| Abdominal Hysterectomy | $5,390$1.2k$9.4k | $5,419 | — |
| ACL Reconstruction (Arthroscopic) | $7,907$1.4k$21k | $5,419 | — |
| Allergy Skin Testing | $1,126$16$2.2k | — | — |
| Basic Metabolic Panel | $10$4$159 | $9 | $164 |
| Bone Marrow Biopsy | $2,514$311$4.3k | $5,419 | $3,907 |
| Breast Biopsy (Ultrasound-guided) | $3,266$1.8k$5.2k | $5,419 | $4,963 |
| Bunion Correction Surgery | $3,669$1.0k$7.1k | $5,419 | — |
| Cardiac Ablation for Atrial Fibrillation | $34,387$13k$57k | — | — |
| Cardiac Catheterization (Left Heart) | $9,545$3.2k$21k | $4,790 | $21,894 |
| Cardiac Stress Test (Treadmill) | $465$395$1.1k | — | — |
| Carpal Tunnel Release Surgery | $3,266$572$5.2k | $5,419 | — |
| Cataract Surgery with Lens Implant | $4,288$1.7k$11k | $5,419 | — |
| Cervical Spinal Fusion (Anterior) | $11,819$2.4k$28k | $5,419 | — |
| Cesarean Delivery (Global Package) | $3,780$2.0k$4.3k | $5,419 | — |
| Chemotherapy Infusion (First Hour) | $1,336$125$2.3k | $510 | $2,332 |
| Chest X-ray (2 Views) | $116$31$493 | $112 | $510 |
| Colonoscopy with Biopsy | $2,597$657$5.2k | $5,419 | — |
| Complete Abdominal Ultrasound | $210$108$1.1k | $239 | $1,091 |
| Complete Blood Count (CBC) with Differential | $8$4$141 | $9 | $146 |
| Comprehensive Metabolic Panel | $12$5$317 | $12 | $328 |
| Coronary Angioplasty with Stent | $37,159$13k$51k | — | $24,712 |
| Critical Care, First Hour | $1,792$933$5.4k | $1,218 | $5,566 |
| CT Abdomen and Pelvis with Contrast | $593$221$3.5k | $789 | $3,605 |
| CT Cardiac Calcium Scoring | $121$14$1.8k | $12 | $56 |
| CT Chest without Contrast | $260$118$2.1k | $480 | $2,195 |
| CT Head without Contrast | $258$118$2.0k | $456 | $2,085 |
| DEXA Bone Density Scan | $143$79$839 | $190 | $868 |
| Diagnostic Colonoscopy | $2,491$545$5.2k | $5,419 | — |
| Diagnostic Mammogram (Both Breasts) | $198$110$757 | $171 | $783 |
| Ear Tube Placement (Tympanostomy) | $3,263$245$6.0k | $5,419 | — |
| Echocardiogram (Complete with Doppler) | $1,978$414$4.0k | $860 | $3,931 |
| EKG (Electrocardiogram, 12-lead) | $289$284$334 | — | — |
| Emergency Room Visit (Level 3) | $1,342$306$2.8k | $495 | $2,261 |
| Group Therapy Session | $243$31$399 | $90 | $413 |
| Hemodialysis Treatment | $1,310$1.3k$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$5$111 | $11 | $115 |
| HIV Antibody Test | $10$4$108 | $10 | $112 |
| Holter Monitor (24-48 Hour Heart Monitor) | $449$382$804 | — | — |
| Home Sleep Study | $1,657$173$3.6k | $611 | $2,793 |
| Individual Therapy Session (45 Minutes) | $311$100$501 | $113 | $518 |
| Inguinal Hernia Repair (Open) | $4,685$664$7.8k | $5,419 | — |
| Initial Hospital Admission (Level 1) | $7,286$1.3k$11k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $505$178$830 | $188 | $858 |
| Initial Psychiatric Evaluation with Medication Management | $568$178$933 | $211 | $965 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,488$640$6.5k | $1,468 | $6,708 |
| IUD Insertion | $2,149$293$4.3k | $5,419 | $1,179 |
| IUD Removal | $630$177$4.3k | $5,419 | $712 |
| Knee Arthroscopy with Meniscectomy | $5,115$932$21k | $5,419 | — |
| Laparoscopic Appendectomy | $6,458$747$13k | $5,419 | — |
