| Abdominal Hysterectomy | $14,208$10k$28k | — | — |
| ACL Reconstruction (Arthroscopic) | $14,208$10k$52k | — | — |
| Basic Metabolic Panel | $79$8$584 | $396 | $396 |
| Bone Marrow Biopsy | $2,707$1.6k$6.2k | — | — |
| Breast Biopsy (Ultrasound-guided) | $2,707$1.6k$17k | — | — |
| Bunion Correction Surgery | $5,749$4.7k$17k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $44,177$3.3k$76k | $80,184 | $80,184 |
| Cardiac Catheterization (Left Heart) | $12,618$9.7k$26k | — | — |
| Carpal Tunnel Release Surgery | $2,707$1.6k$7.2k | — | — |
| Cataract Surgery with Lens Implant | $2,707$1.6k$27k | — | — |
| Cervical Spinal Fusion (Anterior) | $33,809$28k$43k | — | — |
| Cesarean Delivery (Global Package) | $5,207$4.7k$6.3k | — | — |
| Chemotherapy Infusion (First Hour) | $864$70$1.6k | $1,690 | $1,690 |
| Chest X-ray (2 Views) | $153$14$727 | $335 | $335 |
| Colonoscopy with Biopsy | $2,000$1.6k$7.2k | — | — |
| Complete Abdominal Ultrasound | $569$101$2.3k | $2,445 | $2,445 |
| Complete Blood Count (CBC) with Differential | $13$7$41 | — | — |
| Comprehensive Metabolic Panel | $98$9$777 | $518 | $518 |
| Coronary Angioplasty with Stent | $18,909$15k$61k | — | — |
| Critical Care, First Hour | $6,224$405$16k | $9,833 | $9,833 |
| CT Abdomen and Pelvis with Contrast | $1,500$364$13k | $13,697 | $13,697 |
| CT Cardiac Calcium Scoring | $497$116$12k | $12,827 | $12,827 |
| CT Chest without Contrast | $627$215$6.4k | $6,690 | $6,690 |
| CT Head without Contrast | $507$171$5.6k | $5,864 | $5,864 |
| DEXA Bone Density Scan | $197$41$1.3k | $1,414 | $1,414 |
| Diagnostic Colonoscopy | $2,000$1.3k$7.2k | — | — |
| Diagnostic Mammogram (Both Breasts) | $518$48$1.1k | $1,153 | $1,153 |
| Ear Tube Placement (Tympanostomy) | $2,707$1.6k$17k | — | — |
| Echocardiogram (Complete with Doppler) | $2,308$211$4.9k | $5,124 | $5,124 |
| EKG (Electrocardiogram, 12-lead) | $12$12$12 | — | — |
| Emergency Room Visit (Level 3) | $2,003$139$3.2k | $3,374 | $3,374 |
| Group Therapy Session | $586$38$879 | $925 | $925 |
| Hemodialysis Treatment | $1,425$81$3.4k | $3,440 | $3,440 |
| Hemoglobin A1c (Diabetes Test) | $90$9$382 | $301 | $301 |
| HIV Antibody Test | $44$8$176 | $185 | $185 |
| Holter Monitor (24-48 Hour Heart Monitor) | $58$58$60 | — | — |
| Home Sleep Study | $795$52$2.9k | $1,256 | $1,256 |
| Individual Therapy Session (45 Minutes) | $717$54$1.2k | $1,302 | $1,302 |
| Inguinal Hernia Repair (Open) | $5,749$4.7k$30k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $416$31$717 | $755 | $755 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $3,930$354$8.2k | $8,581 | $8,581 |
| IUD Insertion | $1,425$40$3.5k | — | — |
| IUD Removal | $2,285$1.3k$6.2k | — | — |
| Knee Arthroscopy with Meniscectomy | $5,749$4.7k$52k | — | — |
| Laparoscopic Appendectomy | $14,208$10k$48k | — | — |
| Laparoscopic Gallbladder Removal | $14,208$10k$34k | — | — |
| Laparoscopic Tubal Ligation | $14,176$10k$20k | — | — |
| Lipid Panel (Cholesterol Test) | $123$12$522 | $411 | $411 |
