| Abdominal Hysterectomy | $5,085$599$9.4k | $3,986 | — |
| ACL Reconstruction (Arthroscopic) | $8,015$718$22k | $3,986 | — |
| Allergy Skin Testing | $1,141$8$2.3k | — | — |
| Basic Metabolic Panel | $10$4$157 | $9 | $164 |
| Bone Marrow Biopsy | $1,836$155$4.3k | $3,986 | $2,641 |
| Breast Biopsy (Ultrasound-guided) | $3,026$1.8k$5.2k | $3,986 | $6,874 |
| Bunion Correction Surgery | $3,640$506$7.2k | $3,986 | — |
| Cardiac Ablation for Atrial Fibrillation | $27,984$4.0k$55k | $6,321 | $31,781 |
| Cardiac Catheterization (Left Heart) | $7,081$2.7k$23k | $4,259 | $21,415 |
| Cardiac Stress Test (Treadmill) | $465$345$563 | — | — |
| Carpal Tunnel Release Surgery | $2,610$286$5.2k | $3,986 | — |
| Cataract Surgery with Lens Implant | $4,045$841$8.4k | $3,986 | — |
| Cervical Spinal Fusion (Anterior) | $11,650$1.2k$29k | $3,986 | — |
| Cesarean Delivery (Global Package) | $3,780$981$4.3k | $3,986 | — |
| Chemotherapy Infusion (First Hour) | $1,313$125$2.4k | $498 | $2,504 |
| Chest X-ray (2 Views) | $99$31$471 | $98 | $493 |
| Colonoscopy with Biopsy | $2,478$328$5.2k | $3,986 | — |
| Complete Abdominal Ultrasound | $169$108$1.0k | $217 | $1,091 |
| Complete Blood Count (CBC) with Differential | $8$4$139 | $9 | $146 |
| Comprehensive Metabolic Panel | $12$5$313 | $12 | $328 |
| Coronary Angioplasty with Stent | $33,607$13k$48k | — | $21,044 |
| Critical Care, First Hour | $1,704$702$5.3k | $1,096 | $5,512 |
| CT Abdomen and Pelvis with Contrast | $498$221$3.4k | $717 | $3,605 |
| CT Cardiac Calcium Scoring | $114$7$759 | $11 | $56 |
| CT Chest without Contrast | $260$119$3.2k | $668 | $3,358 |
| CT Head without Contrast | $252$119$2.0k | $415 | $2,085 |
| DEXA Bone Density Scan | $140$84$1.0k | $217 | $1,092 |
| Diagnostic Colonoscopy | $2,036$272$5.2k | $3,986 | — |
| Diagnostic Mammogram (Both Breasts) | $152$111$583 | — | — |
| Ear Tube Placement (Tympanostomy) | $2,908$123$6.0k | $3,986 | — |
| Echocardiogram (Complete with Doppler) | $2,300$310$4.4k | $876 | $4,406 |
| EKG (Electrocardiogram, 12-lead) | $284$144$334 | — | — |
| Emergency Room Visit (Level 3) | $1,129$309$2.3k | $483 | $2,428 |
| Group Therapy Session | $219$31$394 | $82 | $413 |
| Hemodialysis Treatment | $1,310$638$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$5$191 | $11 | $200 |
| HIV Antibody Test | $10$4$81 | $10 | $85 |
| Holter Monitor (24-48 Hour Heart Monitor) | $402$382$449 | — | — |
| Home Sleep Study | $1,234$176$4.3k | $451 | $2,269 |
| Individual Therapy Session (45 Minutes) | $291$67$494 | $103 | $518 |
| Inguinal Hernia Repair (Open) | $3,959$332$7.9k | $3,986 | — |
| Initial Hospital Admission (Level 1) | $5,624$1.3k$8.8k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $485$119$873 | $182 | $914 |
| Initial Psychiatric Evaluation with Medication Management | $498$119$873 | $182 | $915 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,482$649$6.6k | $1,383 | $6,955 |
| IUD Insertion | $1,679$108$4.3k | $3,986 | $848 |
| IUD Removal | $367$51$4.3k | $3,986 | $401 |
| Knee Arthroscopy with Meniscectomy | $5,085$466$22k | $3,986 | — |
| Laparoscopic Appendectomy | $6,546$373$13k | $3,986 | — |
