| Abdominal Hysterectomy | $7,885$5.5k$10k | $1,554 | $1,942 |
| ACL Reconstruction (Arthroscopic) | $8,885$7.2k$9.5k | $1,665 | $2,081 |
| Allergy Skin Testing | $856 | $8 | $10 |
| Basic Metabolic Panel | $10$8$11 | $235 | $294 |
| Bone Marrow Biopsy | $1,900$1.6k$2.2k | $1,313 | $1,641 |
| Breast Biopsy (Ultrasound-guided) | $1,646$1.2k$3.0k | $1,540 | $1,925 |
| Bunion Correction Surgery | $3,446$3.3k$5.5k | $821 | $1,026 |
| Cardiac Ablation for Atrial Fibrillation | $19,022$12k$26k | — | — |
| Cardiac Catheterization (Left Heart) | $5,115$3.2k$7.0k | — | — |
| Carpal Tunnel Release Surgery | $2,587$1.9k$3.8k | $838 | $1,047 |
| Cataract Surgery with Lens Implant | $3,800$2.3k$4.2k | $774 | $968 |
| Cervical Spinal Fusion (Anterior) | $12,793$9.5k$38k | $2,613 | $3,266 |
| Cesarean Delivery (Global Package) | $10,938 | $3,629 | $4,536 |
| Chemotherapy Infusion (First Hour) | $470$329$611 | $792 | $990 |
| Chest X-ray (2 Views) | $87 | $271 | $339 |
| Colonoscopy with Biopsy | $1,192$1.1k$3.0k | $633 | $791 |
| Complete Abdominal Ultrasound | $104 | $1,561 | $1,951 |
| Complete Blood Count (CBC) with Differential | $8$8$10 | $111 | $139 |
| Comprehensive Metabolic Panel | $13$11$14 | $303 | $379 |
| Coronary Angioplasty with Stent | $11,503$9.5k$13k | — | — |
| Critical Care, First Hour | $823 | $334 | $417 |
| CT Abdomen and Pelvis with Contrast | $348 | $5,874 | $7,342 |
| CT Cardiac Calcium Scoring | $87 | — | — |
| CT Chest without Contrast | $104 | $2,470 | $3,088 |
| CT Head without Contrast | $104 | $2,674 | $3,343 |
| DEXA Bone Density Scan | $104 | $702 | $878 |
| Diagnostic Colonoscopy | $1,016$927$3.0k | $337 | $421 |
| Diagnostic Mammogram (Both Breasts) | $101 | $720 | $900 |
| Ear Tube Placement (Tympanostomy) | $2,369$1.5k$3.0k | $318 | $397 |
| Echocardiogram (Complete with Doppler) | $544 | $2,698 | $3,372 |
| EKG (Electrocardiogram, 12-lead) | — | $92 | $115 |
| Emergency Room Visit (Level 3) | $272 | $626 | $783 |
| Group Therapy Session | $101 | $33 | $41 |
| Hemoglobin A1c (Diabetes Test) | $12$10$13 | $27 | $34 |
| HIV Antibody Test | $11$9$12 | $35 | $44 |
| Home Sleep Study | $215 | $838 | $1,047 |
| Individual Therapy Session (45 Minutes) | — | $146 | $182 |
| Inguinal Hernia Repair (Open) | $4,937$3.6k$5.5k | $1,026 | $1,282 |
| Initial Hospital Admission (Level 1) | — | $110 | $137 |
| Initial Psychiatric Diagnostic Evaluation | — | $168 | $210 |
| Initial Psychiatric Evaluation with Medication Management | — | $203 | $254 |
| IUD Insertion | $1,040$981$1.1k | $74 | $93 |
| IUD Removal | $304$226$1.1k | $267 | $334 |
| Knee Arthroscopy with Meniscectomy | $4,140$3.3k$5.5k | $918 | $1,148 |
| Laparoscopic Appendectomy | $6,540$6.0k$9.5k | $926 | $1,157 |
| Laparoscopic Gallbladder Removal | $6,529$6.0k$9.5k | $1,028 | $1,285 |
| Laparoscopic Tubal Ligation | $6,258$6.0k$9.5k | $1,292 | $1,615 |
| Lipid Panel (Cholesterol Test) | $16$13$17 | $17 | $21 |
