| Abdominal Hysterectomy | $793$507$6.0k | — | $3,500 |
| ACL Reconstruction (Arthroscopic) | $7,611$507$38k | $8,978 | $3,500 |
| Allergy Skin Testing | $1,112$7$5.4k | $1,279 | — |
| Basic Metabolic Panel | $33$8$136 | — | $227 |
| Bone Marrow Biopsy | $1,771$74$8.7k | $2,036 | $2,965 |
| Breast Biopsy (Ultrasound-guided) | $1,771$150$8.7k | $2,036 | $6,500 |
| Bunion Correction Surgery | $3,546$507$17k | $4,078 | $3,500 |
| Cardiac Ablation for Atrial Fibrillation | $26,811$1.2k$131k | $30,832 | — |
| Cardiac Catheterization (Left Heart) | $3,515$343$17k | $4,042 | $19,615 |
| Cardiac Stress Test (Treadmill) | $351$83$620 | — | — |
| Carpal Tunnel Release Surgery | $2,134$438$10k | $2,454 | $5,884 |
| Cataract Surgery with Lens Implant | $2,493$507$15k | $2,866 | $3,500 |
| Cervical Spinal Fusion (Anterior) | $10,573$507$69k | $16,171 | $3,500 |
| Cesarean Delivery (Global Package) | $2,263 | — | — |
| Chemotherapy Infusion (First Hour) | $363$98$8.8k | $417 | $1,500 |
| Chest X-ray (2 Views) | $96$11$472 | $111 | $525 |
| Colonoscopy with Biopsy | $1,289$256$6.3k | $1,482 | $3,823 |
| Complete Abdominal Ultrasound | $167$40$804 | $134 | $1,340 |
| Complete Blood Count (CBC) with Differential | $23$7$95 | — | $159 |
| Comprehensive Metabolic Panel | $58$9$242 | — | $403 |
| Coronary Angioplasty with Stent | $12,394$610$61k | $14,253 | — |
| Critical Care, First Hour | $944$163$4.8k | $1,059 | $3,675 |
| CT Abdomen and Pelvis with Contrast | $1,040$90$4.5k | $449 | $7,182 |
| CT Cardiac Calcium Scoring | $111$23$956 | $111 | — |
| CT Chest without Contrast | $477$50$2.1k | $134 | $3,297 |
| CT Head without Contrast | $270$42$971 | $134 | $3,104 |
| DEXA Bone Density Scan | $138$10$572 | $134 | $953 |
| Diagnostic Colonoscopy | $996$63$6.1k | $1,146 | $2,909 |
| Diagnostic Mammogram (Both Breasts) | $125$48$356 | — | $594 |
| Ear Tube Placement (Tympanostomy) | $1,623$161$9.9k | $1,862 | $3,500 |
| Echocardiogram (Complete with Doppler) | $622$68$2.9k | $689 | $4,593 |
| EKG (Electrocardiogram, 12-lead) | $75$18$132 | — | — |
| Emergency Room Visit (Level 3) | $303$53$2.2k | $348 | $1,523 |
| Group Therapy Session | $101$25$495 | $116 | — |
| Hemodialysis Treatment | $103 | — | — |
| Hemoglobin A1c (Diabetes Test) | $32$9$131 | — | $218 |
| HIV Antibody Test | $28$8$115 | — | $191 |
| Holter Monitor (24-48 Hour Heart Monitor) | $101 | — | — |
| Home Sleep Study | $290$57$4.1k | $197 | $2,000 |
| Individual Therapy Session (45 Minutes) | $176$95$860 | $202 | — |
| Inguinal Hernia Repair (Open) | $3,681$507$19k | $4,435 | $3,500 |
| Initial Hospital Admission (Level 1) | $75 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $176$163$860 | $202 | — |
| Initial Psychiatric Evaluation with Medication Management | $176$170$860 | $202 | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $632$416$7.8k | $727 | $3,236 |
| IUD Insertion | $550$52$3.6k | — | $3,500 |
| IUD Removal | $489$70$4.3k | $382 | $1,927 |
| Knee Arthroscopy with Meniscectomy | $3,546$507$17k | $4,078 | $3,500 |
| Laparoscopic Appendectomy | $6,139$507$31k | $7,333 | $3,500 |
| Laparoscopic Gallbladder Removal | $6,139$507$31k | $7,333 | $8,823 |
