| Abdominal Hysterectomy | $5,959$1.2k$10k | — | $12,113 |
| ACL Reconstruction (Arthroscopic) | $9,072$1.2k$16k | — | $17,767 |
| Allergy Skin Testing | $514$4$1.6k | — | — |
| Basic Metabolic Panel | $32$4$75 | — | $65 |
| Bone Marrow Biopsy | $1,165$400$2.4k | — | $3,893 |
| Breast Biopsy (Ultrasound-guided) | $2,443$640$4.1k | — | $3,893 |
| Bunion Correction Surgery | $4,307$1.2k$8.6k | — | $8,027 |
| Cardiac Ablation for Atrial Fibrillation | $23,336$15k$37k | — | — |
| Cardiac Catheterization (Left Heart) | $2,185$1.2k$6.7k | — | $6,465 |
| Cardiac Stress Test (Treadmill) | $99$81$99 | — | — |
| Carpal Tunnel Release Surgery | $2,596$640$5.2k | — | $4,875 |
| Cataract Surgery with Lens Implant | $3,054$2.2k$5.2k | — | — |
| Cervical Spinal Fusion (Anterior) | $9,445$975$21k | — | $34,922 |
| Cesarean Delivery (Global Package) | $2,961 | — | — |
| Chemotherapy Infusion (First Hour) | $276$140$526 | — | — |
| Chest X-ray (2 Views) | $84$39$141 | — | $168 |
| Colonoscopy with Biopsy | $1,095$640$1.8k | — | $2,848 |
| Complete Abdominal Ultrasound | $173$101$245 | — | $350 |
| Complete Blood Count (CBC) with Differential | $21$3$50 | — | $50 |
| Comprehensive Metabolic Panel | $29$4$68 | — | $68 |
| Coronary Angioplasty with Stent | $12,627$1.1k$27k | — | $22,478 |
| Critical Care, First Hour | $1,019$414$1.5k | — | $1,512 |
| CT Abdomen and Pelvis with Contrast | $474$275$648 | — | $925 |
| CT Cardiac Calcium Scoring | $275$84$600 | — | $233 |
| CT Chest without Contrast | $289$101$600 | — | $550 |
| CT Head without Contrast | $183$101$600 | — | $550 |
| DEXA Bone Density Scan | $81$45$171 | — | — |
| Diagnostic Colonoscopy | $1,095$586$1.5k | — | $2,166 |
| Diagnostic Mammogram (Both Breasts) | $250$48$379 | — | — |
| Ear Tube Placement (Tympanostomy) | $2,633$1.0k$4.6k | — | $3,826 |
| Echocardiogram (Complete with Doppler) | $522$211$1.3k | — | $1,563 |
| EKG (Electrocardiogram, 12-lead) | $25$16$38 | — | — |
| Emergency Room Visit (Level 3) | $415$263$725 | — | $608 |
| Group Therapy Session | $126$26$212 | — | — |
| Hemodialysis Treatment | $552$110$832 | — | — |
| Hemoglobin A1c (Diabetes Test) | $26$4$70 | — | $70 |
| HIV Antibody Test | $25$4$57 | — | $57 |
| Holter Monitor (24-48 Hour Heart Monitor) | $269$83$405 | — | — |
| Home Sleep Study | $149$51$1.1k | — | $900 |
| Individual Therapy Session (45 Minutes) | $179$97$248 | — | — |
| Inguinal Hernia Repair (Open) | $4,258$1.2k$7.5k | — | $8,818 |
| Initial Hospital Admission (Level 1) | $89 | — | — |
| Initial Psychiatric Diagnostic Evaluation | $183$153$275 | — | — |
| Initial Psychiatric Evaluation with Medication Management | $185$153$275 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $660$493$914 | — | — |
| IUD Insertion | $371$242$1.1k | — | $921 |
| IUD Removal | $367$242$1.0k | — | $921 |
| Knee Arthroscopy with Meniscectomy | $4,121$1.2k$7.5k | — | $8,027 |
| Laparoscopic Appendectomy | $6,194$1.2k$10k | — | $14,350 |
| Laparoscopic Gallbladder Removal | $6,194$1.5k$10k | — | $14,350 |
