| Abdominal Hysterectomy | $913$887$15k | $7,319 | $7,319 |
| ACL Reconstruction (Arthroscopic) | $9,284$8.7k$42k | — | — |
| Allergy Skin Testing | $1,104$1.1k$4.9k | — | — |
| Basic Metabolic Panel | $13$8$105 | $124 | $124 |
| Bone Marrow Biopsy | $2,371$300$9.5k | $3,733 | $3,733 |
| Breast Biopsy (Ultrasound-guided) | $2,182$300$9.5k | $3,337 | $3,337 |
| Bunion Correction Surgery | $4,207$4.1k$19k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $33,443$15k$150k | — | — |
| Cardiac Catheterization (Left Heart) | $4,168$4.0k$19k | — | — |
| Cardiac Stress Test (Treadmill) | $107$71$1.3k | $1,521 | $1,521 |
| Carpal Tunnel Release Surgery | $2,511$2.4k$11k | — | — |
| Cataract Surgery with Lens Implant | $2,967$2.9k$13k | — | — |
| Cervical Spinal Fusion (Anterior) | $16,427$14k$74k | — | — |
| Cesarean Delivery (Global Package) | $2,380$2.3k$11k | $5,911 | $5,911 |
| Chemotherapy Infusion (First Hour) | $632$412$1.9k | $900 | $900 |
| Chest X-ray (2 Views) | $218$109$499 | $328 | $328 |
| Colonoscopy with Biopsy | $1,539$1.5k$6.9k | $1,072 | $1,072 |
| Complete Abdominal Ultrasound | $724$131$959 | $1,107 | $1,107 |
| Complete Blood Count (CBC) with Differential | $12$8$114 | $134 | $134 |
| Comprehensive Metabolic Panel | $16$11$249 | $293 | $293 |
| Coronary Angioplasty with Stent | $14,843$14k$66k | — | — |
| Critical Care, First Hour | $1,562$1.0k$4.7k | $3,154 | $3,154 |
| CT Abdomen and Pelvis with Contrast | $660$435$3.0k | $3,548 | $3,548 |
| CT Cardiac Calcium Scoring | $112$109$499 | — | — |
| CT Chest without Contrast | $198$131$3.0k | $3,525 | $3,525 |
| CT Head without Contrast | $198$131$2.8k | $3,320 | $3,320 |
| DEXA Bone Density Scan | $198$131$930 | $1,095 | $1,095 |
| Diagnostic Colonoscopy | $1,196$1.2k$5.3k | $829 | $829 |
| Diagnostic Mammogram (Both Breasts) | $227$150$689 | $754 | $754 |
| Ear Tube Placement (Tympanostomy) | $2,027$300$8.9k | $3,100 | $3,100 |
| Echocardiogram (Complete with Doppler) | $1,033$682$3.1k | $2,006 | $2,006 |
| EKG (Electrocardiogram, 12-lead) | $22$15$216 | $255 | $255 |
| Emergency Room Visit (Level 3) | $516$341$2.2k | $895 | $895 |
| Group Therapy Session | $147$112$582 | $227 | $227 |
| Hemodialysis Treatment | $131$86$1.7k | $1,951 | $1,951 |
| Hemoglobin A1c (Diabetes Test) | $15$10$164 | $194 | $194 |
| HIV Antibody Test | $9$9$41 | — | — |
| Holter Monitor (24-48 Hour Heart Monitor) | $69$67$309 | — | — |
| Home Sleep Study | $278$270$1.2k | — | — |
| Individual Therapy Session (45 Minutes) | $230$215$1.0k | $329 | $329 |
| Inguinal Hernia Repair (Open) | $4,603$4.5k$21k | $3,634 | $3,634 |
| Initial Hospital Admission (Level 1) | $74$72$330 | $219 | $219 |
| Initial Psychiatric Diagnostic Evaluation | $230$215$1.0k | $329 | $329 |
| Initial Psychiatric Evaluation with Medication Management | $233$215$1.0k | $329 | $329 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $460 | — | — |
| IUD Insertion | $153$101$3.1k | $439 | $439 |
| IUD Removal | $380$287$3.1k | $506 | $506 |
| Knee Arthroscopy with Meniscectomy | $4,207$4.1k$19k | — | — |
| Laparoscopic Appendectomy | $7,773$7.5k$35k | $1,811 | $1,811 |
| Laparoscopic Gallbladder Removal | $7,773$7.5k$35k | $1,160 | $1,160 |
