| Abdominal Hysterectomy | $844 | $1,567 | $1,844 |
| ACL Reconstruction (Arthroscopic) | $7,199$2.3k$14k | $1,524 | $1,793 |
| Allergy Skin Testing | $49$39$1.9k | $48 | $56 |
| Anesthesia for Screening Colonoscopy | $60 | — | — |
| Anesthesia for Upper Endoscopy | $75 | — | — |
| Basic Metabolic Panel | $127$8$285 | $136 | $160 |
| Bone Marrow Biopsy | $1,633$525$3.1k | — | — |
| Breast Biopsy (Ultrasound-guided) | $4,872$475$11k | $5,100 | $6,000 |
| Bunion Correction Surgery | $3,270$1.0k$6.2k | $1,050 | $1,235 |
| Cardiac Ablation for Atrial Fibrillation | $26,464$7.5k$57k | $27,200 | $32,000 |
| Cardiac Catheterization (Left Heart) | $12,992$1.9k$28k | $13,600 | $16,000 |
| Cardiac Stress Test (Treadmill) | $115 | $165 | $194 |
| Carpal Tunnel Release Surgery | $2,699$625$6.2k | $2,763 | $3,250 |
| Cataract Surgery with Lens Implant | $2,298$755$4.4k | — | — |
| Cervical Spinal Fusion (Anterior) | $12,966$2.7k$25k | $2,219 | $2,610 |
| Cesarean Delivery (Global Package) | $6,010$4.9k$12k | $5,950 | $7,000 |
| Chemotherapy Infusion (First Hour) | $771$114$1.7k | $808 | $950 |
| Chest X-ray (2 Views) | $406$74$890 | $425 | $500 |
| Colonoscopy with Biopsy | $1,737$382$3.7k | $1,785 | $2,100 |
| Complete Abdominal Ultrasound | $1,218$91$2.7k | $1,275 | $1,500 |
| Complete Blood Count (CBC) with Differential | $87$7$196 | $94 | $110 |
| Comprehensive Metabolic Panel | $182$10$409 | $196 | $230 |
| Coronary Angioplasty with Stent | $18,194$4.1k$39k | $18,700 | $22,000 |
| Critical Care, First Hour | $3,248$122$7.1k | $3,400 | $4,000 |
| CT Abdomen and Pelvis with Contrast | $2,700$252$7.5k | $3,060 | $3,600 |
| CT Cardiac Calcium Scoring | $43$35$169 | $43 | $50 |
| CT Chest without Contrast | $1,170$107$4.5k | $1,615 | $1,900 |
| CT Head without Contrast | $990$107$4.5k | $1,530 | $1,800 |
| DEXA Bone Density Scan | $406$91$890 | $425 | $500 |
| Diagnostic Colonoscopy | $1,654$296$3.6k | $1,700 | $2,000 |
| Diagnostic Mammogram (Both Breasts) | $284$93$623 | $298 | $350 |
| Ear Tube Placement (Tympanostomy) | $1,493$494$2.8k | $258 | $303 |
| Echocardiogram (Complete with Doppler) | $2,598$178$5.7k | $2,720 | $3,200 |
| EKG (Electrocardiogram, 12-lead) | $27$26$28 | $120 | $141 |
| Emergency Room Visit (Level 3) | $1,299$92$2.8k | $1,360 | $1,600 |
| Group Therapy Session | $93$93$177 | $49 | $58 |
| Hemodialysis Treatment | $114 | $174 | $205 |
| Hemoglobin A1c (Diabetes Test) | $87$9$196 | $94 | $110 |
| HIV Antibody Test | $28$8$62 | $30 | $35 |
| Holter Monitor (24-48 Hour Heart Monitor) | $164$149$180 | $243 | $286 |
| Home Sleep Study | $467$127$1.0k | $489 | $575 |
| Individual Therapy Session (45 Minutes) | $172$140$356 | $170 | $200 |
| Inguinal Hernia Repair (Open) | $3,556$1.1k$6.8k | $1,576 | $1,854 |
| Initial Hospital Admission (Level 1) | $76$61$222 | $151 | $178 |
| Initial Psychiatric Diagnostic Evaluation | $301$162$623 | $298 | $350 |
| Initial Psychiatric Evaluation with Medication Management | $172$140$356 | $170 | $200 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,030$487$4.5k | $2,125 | $2,500 |
| IUD Insertion | $645$72$1.6k | $691 | $813 |
| IUD Removal | $560$257$1.4k | $595 | $700 |
| Knee Arthroscopy with Meniscectomy | $3,270$1.0k$6.2k | $961 | $1,131 |
| Laparoscopic Appendectomy | $5,879$1.9k$11k | $1,345 | $1,582 |
