| Abdominal Hysterectomy | $10,016$2.0k$12k | — | — |
| ACL Reconstruction (Arthroscopic) | $11,815$4.0k$18k | — | — |
| Basic Metabolic Panel | $9$7$456 | $507 | $507 |
| Bone Marrow Biopsy | $3,080$1.7k$4.3k | — | — |
| Breast Biopsy (Ultrasound-guided) | $3,863$2.0k$7.1k | — | — |
| Bunion Correction Surgery | $6,914$4.0k$11k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $22,313$4.9k$87k | $97,158 | $97,158 |
| Cardiac Catheterization (Left Heart) | $11,656$3.9k$19k | — | — |
| Cardiac Stress Test (Treadmill) | $660$439$660 | — | — |
| Carpal Tunnel Release Surgery | $4,831$2.4k$9.0k | — | — |
| Cataract Surgery with Lens Implant | $7,120$2.0k$11k | — | — |
| Cervical Spinal Fusion (Anterior) | $21,664$4.3k$53k | — | — |
| Cesarean Delivery (Global Package) | $6,922$2.0k$12k | — | — |
| Chemotherapy Infusion (First Hour) | $1,379$424$2.4k | $2,626 | $2,626 |
| Chest X-ray (2 Views) | $182$32$1.0k | $1,119 | $1,119 |
| Colonoscopy with Biopsy | $3,910$2.0k$4.9k | — | — |
| Complete Abdominal Ultrasound | $510$119$2.2k | $2,465 | $2,465 |
| Complete Blood Count (CBC) with Differential | $8$7$45 | — | — |
| Comprehensive Metabolic Panel | $11$9$792 | $880 | $880 |
| Coronary Angioplasty with Stent | $20,283$5.6k$33k | — | — |
| Critical Care, First Hour | $3,900$1.3k$5.8k | $6,422 | $6,422 |
| CT Abdomen and Pelvis with Contrast | $1,408$267$15k | $16,308 | $16,308 |
| CT Cardiac Calcium Scoring | $334$85$1.4k | $1,534 | $1,534 |
| CT Chest without Contrast | $1,220$158$7.7k | $8,531 | $8,531 |
| CT Head without Contrast | $666$126$4.2k | $4,660 | $4,660 |
| DEXA Bone Density Scan | $245$30$2.2k | $2,456 | $2,456 |
| Diagnostic Colonoscopy | $3,336$1.6k$4.9k | — | — |
| Diagnostic Mammogram (Both Breasts) | $204$91$763 | $750 | $750 |
| Ear Tube Placement (Tympanostomy) | $4,142$2.0k$7.1k | — | — |
| Echocardiogram (Complete with Doppler) | $2,856$1.2k$7.6k | $8,401 | $8,401 |
| EKG (Electrocardiogram, 12-lead) | $11$10$12 | — | — |
| Emergency Room Visit (Level 3) | $2,412$500$3.3k | $3,720 | $3,720 |
| Group Therapy Session | $166$72$452 | $502 | $502 |
| Hemodialysis Treatment | $77$70$82 | — | — |
| Hemoglobin A1c (Diabetes Test) | $10$8$394 | $438 | $438 |
| HIV Antibody Test | $10$8$368 | $409 | $409 |
| Holter Monitor (24-48 Hour Heart Monitor) | $53$49$57 | — | — |
| Home Sleep Study | $1,319$290$2.6k | $2,029 | $2,029 |
| Individual Therapy Session (45 Minutes) | $240$100$664 | $720 | $720 |
| Inguinal Hernia Repair (Open) | $6,922$4.3k$11k | — | — |
| Initial Psychiatric Diagnostic Evaluation | $256$111$699 | $777 | $777 |
| Initial Psychiatric Evaluation with Medication Management | $267$116$727 | $808 | $808 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $3,038$1.1k$6.1k | $6,752 | $6,752 |
| IUD Insertion | $2,056$35$5.0k | — | — |
| IUD Removal | $2,197$1.2k$5.0k | — | — |
| Knee Arthroscopy with Meniscectomy | $8,061$4.3k$18k | — | — |
| Laparoscopic Appendectomy | $10,695$4.0k$17k | — | — |
| Laparoscopic Gallbladder Removal | $11,521$4.3k$17k | — | — |
| Laparoscopic Tubal Ligation | $9,483$4.3k$17k | — | — |
