| Abdominal Hysterectomy | $844 | $1,567 | $1,844 |
| ACL Reconstruction (Arthroscopic) | $6,930 | $1,524 | $1,793 |
| Allergy Skin Testing | $987 | $9 | $10 |
| Anesthesia for Screening Colonoscopy | $60 | — | — |
| Anesthesia for Upper Endoscopy | $75 | — | — |
| Basic Metabolic Panel | $120$8$198 | $136 | $160 |
| Bone Marrow Biopsy | $1,572 | — | — |
| Breast Biopsy (Ultrasound-guided) | $3,570$1.6k$5.2k | $3,570 | $4,200 |
| Bunion Correction Surgery | $3,147 | $1,050 | $1,235 |
| Cardiac Ablation for Atrial Fibrillation | $23,798 | $1,326 | $1,560 |
| Cardiac Catheterization (Left Heart) | $3,120 | $1,584 | $1,863 |
| Cardiac Stress Test (Treadmill) | $89$64$165 | $165 | $194 |
| Carpal Tunnel Release Surgery | $1,894 | $706 | $831 |
| Cataract Surgery with Lens Implant | $2,212 | — | — |
| Cervical Spinal Fusion (Anterior) | $12,481 | $2,219 | $2,610 |
| Cesarean Delivery (Global Package) | $5,340$4.1k$7.4k | $5,100 | $6,000 |
| Chemotherapy Infusion (First Hour) | $808$322$1.2k | $808 | $950 |
| Chest X-ray (2 Views) | $383$85$558 | $383 | $450 |
| Colonoscopy with Biopsy | $1,785$1.1k$2.6k | $1,785 | $2,100 |
| Complete Abdominal Ultrasound | $850$103$1.2k | $850 | $1,000 |
| Complete Blood Count (CBC) with Differential | $75$7$124 | $85 | $100 |
| Comprehensive Metabolic Panel | $169$10$279 | $191 | $225 |
| Coronary Angioplasty with Stent | $11,001 | $1,025 | $1,206 |
| Critical Care, First Hour | $2,975$817$4.3k | $2,975 | $3,500 |
| CT Abdomen and Pelvis with Contrast | $3,230$346$4.7k | $3,230 | $3,800 |
| CT Cardiac Calcium Scoring | $45$35$85 | $43 | $50 |
| CT Chest without Contrast | $2,125$103$3.1k | $2,125 | $2,500 |
| CT Head without Contrast | $2,125$103$3.1k | $2,125 | $2,500 |
| DEXA Bone Density Scan | $425$103$620 | $425 | $500 |
| Diagnostic Colonoscopy | $1,700$884$2.5k | $1,700 | $2,000 |
| Diagnostic Mammogram (Both Breasts) | $263$93$434 | $298 | $350 |
| Ear Tube Placement (Tympanostomy) | $1,437 | $258 | $303 |
| Echocardiogram (Complete with Doppler) | $2,125$532$3.1k | $2,125 | $2,500 |
| EKG (Electrocardiogram, 12-lead) | $26 | $70 | $82 |
| Emergency Room Visit (Level 3) | $1,190$269$1.7k | $1,190 | $1,400 |
| Group Therapy Session | $90 | $49 | $58 |
| Hemodialysis Treatment | $128$95$174 | $174 | $205 |
| Hemoglobin A1c (Diabetes Test) | $60$9$99 | $68 | $80 |
| HIV Antibody Test | $23$8$37 | $26 | $30 |
| Holter Monitor (24-48 Hour Heart Monitor) | $149 | $243 | $286 |
| Home Sleep Study | $489$152$713 | $489 | $575 |
| Individual Therapy Session (45 Minutes) | $156 | $164 | $193 |
| Inguinal Hernia Repair (Open) | $3,423 | $1,576 | $1,854 |
| Initial Hospital Admission (Level 1) | $76$64$151 | $151 | $178 |
| Initial Psychiatric Diagnostic Evaluation | $156 | $252 | $296 |
| Initial Psychiatric Evaluation with Medication Management | $156 | $246 | $289 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $561 | — | — |
| IUD Insertion | $72 | $247 | $290 |
| IUD Removal | $489$295$744 | $499 | $588 |
| Knee Arthroscopy with Meniscectomy | $3,147 | $961 | $1,131 |
| Laparoscopic Appendectomy | $5,660 | $1,345 | $1,582 |
| Laparoscopic Gallbladder Removal | $5,660 | $1,692 | $1,991 |
