| Abdominal Hysterectomy | $5,463$606$10k | $6,839 | — |
| ACL Reconstruction (Arthroscopic) | $8,015$727$23k | $6,839 | — |
| Allergy Skin Testing | $1,141$8$2.3k | — | — |
| Basic Metabolic Panel | $9$4$139 | $9 | $164 |
| Bone Marrow Biopsy | $2,413$157$4.3k | $6,839 | — |
| Breast Biopsy (Ultrasound-guided) | $3,274$1.8k$5.5k | $6,839 | — |
| Bunion Correction Surgery | $3,677$512$7.3k | $6,839 | — |
| Cardiac Ablation for Atrial Fibrillation | $34,867$7.6k$65k | $10,116 | $47,740 |
| Cardiac Catheterization (Left Heart) | $7,217$3.2k$22k | $6,278 | $29,629 |
| Cardiac Stress Test (Treadmill) | $465$395$569 | — | — |
| Carpal Tunnel Release Surgery | $3,048$289$5.5k | $6,839 | — |
| Cataract Surgery with Lens Implant | $4,220$852$9.1k | $6,839 | — |
| Cervical Spinal Fusion (Anterior) | $11,979$1.2k$29k | $6,839 | — |
| Cesarean Delivery (Global Package) | $3,780$993$4.3k | $6,839 | — |
| Chemotherapy Infusion (First Hour) | $1,281$125$2.1k | $494 | $2,332 |
| Chest X-ray (2 Views) | $99$31$434 | $108 | $510 |
| Colonoscopy with Biopsy | $2,666$332$5.5k | $6,839 | — |
| Complete Abdominal Ultrasound | $173$108$927 | $231 | $1,091 |
| Complete Blood Count (CBC) with Differential | $8$4$124 | $9 | $146 |
| Comprehensive Metabolic Panel | $11$5$279 | $12 | $328 |
| Coronary Angioplasty with Stent | $38,053$13k$52k | — | $29,649 |
| Critical Care, First Hour | $1,891$914$4.9k | $1,224 | $5,775 |
| CT Abdomen and Pelvis with Contrast | $603$247$3.1k | $764 | $3,605 |
| CT Cardiac Calcium Scoring | $114$9$1.8k | $12 | $56 |
| CT Chest without Contrast | $281$119$2.5k | $621 | $2,929 |
| CT Head without Contrast | $276$119$1.8k | $442 | $2,085 |
| DEXA Bone Density Scan | $119$84$319 | — | — |
| Diagnostic Colonoscopy | $2,366$276$5.5k | $6,839 | — |
| Diagnostic Mammogram (Both Breasts) | $152$110$583 | — | — |
| Ear Tube Placement (Tympanostomy) | $3,274$124$6.7k | $6,839 | — |
| Echocardiogram (Complete with Doppler) | $1,880$310$4.2k | $988 | $4,661 |
| EKG (Electrocardiogram, 12-lead) | $284$146$334 | — | — |
| Emergency Room Visit (Level 3) | $1,346$311$3.3k | $492 | $2,321 |
| Group Therapy Session | $235$31$351 | $88 | $413 |
| Hemodialysis Treatment | $1,310$646$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$5$127 | $11 | $149 |
| HIV Antibody Test | $9$4$85 | $10 | $100 |
| Holter Monitor (24-48 Hour Heart Monitor) | $407$382$449 | — | — |
| Home Sleep Study | $1,742$176$4.2k | $648 | $3,056 |
| Individual Therapy Session (45 Minutes) | $303$84$440 | $110 | $518 |
| Inguinal Hernia Repair (Open) | $4,113$336$7.9k | $6,839 | — |
| Initial Hospital Admission (Level 1) | $7,870$1.3k$12k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $491$139$733 | $183 | $862 |
| Initial Psychiatric Evaluation with Medication Management | $417$117$616 | $154 | $725 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,511$649$5.6k | $1,395 | $6,581 |
| IUD Insertion | $2,039$119$4.3k | $6,839 | $750 |
| IUD Removal | $2,039$341$4.3k | $6,839 | — |
| Knee Arthroscopy with Meniscectomy | $5,130$471$23k | $6,839 | — |
| Laparoscopic Appendectomy | $6,611$378$13k | $6,839 | — |
