $200 | $200 |
| Basic Metabolic Panel | $23$4$139 | $100 | $100 |
| Bone Marrow Biopsy | $1,770$62$3.0k | $3,144 | $3,144 |
| Breast Biopsy (Ultrasound-guided) | $1,770$130$4.0k | $4,715 | $4,715 |
| Bunion Correction Surgery | $3,506$470$3.6k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $28,010$1.0k$37k | $43,208 | $43,208 |
| Cardiac Catheterization (Left Heart) | $3,544$1.1k$17k | $19,488 | $19,488 |
| Cardiac Stress Test (Treadmill) | $70$70$75 | — | — |
| Carpal Tunnel Release Surgery | $2,093$374$2.1k | — | — |
| Cataract Surgery with Lens Implant | $2,473$539$2.5k | — | — |
| Cervical Spinal Fusion (Anterior) | $13,758$1.6k$14k | — | — |
| Cesarean Delivery (Global Package) | $2,660$2.0k$2.7k | — | — |
| Chemotherapy Infusion (First Hour) | $361$130$1.1k | $1,334 | $1,334 |
| Chest X-ray (2 Views) | $95$29$518 | $609 | $609 |
| Colonoscopy with Biopsy | $1,308$194$3.8k | $4,431 | $4,431 |
| Complete Abdominal Ultrasound | $1,131$99$1.9k | $2,085 | $2,085 |
| Complete Blood Count (CBC) with Differential | $78$7$224 | $125 | $125 |
| Comprehensive Metabolic Panel | $98$4$433 | $313 | $313 |
| Coronary Angioplasty with Stent | $12,371$588$15k | $17,955 | $17,955 |
| Critical Care, First Hour | $903$152$3.2k | $3,780 | $3,780 |
| CT Abdomen and Pelvis with Contrast | $752$322$6.4k | $7,518 | $7,518 |
| CT Cardiac Calcium Scoring | $108$65$553 | $651 | $651 |
| CT Chest without Contrast | $391$112$3.3k | $3,906 | $3,906 |
| CT Head without Contrast | $373$112$3.2k | $3,812 | $3,812 |
| DEXA Bone Density Scan | $114$32$750 | $882 | $882 |
| Diagnostic Colonoscopy | $1,011$179$2.9k | $3,371 | $3,371 |
| Diagnostic Mammogram (Both Breasts) | $151$92$785 | $924 | $924 |
| Ear Tube Placement (Tympanostomy) | $1,663$139$1.7k | — | — |
| Echocardiogram (Complete with Doppler) | $2,836$201$4.1k | $4,836 | $4,836 |
| EKG (Electrocardiogram, 12-lead) | $15$15$16 | — | — |
| Emergency Room Visit (Level 3) | $527$52$1.1k | $1,072 | $1,072 |
| Group Therapy Session | $109$23$303 | $357 | $357 |
| Hemodialysis Treatment | $90$90$103 | — | — |
| Hemoglobin A1c (Diabetes Test) | $24$3$224 | $41 | $41 |
| HIV Antibody Test | $38$4$183 | $102 | $102 |
| Holter Monitor (24-48 Hour Heart Monitor) | $66$66$76 | — | — |
| Home Sleep Study | $231$87$236 | — | — |
| Individual Therapy Session (45 Minutes) | $190$60$509 | $599 | $599 |
| Inguinal Hernia Repair (Open) | $3,837$523$3.9k | — | — |
| Initial Hospital Admission (Level 1) | $77$17$143 | $168 | $168 |
| Initial Psychiatric Diagnostic Evaluation | $190$60$509 | $599 | $599 |
| Initial Psychiatric Evaluation with Medication Management | $194$67$571 | $672 | $672 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $306$297$313 | — | — |
| IUD Insertion | $439$44$732 | $804 | $804 |
| IUD Removal | $333$58$1.1k | $1,250 | $1,250 |
| Knee Arthroscopy with Meniscectomy | $3,506$505$3.6k | — | — |
| Laparoscopic Appendectomy | $6,479$603$6.6k | — | — |
| Laparoscopic Gallbladder Removal | $6,479$661$6.6k | — | — |
| Laparoscopic Tubal Ligation | $6,479$569$6.6k | — | — |
