| Abdominal Hysterectomy | $3,085$825$3.1k | — | — |
| ACL Reconstruction (Arthroscopic) | $11,739$825$35k | — | — |
| Allergy Skin Testing | $1,061$91$3.0k | — | — |
| Basic Metabolic Panel | $17$8$57 | — | — |
| Bone Marrow Biopsy | $2,833$725$7.0k | — | — |
| Breast Biopsy (Ultrasound-guided) | $2,833$750$5.8k | $3,697 | $3,697 |
| Bunion Correction Surgery | $5,403$825$12k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $39,572$900$92k | — | — |
| Cardiac Catheterization (Left Heart) | $5,634$825$13k | $8,999 | $8,999 |
| Cardiac Stress Test (Treadmill) | $221$221$1.1k | — | — |
| Carpal Tunnel Release Surgery | $3,360$775$6.9k | — | — |
| Cataract Surgery with Lens Implant | $3,948$775$8.7k | — | — |
| Cervical Spinal Fusion (Anterior) | $22,066$825$52k | — | — |
| Cesarean Delivery (Global Package) | $7,278 | — | — |
| Chemotherapy Infusion (First Hour) | $594$396$1.4k | $1,163 | $1,163 |
| Chest X-ray (2 Views) | $118$89$306 | $286 | $286 |
| Colonoscopy with Biopsy | $2,018$750$4.2k | $1,852 | $1,852 |
| Complete Abdominal Ultrasound | $161$125$386 | $669 | $669 |
| Complete Blood Count (CBC) with Differential | $16$8$53 | $38 | $38 |
| Comprehensive Metabolic Panel | $21$11$72 | — | — |
| Coronary Angioplasty with Stent | $19,914$825$48k | — | — |
| Critical Care, First Hour | $1,460$990$2.9k | $3,319 | $3,319 |
| CT Abdomen and Pelvis with Contrast | $667$418$1.3k | $1,531 | $1,531 |
| CT Cardiac Calcium Scoring | $129$26$306 | $198 | $198 |
| CT Chest without Contrast | $208$125$385 | $515 | $515 |
| CT Head without Contrast | $208$125$385 | $515 | $515 |
| DEXA Bone Density Scan | $161$125$385 | $442 | $442 |
| Diagnostic Colonoscopy | $1,534$750$3.7k | $1,851 | $1,851 |
| Diagnostic Mammogram (Both Breasts) | $221$132$495 | $612 | $612 |
| Ear Tube Placement (Tympanostomy) | $2,634$750$8.1k | — | — |
| Echocardiogram (Complete with Doppler) | $1,003$655$2.1k | $2,008 | $2,008 |
| EKG (Electrocardiogram, 12-lead) | $77$53$279 | — | — |
| Emergency Room Visit (Level 3) | $459$327$1.1k | $1,103 | $1,103 |
| Group Therapy Session | $152$22$357 | — | — |
| Hemodialysis Treatment | $310$310$618 | — | — |
| Hemoglobin A1c (Diabetes Test) | $19$10$66 | $47 | $47 |
| HIV Antibody Test | $17$9$60 | $40 | $40 |
| Holter Monitor (24-48 Hour Heart Monitor) | $368$282$636 | — | — |
| Home Sleep Study | $295$259$759 | — | — |
| Individual Therapy Session (45 Minutes) | $259$39$624 | $169 | $169 |
| Inguinal Hernia Repair (Open) | $6,070$825$13k | — | — |
| Initial Hospital Admission (Level 1) | $301$301$3.6k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $259$39$624 | $417 | $417 |
| Initial Psychiatric Evaluation with Medication Management | $259$39$624 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,449$839$2.5k | — | — |
| IUD Insertion | $300$162$597 | — | — |
| IUD Removal | $393$300$1.2k | $626 | $626 |
| Knee Arthroscopy with Meniscectomy | $5,403$825$12k | — | — |
| Laparoscopic Appendectomy | $9,465$825$21k | — | — |
| Laparoscopic Gallbladder Removal | $9,465$825$21k | — | — |
