| Abdominal Hysterectomy | $2,550$2.5k$9.8k | — | — |
| ACL Reconstruction (Arthroscopic) | $4,950$1.7k$17k | — | — |
| Allergy Skin Testing | $66$39$76 | — | — |
| Basic Metabolic Panel | $9$7$164 | $544 | $544 |
| Bone Marrow Biopsy | $824$364$5.5k | — | — |
| Breast Biopsy (Ultrasound-guided) | $1,398$581$6.3k | — | — |
| Bunion Correction Surgery | $4,950$1.7k$11k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $8,781$1.7k$27k | — | — |
| Cardiac Catheterization (Left Heart) | $5,419$2.5k$15k | — | — |
| Carpal Tunnel Release Surgery | $3,469$1.0k$9.0k | — | — |
| Cataract Surgery with Lens Implant | $4,670$2.1k$9.2k | — | — |
| Cervical Spinal Fusion (Anterior) | $8,516$776$40k | — | — |
| Cesarean Delivery (Global Package) | $2,550 | — | — |
| Chemotherapy Infusion (First Hour) | $1,455$470$3.4k | — | — |
| Chest X-ray (2 Views) | $149$18$280 | $514 | $514 |
| Colonoscopy with Biopsy | $2,132$815$6.3k | — | — |
| Complete Abdominal Ultrasound | $245$128$610 | $3,617 | $3,617 |
| Complete Blood Count (CBC) with Differential | $8$7$107 | — | — |
| Comprehensive Metabolic Panel | $11$9$182 | $595 | $595 |
| Coronary Angioplasty with Stent | $8,171$1.7k$32k | — | — |
| Critical Care, First Hour | $2,551$808$4.5k | $4,336 | $4,336 |
| CT Abdomen and Pelvis with Contrast | $901$443$3.1k | $9,650 | $9,650 |
| CT Cardiac Calcium Scoring | $182$34$700 | — | — |
| CT Chest without Contrast | $410$187$1.2k | $4,655 | $4,655 |
| CT Head without Contrast | $349$187$1.2k | $4,458 | $4,458 |
| DEXA Bone Density Scan | $245$66$469 | $1,079 | $1,079 |
| Diagnostic Colonoscopy | $2,132$815$6.3k | — | — |
| Diagnostic Mammogram (Both Breasts) | $104$49$263 | $839 | $839 |
| Ear Tube Placement (Tympanostomy) | $2,550$1.0k$6.4k | — | — |
| Echocardiogram (Complete with Doppler) | $844$636$1.3k | $4,701 | $4,701 |
| EKG (Electrocardiogram, 12-lead) | $11 | — | — |
| Emergency Room Visit (Level 3) | $903$386$3.6k | $1,869 | $1,869 |
| Group Therapy Session | $269$183$532 | — | — |
| Hemodialysis Treatment | $80 | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$8$171 | $559 | $559 |
| HIV Antibody Test | $9$8$245 | $287 | $287 |
| Holter Monitor (24-48 Hour Heart Monitor) | $55 | — | — |
| Home Sleep Study | $451$100$2.1k | — | — |
| Individual Therapy Session (45 Minutes) | $328$304$649 | — | — |
| Inguinal Hernia Repair (Open) | $4,950$1.7k$11k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $328$304$649 | — | — |
| Initial Psychiatric Evaluation with Medication Management | $328$304$649 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $427$173$1.0k | — | — |
| IUD Insertion | $2,500$40$5.0k | — | — |
| IUD Removal | $1,434$265$5.0k | — | — |
| Knee Arthroscopy with Meniscectomy | $4,950$2.0k$11k | — | — |
| Laparoscopic Appendectomy | $5,492$2.0k$17k | — | — |
| Laparoscopic Gallbladder Removal | $4,950$1.0k$17k | — | — |
| Laparoscopic Tubal Ligation | $5,492$1.7k$17k | — | — |
| Lipid Panel (Cholesterol Test) | $14$11$159 | $517 | $517 |
| Lumbar Epidural Steroid Injection | $1,792$229$5.5k | — | — |
| Lumbar Puncture (Spinal Tap) | $1,610$364$5.5k | — | — |
| Lumbar Spinal Fusion (Posterior) | $8,516$1.0k$63k | — | — |
| Lumpectomy (Partial Mastectomy) | $3,892$1.0k$9.0k | — | — |
| MRI Abdomen with and without Contrast | $1,704$645$3.1k | $6,715 | $6,715 |
| MRI Brain with and without Contrast | $1,613$645$3.1k | $10,459 | $10,459 |
| MRI Brain with Contrast | $871$645$2.3k | $6,222 | $6,222 |
| MRI Brain without Contrast | $726$409$2.2k | $6,222 | $6,222 |
| MRI Cervical Spine (Neck) without Contrast | $726$409$2.2k | $6,286 | $6,286 |
| MRI Knee without Contrast | $726$409$2.2k | $8,396 | $8,396 |
| MRI Lower Back (Lumbar Spine) without Contrast | $811$409$2.2k | $6,286 | $6,286 |
| MRI Thoracic Spine (Mid-back) without Contrast | $811$409$2.2k | $6,286 | $6,286 |
| Newborn Circumcision | $3,405$1.0k$9.2k | — | — |
| Nuclear Cardiac Stress Test | $1,937$291$2.9k | $8,232 | $8,232 |
| Office Visit, Established Patient (Level 3) | $97$49$176 | $1,261 | $1,261 |
| Office Visit, New Patient (Level 3) | $144$73$229 | $1,153 | $1,153 |
| Pacemaker Insertion (Dual Chamber) | $8,997$2.0k$54k | — | — |
| PET/CT Scan, Whole Body | $2,966$2.2k$5.7k | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $245$136$610 | $1,776 | $1,776 |
| Prostate Biopsy | $1,644$876$6.3k | — | — |
| PSA Prostate Cancer Screening | $19$16$168 | $551 | $551 |
| Pulmonary Function Test with Bronchodilator | $259$205$405 | $2,473 | $2,473 |
| Rotator Cuff Repair (Arthroscopic) | $4,950$1.7k$17k | — | — |
| Screening Mammogram | $86$42$217 | $643 | $643 |
| Septoplasty (Deviated Septum Repair) | $4,669$1.0k$9.2k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $4,950$2.0k$9.8k | — | — |
| Skin Biopsy (Tangential) | $487$92$4.3k | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,045$1.0k$5.5k | — | — |
| Sleep Study (In-lab Polysomnography) | $2,139$448$4.5k | $7,483 | $7,483 |
| Spinal Cord Stimulator Trial | $5,492$1.7k$43k | — | — |
| Spirometry (Breathing Test) | $155$131$259 | $1,112 | $1,112 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $2,550$1.7k$9.2k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $2,550$1.7k$9.2k | — | — |
| Total Hip Replacement | $14,000$120$53k | — | — |
| Total Knee Replacement | $10,600$120$53k | — | — |
| Total Mastectomy | $4,950$1.7k$12k | — | — |
| TSH Thyroid Function Test | $17$14$192 | $629 | $629 |
| TURP (Transurethral Prostate Resection) | $5,492$2.0k$13k | — | — |
| Upper GI Endoscopy (EGD) | $2,083$743$6.3k | — | — |
| Urinalysis with Microscopy | $3$3$64 | $214 | $214 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,550 | — | — |
| Vaginal Delivery (Global Package) | $2,550 | — | — |
| Vaginal Hysterectomy | $4,950$2.0k$11k | — | — |
| Vasectomy | $3,405$1.0k$9.2k | — | — |
| Vitamin D Blood Test | $31$25$166 | $212 | $212 |