| Abdominal Hysterectomy | $4,117$3.6k$4.1k | — | — |
| ACL Reconstruction (Arthroscopic) | $5,935$3.6k$13k | — | — |
| Allergy Skin Testing | $920$18$1.5k | — | — |
| Basic Metabolic Panel | $11$8$19 | $217 | $217 |
| Bone Marrow Biopsy | $1,453$226$2.9k | $5,521 | $5,521 |
| Breast Biopsy (Ultrasound-guided) | $2,603$459$2.9k | $5,660 | $5,660 |
| Bunion Correction Surgery | $4,117$1.8k$5.6k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $8,009$4.2k$45k | $42,847 | $42,847 |
| Cardiac Catheterization (Left Heart) | $5,094$3.1k$5.6k | $21,689 | $21,689 |
| Cardiac Stress Test (Treadmill) | $287 | — | — |
| Carpal Tunnel Release Surgery | $3,371$1.5k$3.6k | — | — |
| Cataract Surgery with Lens Implant | $3,594$2.0k$4.0k | — | — |
| Cervical Spinal Fusion (Anterior) | $6,601$5.9k$22k | — | — |
| Cesarean Delivery (Global Package) | $7,969 | — | — |
| Chemotherapy Infusion (First Hour) | $570$354$574 | $2,436 | $2,436 |
| Chest X-ray (2 Views) | $93$75$150 | $136 | $136 |
| Colonoscopy with Biopsy | $2,066$850$2.6k | — | — |
| Complete Abdominal Ultrasound | $180$112$335 | $2,072 | $2,072 |
| Complete Blood Count (CBC) with Differential | $10$8$17 | $103 | $103 |
| Comprehensive Metabolic Panel | $14$11$23 | $244 | $244 |
| Coronary Angioplasty with Stent | $5,935$2.3k$20k | $31,704 | $31,704 |
| Critical Care, First Hour | $885$583$1.4k | $4,584 | $4,584 |
| CT Abdomen and Pelvis with Contrast | $602$374$979 | $8,609 | $8,609 |
| CT Cardiac Calcium Scoring | $150$93$247 | $1,391 | $1,391 |
| CT Chest without Contrast | $180$112$367 | $2,497 | $2,497 |
| CT Head without Contrast | $180$112$222 | $2,592 | $2,592 |
| DEXA Bone Density Scan | $122$112$180 | $1,202 | $1,202 |
| Diagnostic Colonoscopy | $1,605$736$2.6k | — | — |
| Diagnostic Mammogram (Both Breasts) | $180$112$365 | $1,027 | $1,027 |
| Ear Tube Placement (Tympanostomy) | $2,603$545$2.7k | — | — |
| Echocardiogram (Complete with Doppler) | $586$497$943 | $2,226 | $2,226 |
| EKG (Electrocardiogram, 12-lead) | $67 | $42 | $42 |
| Emergency Room Visit (Level 3) | $293$191$471 | $1,222 | $1,222 |
| Group Therapy Session | $109$74$175 | — | — |
| Hemodialysis Treatment | $252 | — | — |
| Hemoglobin A1c (Diabetes Test) | $13$10$21 | $129 | $129 |
| HIV Antibody Test | $12$9$20 | $103 | $103 |
| Holter Monitor (24-48 Hour Heart Monitor) | $280 | — | — |
| Home Sleep Study | $231$153$373 | $1,767 | $1,767 |
| Individual Therapy Session (45 Minutes) | $280$190$306 | — | — |
| Inguinal Hernia Repair (Open) | $4,117$1.7k$6.2k | — | — |
| Initial Hospital Admission (Level 1) | $207 | $227 | $227 |
| Initial Psychiatric Diagnostic Evaluation | $306$190$478 | $335 | $335 |
| Initial Psychiatric Evaluation with Medication Management | $306$190$538 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,171 | $7,512 | $7,512 |
| IUD Insertion | $319$175$322 | — | — |
| IUD Removal | $322$237$526 | $695 | $695 |
| Knee Arthroscopy with Meniscectomy | $4,117$2.1k$5.6k | — | — |
| Laparoscopic Appendectomy | $5,935$1.9k$10k | — | — |
