| Abdominal Hysterectomy | $2,077 | — | — |
| ACL Reconstruction (Arthroscopic) | $6,727$2.2k$9.8k | — | — |
| Allergy Skin Testing | $796$14$1.2k | $43 | $43 |
| Basic Metabolic Panel | $11$8$15 | $45 | $45 |
| Bone Marrow Biopsy | $1,531$140$2.2k | $5,578 | $5,578 |
| Breast Biopsy (Ultrasound-guided) | $1,531$307$2.2k | $4,855 | $4,855 |
| Bunion Correction Surgery | $3,555$1.1k$4.4k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $24,231$3.7k$35k | $72,263 | $72,263 |
| Cardiac Catheterization (Left Heart) | $3,261$2.9k$4.4k | $15,085 | $15,085 |
| Cardiac Stress Test (Treadmill) | $83$83$295 | — | — |
| Carpal Tunnel Release Surgery | $2,122$913$2.6k | $7,256 | $7,256 |
| Cataract Surgery with Lens Implant | $2,508$1.1k$3.3k | — | — |
| Cervical Spinal Fusion (Anterior) | $12,913$3.5k$17k | — | — |
| Cesarean Delivery (Global Package) | $4,452 | — | — |
| Chemotherapy Infusion (First Hour) | $393$306$511 | $1,199 | $1,199 |
| Chest X-ray (2 Views) | $81$46$117 | $384 | $384 |
| Colonoscopy with Biopsy | $1,200$403$1.6k | — | — |
| Complete Abdominal Ultrasound | $113$97$152 | $1,207 | $1,207 |
| Complete Blood Count (CBC) with Differential | $10$7$10 | $37 | $37 |
| Comprehensive Metabolic Panel | $13$10$19 | $59 | $59 |
| Coronary Angioplasty with Stent | $10,702$1.2k$16k | $35,038 | $35,038 |
| Critical Care, First Hour | $766$402$1.1k | $4,708 | $4,708 |
| CT Abdomen and Pelvis with Contrast | $407$323$469 | $5,181 | $5,181 |
| CT Cardiac Calcium Scoring | $104$81$147 | $134 | $134 |
| CT Chest without Contrast | $141$97$435 | $2,304 | $2,304 |
| CT Head without Contrast | $135$97$335 | $2,244 | $2,244 |
| DEXA Bone Density Scan | $105$59$141 | $628 | $628 |
| Diagnostic Colonoscopy | $1,010$371$1.3k | — | — |
| Diagnostic Mammogram (Both Breasts) | $121$94$220 | $857 | $857 |
| Ear Tube Placement (Tympanostomy) | $1,686$328$2.3k | — | — |
| Echocardiogram (Complete with Doppler) | $550$507$735 | $2,260 | $2,260 |
| EKG (Electrocardiogram, 12-lead) | $20$20$46 | — | — |
| Emergency Room Visit (Level 3) | $281$133$367 | $1,316 | $1,316 |
| Group Therapy Session | $98$80$137 | — | — |
| Hemodialysis Treatment | $243$243$409 | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$7$18 | $42 | $42 |
| HIV Antibody Test | $9$8$12 | — | — |
| Holter Monitor (24-48 Hour Heart Monitor) | $63$63$284 | — | — |
| Home Sleep Study | $214$160$291 | $1,393 | $1,393 |
| Individual Therapy Session (45 Minutes) | $180$149$298 | $348 | $348 |
| Inguinal Hernia Repair (Open) | $3,890$1.1k$4.8k | — | — |
| Initial Hospital Admission (Level 1) | $85$85$242 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $180$149$469 | $512 | $512 |
| Initial Psychiatric Evaluation with Medication Management | $180$149$537 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $621$621$1.3k | $1,982 | $1,982 |
| IUD Insertion | $206$81$206 | $434 | $434 |
| IUD Removal | $331$106$410 | $1,120 | $1,120 |
| Knee Arthroscopy with Meniscectomy | $3,555$1.2k$4.4k | — | — |
| Laparoscopic Appendectomy | $6,035$1.2k$8.1k | — | — |
