| Abdominal Hysterectomy | $3,259$2.2k$6.5k | — | — |
| ACL Reconstruction (Arthroscopic) | $5,108$2.1k$9.9k | — | — |
| Allergy Skin Testing | $466$11$1.2k | — | — |
| Basic Metabolic Panel | $11$8$13 | $87 | $87 |
| Bone Marrow Biopsy | $864$136$2.3k | $4,358 | $4,358 |
| Breast Biopsy (Ultrasound-guided) | $1,607$276$2.3k | $6,187 | $6,187 |
| Bunion Correction Surgery | $2,812$1.1k$4.5k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $9,052$2.5k$36k | $42,847 | $42,847 |
| Cardiac Catheterization (Left Heart) | $3,950$1.9k$6.5k | $21,689 | $21,689 |
| Cardiac Stress Test (Treadmill) | $184$172$196 | — | — |
| Carpal Tunnel Release Surgery | $1,893$884$3.8k | — | — |
| Cataract Surgery with Lens Implant | $2,812$1.2k$5.1k | — | — |
| Cervical Spinal Fusion (Anterior) | $6,864$4.0k$18k | — | — |
| Cesarean Delivery (Global Package) | $5,108$4.8k$5.4k | — | — |
| Chemotherapy Infusion (First Hour) | $373$344$451 | $1,075 | $1,075 |
| Chest X-ray (2 Views) | $72$45$119 | $403 | $403 |
| Colonoscopy with Biopsy | $1,401$510$1.7k | — | — |
| Complete Abdominal Ultrasound | $172$112$228 | $1,045 | $1,045 |
| Complete Blood Count (CBC) with Differential | $10$8$12 | $57 | $57 |
| Comprehensive Metabolic Panel | $14$11$16 | $126 | $126 |
| Coronary Angioplasty with Stent | $7,626$1.4k$16k | $31,704 | $31,704 |
| Critical Care, First Hour | $641$350$1.1k | $4,454 | $4,454 |
| CT Abdomen and Pelvis with Contrast | $532$374$667 | $4,206 | $4,206 |
| CT Cardiac Calcium Scoring | $134$93$169 | $76 | $76 |
| CT Chest without Contrast | $181$112$250 | $1,640 | $1,640 |
| CT Head without Contrast | $138$112$152 | $1,808 | $1,808 |
| DEXA Bone Density Scan | $98$73$143 | $508 | $508 |
| Diagnostic Colonoscopy | $1,133$441$1.7k | — | — |
| Diagnostic Mammogram (Both Breasts) | $181$112$249 | $589 | $589 |
| Ear Tube Placement (Tympanostomy) | $1,591$327$2.1k | — | — |
| Echocardiogram (Complete with Doppler) | $462$298$746 | $3,756 | $3,756 |
| EKG (Electrocardiogram, 12-lead) | $43$40$46 | — | — |
| Emergency Room Visit (Level 3) | $211$114$373 | $1,443 | $1,443 |
| Group Therapy Session | $80$44$139 | $625 | $625 |
| Hemodialysis Treatment | $161$151$172 | — | — |
| Hemoglobin A1c (Diabetes Test) | $13$10$15 | $73 | $73 |
| HIV Antibody Test | $12$9$13 | $56 | $56 |
| Holter Monitor (24-48 Hour Heart Monitor) | $179$168$191 | — | — |
| Home Sleep Study | $168$92$295 | $800 | $800 |
| Individual Therapy Session (45 Minutes) | $190$168$242 | $346 | $346 |
| Inguinal Hernia Repair (Open) | $3,824$1.0k$4.9k | — | — |
| Initial Hospital Admission (Level 1) | $132$124$141 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $265$190$326 | $335 | $335 |
| Initial Psychiatric Evaluation with Medication Management | $283$190$367 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $751$703$799 | $3,606 | $3,606 |
| IUD Insertion | $167$105$1.0k | — | — |
| IUD Removal | $270$142$1.0k | $565 | $565 |
| Knee Arthroscopy with Meniscectomy | $3,659$1.2k$4.5k | — | — |
| Laparoscopic Appendectomy | $4,298$1.2k$8.3k | — | — |
| Laparoscopic Gallbladder Removal | $5,780$1.3k$8.3k | — | — |