| Laparoscopic Gallbladder Removal | $7,853$495$13k | $6,839 | — |
| Laparoscopic Tubal Ligation | $6,611$475$13k | $6,839 | — |
| Lipid Panel (Cholesterol Test) | $14$6$210 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $1,554$181$4.3k | $6,839 | — |
| Lumbar Puncture (Spinal Tap) | $1,426$66$4.3k | $6,839 | $2,405 |
| Lumbar Spinal Fusion (Posterior) | $15,078$1.1k$41k | $6,839 | — |
| Lumpectomy (Partial Mastectomy) | $4,346$3.1k$8.6k | $6,839 | — |
| MRI Abdomen with and without Contrast | $733$401$3.9k | $962 | $4,542 |
| MRI Brain with and without Contrast | $798$401$4.3k | $1,068 | $5,038 |
| MRI Brain with Contrast | $603$401$3.3k | $766 | $3,615 |
| MRI Brain without Contrast | $529$271$3.3k | $695 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $445$271$3.3k | $584 | $2,756 |
| MRI Knee without Contrast | $406$271$3.3k | — | $2,458 |
| MRI Lower Back (Lumbar Spine) without Contrast | $461$271$3.3k | $605 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $484$271$3.3k | $635 | $2,996 |
| Newborn Circumcision | $2,805$100$5.1k | $6,839 | — |
| Nuclear Cardiac Stress Test | $1,465$276$4.0k | $1,009 | $4,764 |
| Office Visit, Established Patient (Level 3) | $298$81$436 | $109 | $513 |
| Office Visit, New Patient (Level 3) | $335$64$491 | $122 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,741$485$52k | $6,839 | $42,168 |
| PET/CT Scan, Whole Body | $1,897$1.6k$4.2k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $169$106$791 | $197 | $931 |
| Prostate Biopsy | $3,048$70$5.5k | $6,839 | — |
| PSA Prostate Cancer Screening | $19$9$271 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $695$224$1.2k | $299 | $1,412 |
| Rotator Cuff Repair (Arthroscopic) | $8,055$739$23k | $6,839 | — |
| Screening Mammogram | $126$84$481 | — | — |
| Septoplasty (Deviated Septum Repair) | $4,035$358$7.6k | $6,839 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,766$332$16k | $6,839 | — |
| Skin Biopsy (Tangential) | $542$95$4.3k | $6,839 | $875 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,836$114$5.5k | $6,839 | $2,433 |
| Sleep Study (In-lab Polysomnography) | $3,964$1.1k$6.6k | $1,649 | $7,783 |
| Spinal Cord Stimulator Trial | $7,363$710$15k | $6,839 | — |
| Spirometry (Breathing Test) | $507$140$754 | $188 | $887 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,220$225$8.5k | $6,839 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,637$197$13k | $6,839 | — |
| Total Hip Replacement | $22,308$2.7k$29k | $6,839 | — |
| Total Knee Replacement | $22,308$2.7k$29k | $6,839 | — |
| Total Mastectomy | $7,317$3.3k$15k | $6,839 | — |
| TSH Thyroid Function Test | $17$8$234 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $5,703$3.3k$11k | $6,839 | — |
| Upper GI Endoscopy (EGD) | $2,098$251$4.6k | $6,839 | — |
| Urinalysis with Microscopy | $3$1$95 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,294$3.3k$4.3k | $6,839 | — |
| Vaginal Delivery (Global Package) | $3,780$847$4.3k | $6,839 | — |
| Vaginal Hysterectomy | $5,594$579$11k | $6,839 | — |
| Vasectomy | $3,266$2.3k$5.5k | $6,839 | — |
| Vitamin D Blood Test | $30$14$432 | $33 | $508 |