| Abdominal Hysterectomy | $4,655$476$12k | $7,860 | $7,860 |
| ACL Reconstruction (Arthroscopic) | $14,115$6.5k$18k | — | — |
| Allergy Skin Testing | $653$34$1.4k | $1,544 | $1,544 |
| Basic Metabolic Panel | $62$32$221 | $246 | $246 |
| Bone Marrow Biopsy | $548$62$9.8k | $2,021 | $2,021 |
| Breast Biopsy (Ultrasound-guided) | $1,372$94$11k | $4,935 | $4,935 |
| Bunion Correction Surgery | $2,309$288$11k | $3,395 | $3,395 |
| Cardiac Ablation for Atrial Fibrillation | $15,485$9.6k$21k | — | — |
| Cardiac Catheterization (Left Heart) | $9,526$6.8k$12k | — | — |
| Cardiac Stress Test (Treadmill) | $143$61$594 | $660 | $660 |
| Carpal Tunnel Release Surgery | $2,023$201$11k | $3,000 | $3,000 |
| Cataract Surgery with Lens Implant | $8,307$5.7k$14k | — | — |
| Cervical Spinal Fusion (Anterior) | $8,199$677$18k | $17,465 | $17,465 |
| Chemotherapy Infusion (First Hour) | $934$289$3.2k | $1,753 | $1,753 |
| Chest X-ray (2 Views) | $48$9$1.1k | $335 | $335 |
| Colonoscopy with Biopsy | $1,162$162$11k | $2,540 | $2,540 |
| Complete Abdominal Ultrasound | $590$33$1.9k | $957 | $957 |
| Complete Blood Count (CBC) with Differential | $40$14$134 | $115 | $115 |
| Comprehensive Metabolic Panel | $72$32$323 | $359 | $359 |
| Coronary Angioplasty with Stent | $15,485$12k$18k | — | — |
| Critical Care, First Hour | $1,160$247$6.9k | $1,650 | $1,650 |
| CT Abdomen and Pelvis with Contrast | $522$75$3.8k | $2,437 | $2,437 |
| CT Cardiac Calcium Scoring | $103$24$503 | $155 | $155 |
| CT Chest without Contrast | $411$45$2.2k | $1,310 | $1,310 |
| CT Head without Contrast | $473$35$2.2k | $1,278 | $1,278 |
| DEXA Bone Density Scan | $192$8$1.3k | $752 | $752 |
| Diagnostic Colonoscopy | $1,166$83$11k | $1,635 | $1,635 |
| Diagnostic Mammogram (Both Breasts) | $204$41$1.2k | $790 | $790 |
| Ear Tube Placement (Tympanostomy) | $713$101$11k | $1,140 | $1,140 |
| Echocardiogram (Complete with Doppler) | $426$59$4.3k | $555 | $555 |
| Emergency Room Visit (Level 3) | $265$63$383 | $365 | $365 |
| Group Therapy Session | $53$23$135 | $150 | $150 |
| Hemodialysis Treatment | $196$56$639 | $710 | $710 |
| Hemoglobin A1c (Diabetes Test) | $39$8$198 | $220 | $220 |
| Home Sleep Study | $228$38$1.4k | $329 | $329 |
| Individual Therapy Session (45 Minutes) | $185$71$446 | $450 | $450 |
| Inguinal Hernia Repair (Open) | $2,474$234$11k | $3,665 | $3,665 |
| Initial Hospital Admission (Level 1) | $404$74$606 | $575 | $575 |
| Initial Psychiatric Diagnostic Evaluation | $235$108$744 | $740 | $740 |
| Initial Psychiatric Evaluation with Medication Management | $270$116$844 | $825 | $825 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,515$173$5.9k | $6,591 | $6,591 |
| IUD Insertion | $298$45$9.8k | $1,019 | $1,019 |
| IUD Removal | $355$36$9.8k | $1,058 | $1,058 |
| Knee Arthroscopy with Meniscectomy | $7,970$6.8k$11k | — | — |
| Laparoscopic Appendectomy | $2,851$268$18k | $4,280 | $4,280 |
| Laparoscopic Gallbladder Removal | $3,131$334$18k | $5,700 | $5,700 |
