| Abdominal Hysterectomy | — | $826 | $1,377 |
| ACL Reconstruction (Arthroscopic) | $7,511$7.5k$11k | $34,512 | $57,520 |
| Basic Metabolic Panel | $10 | $10 | $16 |
| Bone Marrow Biopsy | $1,704$1.7k$2.6k | $17,535 | $29,224 |
| Breast Biopsy (Ultrasound-guided) | $1,704$1.7k$2.6k | $7,101 | $11,836 |
| Bunion Correction Surgery | $3,411$3.4k$5.1k | $26,785 | $44,642 |
| Cardiac Catheterization (Left Heart) | $3,382$3.4k$5.1k | $17,703 | $29,505 |
| Cardiac Stress Test (Treadmill) | — | $84 | $140 |
| Carpal Tunnel Release Surgery | $2,053$2.1k$3.1k | $9,985 | $16,641 |
| Cesarean Delivery (Global Package) | — | $2,108 | $3,513 |
| Chemotherapy Infusion (First Hour) | $349$349$523 | $692 | $1,153 |
| Chest X-ray (2 Views) | $886$170$1.3k | $177 | $295 |
| Colonoscopy with Biopsy | $1,240$1.2k$1.9k | $3,711 | $6,186 |
| Complete Abdominal Ultrasound | $322$322$483 | $715 | $1,192 |
| Complete Blood Count (CBC) with Differential | $9 | $8 | $14 |
| Comprehensive Metabolic Panel | $13 | $12 | $20 |
| Coronary Angioplasty with Stent | $11,923$12k$18k | $21,238 | $35,397 |
| Critical Care, First Hour | $886$886$1.3k | $1,836 | $3,061 |
| CT Abdomen and Pelvis with Contrast | $457$457$1.0k | $1,490 | $2,484 |
| CT Cardiac Calcium Scoring | $93$93$700 | $30 | $50 |
| CT Chest without Contrast | $236$236$700 | $669 | $1,115 |
| CT Head without Contrast | $236$236$700 | $775 | $1,291 |
| DEXA Bone Density Scan | $112$112$168 | $281 | $468 |
| Diagnostic Colonoscopy | $959$959$1.4k | $2,150 | $3,584 |
| Diagnostic Mammogram (Both Breasts) | $143$143$225 | $344 | $573 |
| Ear Tube Placement (Tympanostomy) | $1,557$1.6k$2.3k | $33,165 | $55,275 |
| Echocardiogram (Complete with Doppler) | $576$576$865 | $1,634 | $2,724 |
| EKG (Electrocardiogram, 12-lead) | — | $14 | $24 |
| Emergency Room Visit (Level 3) | $291$291$437 | $440 | $734 |
| Hemoglobin A1c (Diabetes Test) | $12 | $11 | $18 |
| HIV Antibody Test | $11 | $10 | $17 |
| Holter Monitor (24-48 Hour Heart Monitor) | — | $75 | $125 |
| Home Sleep Study | $165$165$247 | $139 | $232 |
| Individual Therapy Session (45 Minutes) | $430$430$644 | $91 | $152 |
| Inguinal Hernia Repair (Open) | $3,710$3.7k$5.6k | $37,609 | $62,682 |
| Initial Hospital Admission (Level 1) | — | $68 | $114 |
| Initial Psychiatric Diagnostic Evaluation | $430$430$644 | $146 | $243 |
| Initial Psychiatric Evaluation with Medication Management | $430$430$644 | $163 | $272 |
| IUD Insertion | — | $75 | $125 |
| IUD Removal | $320$320$480 | $14,712 | $24,520 |
| Knee Arthroscopy with Meniscectomy | $3,411$3.4k$5.1k | $31,735 | $52,892 |
| Laparoscopic Appendectomy | $6,134$6.1k$9.2k | $28,384 | $47,307 |
| Laparoscopic Gallbladder Removal | $6,134$6.1k$9.2k | $33,645 | $56,076 |
| Laparoscopic Tubal Ligation | $6,134$6.1k$9.2k | $45,791 | $76,318 |
| Lipid Panel (Cholesterol Test) | $13$13$20 | $15 | $25 |