| Lumbar Epidural Steroid Injection | $765$703$1.9k | $1,186 | $1,482 |
| Lumbar Puncture (Spinal Tap) | $1,231$703$1.9k | $598 | $747 |
| Lumbar Spinal Fusion (Posterior) | $17,471$9.5k$29k | $2,628 | $3,285 |
| Lumpectomy (Partial Mastectomy) | $3,901$3.8k$5.1k | $1,001 | $1,251 |
| MRI Abdomen with and without Contrast | $348 | $4,934 | $6,168 |
| MRI Brain with and without Contrast | $348 | $5,052 | $6,315 |
| MRI Brain with Contrast | $348 | $4,606 | $5,758 |
| MRI Brain without Contrast | $238 | $3,994 | $4,992 |
| MRI Cervical Spine (Neck) without Contrast | $238 | $3,631 | $4,539 |
| MRI Knee without Contrast | $238 | $4,621 | $5,777 |
| MRI Lower Back (Lumbar Spine) without Contrast | $238 | $3,631 | $4,539 |
| MRI Thoracic Spine (Mid-back) without Contrast | $238 | $3,631 | $4,539 |
| Newborn Circumcision | $2,083$1.4k$3.8k | $1,855 | $2,319 |
| Nuclear Cardiac Stress Test | $1,290 | $6,863 | $8,579 |
| Office Visit, Established Patient (Level 3) | — | $269 | $336 |
| Office Visit, New Patient (Level 3) | — | $238 | $298 |
| Pacemaker Insertion (Dual Chamber) | $12,000$10k$18k | $803 | $1,004 |
| PET/CT Scan, Whole Body | $1,425 | $7,810 | $9,762 |
| Pregnancy Ultrasound (Second or Third Trimester) | $104 | $1,002 | $1,253 |
| Prostate Biopsy | $2,505$2.0k$3.0k | — | — |
| PSA Prostate Cancer Screening | $21$18$25 | $90 | $112 |
| Pulmonary Function Test with Bronchodilator | $372 | $272 | $340 |
| Rotator Cuff Repair (Arthroscopic) | $7,230$7.1k$9.5k | $1,658 | $2,073 |
| Screening Mammogram | $83 | $618 | $773 |
| Septoplasty (Deviated Septum Repair) | $3,800$3.3k$4.3k | $982 | $1,228 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $5,898$5.5k$7.0k | $613 | $766 |
| Skin Biopsy (Tangential) | $405$110$1.1k | $170 | $212 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,900$1.6k$2.2k | $706 | $882 |
| Sleep Study (In-lab Polysomnography) | $856 | $1,072 | $1,341 |
| Spinal Cord Stimulator Trial | $8,849$6.4k$9.5k | $13,835 | $17,294 |
| Spirometry (Breathing Test) | $215 | $117 | $146 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,304$2.4k$3.8k | $475 | $594 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $3,800$3.6k$5.9k | $457 | $571 |
| Total Hip Replacement | $12,793$11k$23k | $2,422 | $3,027 |
| Total Knee Replacement | $12,793$11k$23k | $2,586 | $3,232 |
| Total Mastectomy | $6,616$5.5k$10.0k | $1,936 | $2,420 |
| TSH Thyroid Function Test | $20$17$22 | $137 | $172 |
| TURP (Transurethral Prostate Resection) | $5,343$5.3k$7.0k | $1,270 | $1,587 |
| Upper GI Endoscopy (EGD) | $904$897$3.0k | $1,411 | $1,764 |
| Urinalysis with Microscopy | $4$3$4 | $82 | $103 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $10,373 | — | — |
| Vaginal Delivery (Global Package) | $9,854 | $3,283 | $4,104 |
| Vaginal Hysterectomy | $5,500$5.0k$6.3k | $1,286 | $1,608 |
| Vasectomy | $2,083$1.8k$3.8k | $1,033 | $1,291 |
| Vitamin D Blood Test | $35$30$39 | $79 | $99 |