| Abdominal Hysterectomy | $844 | $1,567 | $1,844 |
| ACL Reconstruction (Arthroscopic) | $1,010$898$3.2k | $1,524 | $1,793 |
| Allergy Skin Testing | $6$3$13 | $9 | $10 |
| Anesthesia for Screening Colonoscopy | $60 | — | — |
| Anesthesia for Upper Endoscopy | $75 | — | — |
| Basic Metabolic Panel | $136$8$182 | $136 | $160 |
| Bone Marrow Biopsy | $76$64$656 | — | — |
| Breast Biopsy (Ultrasound-guided) | $3,315$2.7k$4.4k | $3,315 | $3,900 |
| Bunion Correction Surgery | $629$477$2.3k | $1,050 | $1,235 |
| Cardiac Ablation for Atrial Fibrillation | $1,163$862$1.4k | $1,326 | $1,560 |
| Cardiac Catheterization (Left Heart) | $857$279$1.6k | $1,584 | $1,863 |
| Cardiac Stress Test (Treadmill) | $99$64$347 | $165 | $194 |
| Carpal Tunnel Release Surgery | $428$329$1.3k | $706 | $831 |
| Cataract Surgery with Lens Implant | $666$484$2.2k | — | — |
| Cervical Spinal Fusion (Anterior) | $1,769$1.5k$2.4k | $2,219 | $2,610 |
| Cesarean Delivery (Global Package) | $2,481$1.6k$6.1k | $4,780 | $5,624 |
| Chemotherapy Infusion (First Hour) | $808$665$1.1k | $808 | $950 |
| Chest X-ray (2 Views) | $255$210$342 | $255 | $300 |
| Colonoscopy with Biopsy | $1,530$1.3k$2.1k | $1,530 | $1,800 |
| Complete Abdominal Ultrasound | $935$770$1.3k | $935 | $1,100 |
| Complete Blood Count (CBC) with Differential | $85$7$114 | $85 | $100 |
| Comprehensive Metabolic Panel | $191$10$257 | $191 | $225 |
| Coronary Angioplasty with Stent | $630$521$1.0k | $1,025 | $1,206 |
| Critical Care, First Hour | $2,720$2.2k$3.6k | $2,720 | $3,200 |
| CT Abdomen and Pelvis with Contrast | $2,125$1.8k$2.9k | $2,125 | $2,500 |
| CT Cardiac Calcium Scoring | $43$35$57 | $43 | $50 |
| CT Chest without Contrast | $1,275$1.1k$1.7k | $1,275 | $1,500 |
| CT Head without Contrast | $1,530$1.3k$2.1k | $1,530 | $1,800 |
| DEXA Bone Density Scan | $425$350$570 | $425 | $500 |
| Diagnostic Colonoscopy | $1,360$1.1k$1.8k | $1,360 | $1,600 |
| Diagnostic Mammogram (Both Breasts) | $255$141$342 | $255 | $300 |
| Ear Tube Placement (Tympanostomy) | $163$137$544 | $258 | $303 |
| Echocardiogram (Complete with Doppler) | $1,785$1.5k$2.4k | $1,785 | $2,100 |
| EKG (Electrocardiogram, 12-lead) | $157$26$211 | $157 | $185 |
| Emergency Room Visit (Level 3) | $850$700$1.1k | $850 | $1,000 |
| Group Therapy Session | $38$10$105 | $49 | $58 |
| Hemodialysis Treatment | $128$95$388 | $174 | $205 |
| Hemoglobin A1c (Diabetes Test) | $64$9$86 | $64 | $75 |
| HIV Antibody Test | $8 | $18 | $21 |
| Holter Monitor (24-48 Hour Heart Monitor) | $149 | $243 | $286 |
| Home Sleep Study | $118$62$657 | $252 | $297 |
| Individual Therapy Session (45 Minutes) | $115$54$167 | $164 | $193 |
| Inguinal Hernia Repair (Open) | $529$385$1.6k | $1,576 | $1,854 |
| Initial Hospital Admission (Level 1) | $98$64$222 | $129 | $152 |
| Initial Psychiatric Diagnostic Evaluation | $169$97$256 | $252 | $296 |
| Initial Psychiatric Evaluation with Medication Management | $160$86$250 | $246 | $289 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $446 | — | — |
| IUD Insertion | $765$72$1.0k | $765 | $900 |
| IUD Removal | $680$560$912 | $680 | $800 |
| Knee Arthroscopy with Meniscectomy | $550$488$2.0k | $961 | $1,131 |
| Laparoscopic Appendectomy | $612$479$1.7k | $1,345 | $1,582 |
