| Abdominal Hysterectomy | $1,110$431$1.6k | $708 | $1,762 |
| ACL Reconstruction (Arthroscopic) | $7,019$2.7k$14k | — | — |
| Basic Metabolic Panel | $9$6$204 | $90 | $224 |
| Bone Marrow Biopsy | $1,656$674$6.6k | $1,108 | $2,758 |
| Breast Biopsy (Ultrasound-guided) | $1,376$431$3.2k | $709 | $1,764 |
| Bunion Correction Surgery | $3,299$2.7k$6.4k | — | — |
| Cardiac Catheterization (Left Heart) | $5,889$3.2k$13k | $5,829 | $14,512 |
| Carpal Tunnel Release Surgery | $1,986$1.9k$3.8k | — | — |
| Cataract Surgery with Lens Implant | $2,342$2.2k$5.4k | — | — |
| Cervical Spinal Fusion (Anterior) | $12,831$5.4k$25k | — | — |
| Cesarean Delivery (Global Package) | $3,078 | — | — |
| Chemotherapy Infusion (First Hour) | $341$209$780 | $344 | $857 |
| Chest X-ray (2 Views) | $168$67$575 | $254 | $632 |
| Colonoscopy with Biopsy | $1,785$872$3.2k | $1,434 | $3,569 |
| Complete Abdominal Ultrasound | $492$104$1.7k | $760 | $1,891 |
| Complete Blood Count (CBC) with Differential | $8$7$160 | $71 | $176 |
| Comprehensive Metabolic Panel | $11$7$389 | $172 | $427 |
| Coronary Angioplasty with Stent | $7,407$2.8k$34k | $4,649 | $11,574 |
| Critical Care, First Hour | $1,656$828$3.4k | $1,504 | $3,744 |
| CT Abdomen and Pelvis with Contrast | $1,030$340$3.6k | $1,607 | $4,000 |
| CT Chest without Contrast | $510$104$1.8k | $796 | $1,982 |
| CT Head without Contrast | $460$104$1.6k | $718 | $1,788 |
| DEXA Bone Density Scan | $198$89$679 | $300 | $746 |
| Diagnostic Colonoscopy | $936$896$2.9k | — | — |
| Diagnostic Mammogram (Both Breasts) | $345$134$498 | $220 | $547 |
| Ear Tube Placement (Tympanostomy) | $1,521$1.5k$4.6k | — | — |
| Echocardiogram (Complete with Doppler) | $1,258$539$4.3k | $1,877 | $4,673 |
| Emergency Room Visit (Level 3) | $544$272$1.3k | $591 | $1,471 |
| Hemodialysis Treatment | $2,193$851$3.2k | $1,398 | $3,481 |
| Hemoglobin A1c (Diabetes Test) | $10$8$198 | $88 | $218 |
| HIV Antibody Test | $9$8$285 | $126 | $313 |
| Home Sleep Study | $290$154$979 | $432 | $1,076 |
| Individual Therapy Session (45 Minutes) | $165$152$565 | $249 | $621 |
| Inguinal Hernia Repair (Open) | $3,589$3.1k$6.9k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $202$158$683 | $301 | $750 |
| Initial Psychiatric Evaluation with Medication Management | $165$110$410 | $181 | $450 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,569$568$5.5k | $2,424 | $6,034 |
| IUD Insertion | $272$106$2.6k | $174 | $432 |
| IUD Removal | $266$83$2.6k | $137 | $341 |
| Knee Arthroscopy with Meniscectomy | $3,299$3.1k$6.4k | — | — |
| Laparoscopic Appendectomy | $5,818$4.3k$11k | — | — |
| Laparoscopic Gallbladder Removal | $5,732$4.3k$11k | — | — |
| Laparoscopic Tubal Ligation | $5,732$3.5k$11k | — | — |
| Lipid Panel (Cholesterol Test) | $13$5$228 | $52 | $129 |
| Lumbar Epidural Steroid Injection | $1,149$561$2.6k | $923 | $2,297 |
| Lumbar Puncture (Spinal Tap) | $1,361$680$2.6k | $1,166 | $2,904 |
