| ACL Reconstruction (Arthroscopic) | $6,763$780$8.5k | $20,131 | $20,131 |
| Basic Metabolic Panel | $8$7$17 | $493 | $493 |
| Bone Marrow Biopsy | $1,917$1.5k$5.2k | $2,052 | $2,052 |
| Breast Biopsy (Ultrasound-guided) | $2,785$1.5k$7.3k | $4,352 | $4,352 |
| Bunion Correction Surgery | $3,840$780$7.3k | $11,503 | $11,503 |
| Cardiac Catheterization (Left Heart) | $3,806$3.0k$13k | $17,411 | $17,411 |
| Carpal Tunnel Release Surgery | $2,311$725$7.3k | $9,332 | $9,332 |
| Chemotherapy Infusion (First Hour) | $393$314$1.4k | $1,519 | $1,519 |
| Chest X-ray (2 Views) | $104$83$208 | $274 | $274 |
| Colonoscopy with Biopsy | $1,395$725$7.3k | $4,727 | $4,727 |
| Complete Abdominal Ultrasound | $126$101$704 | $1,493 | $1,493 |
| Complete Blood Count (CBC) with Differential | $8$6$16 | $193 | $193 |
| Comprehensive Metabolic Panel | $11$8$21 | $398 | $398 |
| Coronary Angioplasty with Stent | $12,078$3.4k$27k | $40,325 | $40,325 |
| Critical Care, First Hour | $997$572$1.6k | $3,238 | $3,238 |
| CT Abdomen and Pelvis with Contrast | $423$338$845 | $5,114 | $5,114 |
| CT Cardiac Calcium Scoring | $104$83$633 | $265 | $265 |
| CT Chest without Contrast | $126$101$633 | $2,533 | $2,533 |
| CT Head without Contrast | $126$101$633 | $2,449 | $2,449 |
| DEXA Bone Density Scan | $126$101$252 | $1,028 | $1,028 |
| Diagnostic Colonoscopy | $1,079$725$7.3k | $14,934 | $14,934 |
| Diagnostic Mammogram (Both Breasts) | $50$40$100 | $1,020 | $1,020 |
| Ear Tube Placement (Tympanostomy) | $1,753$780$7.3k | $9,586 | $9,586 |
| Echocardiogram (Complete with Doppler) | $649$519$1.4k | $3,212 | $3,212 |
| EKG (Electrocardiogram, 12-lead) | $78$74$81 | $460 | $460 |
| Emergency Room Visit (Level 3) | $572$262$1.6k | $2,490 | $2,490 |
| Group Therapy Session | $109$88$353 | $357 | $357 |
| Hemoglobin A1c (Diabetes Test) | $10$8$19 | $257 | $257 |
| HIV Antibody Test | $9$7$18 | $213 | $213 |
| Home Sleep Study | $185$148$1.3k | $1,061 | $1,061 |
| Individual Therapy Session (45 Minutes) | $190$152$926 | $710 | $710 |
| Inguinal Hernia Repair (Open) | $4,176$572$7.3k | $7,669 | $7,669 |
| Initial Psychiatric Diagnostic Evaluation | $190$152$380 | $238 | $238 |
| Initial Psychiatric Evaluation with Medication Management | $190$152$380 | $477 | $477 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $685$548$5.1k | $2,917 | $2,917 |
| IUD Insertion | $4,288$413$7.3k | $3,834 | $3,834 |
| IUD Removal | $926$288$7.3k | $3,261 | $3,261 |
| Knee Arthroscopy with Meniscectomy | $3,840$1.0k$7.3k | $10,864 | $10,864 |
| Laparoscopic Appendectomy | $6,485$2.8k$7.3k | $11,024 | $11,024 |
| Laparoscopic Gallbladder Removal | $6,485$2.8k$7.3k | $19,172 | $19,172 |
| Laparoscopic Tubal Ligation | $6,066$1.6k$7.3k | $14,379 | $14,379 |
| Lipid Panel (Cholesterol Test) | $13$11$27 | $655 | $655 |
| Lumbar Epidural Steroid Injection | $820$656$7.3k | $2,562 | $2,562 |
| Lumbar Puncture (Spinal Tap) | $820$572$1.6k | $2,914 | $2,914 |
| Lumpectomy (Partial Mastectomy) | $4,531$780$7.3k | $19,172 | $19,172 |
| MRI Abdomen with and without Contrast | $423$338$3.2k | $8,446 | $8,446 |
| MRI Brain with and without Contrast | $423$338$3.2k | $9,578 | $9,578 |
| MRI Brain with Contrast | $423$338$3.2k | $8,272 | $8,272 |
| MRI Brain without Contrast | $286$229$3.2k | $5,800 | $5,800 |
| MRI Cervical Spine (Neck) without Contrast | $286$229$3.2k | $6,167 | $6,167 |
| MRI Knee without Contrast | $286$229$3.2k | $4,093 | $4,093 |
| MRI Lower Back (Lumbar Spine) without Contrast | $286$229$3.2k | $6,074 | $6,074 |
| MRI Thoracic Spine (Mid-back) without Contrast | $286$229$3.2k | $6,286 | $6,286 |
| Newborn Circumcision | $2,424$580$7.3k | $11,503 | $11,503 |
| Nuclear Cardiac Stress Test | $1,545$1.2k$3.1k | $5,431 | $5,431 |
| Office Visit, Established Patient (Level 3) | $72$57$926 | $624 | $624 |
| Office Visit, New Patient (Level 3) | $90$72$926 | $724 | $724 |
| Pacemaker Insertion (Dual Chamber) | $9,907$2.8k$12k | $42,786 | $42,786 |
| PET/CT Scan, Whole Body | $1,726$1.4k$3.5k | $5,673 | $5,673 |
| Pregnancy Ultrasound (Second or Third Trimester) | $126$101$704 | $575 | $575 |
| Prostate Biopsy | $2,424$1.9k$7.3k | $6,151 | $6,151 |
| PSA Prostate Cancer Screening | $18$15$37 | $410 | $410 |
| Pulmonary Function Test with Bronchodilator | $369$295$1.0k | $1,167 | $1,167 |
| Rotator Cuff Repair (Arthroscopic) | $6,763$1.6k$8.5k | $13,421 | $13,421 |
| Screening Mammogram | $39$31$704 | $460 | $460 |
| Septoplasty (Deviated Septum Repair) | $3,838$1.0k$7.3k | $19,172 | $19,172 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,553$1.6k$8.2k | $5,752 | $5,752 |
| Skin Biopsy (Tangential) | $235$188$7.3k | $830 | $830 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,917$572$7.3k | $7,669 | $7,669 |
| Sleep Study (In-lab Polysomnography) | $1,204$482$4.1k | $6,243 | $6,243 |
| Spirometry (Breathing Test) | $185$148$1.0k | $639 | $639 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,838$1.6k$7.3k | $11,503 | $11,503 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,066$780$7.3k | $11,503 | $11,503 |
| Total Mastectomy | $6,174$1.0k$7.7k | $30,675 | $30,675 |
| TSH Thyroid Function Test | $17$13$34 | $579 | $579 |
| TURP (Transurethral Prostate Resection) | $6,016$1.0k$7.3k | $13,044 | $13,044 |
| Upper GI Endoscopy (EGD) | $1,109$580$7.3k | $4,418 | $4,418 |
| Urinalysis with Microscopy | $3$3$6 | $155 | $155 |
| Vasectomy | $2,424$725$7.3k | $13,044 | $13,044 |
| Vitamin D Blood Test | $30$24$59 | $500 | $500 |