| Abdominal Hysterectomy | $6,406$551$9.6k | $5,741 | — |
| ACL Reconstruction (Arthroscopic) | $8,289$661$24k | $5,741 | — |
| Allergy Skin Testing | $28$5$2.5k | $8 | $38 |
| Basic Metabolic Panel | $10$4$136 | $9 | $164 |
| Bone Marrow Biopsy | $2,420$124$4.4k | $5,741 | $4,033 |
| Breast Biopsy (Ultrasound-guided) | $3,845$267$5.2k | $5,741 | $4,963 |
| Bunion Correction Surgery | $4,545$466$7.9k | $5,741 | — |
| Cardiac Ablation for Atrial Fibrillation | $35,464$206$69k | $10,183 | $47,740 |
| Cardiac Catheterization (Left Heart) | $8,078$784$23k | $6,320 | $29,629 |
| Cardiac Stress Test (Treadmill) | $638$14$1.4k | $358 | $1,680 |
| Carpal Tunnel Release Surgery | $3,922$263$5.7k | $5,741 | — |
| Cataract Surgery with Lens Implant | $4,565$534$14k | $5,741 | — |
| Cervical Spinal Fusion (Anterior) | $14,930$274$31k | $5,741 | — |
| Cesarean Delivery (Global Package) | $2,812$903$4.4k | $5,741 | — |
| Chemotherapy Infusion (First Hour) | $886$20$2.1k | $497 | $2,332 |
| Chest X-ray (2 Views) | $102$30$424 | $109 | $510 |
| Colonoscopy with Biopsy | $2,723$302$5.2k | $5,741 | — |
| Complete Abdominal Ultrasound | $177$62$908 | $233 | $1,091 |
| Complete Blood Count (CBC) with Differential | $8$4$121 | $9 | $146 |
| Comprehensive Metabolic Panel | $12$5$273 | $12 | $328 |
| Coronary Angioplasty with Stent | $28,177$9.1k$57k | — | $29,649 |
| Critical Care, First Hour | $1,891$86$4.6k | $1,294 | $6,067 |
| CT Abdomen and Pelvis with Contrast | $556$247$3.0k | $769 | $3,605 |
| CT Cardiac Calcium Scoring | $110$8$378 | $12 | $56 |
| CT Chest without Contrast | $268$122$2.4k | $625 | $2,929 |
| CT Head without Contrast | $268$108$1.7k | $445 | $2,085 |
| DEXA Bone Density Scan | $127$32$722 | $185 | $868 |
| Diagnostic Colonoscopy | $2,105$251$5.2k | $5,741 | — |
| Diagnostic Mammogram (Both Breasts) | $171$91$651 | $167 | $783 |
| Ear Tube Placement (Tympanostomy) | $2,671$113$6.1k | $5,741 | $5,570 |
| Echocardiogram (Complete with Doppler) | $1,336$97$4.1k | $994 | $4,661 |
| EKG (Electrocardiogram, 12-lead) | $95$5$334 | $33 | $153 |
| Emergency Room Visit (Level 3) | $1,500$85$3.7k | $641 | $3,005 |
| Group Therapy Session | $107$31$225 | — | — |
| Hemodialysis Treatment | $1,310$587$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$5$124 | $11 | $149 |
| HIV Antibody Test | $10$4$83 | $10 | $100 |
| Holter Monitor (24-48 Hour Heart Monitor) | $382$13$449 | — | — |
| Home Sleep Study | $361$182$4.3k | — | — |
| Individual Therapy Session (45 Minutes) | $223$77$431 | $110 | $518 |
| Inguinal Hernia Repair (Open) | $5,739$306$8.6k | $5,741 | — |
| Initial Hospital Admission (Level 1) | $8,617$1.7k$11k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $271$84$712 | $120 | $563 |
| Initial Psychiatric Evaluation with Medication Management | $235$73$511 | $104 | $489 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,493$568$5.5k | $1,404 | $6,581 |
| IUD Insertion | $624$102$4.4k | $5,741 | $750 |
| IUD Removal | $463$117$4.4k | $5,741 | $858 |
| Knee Arthroscopy with Meniscectomy | $5,739$429$24k | $5,741 | — |
| Laparoscopic Appendectomy | $6,770$344$14k | $5,741 | — |