| Laparoscopic Gallbladder Removal | $671$615$2.2k | $1,692 | $1,991 |
| Laparoscopic Tubal Ligation | $672$589$2.1k | $1,028 | $1,209 |
| Lipid Panel (Cholesterol Test) | $94$13$125 | $94 | $110 |
| Lumbar Epidural Steroid Injection | $1,530$1.3k$2.1k | $1,530 | $1,800 |
| Lumbar Puncture (Spinal Tap) | $1,530$1.3k$2.1k | $1,530 | $1,800 |
| Lumbar Spinal Fusion (Posterior) | $1,642$1.4k$4.9k | $2,449 | $2,881 |
| Lumpectomy (Partial Mastectomy) | $662$327$928 | $911 | $1,072 |
| MRI Abdomen with and without Contrast | $3,315$2.7k$4.4k | $3,315 | $3,900 |
| MRI Brain with and without Contrast | $3,400$2.8k$4.6k | $3,400 | $4,000 |
| MRI Brain with Contrast | $2,720$2.2k$3.6k | $2,720 | $3,200 |
| MRI Brain without Contrast | $2,040$1.7k$2.7k | $2,040 | $2,400 |
| MRI Cervical Spine (Neck) without Contrast | $1,955$1.6k$2.6k | $1,955 | $2,300 |
| MRI Knee without Contrast | $2,125$1.8k$2.9k | $2,125 | $2,500 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,947$1.6k$2.6k | $1,947 | $2,290 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,947$1.6k$2.6k | $1,947 | $2,290 |
| Newborn Circumcision | $148$89$772 | $608 | $715 |
| Nuclear Cardiac Stress Test | $3,145$2.6k$4.2k | $3,145 | $3,700 |
| Office Visit, Established Patient (Level 3) | $128$105$171 | $128 | $150 |
| Office Visit, New Patient (Level 3) | $106$88$143 | $106 | $125 |
| Pacemaker Insertion (Dual Chamber) | $573$471$1.7k | $870 | $1,023 |
| PET/CT Scan, Whole Body | $124$77$2.3k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $829$683$1.1k | $829 | $975 |
| Prostate Biopsy | $142$120$717 | $388 | $456 |
| PSA Prostate Cancer Screening | $68$17$91 | $68 | $80 |
| Pulmonary Function Test with Bronchodilator | $553$455$741 | $553 | $650 |
| Rotator Cuff Repair (Arthroscopic) | $1,098$958$3.6k | $1,717 | $2,020 |
| Screening Mammogram | $191$114$257 | $191 | $225 |
| Septoplasty (Deviated Septum Repair) | $627$597$1.6k | $862 | $1,014 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $451$298$1.4k | $649 | $764 |
| Skin Biopsy (Tangential) | $418$245$713 | $414 | $488 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,615$1.3k$2.2k | $1,615 | $1,900 |
| Sleep Study (In-lab Polysomnography) | $539$123$2.6k | $915 | $1,077 |
| Spinal Cord Stimulator Trial | $424$133$2.1k | $2,081 | $2,448 |
| Spirometry (Breathing Test) | $213$175$285 | $213 | $250 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $310$280$998 | $459 | $540 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $298$255$921 | $439 | $516 |
| Total Hip Replacement | $1,394$1.2k$4.5k | $2,238 | $2,633 |
| Total Knee Replacement | $1,476$1.2k$4.9k | $2,396 | $2,819 |
| Total Mastectomy | $1,026$719$1.7k | $1,631 | $1,919 |
| TSH Thyroid Function Test | $119$16$160 | $119 | $140 |
| TURP (Transurethral Prostate Resection) | $776$673$2.3k | — | — |
| Umbilical Hernia Repair | $451$451$1.3k | — | — |
| Upper GI Endoscopy (EGD) | $224$112$947 | $431 | $507 |
| Urinalysis with Microscopy | $21$3$29 | $21 | $25 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,340$1.5k$5.7k | $2,952 | $3,473 |
| Vaginal Delivery (Global Package) | $2,230$1.4k$5.4k | $4,218 | $4,962 |
| Vaginal Hysterectomy | $860$704$2.6k | $1,306 | $1,536 |
| Vasectomy | $2,805$2.3k$3.8k | $2,805 | $3,300 |
| Vitamin D Blood Test | $153$28$205 | $153 | $180 |