| Laparoscopic Tubal Ligation | $7,773$7.5k$35k | $1,674 | $1,674 |
| Lipid Panel (Cholesterol Test) | $20$13$220 | $259 | $259 |
| Lumbar Epidural Steroid Injection | $1,013$300$4.0k | $1,591 | $1,591 |
| Lumbar Puncture (Spinal Tap) | $1,155$300$4.0k | $1,567 | $1,567 |
| Lumbar Spinal Fusion (Posterior) | $22,434$14k$100k | — | — |
| Lumpectomy (Partial Mastectomy) | $5,034$4.9k$22k | $1,512 | $1,512 |
| MRI Abdomen with and without Contrast | $660$435$4.0k | $4,751 | $4,751 |
| MRI Brain with and without Contrast | $660$435$7.2k | $8,432 | $8,432 |
| MRI Brain with Contrast | $660$435$2.5k | $2,689 | $2,689 |
| MRI Brain without Contrast | $451$298$5.2k | $6,108 | $6,108 |
| MRI Cervical Spine (Neck) without Contrast | $451$298$5.0k | $5,867 | $5,867 |
| MRI Knee without Contrast | $451$298$4.4k | $5,131 | $5,131 |
| MRI Lower Back (Lumbar Spine) without Contrast | $451$298$5.2k | $6,078 | $6,078 |
| MRI Thoracic Spine (Mid-back) without Contrast | $451$298$2.5k | $1,706 | $1,706 |
| Newborn Circumcision | $2,688$2.6k$12k | $827 | $827 |
| Nuclear Cardiac Stress Test | $1,915$1.6k$7.4k | $2,928 | $2,928 |
| Office Visit, Established Patient (Level 3) | $163$92$763 | $197 | $197 |
| Office Visit, New Patient (Level 3) | $166$113$763 | $197 | $197 |
| Pacemaker Insertion (Dual Chamber) | $13,438$13k$60k | — | — |
| PET/CT Scan, Whole Body | $2,442$1.8k$8.2k | $5,331 | $5,331 |
| Pregnancy Ultrasound (Second or Third Trimester) | $439$131$599 | $658 | $658 |
| Prostate Biopsy | $3,978 | $397 | $397 |
| PSA Prostate Cancer Screening | $20$18$325 | $383 | $383 |
| Pulmonary Function Test with Bronchodilator | $478$375$2.1k | $646 | $646 |
| Rotator Cuff Repair (Arthroscopic) | $9,330$9.1k$42k | — | — |
| Screening Mammogram | $170$121$554 | $315 | $315 |
| Septoplasty (Deviated Septum Repair) | $4,263$4.1k$19k | $1,484 | $1,484 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $9,074$8.8k$40k | $701 | $701 |
| Skin Biopsy (Tangential) | $354$265$3.1k | $413 | $413 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,293$300$9.5k | $3,506 | $3,506 |
| Sleep Study (In-lab Polysomnography) | $1,624$1.1k$4.9k | $4,706 | $4,706 |
| Spinal Cord Stimulator Trial | $8,154$4.0k$37k | $3,462 | $3,462 |
| Spirometry (Breathing Test) | $270$206$1.2k | $328 | $328 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,263$300$19k | $6,352 | $6,352 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $7,611$7.4k$34k | $638 | $638 |
| Total Hip Replacement | $16,427$14k$74k | — | — |
| Total Knee Replacement | $16,427$14k$74k | — | — |
| Total Mastectomy | $8,537$8.3k$38k | $2,190 | $2,190 |
| TSH Thyroid Function Test | $25$17$338 | $398 | $398 |
| TURP (Transurethral Prostate Resection) | $6,894$6.7k$31k | $5,263 | $5,263 |
| Umbilical Hernia Repair | $3,058 | $3,822 | $3,822 |
| Upper GI Endoscopy (EGD) | $1,166$1.1k$5.2k | $723 | $723 |
| Urinalysis with Microscopy | $5$3$54 | $64 | $64 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,241$2.2k$10.0k | $5,601 | $5,601 |
| Vaginal Delivery (Global Package) | $2,141$2.1k$9.5k | $5,351 | $5,351 |
| Vaginal Hysterectomy | $6,432$6.2k$29k | — | — |
| Vasectomy | $2,609$300$12k | $2,270 | $2,270 |
| Vitamin D Blood Test | $39$30$136 | $68 | $68 |