| Abdominal Hysterectomy | $2,160$739$7.2k | $4,161 | $4,161 |
| ACL Reconstruction (Arthroscopic) | $9,092$1.5k$25k | $3,330 | $3,330 |
| Allergy Skin Testing | $1,287$210$2.9k | $2,573 | $2,573 |
| Basic Metabolic Panel | $17$8$256 | $256 | $256 |
| Bone Marrow Biopsy | $2,284$699$5.6k | $3,936 | $3,936 |
| Breast Biopsy (Ultrasound-guided) | $3,623$121$9.8k | $7,747 | $7,747 |
| Bunion Correction Surgery | $4,338$1.5k$11k | $3,216 | $3,216 |
| Cardiac Ablation for Atrial Fibrillation | $31,052$5.2k$88k | $62,118 | $62,118 |
| Cardiac Catheterization (Left Heart) | $6,310$3.3k$19k | $18,786 | $18,786 |
| Cardiac Stress Test (Treadmill) | $116$83$802 | — | — |
| Carpal Tunnel Release Surgery | $2,958$1.5k$6.6k | $1,472 | $1,472 |
| Cataract Surgery with Lens Implant | $3,496$2.7k$7.8k | $2,180 | $2,180 |
| Cervical Spinal Fusion (Anterior) | $15,634$9.1k$43k | $5,750 | $5,750 |
| Cesarean Delivery (Global Package) | $3,101$2.7k$7.7k | $8,602 | $8,602 |
| Chemotherapy Infusion (First Hour) | $589$383$2.2k | $2,153 | $2,153 |
| Chest X-ray (2 Views) | $130$31$340 | $340 | $340 |
| Colonoscopy with Biopsy | $2,895$808$6.4k | $4,547 | $4,547 |
| Complete Abdominal Ultrasound | $300$108$1.5k | $1,514 | $1,514 |
| Complete Blood Count (CBC) with Differential | $16$5$151 | $151 | $151 |
| Comprehensive Metabolic Panel | $22$10$405 | $405 | $405 |
| Coronary Angioplasty with Stent | $14,319$4.9k$39k | $27,966 | $27,966 |
| Critical Care, First Hour | $2,391$882$12k | $8,637 | $8,637 |
| CT Abdomen and Pelvis with Contrast | $660$246$3.7k | $3,716 | $3,716 |
| CT Cardiac Calcium Scoring | $103$18$306 | $203 | $203 |
| CT Chest without Contrast | $337$124$3.8k | $3,802 | $3,802 |
| CT Head without Contrast | $337$124$2.9k | $2,872 | $2,872 |
| DEXA Bone Density Scan | $186$106$967 | $967 | $967 |
| Diagnostic Colonoscopy | $2,254$761$6.4k | $4,281 | $4,281 |
| Diagnostic Mammogram (Both Breasts) | $250$133$1.2k | $1,206 | $1,206 |
| Ear Tube Placement (Tympanostomy) | $2,028$1.1k$5.2k | $538 | $538 |
| Echocardiogram (Complete with Doppler) | $974$615$3.5k | $3,462 | $3,462 |
| EKG (Electrocardiogram, 12-lead) | $24$17$194 | $58 | $58 |
| Emergency Room Visit (Level 3) | $662$324$1.9k | $1,827 | $1,827 |
| Group Therapy Session | $200$54$436 | $436 | $436 |
| Hemodialysis Treatment | $203$96$718 | $718 | $718 |
| Hemoglobin A1c (Diabetes Test) | $20$6$207 | $207 | $207 |
| HIV Antibody Test | $18$9$137 | $137 | $137 |
| Holter Monitor (24-48 Hour Heart Monitor) | $92$80$229 | $283 | $283 |
| Home Sleep Study | $688$257$4.8k | $3,346 | $3,346 |
| Individual Therapy Session (45 Minutes) | $295$67$600 | $540 | $540 |
| Inguinal Hernia Repair (Open) | $5,074$1.5k$12k | $1,748 | $1,748 |
| Initial Hospital Admission (Level 1) | $93$81$229 | $332 | $332 |
| Initial Psychiatric Diagnostic Evaluation | $278$60$1.9k | $485 | $485 |
| Initial Psychiatric Evaluation with Medication Management | $296$66$1.9k | $531 | $531 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $433 | — | — |
| IUD Insertion | $252$103$6.3k | $579 | $579 |
| IUD Removal | $505$140$6.3k | $788 | $788 |
| Knee Arthroscopy with Meniscectomy | $4,863$1.5k$11k | $1,847 | $1,847 |
| Laparoscopic Appendectomy | $8,260$3.2k$20k | $2,018 | $2,018 |
| Laparoscopic Gallbladder Removal | $8,337$3.0k$20k | $2,243 | $2,243 |