| Lumbar Epidural Steroid Injection | $728$728$1.1k | $1,606 | $2,676 |
| Lumbar Puncture (Spinal Tap) | $728$728$1.1k | $1,461 | $2,435 |
| Lumpectomy (Partial Mastectomy) | $4,026$4.0k$6.0k | $17,873 | $29,788 |
| MRI Abdomen with and without Contrast | $899$850$1.3k | $715 | $1,192 |
| MRI Brain with and without Contrast | $899$700$1.3k | $715 | $1,192 |
| MRI Brain with Contrast | $899$700$1.3k | $715 | $1,192 |
| MRI Brain without Contrast | $568$568$858 | $716 | $1,193 |
| MRI Cervical Spine (Neck) without Contrast | $568$568$858 | $716 | $1,193 |
| MRI Knee without Contrast | $568$568$858 | $716 | $1,193 |
| MRI Lower Back (Lumbar Spine) without Contrast | $568$568$858 | $716 | $1,193 |
| MRI Thoracic Spine (Mid-back) without Contrast | $568$568$858 | $716 | $1,193 |
| Newborn Circumcision | $2,154$2.2k$3.2k | $161 | $269 |
| Nuclear Cardiac Stress Test | $1,373$1.4k$2.1k | $5,318 | $8,864 |
| Office Visit, Established Patient (Level 3) | — | $77 | $129 |
| Office Visit, New Patient (Level 3) | — | $94 | $157 |
| Pacemaker Insertion (Dual Chamber) | $11,003$11k$17k | $22,180 | $36,966 |
| PET/CT Scan, Whole Body | $1,534$1.5k$2.3k | $6,038 | $10,064 |
| Pregnancy Ultrasound (Second or Third Trimester) | $112$112$325 | $599 | $998 |
| PSA Prostate Cancer Screening | $22 | $20 | $34 |
| Pulmonary Function Test with Bronchodilator | $327$327$491 | $332 | $554 |
| Rotator Cuff Repair (Arthroscopic) | $7,511$7.5k$11k | $21,538 | $35,896 |
| Screening Mammogram | $116$116$225 | $284 | $473 |
| Septoplasty (Deviated Septum Repair) | $3,410$3.4k$5.1k | $41,739 | $69,565 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,278$7.3k$11k | $39,981 | $66,635 |
| Skin Biopsy (Tangential) | $209$209$313 | $395 | $658 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,704$1.7k$2.6k | $13,996 | $23,326 |
| Sleep Study (In-lab Polysomnography) | $1,070$1.1k$1.6k | $2,107 | $3,512 |
| Spirometry (Breathing Test) | $165$165$247 | $273 | $455 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,410$3.4k$5.1k | $16,381 | $27,301 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,220$6.2k$9.3k | $16,573 | $27,622 |
| Total Hip Replacement | $13,528$14k$20k | $70,888 | $118,146 |
| Total Knee Replacement | $13,528$14k$20k | $70,703 | $117,838 |
| Total Mastectomy | $6,857$6.9k$10k | $75,226 | $125,376 |
| TSH Thyroid Function Test | $20 | $19 | $31 |
| TURP (Transurethral Prostate Resection) | $5,345$5.3k$8.0k | $13,321 | $22,202 |
| Upper GI Endoscopy (EGD) | $986$986$1.5k | $5,971 | $9,951 |
| Urinalysis with Microscopy | $4 | $6 | $10 |
| Vaginal Birth After Cesarean (VBAC) Global Package | — | $1,986 | $3,310 |
| Vaginal Delivery (Global Package) | — | $1,910 | $3,184 |
| Vaginal Hysterectomy | $5,190$5.2k$7.8k | $680 | $1,134 |
| Vasectomy | $2,154$2.2k$3.2k | $14,380 | $23,966 |
| Vitamin D Blood Test | $36 | $33 | $55 |