| Abdominal Hysterectomy | $5,390$621$9.2k | $3,786 | — |
| ACL Reconstruction (Arthroscopic) | $7,807$745$21k | $3,786 | — |
| Allergy Skin Testing | $1,112$9$2.2k | — | — |
| Basic Metabolic Panel | $9$4$150 | $9 | $164 |
| Bone Marrow Biopsy | $2,710$161$4.2k | $3,786 | $3,907 |
| Breast Biopsy (Ultrasound-guided) | $3,266$1.8k$5.0k | $3,786 | $4,963 |
| Bunion Correction Surgery | $3,941$524$7.1k | $3,786 | — |
| Cardiac Ablation for Atrial Fibrillation | $34,444$13k$53k | — | — |
| Cardiac Catheterization (Left Heart) | $9,545$2.7k$22k | $4,541 | $21,894 |
| Cardiac Stress Test (Treadmill) | $465$395$583 | — | — |
| Carpal Tunnel Release Surgery | $3,401$296$5.0k | $3,786 | — |
| Cataract Surgery with Lens Implant | $4,288$872$11k | $3,786 | — |
| Cervical Spinal Fusion (Anterior) | $11,729$1.3k$28k | $3,786 | — |
| Cesarean Delivery (Global Package) | $3,720$1.0k$4.2k | $3,786 | — |
| Chemotherapy Infusion (First Hour) | $1,386$125$2.1k | $484 | $2,332 |
| Chest X-ray (2 Views) | $96$31$467 | $106 | $510 |
| Colonoscopy with Biopsy | $2,677$340$5.0k | $3,786 | — |
| Complete Abdominal Ultrasound | $169$108$998 | $226 | $1,091 |
| Complete Blood Count (CBC) with Differential | $8$4$134 | $9 | $146 |
| Comprehensive Metabolic Panel | $12$5$300 | $12 | $328 |
| Coronary Angioplasty with Stent | $34,444$12k$51k | — | $24,712 |
| Critical Care, First Hour | $1,845$691$5.1k | $1,154 | $5,566 |
| CT Abdomen and Pelvis with Contrast | $494$221$3.3k | $748 | $3,605 |
| CT Cardiac Calcium Scoring | $114$7$759 | $12 | $56 |
| CT Chest without Contrast | $254$116$2.0k | $455 | $2,195 |
| CT Head without Contrast | $245$116$1.9k | $432 | $2,085 |
| DEXA Bone Density Scan | $117$77$794 | $180 | $868 |
| Diagnostic Colonoscopy | $2,677$282$5.0k | $3,786 | — |
| Diagnostic Mammogram (Both Breasts) | $190$97$716 | $162 | $783 |
| Ear Tube Placement (Tympanostomy) | $3,222$127$5.8k | $3,786 | — |
| Echocardiogram (Complete with Doppler) | $2,059$310$3.8k | $815 | $3,931 |
| EKG (Electrocardiogram, 12-lead) | $284$150$334 | — | — |
| Emergency Room Visit (Level 3) | $1,342$281$2.7k | $469 | $2,261 |
| Group Therapy Session | $101$31$201 | — | — |
| Hemodialysis Treatment | $1,310$661$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$5$105 | $11 | $115 |
| HIV Antibody Test | $10$4$102 | $10 | $112 |
| Holter Monitor (24-48 Hour Heart Monitor) | $417$382$449 | — | — |
| Home Sleep Study | $1,666$171$4.3k | $579 | $2,793 |
| Individual Therapy Session (45 Minutes) | $176$100$349 | — | — |
| Inguinal Hernia Repair (Open) | $4,791$344$7.7k | $3,786 | — |
| Initial Hospital Admission (Level 1) | $7,197$1.3k$9.8k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $499$108$785 | $178 | $858 |
| Initial Psychiatric Evaluation with Medication Management | $562$122$883 | $200 | $965 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,615$632$6.1k | $1,391 | $6,708 |
| IUD Insertion | $2,814$2.0k$4.2k | $3,786 | — |
| IUD Removal | $2,239$332$4.2k | $3,786 | — |
| Knee Arthroscopy with Meniscectomy | $5,115$483$21k | $3,786 | — |
| Laparoscopic Appendectomy | $6,376$387$13k | $3,786 | — |