| Lipid Panel (Cholesterol Test) | $14$12$522 | $580 | $580 |
| Lumbar Epidural Steroid Injection | $2,380$1.6k$3.6k | — | — |
| Lumbar Puncture (Spinal Tap) | $2,661$1.6k$3.6k | — | — |
| Lumbar Spinal Fusion (Posterior) | $15,417$4.3k$64k | — | — |
| Lumpectomy (Partial Mastectomy) | $6,914$4.0k$9.0k | — | — |
| MRI Abdomen with and without Contrast | $1,438$323$7.0k | $7,750 | $7,750 |
| MRI Brain with and without Contrast | $1,410$335$7.2k | $7,981 | $7,981 |
| MRI Brain with Contrast | $1,217$261$7.0k | $7,737 | $7,737 |
| MRI Brain without Contrast | $883$216$7.0k | $7,737 | $7,737 |
| MRI Cervical Spine (Neck) without Contrast | $861$217$7.0k | $7,737 | $7,737 |
| MRI Knee without Contrast | $1,607$200$6.8k | $7,511 | $7,511 |
| MRI Lower Back (Lumbar Spine) without Contrast | $866$218$7.0k | $7,737 | $7,737 |
| MRI Thoracic Spine (Mid-back) without Contrast | $860$217$7.0k | $7,737 | $7,737 |
| Newborn Circumcision | $3,591$1.7k$9.0k | — | — |
| Nuclear Cardiac Stress Test | $2,210$238$10k | $11,632 | $11,632 |
| Office Visit, Established Patient (Level 3) | $126$24$447 | $296 | $296 |
| Office Visit, New Patient (Level 3) | $189$44$561 | $352 | $352 |
| Pacemaker Insertion (Dual Chamber) | $40,463$2.0k$67k | — | — |
| PET/CT Scan, Whole Body | $5,308$349$11k | $11,795 | $11,795 |
| Pregnancy Ultrasound (Second or Third Trimester) | $447$150$1.5k | $1,633 | $1,633 |
| Prostate Biopsy | $4,553$2.4k$4.9k | — | — |
| PSA Prostate Cancer Screening | $20$16$572 | $636 | $636 |
| Pulmonary Function Test with Bronchodilator | $1,015$440$2.8k | $3,077 | $3,077 |
| Rotator Cuff Repair (Arthroscopic) | $9,552$4.3k$17k | — | — |
| Screening Mammogram | $217$75$675 | $750 | $750 |
| Septoplasty (Deviated Septum Repair) | $5,800$3.1k$9.0k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $9,483$4.3k$17k | — | — |
| Skin Biopsy (Tangential) | $2,085$1.2k$2.5k | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $3,080$2.0k$4.3k | — | — |
| Sleep Study (In-lab Polysomnography) | $2,795$1.1k$12k | $10,700 | $10,700 |
| Spinal Cord Stimulator Trial | $11,102$2.4k$64k | — | — |
| Spirometry (Breathing Test) | $538$233$1.5k | $1,630 | $1,630 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $5,960$2.0k$9.5k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $6,914$2.0k$9.0k | — | — |
| Total Hip Replacement | $27,975$2.0k$41k | — | — |
| Total Knee Replacement | $27,975$2.0k$41k | — | — |
| Total Mastectomy | $8,531$4.3k$14k | — | — |
| TSH Thyroid Function Test | $18$15$569 | $632 | $632 |
| TURP (Transurethral Prostate Resection) | $8,265$4.3k$17k | — | — |
| Umbilical Hernia Repair | $6,922$4.3k$8.1k | — | — |
| Upper GI Endoscopy (EGD) | $3,014$1.6k$4.9k | — | — |
| Urinalysis with Microscopy | $3$3$249 | $277 | $277 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $6,922$2.0k$12k | — | — |
| Vaginal Delivery (Global Package) | $6,922$2.0k$12k | — | — |
| Vaginal Hysterectomy | $8,081$4.3k$11k | — | — |
| Vasectomy | $4,816$2.0k$9.0k | — | — |
| Vitamin D Blood Test | $32$26$806 | $896 | $896 |