| Laparoscopic Tubal Ligation | $5,660 | $1,028 | $1,209 |
| Lipid Panel (Cholesterol Test) | $90$13$149 | $102 | $120 |
| Lumbar Epidural Steroid Injection | $1,488$672$2.2k | $1,488 | $1,750 |
| Lumbar Puncture (Spinal Tap) | $1,530$672$2.2k | $1,530 | $1,800 |
| Lumbar Spinal Fusion (Posterior) | $17,839 | $2,449 | $2,881 |
| Lumpectomy (Partial Mastectomy) | $3,715 | $911 | $1,072 |
| MRI Abdomen with and without Contrast | $3,315$346$4.8k | $3,315 | $3,900 |
| MRI Brain with and without Contrast | $3,825$346$5.6k | $3,825 | $4,500 |
| MRI Brain with Contrast | $2,720$346$4.0k | $2,720 | $3,200 |
| MRI Brain without Contrast | $2,295$234$3.3k | $2,295 | $2,700 |
| MRI Cervical Spine (Neck) without Contrast | $2,125$234$3.1k | $2,125 | $2,500 |
| MRI Knee without Contrast | $2,125$234$3.1k | $2,125 | $2,500 |
| MRI Lower Back (Lumbar Spine) without Contrast | $2,125$234$3.1k | $2,125 | $2,500 |
| MRI Thoracic Spine (Mid-back) without Contrast | $2,125$234$3.1k | $2,125 | $2,500 |
| Newborn Circumcision | $267$207$2.0k | $255 | $300 |
| Nuclear Cardiac Stress Test | $4,590$1.3k$6.7k | $4,590 | $5,400 |
| Office Visit, Established Patient (Level 3) | $223$173$310 | $213 | $250 |
| Office Visit, New Patient (Level 3) | $111$86$155 | $106 | $125 |
| Pacemaker Insertion (Dual Chamber) | $10,152 | $870 | $1,023 |
| PET/CT Scan, Whole Body | $6,630$1.4k$9.7k | $6,630 | $7,800 |
| Pregnancy Ultrasound (Second or Third Trimester) | $510$103$744 | $510 | $600 |
| Prostate Biopsy | $1,987 | $388 | $456 |
| PSA Prostate Cancer Screening | $68$17$112 | $77 | $90 |
| Pulmonary Function Test with Bronchodilator | $553$302$806 | $553 | $650 |
| Rotator Cuff Repair (Arthroscopic) | $6,930 | $1,717 | $2,020 |
| Screening Mammogram | $188$77$310 | $213 | $250 |
| Septoplasty (Deviated Septum Repair) | $3,146 | $862 | $1,014 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,715 | $649 | $764 |
| Skin Biopsy (Tangential) | $553$193$806 | $553 | $650 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,572 | $162 | $191 |
| Sleep Study (In-lab Polysomnography) | $4,059$987$5.9k | $4,059 | $4,775 |
| Spinal Cord Stimulator Trial | $6,366 | $2,081 | $2,448 |
| Spirometry (Breathing Test) | $213$152$310 | $213 | $250 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,146 | $459 | $540 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,738 | $439 | $516 |
| Total Hip Replacement | $12,481 | $2,238 | $2,633 |
| Total Knee Replacement | $12,481 | $2,396 | $2,819 |
| Total Mastectomy | $6,326 | $1,631 | $1,919 |
| TSH Thyroid Function Test | $105$16$174 | $119 | $140 |
| TURP (Transurethral Prostate Resection) | $4,931 | — | — |
| Umbilical Hernia Repair | $451$421$652 | — | — |
| Upper GI Endoscopy (EGD) | $2,125$909$3.1k | $2,125 | $2,500 |
| Urinalysis with Microscopy | $60$3$99 | $68 | $80 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,340$1.5k$3.6k | $2,952 | $3,473 |
| Vaginal Delivery (Global Package) | $2,230$1.4k$4.2k | $4,218 | $4,962 |
| Vaginal Hysterectomy | $4,789 | $1,306 | $1,536 |
| Vasectomy | $1,987 | $677 | $796 |
| Vitamin D Blood Test | $135$28$223 | $153 | $180 |