| Laparoscopic Gallbladder Removal | $7,514$495$13k | $3,786 | — |
| Laparoscopic Tubal Ligation | $6,800$487$13k | $3,786 | — |
| Lipid Panel (Cholesterol Test) | $15$6$226 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $2,552$181$4.2k | $3,786 | $4,047 |
| Lumbar Puncture (Spinal Tap) | $1,804$66$4.2k | $3,786 | $2,405 |
| Lumbar Spinal Fusion (Posterior) | $14,747$1.1k$40k | $3,786 | — |
| Lumpectomy (Partial Mastectomy) | $4,227$3.1k$8.3k | $3,786 | — |
| MRI Abdomen with and without Contrast | $613$326$4.2k | $942 | $4,542 |
| MRI Brain with and without Contrast | $631$326$4.6k | $1,045 | $5,038 |
| MRI Brain with Contrast | $535$326$3.3k | $750 | $3,615 |
| MRI Brain without Contrast | $425$264$3.0k | $680 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $394$264$2.5k | $572 | $2,756 |
| MRI Knee without Contrast | $368$264$2.2k | — | $2,458 |
| MRI Lower Back (Lumbar Spine) without Contrast | $401$264$2.6k | $592 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $410$264$2.7k | $621 | $2,996 |
| Newborn Circumcision | $2,721$102$5.0k | $3,786 | — |
| Nuclear Cardiac Stress Test | $1,427$276$4.5k | $1,017 | $4,904 |
| Office Visit, Established Patient (Level 3) | $308$64$469 | $106 | $513 |
| Office Visit, New Patient (Level 3) | $347$64$529 | $120 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,437$497$44k | $3,786 | $42,168 |
| PET/CT Scan, Whole Body | $1,897$1.6k$4.2k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $169$106$852 | $193 | $931 |
| Prostate Biopsy | $3,731$71$6.0k | $3,786 | $6,593 |
| PSA Prostate Cancer Screening | $20$9$292 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $735$179$1.3k | $299 | $1,441 |
| Rotator Cuff Repair (Arthroscopic) | $7,807$757$21k | $3,786 | — |
| Screening Mammogram | $158$79$580 | $131 | $634 |
| Septoplasty (Deviated Septum Repair) | $3,962$367$7.1k | $3,786 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,514$340$15k | $3,786 | — |
| Skin Biopsy (Tangential) | $696$98$4.2k | $3,786 | $1,044 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,033$117$5.0k | $3,786 | $3,041 |
| Sleep Study (In-lab Polysomnography) | $4,281$966$7.1k | $1,614 | $7,783 |
| Spinal Cord Stimulator Trial | $7,172$728$14k | $3,786 | — |
| Spirometry (Breathing Test) | $486$101$745 | $169 | $814 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,288$230$7.5k | $3,786 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,845$201$13k | $3,786 | — |
| Total Hip Replacement | $20,329$2.7k$28k | $3,786 | — |
| Total Knee Replacement | $20,329$2.7k$28k | $3,786 | — |
| Total Mastectomy | $6,680$3.3k$14k | $3,786 | — |
| TSH Thyroid Function Test | $19$8$252 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $5,556$3.3k$11k | $3,786 | — |
| Upper GI Endoscopy (EGD) | $2,039$257$4.5k | $3,786 | — |
| Urinalysis with Microscopy | $3$1$102 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,174$3.3k$4.2k | $3,786 | — |
| Vaginal Delivery (Global Package) | $3,720$867$4.2k | $3,786 | — |
| Vaginal Hysterectomy | $5,503$592$13k | $3,786 | — |
| Vasectomy | $3,492$2.2k$5.0k | $3,786 | — |
| Vitamin D Blood Test | $33$14$257 | $33 | $281 |