| Abdominal Hysterectomy | $5,097$577$9.2k | $5,110 | — |
| ACL Reconstruction (Arthroscopic) | $7,807$692$35k | $5,110 | — |
| Allergy Skin Testing | $1,112$8$4.9k | — | — |
| Basic Metabolic Panel | $15$4$139 | $9 | $164 |
| Bone Marrow Biopsy | $2,255$150$7.8k | $5,110 | $2,934 |
| Breast Biopsy (Ultrasound-guided) | $3,631$1.8k$7.8k | $5,110 | $7,176 |
| Bunion Correction Surgery | $5,085$487$16k | $5,110 | — |
| Cardiac Ablation for Atrial Fibrillation | $33,320$16k$119k | — | — |
| Cardiac Catheterization (Left Heart) | $6,152$2.6k$18k | $3,510 | $21,415 |
| Cardiac Stress Test (Treadmill) | $465$345$542 | — | — |
| Carpal Tunnel Release Surgery | $3,446$275$9.4k | $5,110 | — |
| Cataract Surgery with Lens Implant | $4,362$811$11k | $5,110 | — |
| Cervical Spinal Fusion (Anterior) | $14,062$1.2k$62k | $5,110 | — |
| Cesarean Delivery (Global Package) | $4,174$945$4.2k | $5,110 | — |
| Chemotherapy Infusion (First Hour) | $1,073$125$2.1k | $414 | $2,525 |
| Chest X-ray (2 Views) | $116$31$426 | $81 | $493 |
| Colonoscopy with Biopsy | $3,090$316$5.7k | $5,110 | — |
| Complete Abdominal Ultrasound | $177$108$927 | $179 | $1,091 |
| Complete Blood Count (CBC) with Differential | $14$4$124 | $9 | $146 |
| Comprehensive Metabolic Panel | $21$5$279 | $12 | $328 |
| Coronary Angioplasty with Stent | $34,720$12k$55k | — | $21,044 |
| Critical Care, First Hour | $1,833$631$4.7k | $903 | $5,512 |
| CT Abdomen and Pelvis with Contrast | $494$221$3.1k | $591 | $3,605 |
| CT Cardiac Calcium Scoring | $126$7$3.0k | $9 | $56 |
| CT Chest without Contrast | $239$116$3.0k | $550 | $3,358 |
| CT Head without Contrast | $231$116$3.0k | $342 | $2,085 |
| DEXA Bone Density Scan | $145$77$928 | $179 | $1,092 |
| Diagnostic Colonoscopy | $3,090$262$5.0k | $5,110 | — |
| Diagnostic Mammogram (Both Breasts) | $340$95$666 | $128 | $783 |
| Ear Tube Placement (Tympanostomy) | $3,627$118$7.2k | $5,110 | — |
| Echocardiogram (Complete with Doppler) | $2,396$548$4.2k | $776 | $4,736 |
| EKG (Electrocardiogram, 12-lead) | $284$139$334 | — | — |
| Emergency Room Visit (Level 3) | $1,231$248$2.8k | $398 | $2,428 |
| Group Therapy Session | $102$31$447 | — | — |
| Hemodialysis Treatment | $1,310$615$1.5k | — | — |
| Hemoglobin A1c (Diabetes Test) | $17$5$206 | $11 | $242 |
| HIV Antibody Test | $18$4$135 | $10 | $159 |
| Holter Monitor (24-48 Hour Heart Monitor) | $387$382$449 | — | — |
| Home Sleep Study | $909$171$4.3k | $372 | $2,269 |
| Individual Therapy Session (45 Minutes) | $177$100$777 | — | — |
| Inguinal Hernia Repair (Open) | $5,097$320$17k | $5,110 | — |
| Initial Hospital Admission (Level 1) | $7,529$1.5k$11k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $463$108$777 | $142 | $866 |
| Initial Psychiatric Evaluation with Medication Management | $511$114$778 | $150 | $915 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,238$568$5.9k | $1,140 | $6,955 |
| IUD Insertion | $2,595$1.9k$4.2k | $5,110 | — |
| IUD Removal | $1,396$332$4.2k | $5,110 | — |
| Knee Arthroscopy with Meniscectomy | $5,982$449$22k | $5,110 | — |
| Laparoscopic Appendectomy | $6,418$360$28k | $5,110 | — |
