| Abdominal Hysterectomy | $943$943$6.7k | $1,683 | $2,805 |
| ACL Reconstruction (Arthroscopic) | $7,174$7.2k$12k | $4,806 | $8,010 |
| Allergy Skin Testing | $1,022$12$1.7k | $825 | $1,375 |
| Basic Metabolic Panel | $8$8$14 | $112 | $186 |
| Bone Marrow Biopsy | $1,627$1.6k$2.8k | $2,644 | $4,407 |
| Breast Biopsy (Ultrasound-guided) | $1,627$1.6k$2.8k | $2,106 | $3,511 |
| Bunion Correction Surgery | $3,258$3.3k$5.5k | $2,747 | $4,578 |
| Cardiac Stress Test (Treadmill) | — | $107 | $179 |
| Carpal Tunnel Release Surgery | $1,961$2.0k$3.3k | $2,560 | $4,266 |
| Cataract Surgery with Lens Implant | $2,290$2.3k$3.9k | $2,856 | $4,760 |
| Cesarean Delivery (Global Package) | $2,481$2.5k$4.2k | $3,786 | $6,310 |
| Chemotherapy Infusion (First Hour) | $333$303$566 | $742 | $1,236 |
| Chest X-ray (2 Views) | $88$81$150 | $231 | $386 |
| Colonoscopy with Biopsy | $1,184$1.1k$2.0k | $1,535 | $2,558 |
| Complete Abdominal Ultrasound | $107$98$182 | $825 | $1,375 |
| Complete Blood Count (CBC) with Differential | $8$8$13 | $78 | $131 |
| Comprehensive Metabolic Panel | $11$10$18 | $139 | $232 |
| Critical Care, First Hour | $846$795$1.8k | $1,530 | $2,550 |
| CT Abdomen and Pelvis with Contrast | $359$344$806 | $3,113 | $5,188 |
| CT Cardiac Calcium Scoring | $88$81$806 | $39 | $65 |
| CT Chest without Contrast | $107$98$806 | $1,440 | $2,400 |
| CT Head without Contrast | $107$98$806 | $1,320 | $2,200 |
| DEXA Bone Density Scan | $107$98$182 | $342 | $569 |
| Diagnostic Colonoscopy | $916$818$1.6k | $1,444 | $2,407 |
| Diagnostic Mammogram (Both Breasts) | $44$44$149 | $210 | $350 |
| Ear Tube Placement (Tympanostomy) | $1,488$1.5k$2.5k | $1,269 | $2,115 |
| Echocardiogram (Complete with Doppler) | $551$494$936 | $1,476 | $2,460 |
| Emergency Room Visit (Level 3) | $278$255$685 | $426 | $710 |
| Hemoglobin A1c (Diabetes Test) | $10$10$17 | $42 | $71 |
| HIV Antibody Test | $9$9$15 | $95 | $158 |
| Holter Monitor (24-48 Hour Heart Monitor) | — | $131 | $218 |
| Home Sleep Study | $157$140$267 | $635 | $1,059 |
| Individual Therapy Session (45 Minutes) | $161$143$274 | $112 | $187 |
| Inguinal Hernia Repair (Open) | $3,544$3.5k$6.0k | $3,727 | $6,211 |
| Initial Hospital Admission (Level 1) | $76$76$130 | $160 | $267 |
| Initial Psychiatric Diagnostic Evaluation | $161$143$274 | $172 | $286 |
| Initial Psychiatric Evaluation with Medication Management | $161$143$274 | $204 | $340 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $581$527$988 | $1,113 | $1,856 |
| IUD Insertion | $183 | $1,563 | $2,606 |
| IUD Removal | $305$287$519 | $216 | $359 |
| Knee Arthroscopy with Meniscectomy | $3,258$3.3k$5.5k | $3,230 | $5,383 |
| Laparoscopic Appendectomy | $5,859$5.2k$10.0k | $2,166 | $3,610 |
| Laparoscopic Gallbladder Removal | $5,859$5.2k$10.0k | $5,100 | $8,501 |
| Laparoscopic Tubal Ligation | $5,859$5.9k$10.0k | $3,519 | $5,865 |
| Lipid Panel (Cholesterol Test) | $13$13$23 | $99 | $164 |
| Lumbar Epidural Steroid Injection | $695$619$1.2k | $711 | $1,186 |
| Lumbar Puncture (Spinal Tap) | $695$619$1.2k | $360 | $600 |