| Laparoscopic Gallbladder Removal | $5,935$2.1k$10k | — | — |
| Laparoscopic Tubal Ligation | $5,935$2.4k$10k | — | — |
| Lipid Panel (Cholesterol Test) | $18$13$29 | $251 | $251 |
| Lumbar Epidural Steroid Injection | $1,219$335$1.5k | $3,176 | $3,176 |
| Lumbar Puncture (Spinal Tap) | $1,219$225$1.5k | $1,996 | $1,996 |
| Lumbar Spinal Fusion (Posterior) | $6,037$5.9k$30k | — | — |
| Lumpectomy (Partial Mastectomy) | $3,620$2.1k$6.8k | — | — |
| MRI Abdomen with and without Contrast | $602$374$1.1k | $7,973 | $7,973 |
| MRI Brain with and without Contrast | $602$374$1.5k | $7,315 | $7,315 |
| MRI Brain with Contrast | $602$374$632 | $5,279 | $5,279 |
| MRI Brain without Contrast | $412$256$913 | $4,028 | $4,028 |
| MRI Cervical Spine (Neck) without Contrast | $412$256$916 | $4,287 | $4,287 |
| MRI Knee without Contrast | $412$256$776 | $6,425 | $6,425 |
| MRI Lower Back (Lumbar Spine) without Contrast | $412$256$683 | $4,705 | $4,705 |
| MRI Thoracic Spine (Mid-back) without Contrast | $412$256$488 | $5,582 | $5,582 |
| Newborn Circumcision | $3,594$395$3.6k | $3,225 | $3,225 |
| Nuclear Cardiac Stress Test | $1,387$1.2k$2.2k | $4,821 | $4,821 |
| Office Visit, Established Patient (Level 3) | $162 | $287 | $287 |
| Office Visit, New Patient (Level 3) | $207 | $539 | $539 |
| Pacemaker Insertion (Dual Chamber) | $8,009$1.7k$18k | $27,836 | $27,836 |
| PET/CT Scan, Whole Body | $2,469$1.5k$4.5k | $9,770 | $9,770 |
| Pregnancy Ultrasound (Second or Third Trimester) | $180$112$340 | $1,720 | $1,720 |
| Prostate Biopsy | $2,603$525$2.6k | $7,255 | $7,255 |
| PSA Prostate Cancer Screening | $25$18$31 | $246 | $246 |
| Pulmonary Function Test with Bronchodilator | $400$109$644 | $787 | $787 |
| Rotator Cuff Repair (Arthroscopic) | $5,935$3.8k$13k | — | — |
| Screening Mammogram | $148$92$303 | $463 | $463 |
| Septoplasty (Deviated Septum Repair) | $3,594$2.5k$5.7k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $4,147$1.2k$12k | — | — |
| Skin Biopsy (Tangential) | $322$113$702 | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,453$245$2.9k | — | — |
| Sleep Study (In-lab Polysomnography) | $1,483$920$1.7k | $7,477 | $7,477 |
| Spinal Cord Stimulator Trial | $5,935$1.4k$11k | — | — |
| Spirometry (Breathing Test) | $231$72$373 | $574 | $574 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,594$946$5.7k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $3,620$901$10k | — | — |
| Total Hip Replacement | $6,678$4.7k$22k | — | — |
| Total Knee Replacement | $6,678$4.8k$22k | — | — |
| Total Mastectomy | $4,147$3.1k$11k | — | — |
| TSH Thyroid Function Test | $22$17$37 | $230 | $230 |
| TURP (Transurethral Prostate Resection) | $5,131$3.2k$9.3k | — | — |
| Upper GI Endoscopy (EGD) | $1,566$371$2.6k | — | — |
| Urinalysis with Microscopy | $4$3$7 | $119 | $119 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $9,550 | — | — |
| Vaginal Delivery (Global Package) | $7,377 | — | — |
| Vaginal Hysterectomy | $4,147$3.0k$8.6k | — | — |
| Vasectomy | $3,594$901$3.6k | — | — |
| Vitamin D Blood Test | $39$30$50 | $386 | $386 |