| Lipid Panel (Cholesterol Test) | $39$12$331 | $389 | $389 |
| Lumbar Epidural Steroid Injection | $858$84$2.7k | $3,150 | $3,150 |
| Lumbar Puncture (Spinal Tap) | $778$55$2.5k | $1,649 | $1,649 |
| Lumbar Spinal Fusion (Posterior) | $18,790$1.5k$19k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,196$572$4.3k | — | — |
| MRI Abdomen with and without Contrast | $793$374$6.7k | $7,928 | $7,928 |
| MRI Brain with and without Contrast | $793$374$6.7k | $7,928 | $7,928 |
| MRI Brain with Contrast | $909$333$7.7k | $9,093 | $9,093 |
| MRI Brain without Contrast | $484$241$4.1k | $4,841 | $4,841 |
| MRI Cervical Spine (Neck) without Contrast | $540$235$4.6k | $5,397 | $5,397 |
| MRI Knee without Contrast | $558$248$4.7k | $5,576 | $5,576 |
| MRI Lower Back (Lumbar Spine) without Contrast | $529$235$4.5k | $5,292 | $5,292 |
| MRI Thoracic Spine (Mid-back) without Contrast | $507$235$4.3k | $5,072 | $5,072 |
| Newborn Circumcision | $2,240$97$3.9k | $4,589 | $4,589 |
| Nuclear Cardiac Stress Test | $1,415$366$4.8k | $5,607 | $5,607 |
| Office Visit, Established Patient (Level 3) | $93$22$183 | $215 | $215 |
| Office Visit, New Patient (Level 3) | $115$22$183 | $215 | $215 |
| Pacemaker Insertion (Dual Chamber) | $11,201$570$22k | $25,662 | $25,662 |
| PET/CT Scan, Whole Body | $1,563$1.1k$9.2k | $10,857 | $10,857 |
| Pregnancy Ultrasound (Second or Third Trimester) | $140$112$1.2k | $1,397 | $1,397 |
| Prostate Biopsy | $1,077$128$1.7k | $2,016 | $2,016 |
| PSA Prostate Cancer Screening | $24$2$313 | $78 | $78 |
| Pulmonary Function Test with Bronchodilator | $400$36$688 | $809 | $809 |
| Rotator Cuff Repair (Arthroscopic) | $7,776$1000$7.9k | — | — |
| Screening Mammogram | $121$92$785 | $924 | $924 |
| Septoplasty (Deviated Septum Repair) | $3,553$599$3.6k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,563$292$7.7k | — | — |
| Skin Biopsy (Tangential) | $390$32$563 | $533 | $533 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,770$68$2.8k | $3,245 | $3,245 |
| Sleep Study (In-lab Polysomnography) | $939$566$5.6k | $6,563 | $6,563 |
| Spinal Cord Stimulator Trial | $6,829$353$15k | $18,197 | $18,197 |
| Spirometry (Breathing Test) | $244$25$482 | $481 | $481 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,553$299$3.6k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,344$285$6.5k | — | — |
| Total Hip Replacement | $13,758$1.2k$14k | — | — |
| Total Knee Replacement | $13,758$1.2k$14k | — | — |
| Total Mastectomy | $7,116$831$7.3k | — | — |
| TSH Thyroid Function Test | $42$2$331 | $153 | $153 |
| TURP (Transurethral Prostate Resection) | $5,746$744$5.9k | — | — |
| Upper GI Endoscopy (EGD) | $972$118$1.8k | $2,079 | $2,079 |
| Urinalysis with Microscopy | $10$3$143 | $168 | $168 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,511$1.9k$2.6k | — | — |
| Vaginal Delivery (Global Package) | $2,358$1.8k$2.4k | — | — |
| Vaginal Hysterectomy | $5,361$731$5.5k | — | — |
| Vasectomy | $2,240$225$3.9k | $4,589 | $4,589 |
| Vitamin D Blood Test | $96$12$473 | $247 | $247 |