| Abdominal Hysterectomy | $4,261$518$6.3k | $5,855 | — |
| ACL Reconstruction (Arthroscopic) | $7,807$500$33k | $5,855 | — |
| Allergy Skin Testing | $1,112$4$4.7k | — | — |
| Basic Metabolic Panel | $17$4$105 | $9 | $164 |
| Bone Marrow Biopsy | $2,033$84$7.4k | $5,855 | $3,907 |
| Breast Biopsy (Ultrasound-guided) | $2,612$256$7.4k | $5,855 | $4,963 |
| Bunion Correction Surgery | $3,546$457$15k | $5,855 | — |
| Cardiac Ablation for Atrial Fibrillation | $27,347$466$112k | — | — |
| Cardiac Catheterization (Left Heart) | $6,568$533$17k | $4,110 | $21,894 |
| Cardiac Stress Test (Treadmill) | $430$37$895 | — | — |
| Carpal Tunnel Release Surgery | $2,612$233$8.9k | $5,855 | — |
| Cataract Surgery with Lens Implant | $4,261$275$10k | $5,855 | — |
| Cervical Spinal Fusion (Anterior) | $14,062$873$59k | $5,855 | — |
| Cesarean Delivery (Global Package) | $3,434$1.7k$4.1k | $5,855 | — |
| Chemotherapy Infusion (First Hour) | $1,399$68$2.3k | $438 | $2,332 |
| Chest X-ray (2 Views) | $121$17$403 | $96 | $510 |
| Colonoscopy with Biopsy | $2,564$224$5.4k | $5,855 | — |
| Complete Abdominal Ultrasound | $179$48$798 | $205 | $1,091 |
| Complete Blood Count (CBC) with Differential | $15$4$93 | $9 | $146 |
| Comprehensive Metabolic Panel | $21$5$209 | $12 | $328 |
| Coronary Angioplasty with Stent | $14,694$289$52k | — | $24,712 |
| Critical Care, First Hour | $1,833$144$4.7k | $1,045 | $5,566 |
| CT Abdomen and Pelvis with Contrast | $593$162$2.3k | $677 | $3,605 |
| CT Cardiac Calcium Scoring | $116$8$770 | $11 | $56 |
| CT Chest without Contrast | $281$71$1.4k | $412 | $2,195 |
| CT Head without Contrast | $281$56$1.3k | $391 | $2,085 |
| DEXA Bone Density Scan | $154$28$3.2k | $163 | $868 |
| Diagnostic Colonoscopy | $1,993$175$4.5k | $5,855 | — |
| Diagnostic Mammogram (Both Breasts) | $331$82$1.2k | $147 | $783 |
| Ear Tube Placement (Tympanostomy) | $2,612$83$6.8k | $5,855 | — |
| Echocardiogram (Complete with Doppler) | $1,524$102$4.3k | $738 | $3,931 |
| EKG (Electrocardiogram, 12-lead) | $284$7$334 | — | — |
| Emergency Room Visit (Level 3) | $759$37$1.6k | $424 | $2,261 |
| Group Therapy Session | $218$31$423 | $68 | $364 |
| Hemodialysis Treatment | $955$51$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $19$5$73 | $11 | $115 |
| HIV Antibody Test | $18$4$71 | $10 | $112 |
| Holter Monitor (24-48 Hour Heart Monitor) | $416$37$639 | — | — |
| Home Sleep Study | $676$49$7.9k | $524 | $2,793 |
| Individual Therapy Session (45 Minutes) | $330$85$735 | $97 | $518 |
| Inguinal Hernia Repair (Open) | $3,857$268$16k | $5,855 | — |
| Initial Hospital Admission (Level 1) | $4,135$801$9.4k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $441$23$836 | $161 | $858 |
| Initial Psychiatric Evaluation with Medication Management | $521$159$940 | $181 | $965 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,487$411$5.7k | $1,259 | $6,708 |
| IUD Insertion | $2,445$126$3.2k | $5,855 | — |
| IUD Removal | $663$107$3.2k | $5,855 | $712 |
| Knee Arthroscopy with Meniscectomy | $3,617$282$24k | $5,855 | — |
| Laparoscopic Appendectomy | $6,376$308$27k | $5,855 | — |