| Lumbar Epidural Steroid Injection | $2,285$1.3k$6.2k | — | — |
| Lumbar Puncture (Spinal Tap) | $2,285$1.3k$6.2k | — | — |
| Lumbar Spinal Fusion (Posterior) | $78,625$69k$87k | — | — |
| Lumpectomy (Partial Mastectomy) | $5,749$4.7k$17k | — | — |
| MRI Abdomen with and without Contrast | $1,676$397$9.1k | $9,630 | $9,630 |
| MRI Brain with and without Contrast | $1,579$377$8.7k | $9,146 | $9,146 |
| MRI Brain with Contrast | $1,342$320$7.4k | $7,759 | $7,759 |
| MRI Brain without Contrast | $973$284$6.5k | $6,891 | $6,891 |
| MRI Cervical Spine (Neck) without Contrast | $949$297$7.2k | $7,613 | $7,613 |
| MRI Knee without Contrast | $2,903$274$9.8k | $6,891 | $6,891 |
| MRI Lower Back (Lumbar Spine) without Contrast | $954$298$7.2k | $7,613 | $7,613 |
| MRI Thoracic Spine (Mid-back) without Contrast | $948$297$7.2k | $7,613 | $7,613 |
| Newborn Circumcision | $2,707$1.6k$6.2k | — | — |
| Nuclear Cardiac Stress Test | $2,148$232$5.4k | $5,642 | $5,642 |
| Office Visit, Established Patient (Level 3) | $514$31$1.4k | $775 | $775 |
| Office Visit, New Patient (Level 3) | $646$37$1.4k | $1,142 | $1,142 |
| Pacemaker Insertion (Dual Chamber) | $39,575$24k$40k | — | — |
| PET/CT Scan, Whole Body | $7,215$477$15k | $16,286 | $16,286 |
| Pregnancy Ultrasound (Second or Third Trimester) | $609$69$1.6k | $1,679 | $1,679 |
| Prostate Biopsy | $1,744$1.6k$3.9k | — | — |
| PSA Prostate Cancer Screening | $133$16$626 | $478 | $478 |
| Pulmonary Function Test with Bronchodilator | $681$62$1.4k | $1,511 | $1,511 |
| Rotator Cuff Repair (Arthroscopic) | $14,176$10k$20k | — | — |
| Screening Mammogram | $415$26$903 | $792 | $792 |
| Septoplasty (Deviated Septum Repair) | $2,707$1.6k$30k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $14,176$10k$20k | — | — |
| Skin Biopsy (Tangential) | $1,425$1.3k$3.5k | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,707$1.6k$6.2k | — | — |
| Sleep Study (In-lab Polysomnography) | $4,162$407$9.4k | $9,886 | $9,886 |
| Spinal Cord Stimulator Trial | $47,428$31k$63k | — | — |
| Spirometry (Breathing Test) | $480$44$1.0k | $1,066 | $1,066 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $2,707$1.6k$20k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $7,622$5.6k$17k | — | — |
| Total Hip Replacement | $37,367$14k$52k | — | — |
| Total Knee Replacement | $37,367$14k$52k | — | — |
| Total Mastectomy | $14,208$10k$30k | — | — |
| TSH Thyroid Function Test | $153$15$751 | $565 | $565 |
| TURP (Transurethral Prostate Resection) | $7,622$5.6k$30k | — | — |
| Umbilical Hernia Repair | $5,207$4.7k$6.3k | — | — |
| Upper GI Endoscopy (EGD) | $2,000$1.3k$6.2k | — | — |
| Urinalysis with Microscopy | $14$3$222 | $234 | $234 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $5,207$4.7k$6.3k | — | — |
| Vaginal Delivery (Global Package) | $5,207$4.7k$6.3k | — | — |
| Vaginal Hysterectomy | $7,622$5.6k$36k | — | — |
| Vasectomy | $2,707$1.6k$7.2k | — | — |
| Vitamin D Blood Test | $193$26$628 | $549 | $549 |