| Laparoscopic Gallbladder Removal | $7,018$495$13k | $3,986 | — |
| Laparoscopic Tubal Ligation | $6,546$470$13k | $3,986 | — |
| Lipid Panel (Cholesterol Test) | $15$6$236 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $2,047$181$4.3k | $3,986 | $4,047 |
| Lumbar Puncture (Spinal Tap) | $777$66$4.3k | $3,986 | $898 |
| Lumbar Spinal Fusion (Posterior) | $14,748$1.1k$41k | $3,986 | — |
| Lumpectomy (Partial Mastectomy) | $4,296$2.3k$8.5k | $3,986 | — |
| MRI Abdomen with and without Contrast | $642$326$4.2k | $878 | $4,413 |
| MRI Brain with and without Contrast | $648$326$4.8k | $1,002 | $5,038 |
| MRI Brain with Contrast | $556$326$3.5k | $719 | $3,615 |
| MRI Brain without Contrast | $431$271$3.1k | $652 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $399$271$2.6k | $548 | $2,756 |
| MRI Knee without Contrast | $399$271$2.2k | — | $2,458 |
| MRI Lower Back (Lumbar Spine) without Contrast | $406$271$2.7k | $568 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $416$271$2.9k | $596 | $2,996 |
| Newborn Circumcision | $2,344$98$4.8k | $3,986 | — |
| Nuclear Cardiac Stress Test | $1,465$276$7.4k | $1,534 | $7,711 |
| Office Visit, Established Patient (Level 3) | $283$65$490 | $102 | $513 |
| Office Visit, New Patient (Level 3) | $319$64$552 | $115 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,741$479$45k | $3,986 | $35,205 |
| PET/CT Scan, Whole Body | $1,897$1.6k$4.2k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $169$106$889 | $185 | $931 |
| Prostate Biopsy | $3,356$69$6.3k | $3,986 | $6,593 |
| PSA Prostate Cancer Screening | $21$9$305 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $691$208$1.6k | $324 | $1,631 |
| Rotator Cuff Repair (Arthroscopic) | $8,015$730$22k | $3,986 | — |
| Screening Mammogram | $126$84$481 | — | — |
| Septoplasty (Deviated Septum Repair) | $3,668$354$7.2k | $3,986 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,729$328$15k | $3,986 | — |
| Skin Biopsy (Tangential) | $443$87$4.3k | $3,986 | $683 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,818$113$5.2k | $3,986 | $2,100 |
| Sleep Study (In-lab Polysomnography) | $4,016$992$7.4k | $1,548 | $7,783 |
| Spinal Cord Stimulator Trial | $7,363$702$15k | $3,986 | — |
| Spirometry (Breathing Test) | $450$105$790 | $165 | $828 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,900$222$7.7k | $3,986 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,012$194$13k | $3,986 | — |
| Total Hip Replacement | $20,742$2.7k$29k | $3,986 | — |
| Total Knee Replacement | $20,742$2.7k$29k | $3,986 | — |
| Total Mastectomy | $6,871$2.9k$15k | $3,986 | — |
| TSH Thyroid Function Test | $19$8$263 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $5,703$2.9k$11k | $3,986 | — |
| Upper GI Endoscopy (EGD) | $1,879$248$4.3k | $3,986 | — |
| Urinalysis with Microscopy | $3$1$107 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,294$3.3k$4.3k | $3,986 | — |
| Vaginal Delivery (Global Package) | $3,780$836$4.3k | $3,986 | — |
| Vaginal Hysterectomy | $5,538$572$11k | $3,986 | — |
| Vasectomy | $2,938$1.9k$5.2k | $3,986 | — |
| Vitamin D Blood Test | $33$14$243 | $33 | $255 |