| Laparoscopic Tubal Ligation | $7,900$3.0k$20k | $2,139 | $2,139 |
| Lipid Panel (Cholesterol Test) | $27$13$267 | $267 | $267 |
| Lumbar Epidural Steroid Injection | $1,258$205$2.4k | $2,220 | $2,220 |
| Lumbar Puncture (Spinal Tap) | $1,410$146$7.2k | $2,671 | $2,671 |
| Lumbar Spinal Fusion (Posterior) | $21,351$9.1k$59k | $5,355 | $5,355 |
| Lumpectomy (Partial Mastectomy) | $5,117$1.5k$13k | $2,191 | $2,191 |
| MRI Abdomen with and without Contrast | $995$414$5.6k | $5,599 | $5,599 |
| MRI Brain with and without Contrast | $1,006$414$5.7k | $5,662 | $5,662 |
| MRI Brain with Contrast | $880$414$4.9k | $4,880 | $4,880 |
| MRI Brain without Contrast | $770$283$4.6k | $4,606 | $4,606 |
| MRI Cervical Spine (Neck) without Contrast | $602$283$3.3k | $3,273 | $3,273 |
| MRI Knee without Contrast | $807$283$6.4k | $5,074 | $5,074 |
| MRI Lower Back (Lumbar Spine) without Contrast | $770$283$4.7k | $4,687 | $4,687 |
| MRI Thoracic Spine (Mid-back) without Contrast | $770$283$4.6k | $4,626 | $4,626 |
| Newborn Circumcision | $3,601$1.4k$7.8k | $7,774 | $7,774 |
| Nuclear Cardiac Stress Test | $2,153$1.0k$5.9k | $5,894 | $5,894 |
| Office Visit, Established Patient (Level 3) | $188$86$486 | $486 | $486 |
| Office Visit, New Patient (Level 3) | $267$98$551 | $551 | $551 |
| Pacemaker Insertion (Dual Chamber) | $13,699$3.2k$35k | $32,352 | $32,352 |
| PET/CT Scan, Whole Body | $2,378$1.7k$9.5k | $9,499 | $9,499 |
| Pregnancy Ultrasound (Second or Third Trimester) | $203$105$1.0k | $1,014 | $1,014 |
| Prostate Biopsy | $3,425$1.5k$4.2k | $865 | $865 |
| PSA Prostate Cancer Screening | $38$18$233 | $233 | $233 |
| Pulmonary Function Test with Bronchodilator | $621$200$1.3k | $1,128 | $1,128 |
| Rotator Cuff Repair (Arthroscopic) | $9,092$3.0k$25k | $3,570 | $3,570 |
| Screening Mammogram | $211$108$1.0k | $1,025 | $1,025 |
| Septoplasty (Deviated Septum Repair) | $4,548$1.5k$11k | $2,090 | $2,090 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $8,594$3.0k$24k | $6,202 | $6,202 |
| Skin Biopsy (Tangential) | $508$141$1.4k | $793 | $793 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,083$699$5.6k | $3,936 | $3,936 |
| Sleep Study (In-lab Polysomnography) | $2,166$1.0k$8.6k | $8,569 | $8,569 |
| Spinal Cord Stimulator Trial | $8,328$1.5k$22k | $4,665 | $4,665 |
| Spirometry (Breathing Test) | $380$135$1.0k | $759 | $759 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,333$1.1k$11k | $1,009 | $1,009 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $7,209$1.5k$20k | $972 | $972 |
| Total Hip Replacement | $15,634$6.3k$43k | $2,288 | $2,288 |
| Total Knee Replacement | $15,634$6.3k$43k | $4,570 | $4,570 |
| Total Mastectomy | $8,349$1.5k$22k | $3,204 | $3,204 |
| TSH Thyroid Function Test | $35$17$221 | $221 | $221 |
| TURP (Transurethral Prostate Resection) | $6,769$1.1k$18k | $2,460 | $2,460 |
| Umbilical Hernia Repair | $734$305$1.5k | $1,526 | $1,526 |
| Upper GI Endoscopy (EGD) | $2,198$642$6.4k | $3,615 | $3,615 |
| Urinalysis with Microscopy | $6$1$70 | $70 | $70 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,921$2.5k$7.2k | $8,110 | $8,110 |
| Vaginal Delivery (Global Package) | $5,026$1.7k$25k | $25,116 | $25,116 |
| Vaginal Hysterectomy | $6,240$5.3k$17k | $2,714 | $2,714 |
| Vasectomy | $3,166$1.5k$7.1k | $1,357 | $1,357 |
| Vitamin D Blood Test | $54$29$234 | $234 | $234 |