| Abdominal Hysterectomy | $5,304$533$9.2k | $4,881 | — |
| ACL Reconstruction (Arthroscopic) | $8,015$515$24k | $4,881 | — |
| Allergy Skin Testing | $1,141$4$2.3k | — | — |
| Basic Metabolic Panel | $10$4$153 | $9 | $164 |
| Bone Marrow Biopsy | $2,102$87$4.0k | $4,881 | $4,033 |
| Breast Biopsy (Ultrasound-guided) | $3,031$264$4.9k | $4,881 | $4,963 |
| Bunion Correction Surgery | $3,640$470$7.3k | $4,881 | — |
| Cardiac Ablation for Atrial Fibrillation | $34,699$480$63k | $9,944 | $47,740 |
| Cardiac Catheterization (Left Heart) | $7,692$549$23k | $6,172 | $29,629 |
| Cardiac Stress Test (Treadmill) | $430$38$1.0k | — | — |
| Carpal Tunnel Release Surgery | $2,611$240$5.1k | $4,881 | — |
| Cataract Surgery with Lens Implant | $4,220$284$8.6k | $4,881 | — |
| Cervical Spinal Fusion (Anterior) | $9,523$899$29k | $4,881 | — |
| Cesarean Delivery (Global Package) | $3,266$1.8k$4.0k | $4,881 | — |
| Chemotherapy Infusion (First Hour) | $1,329$70$2.2k | $486 | $2,332 |
| Chest X-ray (2 Views) | $116$18$476 | $106 | $510 |
| Colonoscopy with Biopsy | $2,588$231$4.9k | $4,881 | — |
| Complete Abdominal Ultrasound | $177$62$1.0k | $227 | $1,091 |
| Complete Blood Count (CBC) with Differential | $8$4$136 | $9 | $146 |
| Comprehensive Metabolic Panel | $12$5$306 | $12 | $328 |
| Coronary Angioplasty with Stent | $36,241$298$52k | — | $29,649 |
| Critical Care, First Hour | $1,862$149$5.4k | $1,203 | $5,775 |
| CT Abdomen and Pelvis with Contrast | $603$167$3.4k | $751 | $3,605 |
| CT Cardiac Calcium Scoring | $114$13$1.8k | $12 | $56 |
| CT Chest without Contrast | $239$73$2.7k | $610 | $2,929 |
| CT Head without Contrast | $239$58$1.9k | $434 | $2,085 |
| DEXA Bone Density Scan | $143$29$810 | $181 | $868 |
| Diagnostic Colonoscopy | $2,041$180$4.9k | $4,881 | — |
| Diagnostic Mammogram (Both Breasts) | $193$85$731 | $163 | $783 |
| Ear Tube Placement (Tympanostomy) | $3,031$85$5.8k | $4,881 | — |
| Echocardiogram (Complete with Doppler) | $2,220$105$4.6k | $971 | $4,661 |
| EKG (Electrocardiogram, 12-lead) | $284$8$334 | — | — |
| Emergency Room Visit (Level 3) | $1,267$38$3.0k | $483 | $2,321 |
| Group Therapy Session | $225$31$385 | $86 | $413 |
| Hemodialysis Treatment | $1,310$52$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$5$139 | $11 | $149 |
| HIV Antibody Test | $10$4$93 | $10 | $100 |
| Holter Monitor (24-48 Hour Heart Monitor) | $416$39$737 | — | — |
| Home Sleep Study | $1,639$50$3.9k | $637 | $3,056 |
| Individual Therapy Session (45 Minutes) | $305$100$483 | $108 | $518 |
| Inguinal Hernia Repair (Open) | $3,962$276$7.9k | $4,881 | — |
| Initial Hospital Admission (Level 1) | $7,601$44$9.5k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $470$180$805 | $180 | $862 |
| Initial Psychiatric Evaluation with Medication Management | $509$180$830 | $185 | $889 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,482$649$6.1k | $1,371 | $6,581 |
| IUD Insertion | $1,519$130$4.0k | $4,881 | $750 |
| IUD Removal | $679$195$4.0k | $4,881 | $858 |
| Knee Arthroscopy with Meniscectomy | $5,130$290$24k | $4,881 | — |
| Laparoscopic Appendectomy | $6,546$317$13k | $4,881 | — |