| Laparoscopic Gallbladder Removal | $7,534$495$28k | $5,110 | — |
| Laparoscopic Tubal Ligation | $7,514$452$28k | $5,110 | — |
| Lipid Panel (Cholesterol Test) | $25$6$210 | $15 | $247 |
| Lumbar Epidural Steroid Injection | $2,255$181$4.2k | $5,110 | — |
| Lumbar Puncture (Spinal Tap) | $763$66$4.2k | $5,110 | $898 |
| Lumbar Spinal Fusion (Posterior) | $20,098$1.0k$89k | $5,110 | — |
| Lumpectomy (Partial Mastectomy) | $4,514$3.4k$8.3k | $5,110 | — |
| MRI Abdomen with and without Contrast | $683$327$5.6k | $1,076 | $6,568 |
| MRI Brain with and without Contrast | $613$327$4.3k | $826 | $5,038 |
| MRI Brain with Contrast | $494$327$3.5k | $592 | $3,615 |
| MRI Brain without Contrast | $414$264$3.5k | $537 | $3,279 |
| MRI Cervical Spine (Neck) without Contrast | $368$264$3.5k | $452 | $2,756 |
| MRI Knee without Contrast | $368$264$3.5k | — | $2,458 |
| MRI Lower Back (Lumbar Spine) without Contrast | $380$264$3.5k | $468 | $2,854 |
| MRI Thoracic Spine (Mid-back) without Contrast | $399$264$3.5k | $491 | $2,996 |
| Newborn Circumcision | $3,446$95$9.9k | $5,110 | — |
| Nuclear Cardiac Stress Test | $1,779$276$7.8k | $1,496 | $9,127 |
| Office Visit, Established Patient (Level 3) | $266$62$436 | $84 | $513 |
| Office Visit, New Patient (Level 3) | $299$64$491 | $95 | $578 |
| Pacemaker Insertion (Dual Chamber) | $11,437$462$51k | $5,110 | — |
| PET/CT Scan, Whole Body | $2,280$1.6k$7.1k | — | $14,233 |
| Pregnancy Ultrasound (Second or Third Trimester) | $177$106$514 | — | — |
| Prostate Biopsy | $3,329$66$9.9k | $5,110 | — |
| PSA Prostate Cancer Screening | $37$9$271 | $20 | $319 |
| Pulmonary Function Test with Bronchodilator | $677$198$1.5k | $267 | $1,631 |
| Rotator Cuff Repair (Arthroscopic) | $7,807$703$35k | $5,110 | — |
| Screening Mammogram | $277$77$539 | $104 | $634 |
| Septoplasty (Deviated Septum Repair) | $4,759$341$16k | $5,110 | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,565$316$33k | $5,110 | — |
| Skin Biopsy (Tangential) | $497$83$4.2k | $5,110 | $683 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,771$109$5.0k | $5,110 | $2,100 |
| Sleep Study (In-lab Polysomnography) | $3,964$946$6.6k | $1,276 | $7,783 |
| Spinal Cord Stimulator Trial | $7,534$676$32k | $5,110 | — |
| Spirometry (Breathing Test) | $443$68$756 | $136 | $828 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,759$214$16k | $5,110 | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,465$187$29k | $5,110 | — |
| Total Hip Replacement | $22,525$8.7k$62k | $5,110 | — |
| Total Knee Replacement | $22,525$8.7k$62k | $5,110 | — |
| Total Mastectomy | $7,127$4.3k$32k | $5,110 | — |
| TSH Thyroid Function Test | $33$8$234 | $18 | $275 |
| TURP (Transurethral Prostate Resection) | $6,111$4.9k$25k | $5,110 | — |
| Upper GI Endoscopy (EGD) | $2,360$239$4.5k | $5,110 | — |
| Urinalysis with Microscopy | $6$1$95 | $3 | $112 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,174 | $5,110 | — |
| Vaginal Delivery (Global Package) | $4,174$806$4.2k | $5,110 | — |
| Vaginal Hysterectomy | $5,982$551$24k | $5,110 | — |
| Vasectomy | $3,682$2.2k$9.9k | $5,110 | — |
| Vitamin D Blood Test | $52$14$349 | $33 | $411 |