| Abdominal Hysterectomy | $990$814$14k | — | — |
| ACL Reconstruction (Arthroscopic) | $8,164$977$17k | — | — |
| Allergy Skin Testing | $966$11$2.0k | — | — |
| Basic Metabolic Panel | $8$5$39 | $29 | $29 |
| Bone Marrow Biopsy | $1,858$344$13k | $1,997 | $1,997 |
| Breast Biopsy (Ultrasound-guided) | $1,925$513$8.2k | $2,977 | $2,977 |
| Bunion Correction Surgery | $3,681$688$11k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $29,407$1.3k$60k | — | — |
| Cardiac Catheterization (Left Heart) | $3,848$2.9k$158k | $17,050 | $17,050 |
| Cardiac Stress Test (Treadmill) | $80$79$3.1k | — | — |
| Carpal Tunnel Release Surgery | $2,197$389$8.2k | — | — |
| Cataract Surgery with Lens Implant | $2,596$1.1k$13k | — | — |
| Cervical Spinal Fusion (Anterior) | $14,444$1.7k$30k | — | — |
| Cesarean Delivery (Global Package) | $2,632$1.3k$5.4k | — | — |
| Chemotherapy Infusion (First Hour) | $386$204$991 | $1,186 | $1,186 |
| Chest X-ray (2 Views) | $98$37$214 | $309 | $309 |
| Colonoscopy with Biopsy | $1,346$446$8.2k | — | — |
| Complete Abdominal Ultrasound | $124$98$601 | $571 | $571 |
| Complete Blood Count (CBC) with Differential | $8$5$36 | $26 | $26 |
| Comprehensive Metabolic Panel | $11$6$49 | $32 | $32 |
| Coronary Angioplasty with Stent | $12,988$3.4k$158k | $55,474 | $55,474 |
| Critical Care, First Hour | $980$659$4.1k | $3,829 | $3,829 |
| CT Abdomen and Pelvis with Contrast | $414$285$1.2k | $1,654 | $1,654 |
| CT Cardiac Calcium Scoring | $103$44$419 | $257 | $257 |
| CT Chest without Contrast | $124$92$438 | $536 | $536 |
| CT Head without Contrast | $262$92$626 | $536 | $536 |
| DEXA Bone Density Scan | $118$66$264 | $382 | $382 |
| Diagnostic Colonoscopy | $1,046$370$8.2k | — | — |
| Diagnostic Mammogram (Both Breasts) | $213$122$1.4k | $1,908 | $1,908 |
| Ear Tube Placement (Tympanostomy) | $1,746$167$11k | — | — |
| Echocardiogram (Complete with Doppler) | $1,067$615$4.1k | $5,581 | $5,581 |
| EKG (Electrocardiogram, 12-lead) | $16$16$196 | — | — |
| Emergency Room Visit (Level 3) | $324$221$4.1k | $1,283 | $1,283 |
| Group Therapy Session | $127$31$614 | $735 | $735 |
| Hemodialysis Treatment | $498$93$2.3k | $2,741 | $2,741 |
| Hemoglobin A1c (Diabetes Test) | $10$6$45 | $33 | $33 |
| HIV Antibody Test | $9$6$41 | $30 | $30 |
| Holter Monitor (24-48 Hour Heart Monitor) | $76$76$594 | — | — |
| Home Sleep Study | $447$243$10k | $2,462 | $2,462 |
| Individual Therapy Session (45 Minutes) | $234$95$1.2k | $1,477 | $1,477 |
| Inguinal Hernia Repair (Open) | $4,028$452$13k | — | — |
| Initial Hospital Admission (Level 1) | $79$79$161 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $212$84$816 | $732 | $732 |
| Initial Psychiatric Evaluation with Medication Management | $320$52$816 | $732 | $732 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $4,023$540$7.8k | $10,662 | $10,662 |
| IUD Insertion | $114$114$6.9k | — | — |
| IUD Removal | $360$150$4.1k | $873 | $873 |
| Knee Arthroscopy with Meniscectomy | $3,681$633$13k | — | — |
| Laparoscopic Appendectomy | $6,802$508$14k | — | — |
| Laparoscopic Gallbladder Removal | $6,802$6.8k$14k | — | — |
