| Abdominal Hysterectomy | $4,471 | — | $1,625 |
| ACL Reconstruction (Arthroscopic) | $3,544$2.8k$8.9k | — | — |
| Allergy Skin Testing | $172$172$1.3k | — | — |
| Anesthesia for Screening Colonoscopy | $209 | — | $120 |
| Anesthesia for Upper Endoscopy | $209 | — | $120 |
| Basic Metabolic Panel | $64$4$108 | $101 | $135 |
| Bone Marrow Biopsy | $1,531$646$2.9k | $2,633 | $3,510 |
| Breast Biopsy (Ultrasound-guided) | $1,863$646$3.7k | $3,494 | $4,658 |
| Bunion Correction Surgery | $3,337$1.3k$4.1k | — | $965 |
| Cardiac Ablation for Atrial Fibrillation | $22,676$6.1k$47k | $43,607 | $58,143 |
| Cardiac Catheterization (Left Heart) | $5,611$1.3k$12k | $11,373 | $15,164 |
| Cardiac Stress Test (Treadmill) | $135 | — | $130 |
| Carpal Tunnel Release Surgery | $925$778$2.4k | — | — |
| Cataract Surgery with Lens Implant | $1,109$909$2.9k | — | — |
| Cervical Spinal Fusion (Anterior) | $7,547$5.1k$16k | — | $4,300 |
| Cesarean Delivery (Global Package) | $912 | — | $4,950 |
| Chemotherapy Infusion (First Hour) | $502$132$1.0k | $895 | $1,193 |
| Chest X-ray (2 Views) | $142$35$291 | $273 | $364 |
| Colonoscopy with Biopsy | $764$470$1.5k | — | $650 |
| Complete Abdominal Ultrasound | $486$42$1.1k | $986 | $1,314 |
| Complete Blood Count (CBC) with Differential | $51$3$80 | $75 | $100 |
| Comprehensive Metabolic Panel | $76$5$220 | $206 | $275 |
| Coronary Angioplasty with Stent | $6,405$4.5k$14k | $12,010 | $16,013 |
| Critical Care, First Hour | $1,319$103$5.1k | $2,537 | $3,383 |
| CT Abdomen and Pelvis with Contrast | $1,351$142$2.7k | $2,507 | $3,343 |
| CT Cardiac Calcium Scoring | $196$35$196 | — | — |
| CT Chest without Contrast | $830$42$1.8k | $1,683 | $2,244 |
| CT Head without Contrast | $635$42$1.4k | $1,288 | $1,717 |
| DEXA Bone Density Scan | $137$42$295 | $277 | $369 |
| Diagnostic Colonoscopy | $764$363$1.1k | — | $350 |
| Diagnostic Mammogram (Both Breasts) | $293$89$633 | $593 | $791 |
| Ear Tube Placement (Tympanostomy) | $803$590$1.9k | — | $285 |
| Echocardiogram (Complete with Doppler) | $1,188$219$2.4k | $2,208 | $2,945 |
| EKG (Electrocardiogram, 12-lead) | $67 | — | $50 |
| Emergency Room Visit (Level 3) | $422$103$1.2k | $792 | $1,056 |
| Group Therapy Session | $141$37$306 | $236 | $315 |
| Hemodialysis Treatment | $348 | — | — |
| Hemoglobin A1c (Diabetes Test) | $46$4$92 | $54 | $73 |
| HIV Antibody Test | $44$4$67 | — | — |
| Holter Monitor (24-48 Hour Heart Monitor) | $118 | — | $140 |
| Home Sleep Study | $117$62$196 | — | $100 |
| Individual Therapy Session (45 Minutes) | $132$64$242 | $227 | $302 |
| Inguinal Hernia Repair (Open) | $2,007$1.4k$4.4k | — | $985 |
| Initial Hospital Admission (Level 1) | $103 | — | $200 |
| Initial Psychiatric Diagnostic Evaluation | $193$64$386 | $362 | $483 |
| Initial Psychiatric Evaluation with Medication Management | $187$64$201 | — | $365 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $983$231$2.1k | $1,993 | $2,657 |
| IUD Insertion | $103 | — | $200 |
| IUD Removal | $346$103$2.3k | $649 | $865 |
| Knee Arthroscopy with Meniscectomy | $1,521$1.3k$4.1k | — | $1,800 |
| Laparoscopic Appendectomy | $2,835$2.3k$7.3k | — | $975 |
| Laparoscopic Gallbladder Removal | $2,479$2.3k$7.3k | — | $1,250 |
