| Abdominal Hysterectomy | $5,500$2.3k$8.7k2 plans | — | — |
| ACL Reconstruction (Arthroscopic) | $7,631$2.3k$13k10 plansshared rate · 2 | — | — |
| Allergy Skin Testing | $23$11$1.5k8 plans | — | — |
| Basic Metabolic Panel | $24$8$528 plans | $68 | $123 |
| Bone Marrow Biopsy | $1,737$1.3k$3.0k10 plansshared rate · 2 | $785 | $1,427 |
| Breast Biopsy (Ultrasound-guided) | $2,034$1.6k$3.0k10 plansshared rate · 2 | $2,192 | $3,986 |
| Bunion Correction Surgery | $3,333$2.0k$5.9k10 plans | — | — |
| Cardiac Ablation for Atrial Fibrillation | $4,634$2.0k$47k9 plans | — | — |
| Cardiac Arrhythmia (with Complications) Inpatient | $6,947$6.1k$12k15 plans | — | — |
| Cardiac Arrhythmia (with Major Complications) Inpatient | $10,450$10k$18k15 plans | — | — |
| Cardiac Arrhythmia (without Complications) Inpatient | $5,584$4.6k$10k15 plans | — | — |
| Cardiac Catheterization (Left Heart) | $2,957$1.3k$11k9 plans | $8,772 | $15,950 |
| Cardiac Stress Test (Treadmill) | $238$136$3211 plan | — | — |
| Carpal Tunnel Release Surgery | $2,054$1.8k$3.5k10 plans | $4,322 | $7,859 |
| Cataract Surgery with Lens Implant | $2,427$2.3k$4.2k10 plans | — | — |
| Cellulitis (with Major Complications) Inpatient | $12,197$12k$21k15 plans | — | — |
| Cellulitis (without Major Complications) Inpatient | $7,958$7.3k$14k15 plans | — | — |
| Cervical Spinal Fusion (Anterior) | $13,065$7.3k$23k9 plansshared rate · 3 | — | — |
| Cesarean Delivery (Global Package) | $2,2771 planshared rate · 5 | — | — |
| Chemotherapy Infusion (First Hour) | $393$235$5968 plans | $534 | $970 |
| Chest Pain Inpatient | $6,830$5.9k$12k15 plans | — | — |
| Chest X-ray (2 Views) | $71$33$1828 plans | $279 | $507 |
| Colonoscopy with Biopsy | $1,647$1.2k$2.7k10 plans | — | — |
| Complete Abdominal Ultrasound | $217$104$3798 plansshared rate · 2 | $712 | $1,294 |
| Complete Blood Count (CBC) with Differential | $22$7$488 plans | $39 | $71 |
| Comprehensive Metabolic Panel | $30$10$658 plans | $83 | $150 |
| COPD (with Complications) Inpatient | $7,750$7.1k$14k15 plans | — | — |
| COPD (with Major Complications) Inpatient | $9,730$9.3k$17k15 plans | — | — |
| COPD (without Complications) Inpatient | $6,246$5.4k$11k15 plans | — | — |
| Coronary Angioplasty with Stent | $2,555$1.1k$21k9 plans | $9,288 | $16,887 |
| Critical Care, First Hour | $855$823$1.5k8 plans | $1,478 | $2,688 |
| CT Abdomen and Pelvis with Contrast | $641$348$9988 plans | $2,117 | $3,850 |
| CT Cardiac Calcium Scoring | $132$80$1908 plans | $81 | $148 |
| CT Chest without Contrast | $286$104$6258 plans | $547 | $994 |
| CT Head without Contrast | $237$104$4838 plans | $820 | $1,490 |
| DEXA Bone Density Scan | $112$66$2458 plans | $224 | $408 |
| Diabetes (with Complications) Inpatient | $8,148$7.6k$14k15 plans | — | — |
| Diabetes (with Major Complications) Inpatient | $12,191$12k$22k15 plans | — | — |
| Diabetes (without Complications) Inpatient | $6,091$5.2k$11k15 plans | — | — |
| Diagnostic Colonoscopy | $1,304$926$2.7k10 plans | — | — |
