| Abdominal Hysterectomy | $12,594$228$25k | $1,269 | $1,269 |
| ACL Reconstruction (Arthroscopic) | $6,658$364$15k | $10,879 | $10,879 |
| Allergy Skin Testing | $948$75$1.9k | — | — |
| Basic Metabolic Panel | $9$4$109 | $70 | $70 |
| Bone Marrow Biopsy | $1,510$671$3.0k | — | — |
| Breast Biopsy (Ultrasound-guided) | $898$61$4.7k | $1,070 | $1,070 |
| Bunion Correction Surgery | $3,024$177$9.4k | $4,831 | $4,831 |
| Cardiac Ablation for Atrial Fibrillation | $22,865$21k$46k | — | — |
| Cardiac Catheterization (Left Heart) | $2,998$55$12k | $6,294 | $6,294 |
| Cardiac Stress Test (Treadmill) | $85$30$123 | $169 | $169 |
| Carpal Tunnel Release Surgery | $768$161$5.6k | $902 | $902 |
| Cataract Surgery with Lens Implant | $2,126$2.1k$7.3k | — | — |
| Cervical Spinal Fusion (Anterior) | $11,992$621$24k | $3,447 | $3,447 |
| Cesarean Delivery (Global Package) | $1,355$418$3.4k | $3,481 | $3,481 |
| Chemotherapy Infusion (First Hour) | $325$228$968 | $1,300 | $1,300 |
| Chest X-ray (2 Views) | $29$4$197 | $54 | $54 |
| Colonoscopy with Biopsy | $1,099$106$2.8k | $2,213 | $2,213 |
| Complete Abdominal Ultrasound | $112$43$587 | $523 | $523 |
| Complete Blood Count (CBC) with Differential | $8$3$95 | $24 | $24 |
| Comprehensive Metabolic Panel | $11$11$328 | $451 | $451 |
| Coronary Angioplasty with Stent | $10,570$221$26k | $16,218 | $16,218 |
| Critical Care, First Hour | $785$54$2.3k | $1,761 | $1,761 |
| CT Abdomen and Pelvis with Contrast | $666$333$4.7k | $2,209 | $2,209 |
| CT Cardiac Calcium Scoring | $82$11$409 | $146 | $146 |
| CT Chest without Contrast | $200$99$1.6k | $1,504 | $1,504 |
| CT Head without Contrast | $354$99$1.5k | $1,875 | $1,875 |
| DEXA Bone Density Scan | $99$58$316 | $323 | $323 |
| Diagnostic Colonoscopy | $850$90$2.9k | $2,264 | $2,264 |
| Diagnostic Mammogram (Both Breasts) | $143$29$560 | $183 | $183 |
| Ear Tube Placement (Tympanostomy) | $925$41$5.2k | $436 | $436 |
| Echocardiogram (Complete with Doppler) | $511$15$2.0k | $2,239 | $2,239 |
| EKG (Electrocardiogram, 12-lead) | $71$26$103 | $142 | $142 |
| Emergency Room Visit (Level 3) | $258$16$779 | $581 | $581 |
| Group Therapy Session | $86$86$296 | — | — |
| Hemodialysis Treatment | $95$38$98 | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$3$138 | $34 | $34 |
| HIV Antibody Test | $9$9$190 | $122 | $122 |
| Holter Monitor (24-48 Hour Heart Monitor) | $63$7$68 | — | — |
| Home Sleep Study | $146$59$699 | $329 | $329 |
| Individual Therapy Session (45 Minutes) | $150$150$492 | — | — |
| Inguinal Hernia Repair (Open) | $3,289$134$9.6k | $742 | $742 |
| Initial Hospital Admission (Level 1) | $41$15$60 | $83 | $83 |
| Initial Psychiatric Diagnostic Evaluation | $150$150$492 | — | — |
| Initial Psychiatric Evaluation with Medication Management | $150$150$492 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $539$539$1.1k | — | — |
| IUD Insertion | $70$24$119 | $148 | $148 |
| IUD Removal | $262$26$567 | $237 | $237 |
| Knee Arthroscopy with Meniscectomy | $3,024$203$8.9k | $1,126 | $1,126 |
| Laparoscopic Appendectomy | $5,438$217$14k | $1,207 | $1,207 |
| Laparoscopic Gallbladder Removal | $5,438$238$14k | $1,322 | $1,322 |