| Laparoscopic Gallbladder Removal | $7,304$337$27k | $5,855 | — |
| Laparoscopic Tubal Ligation | $6,376$332$27k | $5,855 | — |
| Lipid Panel (Cholesterol Test) | $27$6$158 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $1,514$134$3.3k | $5,855 | — |
| Lumbar Puncture (Spinal Tap) | $1,506$76$3.3k | $5,855 | $2,405 |
| Lumbar Spinal Fusion (Posterior) | $20,098$811$84k | $5,855 | — |
| Lumpectomy (Partial Mastectomy) | $4,185$338$8.4k | $5,855 | — |
| MRI Abdomen with and without Contrast | $747$181$2.9k | $853 | $4,542 |
| MRI Brain with and without Contrast | $757$170$3.2k | $946 | $5,038 |
| MRI Brain with Contrast | $603$144$2.3k | $679 | $3,615 |
| MRI Brain without Contrast | $493$105$2.1k | $615 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $436$102$1.8k | $517 | $2,756 |
| MRI Knee without Contrast | $391$108$1.5k | — | $2,458 |
| MRI Lower Back (Lumbar Spine) without Contrast | $436$102$1.8k | $536 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $450$101$1.9k | $562 | $2,996 |
| Newborn Circumcision | $2,284$15$9.4k | $5,855 | — |
| Nuclear Cardiac Stress Test | $1,779$226$6.0k | $920 | $4,904 |
| Office Visit, Established Patient (Level 3) | $317$48$500 | $96 | $513 |
| Office Visit, New Patient (Level 3) | $358$59$563 | $108 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,437$258$48k | $5,855 | $42,168 |
| PET/CT Scan, Whole Body | $2,285$853$6.7k | — | $9,166 |
| Pregnancy Ultrasound (Second or Third Trimester) | $177$70$898 | $175 | $931 |
| Prostate Biopsy | $2,612$124$9.4k | $5,855 | $6,593 |
| PSA Prostate Cancer Screening | $37$9$203 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $596$20$1.4k | $270 | $1,441 |
| Rotator Cuff Repair (Arthroscopic) | $7,807$548$33k | $5,855 | — |
| Screening Mammogram | $268$67$953 | $119 | $634 |
| Septoplasty (Deviated Septum Repair) | $3,615$351$15k | $5,855 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,565$163$32k | $5,855 | — |
| Skin Biopsy (Tangential) | $434$52$3.2k | $5,855 | $1,044 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,771$66$3.5k | $5,855 | — |
| Sleep Study (In-lab Polysomnography) | $2,224$326$7.9k | $1,461 | $7,783 |
| Spinal Cord Stimulator Trial | $7,172$1.2k$30k | $5,855 | — |
| Spirometry (Breathing Test) | $341$14$716 | — | — |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,615$157$15k | $5,855 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,465$151$27k | $5,855 | — |
| Total Hip Replacement | $14,343$656$59k | $5,855 | — |
| Total Knee Replacement | $14,343$655$59k | $5,855 | — |
| Total Mastectomy | $7,127$489$30k | $5,855 | — |
| TSH Thyroid Function Test | $34$8$175 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $5,556$367$23k | $5,855 | — |
| Upper GI Endoscopy (EGD) | $2,033$149$4.5k | $5,855 | — |
| Urinalysis with Microscopy | $6$1$71 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,118$2.6k$4.1k | $5,855 | — |
| Vaginal Delivery (Global Package) | $3,296$1.7k$4.1k | $5,855 | — |
| Vaginal Hysterectomy | $5,395$428$23k | $5,855 | — |
| Vasectomy | $2,612$173$9.4k | $5,855 | — |
| Vitamin D Blood Test | $59$14$181 | $33 | $281 |