| Laparoscopic Gallbladder Removal | $7,729$495$13k | $5,419 | — |
| Laparoscopic Tubal Ligation | $6,631$939$13k | $5,419 | — |
| Lipid Panel (Cholesterol Test) | $15$6$239 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $2,417$181$4.3k | $5,419 | $4,047 |
| Lumbar Puncture (Spinal Tap) | $1,525$66$4.3k | $5,419 | $2,405 |
| Lumbar Spinal Fusion (Posterior) | $14,876$2.1k$41k | $5,419 | — |
| Lumpectomy (Partial Mastectomy) | $4,254$2.9k$8.4k | $5,419 | — |
| MRI Abdomen with and without Contrast | $739$326$4.4k | $994 | $4,542 |
| MRI Brain with and without Contrast | $739$326$4.9k | $1,102 | $5,038 |
| MRI Brain with Contrast | $648$326$3.5k | $791 | $3,615 |
| MRI Brain without Contrast | $500$268$3.3k | $717 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $500$268$3.3k | $603 | $2,756 |
| MRI Knee without Contrast | $377$268$3.3k | — | $3,687 |
| MRI Lower Back (Lumbar Spine) without Contrast | $500$268$3.3k | $624 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $500$268$3.3k | $656 | $2,996 |
| Newborn Circumcision | $2,533$197$5.0k | $5,419 | — |
| Nuclear Cardiac Stress Test | $1,445$276$4.7k | $1,073 | $4,904 |
| Office Visit, Established Patient (Level 3) | $308$82$496 | $112 | $513 |
| Office Visit, New Patient (Level 3) | $347$64$559 | $126 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,584$959$43k | $5,419 | $42,168 |
| PET/CT Scan, Whole Body | $2,280$1.6k$4.2k | — | $9,166 |
| Pregnancy Ultrasound (Second or Third Trimester) | $226$106$900 | $204 | $931 |
| Prostate Biopsy | $3,266$138$5.2k | $5,419 | — |
| PSA Prostate Cancer Screening | $21$9$309 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $708$345$1.4k | $315 | $1,441 |
| Rotator Cuff Repair (Arthroscopic) | $7,907$1.5k$21k | $5,419 | — |
| Screening Mammogram | $161$84$613 | $139 | $634 |
| Septoplasty (Deviated Septum Repair) | $3,811$708$7.1k | $5,419 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,662$656$15k | $5,419 | — |
| Skin Biopsy (Tangential) | $657$189$4.3k | $5,419 | $1,044 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,825$226$5.2k | $5,419 | $3,041 |
| Sleep Study (In-lab Polysomnography) | $3,964$1.1k$7.5k | $1,703 | $7,783 |
| Spinal Cord Stimulator Trial | $7,264$1.4k$14k | $5,419 | — |
| Spirometry (Breathing Test) | $488$173$787 | $178 | $814 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,288$445$7.7k | $5,419 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,012$389$13k | $5,419 | — |
| Total Hip Replacement | $20,236$2.7k$28k | $5,419 | — |
| Total Knee Replacement | $20,236$2.7k$28k | $5,419 | — |
| Total Mastectomy | $6,871$3.3k$14k | $5,419 | — |
| TSH Thyroid Function Test | $19$8$266 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $5,627$3.3k$11k | $5,419 | — |
| Upper GI Endoscopy (EGD) | $2,065$495$4.5k | $5,419 | — |
| Urinalysis with Microscopy | $3$1$108 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,294$3.3k$4.3k | $5,419 | — |
| Vaginal Delivery (Global Package) | $3,780$1.7k$4.3k | $5,419 | — |
| Vaginal Hysterectomy | $5,503$1.1k$13k | $5,419 | — |
| Vasectomy | $3,300$2.3k$5.2k | $5,419 | — |
| Vitamin D Blood Test | $33$14$272 | $33 | $281 |