| Diagnostic Mammogram (Both Breasts) | $242$103$4668 plans | $330 | $600 |
| Digestive Disorders, E.g. Gastroenteritis (with Major Complications) Inpatient | $10,931$11k$19k15 plans | — | — |
| Digestive Disorders, E.g. Gastroenteritis (without Major Complications) Inpatient | $7,275$6.5k$13k15 plans | — | — |
| Ear Tube Placement (Tympanostomy) | $2,034$1.5k$2.8k10 plansshared rate · 2 | — | — |
| Echocardiogram (Complete with Doppler) | $432$206$9858 plans | $2,077 | $3,777 |
| EKG (Electrocardiogram, 12-lead) | $55$32$741 plan | — | — |
| Emergency Room Visit (Level 3) | $283$272$4928 plans | $424 | $772 |
| GI Hemorrhage (with Complications) Inpatient | $8,780$8.2k$16k15 plans | — | — |
| GI Hemorrhage (with Major Complications) Inpatient | $15,118$15k$27k15 plans | — | — |
| GI Hemorrhage (without Complications) Inpatient | $6,159$5.3k$11k15 plans | — | — |
| Group Therapy Session | $95$46$1838 plans | $194 | $353 |
| Heart Attack, Discharged Alive (with Complications) Inpatient | $8,319$7.7k$15k15 plans | — | — |
| Heart Attack, Discharged Alive (with Major Complications) Inpatient | $13,626$13k$24k15 plans | — | — |
| Heart Attack, Discharged Alive (without Complications) Inpatient | $6,853$6.0k$12k15 plans | — | — |
| Heart Failure and Shock (with Complications) Inpatient | $7,795$7.1k$14k15 plans | — | — |
| Heart Failure and Shock (with Major Complications) Inpatient | $11,047$11k$20k15 plans | — | — |
| Heart Failure and Shock (without Complications) Inpatient | $5,583$4.6k$10k15 plans | — | — |
| Hemodialysis Treatment | $325$186$4381 plan | $832 | $1,513 |
| Hemoglobin A1c (Diabetes Test) | $27$9$608 plans | $39 | $71 |
| Hip and Femur Procedures (with Complications) Inpatient | $17,224$17k$30k15 plans | — | — |
| Hip and Femur Procedures (with Major Complications) Inpatient | $23,982$23k$41k15 plans | — | — |
| Hip and Femur Procedures (without Complications) Inpatient | $13,644$13k$24k15 plans | — | — |
| Hip or Knee Replacement (with Major Complications) Inpatient | $24,916$24k$43k15 plans | — | — |
| Hip or Knee Replacement (without Major Complications) Inpatient | $15,872$16k$28k15 plans | — | — |
| HIV Antibody Test | $25$8$558 plans | $94 | $171 |
| Holter Monitor (24-48 Hour Heart Monitor) | $275$157$3701 plan | — | — |
| Home Sleep Study | $319$198$4678 plans | $825 | $1,500 |
| Individual Therapy Session (45 Minutes) | $231$138$3258 plans | $210 | $382 |
| Inguinal Hernia Repair (Open) | $3,647$2.3k$6.5k10 plans | — | — |
| Initial Hospital Admission (Level 1) | — | $136 | $248 |
| Initial Psychiatric Diagnostic Evaluation | $320$177$5128 plansshared rate · 2 | $229 | $417 |
| Initial Psychiatric Evaluation with Medication Management | $320$177$5308 plansshared rate · 2 | $151 | $275 |
| Inpatient Rehabilitation (with Complications) Inpatient | $13,028$13k$23k15 plans | — | — |
| Inpatient Rehabilitation (without Complications) Inpatient | $10,022$9.3k$18k15 plans | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,127$644$1.5k1 plan | $1,444 | $2,625 |
| IUD Insertion | $1,814$1.4k$2.3k2 plans | $126 | $228 |