| Laparoscopic Tubal Ligation | $5,780$1.4k$8.3k | — | — |
| Lipid Panel (Cholesterol Test) | $17$13$20 | $78 | $78 |
| Lumbar Epidural Steroid Injection | $734$201$1.0k | $3,176 | $3,176 |
| Lumbar Puncture (Spinal Tap) | $734$135$1.0k | $1,458 | $1,458 |
| Lumbar Spinal Fusion (Posterior) | $6,864$3.6k$24k | — | — |
| Lumpectomy (Partial Mastectomy) | $2,935$1.3k$5.3k | — | — |
| MRI Abdomen with and without Contrast | $557$374$724 | $4,256 | $4,256 |
| MRI Brain with and without Contrast | $682$374$1.0k | $4,187 | $4,187 |
| MRI Brain with Contrast | $405$374$476 | $3,640 | $3,640 |
| MRI Brain without Contrast | $437$256$622 | $2,987 | $2,987 |
| MRI Cervical Spine (Neck) without Contrast | $438$256$624 | $2,829 | $2,829 |
| MRI Knee without Contrast | $396$256$529 | $2,860 | $2,860 |
| MRI Lower Back (Lumbar Spine) without Contrast | $368$256$466 | $3,186 | $3,186 |
| MRI Thoracic Spine (Mid-back) without Contrast | $309$256$333 | $3,254 | $3,254 |
| Newborn Circumcision | $1,629$237$3.8k | — | — |
| Nuclear Cardiac Stress Test | $1,100$715$1.8k | $5,475 | $5,475 |
| Office Visit, Established Patient (Level 3) | $104$97$110 | $297 | $297 |
| Office Visit, New Patient (Level 3) | $132$124$141 | $506 | $506 |
| Pacemaker Insertion (Dual Chamber) | $8,860$992$14k | $27,836 | $27,836 |
| PET/CT Scan, Whole Body | $2,331$1.5k$3.1k | $8,828 | $8,828 |
| Pregnancy Ultrasound (Second or Third Trimester) | $173$112$232 | $689 | $689 |
| Prostate Biopsy | $939$315$1.7k | $3,229 | $3,229 |
| PSA Prostate Cancer Screening | $20$18$23 | $98 | $98 |
| Pulmonary Function Test with Bronchodilator | $237$65$509 | $861 | $861 |
| Rotator Cuff Repair (Arthroscopic) | $6,428$2.3k$9.9k | — | — |
| Screening Mammogram | $149$92$206 | $550 | $550 |
| Septoplasty (Deviated Septum Repair) | $3,652$1.5k$4.5k | $6,287 | $6,287 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $4,558$709$9.6k | — | — |
| Skin Biopsy (Tangential) | $325$68$1.0k | $182 | $182 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,203$147$2.3k | $664 | $664 |
| Sleep Study (In-lab Polysomnography) | $1,111$920$1.2k | $4,250 | $4,250 |
| Spinal Cord Stimulator Trial | $4,262$848$8.7k | — | — |
| Spirometry (Breathing Test) | $140$43$295 | $483 | $483 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,652$568$5.1k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $2,935$541$8.1k | — | — |
| Total Hip Replacement | $7,505$2.8k$18k | — | — |
| Total Knee Replacement | $7,505$2.9k$18k | — | — |
| Total Mastectomy | $3,923$1.8k$9.1k | — | — |
| TSH Thyroid Function Test | $22$17$25 | $158 | $158 |
| TURP (Transurethral Prostate Resection) | $4,398$1.9k$7.3k | — | — |
| Upper GI Endoscopy (EGD) | $994$223$1.5k | — | — |
| Urinalysis with Microscopy | $4$3$5 | $46 | $46 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $6,121$5.7k$6.5k | — | — |
| Vaginal Delivery (Global Package) | $4,728$4.4k$5.0k | — | — |
| Vaginal Hysterectomy | $4,558$1.8k$6.8k | — | — |
| Vasectomy | $1,967$541$3.8k | — | — |
| Vitamin D Blood Test | $32$30$38 | $90 | $90 |