| Laparoscopic Tubal Ligation | $3,001$314$18k | $6,305 | $6,305 |
| Lipid Panel (Cholesterol Test) | $72$32$321 | $357 | $357 |
| Lumbar Epidural Steroid Injection | $729$55$9.8k | $1,142 | $1,142 |
| Lumbar Puncture (Spinal Tap) | $716$37$9.8k | $1,644 | $1,644 |
| Lumbar Spinal Fusion (Posterior) | $7,680$763$18k | $13,148 | $13,148 |
| Lumpectomy (Partial Mastectomy) | $3,110$270$11k | $4,750 | $4,750 |
| MRI Abdomen with and without Contrast | $907$91$6.8k | $3,322 | $3,322 |
| MRI Brain with and without Contrast | $907$95$6.8k | $3,880 | $3,880 |
| MRI Brain with Contrast | $907$74$6.8k | $3,666 | $3,666 |
| MRI Brain without Contrast | $601$62$6.8k | $3,246 | $3,246 |
| MRI Cervical Spine (Neck) without Contrast | $470$31$6.8k | $3,457 | $3,457 |
| MRI Knee without Contrast | $1,071$57$9.3k | $5,181 | $5,181 |
| MRI Lower Back (Lumbar Spine) without Contrast | $601$62$6.8k | $3,247 | $3,247 |
| MRI Thoracic Spine (Mid-back) without Contrast | $601$62$6.8k | $2,798 | $2,798 |
| Newborn Circumcision | $441$51$11k | $725 | $725 |
| Nuclear Cardiac Stress Test | $842$66$5.5k | $3,306 | $3,306 |
| Office Visit, Established Patient (Level 3) | $296$80$448 | $430 | $430 |
| Office Visit, New Patient (Level 3) | $413$100$645 | $615 | $615 |
| Pacemaker Insertion (Dual Chamber) | $14,857$9.3k$21k | — | — |
| PET/CT Scan, Whole Body | $546$49$12k | $4,175 | $4,175 |
| Prostate Biopsy | $1,746$67$11k | $2,791 | $2,791 |
| PSA Prostate Cancer Screening | $74$13$345 | $383 | $383 |
| Pulmonary Function Test with Bronchodilator | $304$9$1.2k | $703 | $703 |
| Rotator Cuff Repair (Arthroscopic) | $14,115$7.8k$18k | — | — |
| Screening Mammogram | $166$16$854 | $368 | $368 |
| Septoplasty (Deviated Septum Repair) | $3,055$279$11k | $5,240 | $5,240 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $1,470$204$14k | $3,145 | $3,145 |
| Skin Biopsy (Tangential) | $814$22$9.8k | $1,791 | $1,791 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $594$38$9.8k | $640 | $640 |
| Spinal Cord Stimulator Trial | $5,575$203$41k | $7,429 | $7,429 |
| Spirometry (Breathing Test) | $96$7$795 | $467 | $467 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $1,392$148$11k | $2,105 | $2,105 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $8,396$6.5k$11k | — | — |
| Total Hip Replacement | $6,325$697$21k | $12,950 | $12,950 |
| Total Knee Replacement | $6,315$749$21k | $11,645 | $11,645 |
| Total Mastectomy | $5,377$416$18k | $9,825 | $9,825 |
| TSH Thyroid Function Test | $75$31$343 | $381 | $381 |
| TURP (Transurethral Prostate Resection) | $3,297$416$12k | $5,515 | $5,515 |
| Umbilical Hernia Repair | $7,744$6.8k$10k | — | — |
| Upper GI Endoscopy (EGD) | $1,004$81$11k | $1,305 | $1,305 |
| Urinalysis with Microscopy | $23$13$83 | $92 | $92 |
| Vaginal Hysterectomy | $3,849$400$14k | $5,890 | $5,890 |
| Vasectomy | $1,007$116$11k | $2,400 | $2,400 |
| Vitamin D Blood Test | $118$41$504 | $560 | $560 |