| Laparoscopic Gallbladder Removal | $7,346$347$13k | $4,881 | — |
| Laparoscopic Tubal Ligation | $6,546$342$13k | $4,881 | — |
| Lipid Panel (Cholesterol Test) | $15$6$231 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $1,930$138$4.0k | $4,881 | $4,047 |
| Lumbar Puncture (Spinal Tap) | $1,546$66$4.0k | $4,881 | $2,405 |
| Lumbar Spinal Fusion (Posterior) | $9,523$835$41k | $4,881 | — |
| Lumpectomy (Partial Mastectomy) | $4,296$348$8.6k | $4,881 | — |
| MRI Abdomen with and without Contrast | $797$186$4.2k | $946 | $4,542 |
| MRI Brain with and without Contrast | $797$175$4.7k | $1,049 | $5,038 |
| MRI Brain with Contrast | $603$149$3.4k | $753 | $3,615 |
| MRI Brain without Contrast | $540$108$3.3k | $683 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $540$105$3.3k | $574 | $2,756 |
| MRI Knee without Contrast | $399$111$3.3k | — | $2,458 |
| MRI Lower Back (Lumbar Spine) without Contrast | $540$105$3.3k | $594 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $540$104$3.3k | $624 | $2,996 |
| Newborn Circumcision | $2,321$16$5.1k | $4,881 | — |
| Nuclear Cardiac Stress Test | $1,465$233$4.4k | $992 | $4,764 |
| Office Visit, Established Patient (Level 3) | $294$50$479 | $107 | $513 |
| Office Visit, New Patient (Level 3) | $331$61$539 | $120 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,741$265$49k | $4,881 | $42,168 |
| PET/CT Scan, Whole Body | $1,897$878$4.2k | — | $8,719 |
| Pregnancy Ultrasound (Second or Third Trimester) | $177$72$869 | $194 | $931 |
| Prostate Biopsy | $3,266$126$6.2k | $4,881 | $6,593 |
| PSA Prostate Cancer Screening | $21$9$298 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $699$21$1.3k | $294 | $1,412 |
| Rotator Cuff Repair (Arthroscopic) | $8,015$565$24k | $4,881 | — |
| Screening Mammogram | $158$69$592 | $132 | $634 |
| Septoplasty (Deviated Septum Repair) | $3,738$361$7.3k | $4,881 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,956$167$16k | $4,881 | — |
| Skin Biopsy (Tangential) | $446$54$4.0k | $4,881 | $875 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,818$68$4.9k | $4,881 | $2,433 |
| Sleep Study (In-lab Polysomnography) | $3,892$335$7.3k | $1,621 | $7,783 |
| Spinal Cord Stimulator Trial | $7,363$1.2k$15k | $4,881 | $11,161 |
| Spirometry (Breathing Test) | $506$15$828 | $185 | $887 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,050$162$7.5k | $4,881 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,441$155$13k | $4,881 | — |
| Total Hip Replacement | $19,628$675$29k | $4,881 | — |
| Total Knee Replacement | $19,628$674$29k | $4,881 | — |
| Total Mastectomy | $6,625$504$15k | $4,881 | — |
| TSH Thyroid Function Test | $19$8$257 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $5,703$378$11k | $4,881 | — |
| Upper GI Endoscopy (EGD) | $1,982$154$4.6k | $4,881 | — |
| Urinalysis with Microscopy | $3$1$105 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $3,658$2.7k$4.0k | $4,881 | — |
| Vaginal Delivery (Global Package) | $3,266$1.5k$4.0k | $4,881 | — |
| Vaginal Hysterectomy | $5,594$441$11k | $4,881 | — |
| Vasectomy | $2,678$178$5.1k | $4,881 | — |
| Vitamin D Blood Test | $33$14$474 | $33 | $508 |