| Laparoscopic Gallbladder Removal | $7,865$495$16k | $5,741 | — |
| Laparoscopic Tubal Ligation | $7,865$432$14k | $5,741 | — |
| Lipid Panel (Cholesterol Test) | $14$6$206 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $1,941$96$4.4k | $5,741 | $4,047 |
| Lumbar Puncture (Spinal Tap) | $1,443$66$4.4k | $5,741 | $2,405 |
| Lumbar Spinal Fusion (Posterior) | $21,338$270$45k | $5,741 | — |
| Lumpectomy (Partial Mastectomy) | $4,779$634$9.3k | $5,741 | — |
| MRI Abdomen with and without Contrast | $679$247$3.8k | $969 | $4,542 |
| MRI Brain with and without Contrast | $717$278$4.2k | $1,075 | $5,038 |
| MRI Brain with Contrast | $578$232$3.0k | $771 | $3,615 |
| MRI Brain without Contrast | $466$198$2.7k | $699 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $425$201$2.3k | $588 | $2,756 |
| MRI Knee without Contrast | $405$230$1.0k | — | $3,687 |
| MRI Lower Back (Lumbar Spine) without Contrast | $430$198$2.4k | $609 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $441$200$2.5k | $639 | $2,996 |
| Newborn Circumcision | $2,823$91$5.7k | $5,741 | — |
| Nuclear Cardiac Stress Test | $1,515$190$4.0k | $1,016 | $4,764 |
| Office Visit, Established Patient (Level 3) | $195$70$427 | $109 | $513 |
| Office Visit, New Patient (Level 3) | $220$64$481 | $123 | $578 |
| Pacemaker Insertion (Dual Chamber) | $12,143$109$53k | $5,741 | $42,168 |
| PET/CT Scan, Whole Body | $2,280$1.2k$4.2k | — | $8,719 |
| Pregnancy Ultrasound (Second or Third Trimester) | $177$61$775 | $199 | $931 |
| Prostate Biopsy | $3,922$63$5.5k | $5,741 | $6,593 |
| PSA Prostate Cancer Screening | $20$9$265 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $537$44$1.2k | $301 | $1,412 |
| Rotator Cuff Repair (Arthroscopic) | $8,289$645$24k | $5,741 | — |
| Screening Mammogram | $126$39$527 | $135 | $634 |
| Septoplasty (Deviated Septum Repair) | $3,763$105$7.9k | $5,741 | $4,202 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $8,032$124$17k | $5,741 | — |
| Skin Biopsy (Tangential) | $420$36$4.4k | $5,741 | $875 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,880$104$5.2k | $5,741 | $2,433 |
| Sleep Study (In-lab Polysomnography) | $1,705$466$4.7k | — | — |
| Spinal Cord Stimulator Trial | $7,615$596$16k | $5,741 | — |
| Spirometry (Breathing Test) | $381$120$738 | $189 | $887 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,693$205$8.9k | $5,741 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,118$179$14k | $5,741 | — |
| Total Hip Replacement | $22,525$1.2k$31k | $5,741 | — |
| Total Knee Replacement | $22,525$585$31k | $5,741 | — |
| Total Mastectomy | $7,348$803$16k | $5,741 | — |
| TSH Thyroid Function Test | $19$8$229 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $6,053$283$12k | $5,741 | — |
| Upper GI Endoscopy (EGD) | $2,165$228$5.1k | $5,741 | — |
| Urinalysis with Microscopy | $3$1$93 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,370$1.3k$4.4k | $5,741 | — |
| Vaginal Delivery (Global Package) | $2,738$770$4.4k | $5,741 | — |
| Vaginal Hysterectomy | $5,842$526$16k | $5,741 | — |
| Vasectomy | $4,027$127$5.7k | $5,741 | — |
| Vitamin D Blood Test | $30$14$423 | $33 | $508 |