| Lumbar Spinal Fusion (Posterior) | $18,468$17k$31k | $2,551 | $4,252 |
| Lumpectomy (Partial Mastectomy) | $3,845$3.8k$6.5k | $3,000 | $5,001 |
| MRI Abdomen with and without Contrast | $359$344$1.2k | $2,163 | $3,605 |
| MRI Brain with and without Contrast | $359$344$1.2k | $2,040 | $3,400 |
| MRI Brain with Contrast | $359$344$1.2k | $1,860 | $3,100 |
| MRI Brain without Contrast | $243$219$1.2k | $1,618 | $2,697 |
| MRI Cervical Spine (Neck) without Contrast | $243$219$1.2k | $1,826 | $3,044 |
| MRI Knee without Contrast | $243$219$1.2k | $1,776 | $2,960 |
| MRI Lower Back (Lumbar Spine) without Contrast | $243$219$1.2k | $1,826 | $3,044 |
| MRI Thoracic Spine (Mid-back) without Contrast | $243$219$1.2k | $1,826 | $3,044 |
| Newborn Circumcision | $2,057$1.8k$3.5k | $1,526 | $2,544 |
| Nuclear Cardiac Stress Test | $1,311$1.3k$2.2k | $2,988 | $4,980 |
| Office Visit, Established Patient (Level 3) | $61$61$104 | $77 | $128 |
| Office Visit, New Patient (Level 3) | $76$76$129 | $138 | $230 |
| Pacemaker Insertion (Dual Chamber) | $10,510$9.6k$18k | $8,773 | $14,622 |
| PET/CT Scan, Whole Body | $1,465$1.4k$2.5k | $3,781 | $6,301 |
| Pregnancy Ultrasound (Second or Third Trimester) | $107$98$182 | $566 | $944 |
| Prostate Biopsy | $2,057$1.8k$3.5k | $2,452 | $4,086 |
| PSA Prostate Cancer Screening | $18$18$31 | $74 | $124 |
| Pulmonary Function Test with Bronchodilator | $313$281$532 | $355 | $592 |
| Rotator Cuff Repair (Arthroscopic) | $7,891$7.2k$12k | $5,046 | $8,410 |
| Screening Mammogram | $34$34$120 | $183 | $305 |
| Septoplasty (Deviated Septum Repair) | $3,257$2.9k$5.5k | $2,073 | $3,454 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,952$7.0k$12k | $2,008 | $3,347 |
| Skin Biopsy (Tangential) | $200$179$339 | $135 | $224 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,627$1.5k$2.8k | $1,399 | $2,332 |
| Sleep Study (In-lab Polysomnography) | $936$511$1.7k | $2,995 | $4,991 |
| Spinal Cord Stimulator Trial | $6,591$6.1k$11k | $4,388 | $7,313 |
| Spirometry (Breathing Test) | $157$140$267 | $111 | $184 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,257$2.9k$5.5k | $2,216 | $3,693 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,941$5.2k$10k | $3,331 | $5,552 |
| Total Hip Replacement | $12,921$13k$22k | $2,212 | $3,687 |
| Total Knee Replacement | $12,921$13k$22k | $2,535 | $4,225 |
| Total Mastectomy | $6,549$6.5k$11k | $3,668 | $6,113 |
| TSH Thyroid Function Test | $17$17$29 | $74 | $124 |
| TURP (Transurethral Prostate Resection) | $5,105$4.6k$8.7k | $3,500 | $5,833 |
| Umbilical Hernia Repair | — | $2,620 | $4,367 |
| Upper GI Endoscopy (EGD) | $942$812$1.6k | $1,371 | $2,285 |
| Urinalysis with Microscopy | $3$3$5 | $53 | $88 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,340$2.3k$4.0k | $3,521 | $5,868 |
| Vaginal Delivery (Global Package) | $2,230$2.2k$3.8k | $3,352 | $5,586 |
| Vaginal Hysterectomy | $4,957$4.5k$8.4k | $4,353 | $7,256 |
| Vasectomy | $2,057$1.8k$3.5k | $1,625 | $2,708 |
| Vitamin D Blood Test | $30$29$50 | $136 | $227 |