| Laparoscopic Tubal Ligation | $6,802$639$14k | — | — |
| Lipid Panel (Cholesterol Test) | $13$9$62 | $45 | $45 |
| Lumbar Epidural Steroid Injection | $834$414$13k | $2,404 | $2,404 |
| Lumbar Puncture (Spinal Tap) | $1,058$258$13k | $1,501 | $1,501 |
| Lumbar Spinal Fusion (Posterior) | $19,727$1.4k$40k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,405$4.4k$11k | — | — |
| MRI Abdomen with and without Contrast | $414$360$1.5k | $2,090 | $2,090 |
| MRI Brain with and without Contrast | $414$360$1.6k | $2,090 | $2,090 |
| MRI Brain with Contrast | $414$311$1.3k | $1,809 | $1,809 |
| MRI Brain without Contrast | $283$215$990 | $1,250 | $1,250 |
| MRI Cervical Spine (Neck) without Contrast | $283$215$990 | $1,250 | $1,250 |
| MRI Knee without Contrast | $500$215$1.8k | $1,875 | $1,875 |
| MRI Lower Back (Lumbar Spine) without Contrast | $283$215$990 | $1,250 | $1,250 |
| MRI Thoracic Spine (Mid-back) without Contrast | $283$215$990 | $1,250 | $1,250 |
| Newborn Circumcision | $2,446$134$9.2k | $10,980 | $10,980 |
| Nuclear Cardiac Stress Test | $1,457$504$3.6k | $4,892 | $4,892 |
| Office Visit, Established Patient (Level 3) | $103$77$1.2k | $449 | $449 |
| Office Visit, New Patient (Level 3) | $126$64$258 | — | — |
| Pacemaker Insertion (Dual Chamber) | $12,406$3.4k$158k | $72,792 | $72,792 |
| PET/CT Scan, Whole Body | $1,697$957$4.1k | $5,558 | $5,558 |
| Pregnancy Ultrasound (Second or Third Trimester) | $124$98$419 | $571 | $571 |
| Prostate Biopsy | $2,927$94$8.2k | $4,503 | $4,503 |
| PSA Prostate Cancer Screening | $18$12$85 | $62 | $62 |
| Pulmonary Function Test with Bronchodilator | $443$168$861 | $977 | $977 |
| Rotator Cuff Repair (Arthroscopic) | $8,164$992$17k | — | — |
| Screening Mammogram | $139$93$421 | $572 | $572 |
| Septoplasty (Deviated Septum Repair) | $3,730$481$13k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,940$446$16k | — | — |
| Skin Biopsy (Tangential) | $476$128$6.9k | $897 | $897 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,932$154$4.1k | $7,200 | $7,200 |
| Sleep Study (In-lab Polysomnography) | $1,978$966$10k | $10,326 | $10,326 |
| Spinal Cord Stimulator Trial | $7,170$954$15k | — | — |
| Spirometry (Breathing Test) | $256$79$838 | $458 | $458 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,730$302$13k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,660$264$14k | — | — |
| Total Hip Replacement | $14,444$1.9k$30k | — | — |
| Total Knee Replacement | $14,444$1.5k$30k | — | — |
| Total Mastectomy | $7,471$7.5k$15k | — | — |
| TSH Thyroid Function Test | $17$11$77 | $57 | $57 |
| TURP (Transurethral Prostate Resection) | $6,032$6.0k$13k | — | — |
| Umbilical Hernia Repair | $406 | — | — |
| Upper GI Endoscopy (EGD) | $1,061$337$4.1k | $2,728 | $2,728 |
| Urinalysis with Microscopy | $3$1$15 | $11 | $11 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,480$2.5k$5.1k | — | — |
| Vaginal Delivery (Global Package) | $2,356$1.1k$4.8k | — | — |
| Vaginal Hysterectomy | $5,628$777$13k | — | — |
| Vasectomy | $2,352$2.4k$8.2k | — | — |
| Vitamin D Blood Test | $30$19$136 | $100 | $100 |