| Laparoscopic Tubal Ligation | $5,438$163$14k | $904 | $904 |
| Lipid Panel (Cholesterol Test) | $14$5$157 | $31 | $31 |
| Lumbar Epidural Steroid Injection | $645$70$2.2k | $1,178 | $1,178 |
| Lumbar Puncture (Spinal Tap) | $645$43$1.6k | $1,190 | $1,190 |
| Lumbar Spinal Fusion (Posterior) | $17,140$588$63k | $45,073 | $45,073 |
| Lumpectomy (Partial Mastectomy) | $3,569$235$7.1k | $1,303 | $1,303 |
| MRI Abdomen with and without Contrast | $419$176$3.8k | $3,076 | $3,076 |
| MRI Brain with and without Contrast | $350$132$2.4k | $1,333 | $1,333 |
| MRI Brain with Contrast | $333$111$1.9k | $1,100 | $1,100 |
| MRI Brain without Contrast | $226$80$1.5k | $788 | $788 |
| MRI Cervical Spine (Neck) without Contrast | $237$78$1.5k | $432 | $432 |
| MRI Knee without Contrast | $316$225$1.5k | $1,580 | $1,580 |
| MRI Lower Back (Lumbar Spine) without Contrast | $237$77$1.5k | $996 | $996 |
| MRI Thoracic Spine (Mid-back) without Contrast | $237$78$1.5k | $997 | $997 |
| Newborn Circumcision | $1,909$47$6.9k | $263 | $263 |
| Nuclear Cardiac Stress Test | $806$21$3.3k | $939 | $939 |
| Office Visit, Established Patient (Level 3) | $72$11$315 | $216 | $216 |
| Office Visit, New Patient (Level 3) | $215$71$410 | $427 | $427 |
| Pacemaker Insertion (Dual Chamber) | $9,754$193$43k | $22,413 | $22,413 |
| PET/CT Scan, Whole Body | $1,359$535$4.6k | $2,974 | $2,974 |
| Pregnancy Ultrasound (Second or Third Trimester) | $101$37$430 | $244 | $244 |
| Prostate Biopsy | $1,909$856$4.1k | $5,337 | $5,337 |
| PSA Prostate Cancer Screening | $36$18$285 | $205 | $205 |
| Pulmonary Function Test with Bronchodilator | $290$5$593 | $540 | $540 |
| Rotator Cuff Repair (Arthroscopic) | $6,658$402$15k | $2,231 | $2,231 |
| Screening Mammogram | $108$27$662 | $174 | $174 |
| Septoplasty (Deviated Septum Repair) | $3,023$113$7.5k | $4,715 | $4,715 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,452$117$13k | $652 | $652 |
| Skin Biopsy (Tangential) | $185$17$458 | $342 | $342 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,510$399$3.1k | $3,265 | $3,265 |
| Sleep Study (In-lab Polysomnography) | $972$216$4.3k | $3,312 | $3,312 |
| Spinal Cord Stimulator Trial | $6,117$233$19k | $22,410 | $22,410 |
| Spirometry (Breathing Test) | $89$8$324 | $70 | $70 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,023$75$7.5k | $419 | $419 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,514$106$11k | $588 | $588 |
| Total Hip Replacement | $11,992$476$27k | $2,645 | $2,645 |
| Total Knee Replacement | $11,992$475$24k | $2,641 | $2,641 |
| Total Mastectomy | $6,078$363$12k | $2,019 | $2,019 |
| TSH Thyroid Function Test | $17$3$209 | $31 | $31 |
| TURP (Transurethral Prostate Resection) | $4,738$4.7k$11k | — | — |
| Umbilical Hernia Repair | $257$92$373 | $513 | $513 |
| Upper GI Endoscopy (EGD) | $874$71$2.6k | $1,882 | $1,882 |
| Urinalysis with Microscopy | $6$2$47 | $24 | $24 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,199$792$3.2k | $4,399 | $4,399 |
| Vaginal Delivery (Global Package) | $940$338$1.4k | $1,879 | $1,879 |
| Vaginal Hysterectomy | $4,601$299$10k | $1,660 | $1,660 |
| Vasectomy | $1,909$1.9k$6.9k | — | — |
| Vitamin D Blood Test | $30$23$231 | $129 | $129 |