| Laparoscopic Gallbladder Removal | $5,879$1.9k$11k | $1,692 | $1,991 |
| Laparoscopic Tubal Ligation | $5,879$1.9k$11k | $1,028 | $1,209 |
| Lipid Panel (Cholesterol Test) | $95$13$214 | $102 | $120 |
| Lumbar Epidural Steroid Injection | $1,698$377$4.1k | $1,798 | $2,115 |
| Lumbar Puncture (Spinal Tap) | $1,462$224$3.2k | $1,530 | $1,800 |
| Lumbar Spinal Fusion (Posterior) | $18,532$6.0k$35k | $2,449 | $2,881 |
| Lumpectomy (Partial Mastectomy) | $3,859$801$8.0k | $3,825 | $4,500 |
| MRI Abdomen with and without Contrast | $2,250$313$6.9k | $2,720 | $3,200 |
| MRI Brain with and without Contrast | $2,700$360$8.0k | $3,188 | $3,750 |
| MRI Brain with Contrast | $2,070$313$5.7k | $2,338 | $2,750 |
| MRI Brain without Contrast | $1,170$234$4.8k | $1,700 | $2,000 |
| MRI Cervical Spine (Neck) without Contrast | $1,350$234$4.5k | $1,700 | $2,000 |
| MRI Knee without Contrast | $1,620$234$4.5k | $1,828 | $2,150 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,350$234$4.5k | $1,700 | $2,000 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,350$198$4.5k | $1,700 | $2,000 |
| Newborn Circumcision | $2,064$210$6.2k | $1,615 | $1,900 |
| Nuclear Cardiac Stress Test | $4,385$1.1k$9.6k | $4,590 | $5,400 |
| Office Visit, Established Patient (Level 3) | $223$182$463 | $221 | $260 |
| Office Visit, New Patient (Level 3) | $107$88$223 | $106 | $125 |
| Pacemaker Insertion (Dual Chamber) | $19,021$8.8k$41k | $19,550 | $23,000 |
| PET/CT Scan, Whole Body | $6,334$1.3k$14k | $6,630 | $7,800 |
| Pregnancy Ultrasound (Second or Third Trimester) | $736$107$1.8k | $680 | $800 |
| Prostate Biopsy | $2,064$660$3.9k | $388 | $456 |
| PSA Prostate Cancer Screening | $71$17$160 | $77 | $90 |
| Pulmonary Function Test with Bronchodilator | $609$102$1.3k | $638 | $750 |
| Rotator Cuff Repair (Arthroscopic) | $7,199$2.3k$14k | $1,717 | $2,020 |
| Screening Mammogram | $203$77$445 | $213 | $250 |
| Septoplasty (Deviated Septum Repair) | $3,268$1.0k$6.2k | $862 | $1,014 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,976$2.2k$13k | $649 | $764 |
| Skin Biopsy (Tangential) | $482$126$1.1k | $499 | $588 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,631$525$3.4k | $1,615 | $1,900 |
| Sleep Study (In-lab Polysomnography) | $4,060$339$8.9k | $4,250 | $5,000 |
| Spinal Cord Stimulator Trial | $6,613$6.6k$13k | $2,081 | $2,448 |
| Spirometry (Breathing Test) | $227$51$490 | $234 | $275 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,268$1.0k$6.2k | $459 | $540 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,961$1.9k$11k | $439 | $516 |
| Total Hip Replacement | $12,966$8.5k$25k | $2,238 | $2,633 |
| Total Knee Replacement | $12,966$4.3k$25k | $2,396 | $2,819 |
| Total Mastectomy | $6,572$1.2k$12k | $1,631 | $1,919 |
| TSH Thyroid Function Test | $142$16$320 | $153 | $180 |
| TURP (Transurethral Prostate Resection) | $5,123$1.7k$9.7k | — | — |
| Umbilical Hernia Repair | $463$447$1.3k | — | — |
| Upper GI Endoscopy (EGD) | $2,030$294$4.5k | $2,125 | $2,500 |
| Urinalysis with Microscopy | $71$3$160 | $77 | $90 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $1,380 | $2,952 | $3,473 |
| Vaginal Delivery (Global Package) | $2,326$1.4k$5.4k | $4,218 | $4,962 |
| Vaginal Hysterectomy | $4,974$1.6k$9.5k | $1,306 | $1,536 |
| Vasectomy | $2,842$660$6.2k | $2,890 | $3,400 |
| Vitamin D Blood Test | $142$25$320 | $153 | $180 |