| Laparoscopic Tubal Ligation | $9,465$825$21k | — | — |
| Lipid Panel (Cholesterol Test) | $27$13$91 | $65 | $65 |
| Lumbar Epidural Steroid Injection | $1,233$725$2.9k | $2,300 | $2,300 |
| Lumbar Puncture (Spinal Tap) | $1,233$725$2.9k | $2,300 | $2,300 |
| Lumbar Spinal Fusion (Posterior) | $22,066$825$62k | — | — |
| Lumpectomy (Partial Mastectomy) | $5,800$775$14k | — | — |
| MRI Abdomen with and without Contrast | $726$418$1.3k | $2,021 | $2,021 |
| MRI Brain with and without Contrast | $726$418$1.3k | $2,021 | $2,021 |
| MRI Brain with Contrast | $726$418$1.3k | $1,576 | $1,576 |
| MRI Brain without Contrast | $461$286$841 | $1,075 | $1,075 |
| MRI Cervical Spine (Neck) without Contrast | $461$286$841 | $1,075 | $1,075 |
| MRI Knee without Contrast | $461$286$841 | $1,613 | $1,613 |
| MRI Lower Back (Lumbar Spine) without Contrast | $461$286$841 | $1,075 | $1,075 |
| MRI Thoracic Spine (Mid-back) without Contrast | $461$286$841 | $1,075 | $1,075 |
| Newborn Circumcision | $3,583$775$7.5k | — | — |
| Nuclear Cardiac Stress Test | $2,250$1.6k$4.8k | $5,220 | $5,220 |
| Office Visit, Established Patient (Level 3) | $152$33$152 | $139 | $139 |
| Office Visit, New Patient (Level 3) | $227$33$227 | $207 | $207 |
| Pacemaker Insertion (Dual Chamber) | $18,789$900$37k | $25,959 | $25,959 |
| PET/CT Scan, Whole Body | $2,590$1.7k$5.3k | $5,916 | $5,916 |
| Pregnancy Ultrasound (Second or Third Trimester) | $161$125$385 | $580 | $580 |
| Prostate Biopsy | $3,583$750$7.5k | — | — |
| PSA Prostate Cancer Screening | $36$18$125 | $89 | $89 |
| Pulmonary Function Test with Bronchodilator | $528$447$1.3k | $966 | $966 |
| Rotator Cuff Repair (Arthroscopic) | $11,739$825$26k | — | — |
| Screening Mammogram | $173$96$409 | $506 | $506 |
| Septoplasty (Deviated Septum Repair) | $4,595$775$12k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $10,602$825$25k | — | — |
| Skin Biopsy (Tangential) | $524$300$1.4k | $437 | $437 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,833$725$5.8k | $2,314 | $2,314 |
| Sleep Study (In-lab Polysomnography) | $1,712$1.0k$4.3k | — | — |
| Spinal Cord Stimulator Trial | $11,075$825$26k | $11,342 | $11,342 |
| Spirometry (Breathing Test) | $295$259$759 | $526 | $526 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,595$775$12k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $8,052$775$21k | — | — |
| Total Hip Replacement | $18,288$900$45k | — | — |
| Total Knee Replacement | $20,848$900$45k | — | — |
| Total Mastectomy | $10,123$825$23k | — | — |
| TSH Thyroid Function Test | $33$17$114 | $81 | $81 |
| TURP (Transurethral Prostate Resection) | $8,280$825$19k | — | — |
| Upper GI Endoscopy (EGD) | $1,568$750$3.7k | $2,300 | $2,300 |
| Urinalysis with Microscopy | $6$3$22 | $15 | $15 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $7,278 | — | — |
| Vaginal Delivery (Global Package) | $6,438$6.0k$6.4k | $7,014 | $7,014 |
| Vaginal Hysterectomy | $8,497$825$18k | — | — |
| Vasectomy | $3,583$775$7.5k | — | — |
| Vitamin D Blood Test | $58$30$201 | $143 | $143 |