| Abdominal Hysterectomy | $8,657$5.3k$8.8k3 plans | — | — |
| ACL Reconstruction (Arthroscopic) | $8,333$5.4k$18k7 plansshared rate · 2 | — | — |
| Allergy Skin Testing | $858$637$1.6k4 plansshared rate · 2 | — | — |
| Basic Metabolic Panel | $11$6$177 plans | $99 | $180 |
| Bone Marrow Biopsy | $2,959$1.2k$4.1k6 plansshared rate · 4 | $1,881 | $3,420 |
| Breast Biopsy (Ultrasound-guided) | $3,579$1.2k$4.8k6 plansshared rate · 2 | $2,413 | $4,387 |
| Bunion Correction Surgery | $4,589$2.4k$8.8k6 plansshared rate · 6 | — | — |
| Cardiac Ablation for Atrial Fibrillation | $42,382$19k$50k6 plans | $25,527 | $46,413 |
| Cardiac Arrhythmia (with Complications) Inpatient | $9,844$4.0k$15k17 plans | — | — |
| Cardiac Arrhythmia (with Major Complications) Inpatient | $16,109$6.6k$25k17 plans | — | — |
| Cardiac Arrhythmia (without Complications) Inpatient | $7,574$3.1k$12k17 plans | — | — |
| Cardiac Catheterization (Left Heart) | $4,589$2.4k$16k6 plansshared rate · 6 | $7,956 | $14,466 |
| Carpal Tunnel Release Surgery | $3,917$1.4k$7.8k7 plans | $4,568 | $8,305 |
| Cataract Surgery with Lens Implant | $4,109$1.7k$7.8k7 plans | — | — |
| Cellulitis (with Major Complications) Inpatient | $19,017$7.8k$29k17 plans | — | — |
| Cellulitis (without Major Complications) Inpatient | $11,652$4.8k$18k17 plans | — | — |
| Cervical Spinal Fusion (Anterior) | $12,953$7.6k$25k6 plans | — | — |
| Cesarean Delivery (Global Package) | $4,589$3.7k$4.6k1 planshared rate · 6 | — | — |
| Chemotherapy Infusion (First Hour) | $330$245$6314 plans | $499 | $908 |
| Chest Pain Inpatient | $9,633$4.0k$15k17 plans | — | — |
| Chest X-ray (2 Views) | $67$65$1664 plans | $261 | $475 |
| Colonoscopy with Biopsy | $3,484$888$4.8k7 plansshared rate · 2 | — | — |
| Complete Abdominal Ultrasound | $200$78$2854 plansshared rate · 4 | $674 | $1,226 |
| Complete Blood Count (CBC) with Differential | $10$6$167 plans | $75 | $137 |
| Comprehensive Metabolic Panel | $13$8$217 plans | $133 | $241 |
| COPD (with Complications) Inpatient | $11,279$4.6k$17k17 plans | — | — |
| COPD (with Major Complications) Inpatient | $14,821$6.1k$23k17 plans | — | — |
| COPD (without Complications) Inpatient | $8,590$3.5k$13k17 plans | — | — |
| Coronary Angioplasty with Stent | $17,839$8.6k$22k6 plans | $7,262 | $13,204 |
| Critical Care, First Hour | $825$613$1.6k4 plans | $1,102 | $2,004 |
| CT Abdomen and Pelvis with Contrast | $666$259$7554 plansshared rate · 4 | $1,713 | $3,115 |
| CT Cardiac Calcium Scoring | $166$65$2464 plans | $14 | $25 |
| CT Chest without Contrast | $200$78$4434 plansshared rate · 4 | $1,555 | $2,827 |
| CT Head without Contrast | $200$78$2514 plansshared rate · 4 | $1,375 | $2,500 |
| DEXA Bone Density Scan | $105$78$2004 plans | $304 | $553 |
| Diabetes (with Complications) Inpatient | $11,991$4.9k$18k17 plans | — | — |
| Diabetes (with Major Complications) Inpatient | $19,223$7.9k$30k17 plans | — | — |
| Diabetes (without Complications) Inpatient | $8,312$3.4k$13k17 plans | — | — |
| Diagnostic Colonoscopy | $2,995$690$4.8k7 plansshared rate · 2 | — | — |
| Diagnostic Mammogram (Both Breasts) | $108$79$2044 plans | $399 | $726 |
| Digestive Disorders, E.g. Gastroenteritis (with Major Complications) Inpatient | $16,970$7.0k$26k17 plans | — | — |
| Digestive Disorders, E.g. Gastroenteritis (without Major Complications) Inpatient | $10,431$4.3k$16k17 plans | — | — |