| IUD Removal | $427$304$2.3k10 plans | $194 | $353 |
| Kidney Failure (with Complications) Inpatient | $7,995$7.4k$14k15 plans | — | — |
| Kidney Failure (with Major Complications) Inpatient | $12,522$12k$22k15 plans | — | — |
| Kidney Failure (without Complications) Inpatient | $5,934$5.0k$11k15 plans | — | — |
| Kidney or Urinary Tract Infection (with Major Complications) Inpatient | $10,123$9.7k$18k15 plans | — | — |
| Kidney or Urinary Tract Infection (without Major Complications) Inpatient | $7,499$6.7k$13k15 plans | — | — |
| Knee Arthroscopy with Meniscectomy | $3,441$2.3k$7.9k10 plans | — | — |
| Laparoscopic Appendectomy | $6,146$2.5k$11k10 plansshared rate · 2 | — | — |
| Laparoscopic Gallbladder Removal | $6,358$5.3k$11k10 plans | — | — |
| Laparoscopic Gallbladder Removal (with Complications) Inpatient | $14,097$14k$25k15 plans | — | — |
| Laparoscopic Gallbladder Removal (with Major Complications) Inpatient | $19,727$19k$34k15 plans | — | — |
| Laparoscopic Gallbladder Removal (without Complications) Inpatient | $11,660$11k$21k15 plans | — | — |
| Laparoscopic Tubal Ligation | $6,146$2.3k$11k10 plansshared rate · 2 | — | — |
| Lipid Panel (Cholesterol Test) | $38$12$828 plans | $69 | $125 |
| Lumbar Epidural Steroid Injection | $990$703$2.3k10 plansshared rate · 2 | $1,426 | $2,592 |
| Lumbar Puncture (Spinal Tap) | $990$703$2.3k10 plansshared rate · 2 | $1,711 | $3,110 |
| Lumbar Spinal Fusion (Posterior) | $17,843$7.3k$32k9 plans | — | — |
| Lumpectomy (Partial Mastectomy) | $3,981$2.0k$7.1k10 plans | — | — |
| Major Bowel Procedure (with Complications) Inpatient | $19,621$19k$34k15 plans | — | — |
| Major Bowel Procedure (with Major Complications) Inpatient | $36,989$35k$63k15 plans | — | — |
| Major Bowel Procedure (without Complications) Inpatient | $14,032$14k$25k15 plans | — | — |
| MRI Abdomen with and without Contrast | $846$348$1.8k8 plans | $1,552 | $2,822 |
| MRI Brain with and without Contrast | $826$348$1.7k8 plans | $1,552 | $2,822 |
| MRI Brain with Contrast | $776$348$1.5k8 plans | $1,366 | $2,484 |
| MRI Brain without Contrast | $590$238$1.3k8 plans | $1,033 | $1,877 |
| MRI Cervical Spine (Neck) without Contrast | $540$238$1.2k8 plans | $1,400 | $2,545 |
| MRI Knee without Contrast | $474$238$8218 plans | $1,180 | $2,146 |
| MRI Lower Back (Lumbar Spine) without Contrast | $541$238$1.2k8 plans | $958 | $1,741 |
| MRI Thoracic Spine (Mid-back) without Contrast | $541$238$1.2k8 plans | $1,180 | $2,146 |
| Newborn Circumcision | $2,198$1.3k$3.8k10 plansshared rate · 2 | $4,220 | $7,673 |
| Nuclear Cardiac Stress Test | $1,317$688$2.9k8 plans | $2,881 | $5,238 |
| Office Visit, Established Patient (Level 3) | — | $131 | $238 |
| Office Visit, New Patient (Level 3) | — | $161 | $294 |
| Pacemaker Insertion (Dual Chamber) | $10,820$2.3k$19k9 plans | $5,676 | $10,320 |
| PET/CT Scan, Whole Body | $2,603$1.4k$4.0k8 plans | $3,521 | $6,402 |
| Pneumonia and Pleurisy (with Complications) Inpatient | $7,472$6.8k$13k15 plans | — | — |