| Laparoscopic Tubal Ligation | $6,139$507$31k | $7,333 | $3,500 |
| Lipid Panel (Cholesterol Test) | $53$12$221 | — | $369 |
| Lumbar Epidural Steroid Injection | $757$103$3.7k | $870 | — |
| Lumbar Puncture (Spinal Tap) | $757$81$4.3k | $870 | $1,393 |
| Lumbar Spinal Fusion (Posterior) | $10,573$507$98k | $23,113 | $3,500 |
| Lumpectomy (Partial Mastectomy) | $4,055$507$21k | $4,813 | $3,500 |
| MRI Abdomen with and without Contrast | $858$126$2.7k | $449 | $5,923 |
| MRI Brain with and without Contrast | $898$126$2.7k | $449 | $6,199 |
| MRI Brain with Contrast | $721$126$1.9k | $449 | $4,981 |
| MRI Brain without Contrast | $631$126$1.7k | $304 | $4,361 |
| MRI Cervical Spine (Neck) without Contrast | $654$126$1.7k | $304 | $4,515 |
| MRI Knee without Contrast | $753$126$2.8k | $304 | $4,281 |
| MRI Lower Back (Lumbar Spine) without Contrast | $647$126$1.7k | $304 | $4,471 |
| MRI Thoracic Spine (Mid-back) without Contrast | $637$126$1.7k | $304 | $4,402 |
| Newborn Circumcision | $2,167$106$11k | $2,575 | $2,661 |
| Nuclear Cardiac Stress Test | $1,427$78$7.0k | $1,641 | $4,838 |
| Office Visit, Established Patient (Level 3) | $94$51$3.6k | — | $600 |
| Office Visit, New Patient (Level 3) | $91$63$3.6k | — | $600 |
| Pacemaker Insertion (Dual Chamber) | $11,361$507$56k | $13,153 | $3,500 |
| PET/CT Scan, Whole Body | $1,594$125$7.8k | $1,833 | $6,715 |
| Pregnancy Ultrasound (Second or Third Trimester) | $167$49$1.7k | $134 | $2,889 |
| Prostate Biopsy | $2,239$150$11k | $2,575 | $4,531 |
| PSA Prostate Cancer Screening | $62$16$257 | — | $428 |
| Pulmonary Function Test with Bronchodilator | $340$13$1.7k | $391 | — |
| Rotator Cuff Repair (Arthroscopic) | $7,611$507$38k | $8,978 | $3,500 |
| Screening Mammogram | $104$37$427 | — | $711 |
| Septoplasty (Deviated Septum Repair) | $3,544$507$17k | $4,076 | $3,500 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $5,999$391$37k | $8,700 | $3,500 |
| Skin Biopsy (Tangential) | $217$35$3.6k | $250 | $835 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,771$72$8.7k | $2,036 | $3,500 |
| Sleep Study (In-lab Polysomnography) | $1,112$113$5.4k | $1,279 | $5,970 |
| Spinal Cord Stimulator Trial | $7,172$425$35k | $8,248 | $3,500 |
| Spirometry (Breathing Test) | $171$8$838 | $197 | — |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,544$306$17k | $4,076 | $3,500 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $4,736$294$32k | $7,435 | $3,500 |
| Total Hip Replacement | $11,836$507$69k | $16,171 | $3,500 |
| Total Knee Replacement | $11,836$507$69k | $16,171 | $3,500 |
| Total Mastectomy | $5,999$507$35k | $8,196 | $3,500 |
| TSH Thyroid Function Test | $29$15$122 | — | $203 |
| TURP (Transurethral Prostate Resection) | $5,505$507$27k | $6,389 | $3,500 |
| Umbilical Hernia Repair | $1,263$507$12k | — | $3,500 |
| Upper GI Endoscopy (EGD) | $1,025$132$5.0k | $1,178 | $4,461 |
| Urinalysis with Microscopy | $17$3$71 | — | $119 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,263 | — | — |
| Vaginal Delivery (Global Package) | $393$362$3.6k | — | $2,500 |
| Vaginal Hysterectomy | $5,292$507$26k | $6,204 | $3,500 |
| Vasectomy | $2,239$246$11k | $2,575 | $3,500 |
| Vitamin D Blood Test | $41$27$176 | — | $280 |