| ACL Reconstruction (Arthroscopic) | $6,816$859$24k | $13,445 | $26,890 |
| Basic Metabolic Panel | $63$8$230 | $123 | $246 |
| Bone Marrow Biopsy | $1,545$128$3.6k | $1,726 | $3,452 |
| Breast Biopsy (Ultrasound-guided) | $1,545$227$6.5k | $3,467 | $6,933 |
| Bunion Correction Surgery | $3,084$806$16k | $9,044 | $18,088 |
| Cardiac Catheterization (Left Heart) | $4,277$911$12k | $6,498 | $12,995 |
| Carpal Tunnel Release Surgery | $1,840$399$7.6k | $4,202 | $8,405 |
| Cataract Surgery with Lens Implant | $2,286$498$9.0k | $4,554 | $9,108 |
| Cesarean Delivery (Global Package) | $5,099$2.2k$16k | $8,850 | $17,700 |
| Chemotherapy Infusion (First Hour) | $501$115$1.4k | $744 | $1,487 |
| Chest X-ray (2 Views) | $87$21$302 | $25 | $49 |
| Colonoscopy with Biopsy | $1,124$391$4.1k | $2,261 | $4,522 |
| Complete Abdominal Ultrasound | $156$94$763 | $109 | $217 |
| Complete Blood Count (CBC) with Differential | $58$8$92 | $49 | $98 |
| Comprehensive Metabolic Panel | $78$11$264 | $141 | $281 |
| Coronary Angioplasty with Stent | $12,104$488$25k | $13,449 | $26,897 |
| Critical Care, First Hour | $845$252$2.8k | $836 | $1,671 |
| CT Abdomen and Pelvis with Contrast | $366$216$3.1k | $250 | $499 |
| CT Cardiac Calcium Scoring | $105$63$373 | $73 | $146 |
| CT Chest without Contrast | $193$105$1.7k | $134 | $268 |
| CT Head without Contrast | $141$85$1.7k | $98 | $196 |
| DEXA Bone Density Scan | $97$34$707 | $39 | $78 |
| Diagnostic Colonoscopy | $1,079$306$3.4k | $1,673 | $3,346 |
| Diagnostic Mammogram (Both Breasts) | $212$63$425 | $73 | $146 |
| Ear Tube Placement (Tympanostomy) | $1,453$145$6.4k | $3,543 | $7,086 |
| Echocardiogram (Complete with Doppler) | $1,626$180$3.5k | $1,807 | $3,614 |
| EKG (Electrocardiogram, 12-lead) | $94$13$350 | $195 | $389 |
| Emergency Room Visit (Level 3) | $272$65$2.0k | $237 | $474 |
| Group Therapy Session | $116$21$470 | $132 | $264 |
| Hemoglobin A1c (Diabetes Test) | $72$10$120 | $64 | $127 |
| HIV Antibody Test | $66$9$176 | $94 | $187 |
| Home Sleep Study | $149$74$427 | $142 | $284 |
| Individual Therapy Session (45 Minutes) | $152$55$578 | $213 | $426 |
| Inguinal Hernia Repair (Open) | $3,296$448$11k | $6,049 | $12,098 |
| Initial Hospital Admission (Level 1) | $259$75$398 | $173 | $345 |
| Initial Psychiatric Diagnostic Evaluation | $152$55$606 | $75 | $150 |
| Initial Psychiatric Evaluation with Medication Management | $188$152$697 | $324 | $647 |
| IUD Removal | $306$55$12k | $6,690 | $13,380 |
| Knee Arthroscopy with Meniscectomy | $3,084$482$9.0k | $5,010 | $10,020 |
| Laparoscopic Appendectomy | $5,498$515$16k | $9,048 | $18,096 |
| Laparoscopic Gallbladder Removal | $5,498$562$13k | $7,439 | $14,879 |
| Laparoscopic Tubal Ligation | $5,498$580$13k | $7,130 | $14,261 |
| Lipid Panel (Cholesterol Test) | $50$8$325 | $41 | $82 |
| Lumbar Epidural Steroid Injection | $659$235$2.1k | $1,161 | $2,322 |
| Lumbar Puncture (Spinal Tap) | $659$98$1.1k | $575 | $1,149 |
| Lumpectomy (Partial Mastectomy) | $3,632$564$21k | $11,605 | $23,209 |
| MRI Abdomen with and without Contrast | $435$261$4.2k | $302 | $604 |
| MRI Brain with and without Contrast | $415$249$4.2k | $288 | $576 |
| MRI Brain with Contrast | $366$184$3.2k | $213 | $425 |
| MRI Brain without Contrast | $256$153$2.8k | $178 | $355 |
| MRI Cervical Spine (Neck) without Contrast | $285$171$2.8k | $198 | $396 |
| MRI Knee without Contrast | $273$164$2.8k | $190 | $379 |
| MRI Lower Back (Lumbar Spine) without Contrast | $285$171$2.8k | $198 | $396 |
| MRI Thoracic Spine (Mid-back) without Contrast | $285$171$2.8k | $198 | $396 |
| Newborn Circumcision | $1,655$135$2.7k | $855 | $1,710 |
| Nuclear Cardiac Stress Test | $1,353$187$5.0k | $217 | $433 |
| Office Visit, Established Patient (Level 3) | $171$41$351 | $120 | $240 |
| Office Visit, New Patient (Level 3) | $188$54$351 | $125 | $250 |
| Pacemaker Insertion (Dual Chamber) | $11,600$435$57k | $20,955 | $41,910 |
| PET/CT Scan, Whole Body | $1,491$128$8.2k | $148 | $296 |
| Pregnancy Ultrasound (Second or Third Trimester) | $130$78$781 | $90 | $180 |
| Prostate Biopsy | $2,510$218$10k | $3,239 | $6,477 |
| PSA Prostate Cancer Screening | $111$18$198 | $94 | $187 |
| Pulmonary Function Test with Bronchodilator | $299$35$752 | $401 | $802 |
| Rotator Cuff Repair (Arthroscopic) | $6,816$941$23k | $12,624 | $25,248 |
| Screening Mammogram | $200$40$425 | $122 | $243 |
| Septoplasty (Deviated Septum Repair) | $3,068$611$20k | $11,042 | $22,083 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,521$288$15k | $8,609 | $17,218 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,545$101$3.8k | $2,118 | $4,235 |
| Sleep Study (In-lab Polysomnography) | $996$179$2.9k | $207 | $413 |
| Spinal Cord Stimulator Trial | $6,516$2.1k$16k | $8,456 | $16,911 |
| Spirometry (Breathing Test) | $280$25$582 | $311 | $622 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,068$277$8.8k | $4,891 | $9,782 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,580$265$8.5k | $4,710 | $9,420 |
| Total Hip Replacement | $12,540$1.1k$32k | $17,800 | $35,600 |
| Total Knee Replacement | $12,540$1.1k$29k | $16,100 | $32,200 |
| TSH Thyroid Function Test | $50$7$168 | $50 | $100 |
| TURP (Transurethral Prostate Resection) | $4,930$659$11k | $6,049 | $12,098 |
| Upper GI Endoscopy (EGD) | $885$260$4.1k | $2,301 | $4,601 |
| Urinalysis with Microscopy | $37$3$86 | $46 | $92 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $3,121$2.1k$8.3k | $4,600 | $9,200 |
| Vaginal Delivery (Global Package) | $3,090$2.0k$8.3k | $4,600 | $9,200 |
| Vasectomy | $1,941$305$10k | $5,766 | $11,531 |
| Vitamin D Blood Test | $125$30$219 | $113 | $226 |