| Pneumonia and Pleurisy (with Major Complications) Inpatient | $11,276$11k$20k15 plans | — | — |
| Pneumonia and Pleurisy (without Complications) Inpatient | $6,133$5.2k$11k15 plans | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $217$104$3798 plansshared rate · 2 | $605 | $1,100 |
| Prostate Biopsy | $2,277$1.8k$2.7k3 plansshared rate · 5 | $1,410 | $2,564 |
| PSA Prostate Cancer Screening | $52$17$1138 plans | $82 | $149 |
| Psychiatric Admission (Psychoses) Inpatient | $11,892$12k$21k15 plans | — | — |
| Pulmonary Edema and Respiratory Failure Inpatient | $10,685$10k$19k15 plans | — | — |
| Pulmonary Function Test with Bronchodilator | $174$83$6738 plans | $588 | $1,069 |
| Rotator Cuff Repair (Arthroscopic) | $7,631$2.3k$13k10 plansshared rate · 2 | — | — |
| Screening Mammogram | $200$85$3858 plans | $86 | $156 |
| Sepsis (with Major Complications) Inpatient | $16,289$16k$28k15 plans | — | — |
| Sepsis (without Major Complications) Inpatient | $9,098$8.6k$16k15 plans | — | — |
| Septoplasty (Deviated Septum Repair) | $3,377$2.3k$6.0k10 plansshared rate · 2 | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,175$2.3k$13k10 plans | — | — |
| Skin Biopsy (Tangential) | $499$405$2.3k9 plans | $302 | $549 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,737$1.3k$3.0k10 plansshared rate · 2 | $627 | $1,139 |
| Sleep Study (In-lab Polysomnography) | $1,369$851$2.0k8 plans | $1,925 | $3,500 |
| Spinal Cord Stimulator Trial | $6,492$2.3k$11k10 plans | $4,951 | $9,001 |
| Spirometry (Breathing Test) | $99$47$3898 plans | $531 | $965 |
| Stroke (with Complications) Inpatient | $9,001$8.4k$16k15 plans | — | — |
| Stroke (with Major Complications) Inpatient | $16,512$16k$29k15 plans | — | — |
| Stroke (without Complications) Inpatient | $6,563$5.7k$12k15 plans | — | — |
| Syncope and Collapse Inpatient | $7,964$7.2k$14k15 plans | — | — |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,377$2.3k$6.0k10 plansshared rate · 2 | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,018$2.0k$11k10 plans | — | — |
| Total Hip Replacement | $13,065$2.3k$23k9 plansshared rate · 3 | — | — |
| Total Knee Replacement | $13,065$2.3k$23k9 plansshared rate · 3 | — | — |
| Total Mastectomy | $6,751$2.3k$12k10 plans | — | — |
| TSH Thyroid Function Test | $47$15$1038 plans | $53 | $96 |
| TURP (Transurethral Prostate Resection) | $5,451$2.3k$9.7k10 plans | — | — |
| Umbilical Hernia Repair | $2,2771 planshared rate · 5 | — | — |
| Upper GI Endoscopy (EGD) | $1,272$903$2.7k10 plans | — | — |
| Urinalysis with Microscopy | $9$3$198 plans | $39 | $71 |
| Uterine and Adnexa Surgery, Non-cancer (without Complications) Inpatient | $10,725$9.9k$19k15 plans | — | — |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,2771 planshared rate · 5 | — | — |
| Vaginal Delivery (Global Package) | $2,2771 planshared rate · 5 | — | — |
| Vaginal Hysterectomy | $5,261$2.3k$9.0k10 plans | — | — |
| Vasectomy | $2,198$1.8k$3.8k10 plansshared rate · 2 | — | — |
| Vitamin D Blood Test | $83$27$1828 plans | $101 | $184 |