| Laparoscopic Gallbladder Removal | $6,035$1.4k$8.1k | — | — |
| Laparoscopic Tubal Ligation | $6,035$1.3k$8.1k | — | — |
| Lipid Panel (Cholesterol Test) | $15$12$20 | $36 | $36 |
| Lumbar Epidural Steroid Injection | $654$201$950 | $2,585 | $2,585 |
| Lumbar Puncture (Spinal Tap) | $654$131$950 | $2,540 | $2,540 |
| Lumbar Spinal Fusion (Posterior) | $16,255$3.6k$24k | — | — |
| Lumpectomy (Partial Mastectomy) | $3,938$1.4k$5.3k | — | — |
| MRI Abdomen with and without Contrast | $469$323$1.4k | $5,536 | $5,536 |
| MRI Brain with and without Contrast | $425$323$1.3k | $6,234 | $6,234 |
| MRI Brain with Contrast | $379$323$1.1k | $4,563 | $4,563 |
| MRI Brain without Contrast | $259$221$962 | $3,936 | $3,936 |
| MRI Cervical Spine (Neck) without Contrast | $259$221$838 | $3,936 | $3,936 |
| MRI Knee without Contrast | $281$221$930 | $3,636 | $3,636 |
| MRI Lower Back (Lumbar Spine) without Contrast | $259$221$852 | $3,780 | $3,780 |
| MRI Thoracic Spine (Mid-back) without Contrast | $259$221$854 | $3,522 | $3,522 |
| Newborn Circumcision | $2,271$194$2.8k | $3,882 | $3,882 |
| Nuclear Cardiac Stress Test | $1,302$683$1.7k | $5,253 | $5,253 |
| Office Visit, Established Patient (Level 3) | $72$72$217 | — | — |
| Office Visit, New Patient (Level 3) | $72$72$297 | $110 | $110 |
| Pacemaker Insertion (Dual Chamber) | $11,357$1.0k$19k | $36,253 | $36,253 |
| PET/CT Scan, Whole Body | $1,495$1.3k$1.9k | $7,656 | $7,656 |
| Pregnancy Ultrasound (Second or Third Trimester) | $113$97$171 | $1,024 | $1,024 |
| Prostate Biopsy | $623$261$623 | $7,327 | $7,327 |
| PSA Prostate Cancer Screening | $19$17$25 | $55 | $55 |
| Pulmonary Function Test with Bronchodilator | $346$68$502 | $964 | $964 |
| Rotator Cuff Repair (Arthroscopic) | $6,727$2.2k$9.8k | — | — |
| Screening Mammogram | $100$77$182 | $609 | $609 |
| Septoplasty (Deviated Septum Repair) | $3,268$1.4k$4.5k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,543$654$9.5k | — | — |
| Skin Biopsy (Tangential) | $377$60$547 | $803 | $803 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,531$134$2.2k | $5,678 | $5,678 |
| Sleep Study (In-lab Polysomnography) | $871$796$1.6k | $4,804 | $4,804 |
| Spinal Cord Stimulator Trial | $6,925$844$8.6k | $21,880 | $21,880 |
| Spirometry (Breathing Test) | $200$68$291 | $527 | $527 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,074$627$4.5k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,488$602$8.0k | — | — |
| Total Hip Replacement | $11,902$1.6k$17k | — | — |
| Total Knee Replacement | $11,902$2.2k$17k | — | — |
| Total Mastectomy | $6,679$2.0k$8.9k | — | — |
| TSH Thyroid Function Test | $18$16$23 | $84 | $84 |
| TURP (Transurethral Prostate Resection) | $4,971$1.5k$7.2k | — | — |
| Upper GI Endoscopy (EGD) | $985$247$1.2k | — | — |
| Urinalysis with Microscopy | $4$3$4 | $20 | $20 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,675 | — | — |
| Vaginal Delivery (Global Package) | $4,452 | — | — |
| Vaginal Hysterectomy | $4,638$1.7k$6.7k | — | — |
| Vasectomy | $2,271$373$3.3k | $8,014 | $8,014 |
| Vitamin D Blood Test | $31$27$40 | $127 | $127 |