| Lumbar Spinal Fusion (Posterior) | $1,819$695$36k | $1,142 | $2,842 |
| Lumpectomy (Partial Mastectomy) | $1,324$415$12k | $682 | $1,697 |
| MRI Abdomen with and without Contrast | $748$351$2.6k | $1,155 | $2,875 |
| MRI Brain with and without Contrast | $915$351$3.2k | $1,428 | $3,556 |
| MRI Brain with Contrast | $651$351$2.2k | $986 | $2,454 |
| MRI Brain without Contrast | $1,147$237$4.0k | $1,400 | $3,486 |
| MRI Cervical Spine (Neck) without Contrast | $575$237$2.0k | $888 | $2,210 |
| MRI Knee without Contrast | $612$237$2.2k | $955 | $2,378 |
| MRI Lower Back (Lumbar Spine) without Contrast | $590$237$2.0k | $829 | $2,065 |
| MRI Thoracic Spine (Mid-back) without Contrast | $662$237$2.3k | $1,034 | $2,573 |
| Newborn Circumcision | $1,747$667$4.0k | $1,096 | $2,729 |
| Nuclear Cardiac Stress Test | $1,585$1.2k$5.3k | $2,333 | $5,807 |
| Office Visit, Established Patient (Level 3) | $214$83$308 | $136 | $339 |
| Office Visit, New Patient (Level 3) | $253$98$366 | $161 | $402 |
| Pacemaker Insertion (Dual Chamber) | $3,845$1.5k$21k | $2,413 | $6,008 |
| PET/CT Scan, Whole Body | $2,866$1.4k$5.4k | $2,391 | $5,952 |
| Pregnancy Ultrasound (Second or Third Trimester) | $267$104$924 | $408 | $1,015 |
| Prostate Biopsy | $2,113$1.1k$4.0k | $1,738 | $4,327 |
| PSA Prostate Cancer Screening | $19$16$231 | $102 | $254 |
| Pulmonary Function Test with Bronchodilator | $233$88$612 | $145 | $362 |
| Rotator Cuff Repair (Arthroscopic) | $7,019$3.5k$14k | — | — |
| Screening Mammogram | $218$85$315 | $139 | $346 |
| Septoplasty (Deviated Septum Repair) | $2,709$849$6.4k | $1,395 | $3,473 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,801$3.5k$14k | — | — |
| Skin Biopsy (Tangential) | $119$45$1.5k | $75 | $186 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $912$286$5.0k | $470 | $1,169 |
| Sleep Study (In-lab Polysomnography) | $1,758$1000$5.9k | $2,625 | $6,534 |
| Spinal Cord Stimulator Trial | $6,641$1.9k$15k | $6,462 | $16,087 |
| Spirometry (Breathing Test) | $161$67$307 | $110 | $273 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,330$3.2k$6.4k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,812$2.7k$12k | — | — |
| Total Hip Replacement | $12,831$3.1k$25k | — | — |
| Total Knee Replacement | $12,831$3.1k$25k | — | — |
| Total Mastectomy | $6,503$4.2k$13k | — | — |
| TSH Thyroid Function Test | $17$14$154 | $68 | $169 |
| TURP (Transurethral Prostate Resection) | $4,997$3.1k$10.0k | — | — |
| Umbilical Hernia Repair | $4,615$4.2k$5.0k | — | — |
| Upper GI Endoscopy (EGD) | $1,250$611$2.6k | $1,004 | $2,500 |
| Urinalysis with Microscopy | $3$3$108 | $48 | $119 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $3,078 | — | — |
| Vaginal Delivery (Global Package) | $3,078 | — | — |
| Vaginal Hysterectomy | $5,020$1.5k$9.7k | — | — |
| Vasectomy | $2,083$1.9k$4.0k | — | — |
| Vitamin D Blood Test | $31$23$80 | $32 | $80 |