| Ear Tube Placement (Tympanostomy) | $3,484$1.2k$4.8k7 plansshared rate · 2 | — | — |
| Echocardiogram (Complete with Doppler) | $546$405$1.0k4 plans | $1,695 | $3,082 |
| Emergency Room Visit (Level 3) | $273$203$5214 plans | $392 | $713 |
| GI Hemorrhage (with Complications) Inpatient | $13,122$5.4k$20k17 plans | — | — |
| GI Hemorrhage (with Major Complications) Inpatient | $24,458$10k$38k17 plans | — | — |
| GI Hemorrhage (without Complications) Inpatient | $8,435$3.5k$13k17 plans | — | — |
| Group Therapy Session | $101$75$1944 plans | $119 | $217 |
| Heart Attack, Discharged Alive (with Complications) Inpatient | $12,297$5.0k$19k17 plans | — | — |
| Heart Attack, Discharged Alive (with Major Complications) Inpatient | $21,463$8.8k$33k17 plans | — | — |
| Heart Attack, Discharged Alive (without Complications) Inpatient | $9,675$4.0k$15k17 plans | — | — |
| Heart Failure and Shock (with Complications) Inpatient | $11,359$4.7k$17k17 plans | — | — |
| Heart Failure and Shock (with Major Complications) Inpatient | $17,177$7.1k$26k17 plans | — | — |
| Heart Failure and Shock (without Complications) Inpatient | $7,573$3.1k$12k17 plans | — | — |
| Hemoglobin A1c (Diabetes Test) | $12$7$207 plans | $86 | $157 |
| Hip and Femur Procedures (with Complications) Inpatient | $28,024$12k$43k17 plans | — | — |
| Hip and Femur Procedures (with Major Complications) Inpatient | $38,966$16k$60k17 plans | — | — |
| Hip and Femur Procedures (without Complications) Inpatient | $21,822$9.0k$34k17 plans | — | — |
| Hip or Knee Replacement (with Major Complications) Inpatient | $40,584$17k$62k17 plans | — | — |
| Hip or Knee Replacement (without Major Complications) Inpatient | $25,808$11k$40k17 plans | — | — |
| HIV Antibody Test | $11$7$187 plans | $15 | $28 |
| Home Sleep Study | $216$160$4124 plansshared rate · 2 | — | — |
| Individual Therapy Session (45 Minutes) | $177$132$3394 plansshared rate · 3 | $103 | $188 |
| Inguinal Hernia Repair (Open) | $5,002$2.7k$8.8k7 plans | — | — |
| Initial Psychiatric Diagnostic Evaluation | $177$132$3394 plansshared rate · 3 | $213 | $388 |
| Initial Psychiatric Evaluation with Medication Management | $177$132$3394 plansshared rate · 3 | $196 | $356 |
| Inpatient Rehabilitation (with Complications) Inpatient | $20,720$8.5k$32k17 plans | — | — |
| Inpatient Rehabilitation (without Complications) Inpatient | $15,344$6.3k$24k17 plans | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $1,192$1.2k$1.2k1 plan | $2,451 | $4,456 |
| IUD Insertion | $2,334$1.9k$3.3k3 plans | — | — |
| IUD Removal | $1,887$226$3.3k6 plansshared rate · 2 | $426 | $775 |
| Kidney Failure (with Complications) Inpatient | $11,718$4.8k$18k17 plans | — | — |
| Kidney Failure (with Major Complications) Inpatient | $19,816$8.1k$30k17 plans | — | — |
| Kidney Failure (without Complications) Inpatient | $8,032$3.3k$12k17 plans | — | — |
| Kidney or Urinary Tract Infection (with Major Complications) Inpatient | $15,525$6.4k$24k17 plans | — | — |
| Kidney or Urinary Tract Infection (without Major Complications) Inpatient | $10,831$4.4k$17k17 plans | — | — |
| Knee Arthroscopy with Meniscectomy | $4,828$2.4k$8.8k7 plans | — | — |
| Laparoscopic Appendectomy | $6,462$4.5k$18k6 plansshared rate · 2 | — | — |
| Laparoscopic Gallbladder Removal | $7,194$4.5k$18k7 plans | — | — |