| Laparoscopic Tubal Ligation | $2,288$2.3k$7.3k | — | $1,040 |
| Lipid Panel (Cholesterol Test) | $64$6$122 | $114 | $152 |
| Lumbar Epidural Steroid Injection | $1,086$276$2.3k | $2,013 | $2,684 |
| Lumbar Puncture (Spinal Tap) | $778$276$2.3k | $1,460 | $1,946 |
| Lumbar Spinal Fusion (Posterior) | $7,547$7.3k$23k | — | $3,500 |
| Lumpectomy (Partial Mastectomy) | $2,524$1.5k$4.8k | — | $1,050 |
| MRI Abdomen with and without Contrast | $1,341$142$2.9k | $2,719 | $3,625 |
| MRI Brain with and without Contrast | $1,661$142$3.6k | $3,367 | $4,489 |
| MRI Brain with Contrast | $1,160$142$2.5k | $2,351 | $3,135 |
| MRI Brain without Contrast | $1,054$96$2.3k | $2,137 | $2,849 |
| MRI Cervical Spine (Neck) without Contrast | $1,274$96$2.8k | $2,583 | $3,444 |
| MRI Knee without Contrast | $1,233$96$2.7k | $2,500 | $3,333 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,062$96$2.3k | $2,153 | $2,870 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,180$96$2.6k | $2,392 | $3,189 |
| Newborn Circumcision | $1,146$817$2.6k | $2,204 | $2,939 |
| Nuclear Cardiac Stress Test | $1,651$520$3.6k | $3,346 | $4,461 |
| Office Visit, Established Patient (Level 3) | $103 | — | $170 |
| Office Visit, New Patient (Level 3) | $103 | — | $200 |
| Pacemaker Insertion (Dual Chamber) | $6,363$4.2k$13k | $12,236 | $16,315 |
| PET/CT Scan, Whole Body | $3,065$581$6.3k | $5,894 | $7,859 |
| Pregnancy Ultrasound (Second or Third Trimester) | $389$42$840 | $788 | $1,050 |
| Prostate Biopsy | $955$817$2.6k | — | — |
| PSA Prostate Cancer Screening | $65$8$140 | $120 | $160 |
| Pulmonary Function Test with Bronchodilator | $324$124$649 | $608 | $811 |
| Rotator Cuff Repair (Arthroscopic) | $3,544$2.8k$8.9k | — | — |
| Screening Mammogram | $200$73$499 | $380 | $507 |
| Septoplasty (Deviated Septum Repair) | $1,704$1.3k$4.1k | — | $1,100 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $2,779$2.8k$8.7k | — | $550 |
| Skin Biopsy (Tangential) | $298$79$2.3k | $413 | $551 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,017$646$2.8k | $1,907 | $2,543 |
| Sleep Study (In-lab Polysomnography) | $615$406$1.3k | — | — |
| Spinal Cord Stimulator Trial | $4,661$1.2k$11k | $10,925 | $14,567 |
| Spirometry (Breathing Test) | $171$62$342 | $321 | $428 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $1,201$1.2k$4.1k | — | $500 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $1,201$1.2k$7.4k | — | $500 |
| Total Hip Replacement | $6,386$5.1k$16k | — | $4,500 |
| Total Knee Replacement | $6,386$5.1k$16k | — | $3,500 |
| Total Mastectomy | $2,524$2.5k$8.2k | — | $2,000 |
| TSH Thyroid Function Test | $65$7$107 | $101 | $134 |
| TURP (Transurethral Prostate Resection) | $2,689$2.0k$6.4k | — | — |
| Umbilical Hernia Repair | $2,007 | — | $750 |
| Upper GI Endoscopy (EGD) | $675$374$1.2k | — | $450 |
| Urinalysis with Microscopy | $44$1$65 | $61 | $81 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $1,292 | — | $4,675 |
| Vaginal Delivery (Global Package) | $1,292 | — | $4,000 |
| Vaginal Hysterectomy | $2,606$2.0k$6.2k | — | $1,315 |
| Vasectomy | $1,250$817$2.6k | — | — |
| Vitamin D Blood Test | $65$13$185 | $108 | $144 |