| Laparoscopic Tubal Ligation | $6,194$1.5k$10k | — | $14,350 |
| Lipid Panel (Cholesterol Test) | $29$6$60 | — | $86 |
| Lumbar Epidural Steroid Injection | $904$400$1.5k | — | $1,773 |
| Lumbar Puncture (Spinal Tap) | $987$400$1.7k | — | $1,810 |
| Lumbar Spinal Fusion (Posterior) | $9,445$975$28k | — | $34,922 |
| Lumpectomy (Partial Mastectomy) | $5,725$1.2k$9.7k | — | $8,955 |
| MRI Abdomen with and without Contrast | $675$340$1.2k | — | $1,750 |
| MRI Brain with and without Contrast | $649$340$1.2k | — | $1,750 |
| MRI Brain with Contrast | $649$318$1.1k | — | $1,600 |
| MRI Brain without Contrast | $620$230$1.0k | — | $1,450 |
| MRI Cervical Spine (Neck) without Contrast | $366$224$1.0k | — | $1,450 |
| MRI Knee without Contrast | $414$230$1.0k | — | $1,450 |
| MRI Lower Back (Lumbar Spine) without Contrast | $366$224$1.0k | — | $1,450 |
| MRI Thoracic Spine (Mid-back) without Contrast | $366$223$1.0k | — | $1,450 |
| Newborn Circumcision | $2,527$400$4.5k | — | $5,024 |
| Nuclear Cardiac Stress Test | $1,242$587$3.0k | — | $2,960 |
| Office Visit, Established Patient (Level 3) | $71 | — | — |
| Office Visit, New Patient (Level 3) | $89 | — | — |
| Pacemaker Insertion (Dual Chamber) | $13,976$1.2k$26k | — | $25,867 |
| PET/CT Scan, Whole Body | $2,192$1.2k$2.6k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $160$101$324 | — | — |
| Prostate Biopsy | $2,345$640$4.0k | — | $5,024 |
| PSA Prostate Cancer Screening | $29$8$119 | — | $119 |
| Pulmonary Function Test with Bronchodilator | $188$45$488 | — | — |
| Rotator Cuff Repair (Arthroscopic) | $9,072$1.5k$16k | — | $17,767 |
| Screening Mammogram | $241$37$307 | — | — |
| Septoplasty (Deviated Septum Repair) | $4,234$1.2k$8.9k | — | $7,760 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,585$1.5k$10k | — | $16,513 |
| Skin Biopsy (Tangential) | $980$161$2.6k | — | $595 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,541$640$2.6k | — | $3,893 |
| Sleep Study (In-lab Polysomnography) | $1,316$800$1.8k | — | $2,500 |
| Spinal Cord Stimulator Trial | $6,979$640$12k | — | $17,470 |
| Spirometry (Breathing Test) | $149$31$243 | — | — |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,696$1.5k$5.6k | — | $7,760 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $4,111$1.2k$8.9k | — | $14,423 |
| Total Hip Replacement | $14,838$975$25k | — | $34,922 |
| Total Knee Replacement | $14,838$975$25k | — | $34,922 |
| Total Mastectomy | $6,738$1.2k$9.8k | — | $15,694 |
| TSH Thyroid Function Test | $43$7$108 | — | $108 |
| TURP (Transurethral Prostate Resection) | $5,929$1.2k$10k | — | $12,518 |
| Umbilical Hernia Repair | $4,056$1.2k$7.4k | — | $8,818 |
| Upper GI Endoscopy (EGD) | $1,052$400$1.4k | — | $2,229 |
| Urinalysis with Microscopy | $7$1$13 | — | — |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,770$2.2k$3.7k | — | — |
| Vaginal Delivery (Global Package) | $2,667 | — | — |
| Vaginal Hysterectomy | $5,898$1.5k$10k | — | $12,505 |
| Vasectomy | $2,702$640$5.8k | — | $5,024 |
| Vitamin D Blood Test | $88$12$247 | — | $247 |