| Laparoscopic Gallbladder Removal (with Complications) Inpatient | $22,633$9.3k$35k17 plans | — | — |
| Laparoscopic Gallbladder Removal (with Major Complications) Inpatient | $31,930$13k$49k17 plans | — | — |
| Laparoscopic Gallbladder Removal (without Complications) Inpatient | $18,274$7.5k$28k17 plans | — | — |
| Laparoscopic Tubal Ligation | $6,462$4.5k$18k6 plansshared rate · 2 | — | — |
| Lipid Panel (Cholesterol Test) | $17$10$277 plans | $119 | $216 |
| Lumbar Epidural Steroid Injection | $2,959$524$3.3k6 plansshared rate · 4 | $1,709 | $3,107 |
| Lumbar Puncture (Spinal Tap) | $2,959$524$3.3k6 plansshared rate · 4 | $1,512 | $2,749 |
| Lumbar Spinal Fusion (Posterior) | $17,343$7.6k$33k6 plans | — | — |
| Lumpectomy (Partial Mastectomy) | $4,589$2.9k$7.8k6 plansshared rate · 6 | — | — |
| Major Bowel Procedure (with Complications) Inpatient | $32,074$13k$49k17 plans | — | — |
| Major Bowel Procedure (with Major Complications) Inpatient | $61,500$25k$95k17 plans | — | — |
| Major Bowel Procedure (without Complications) Inpatient | $22,517$9.2k$35k17 plans | — | — |
| MRI Abdomen with and without Contrast | $666$259$1.4k4 plansshared rate · 4 | $2,311 | $4,201 |
| MRI Brain with and without Contrast | $666$259$9014 plansshared rate · 4 | $1,844 | $3,352 |
| MRI Brain with Contrast | $666$259$7904 plansshared rate · 4 | $1,756 | $3,192 |
| MRI Brain without Contrast | $455$177$5364 plansshared rate · 5 | $1,672 | $3,040 |
| MRI Cervical Spine (Neck) without Contrast | $455$177$5114 plansshared rate · 5 | $1,784 | $3,244 |
| MRI Knee without Contrast | $455$177$5774 plansshared rate · 5 | $2,297 | $4,176 |
| MRI Lower Back (Lumbar Spine) without Contrast | $455$177$5084 plansshared rate · 5 | $2,257 | $4,104 |
| MRI Thoracic Spine (Mid-back) without Contrast | $455$177$5134 plansshared rate · 5 | $2,195 | $3,990 |
| Newborn Circumcision | $4,106$1.6k$7.8k6 plansshared rate · 3 | $89 | $161 |
| Nuclear Cardiac Stress Test | $1,364$960$2.5k4 plans | $2,445 | $4,446 |
| Office Visit, Established Patient (Level 3) | — | $131 | $238 |
| Office Visit, New Patient (Level 3) | — | $144 | $262 |
| Pacemaker Insertion (Dual Chamber) | $10,545$7.6k$44k6 plans | $5,939 | $10,799 |
| PET/CT Scan, Whole Body | $2,730$1.1k$2.9k4 plans | $3,658 | $6,650 |
| Pneumonia and Pleurisy (with Complications) Inpatient | $10,783$4.4k$17k17 plans | — | — |
| Pneumonia and Pleurisy (with Major Complications) Inpatient | $17,586$7.2k$27k17 plans | — | — |
| Pneumonia and Pleurisy (without Complications) Inpatient | $8,409$3.5k$13k17 plans | — | — |
| Pregnancy Ultrasound (Second or Third Trimester) | $200$78$3174 plansshared rate · 4 | $431 | $784 |
| Prostate Biopsy | $3,579$3.4k$4.8k3 plansshared rate · 2 | $367 | $668 |
| PSA Prostate Cancer Screening | $23$14$377 plans | $124 | $225 |
| Psychiatric Admission (Psychoses) Inpatient | $18,689$7.7k$29k17 plans | — | — |
| Pulmonary Edema and Respiratory Failure Inpatient | $16,529$6.8k$25k17 plans | — | — |
| Pulmonary Function Test with Bronchodilator | $373$277$7124 plans | $303 | $551 |
| Rotator Cuff Repair (Arthroscopic) | $8,333$5.4k$18k7 plansshared rate · 2 | — | — |
| Screening Mammogram | $89$65$1684 plans | $163 | $297 |
| Sepsis (with Major Complications) Inpatient | $25,990$11k$40k17 plans | — | — |
| Sepsis (without Major Complications) Inpatient | $13,692$5.6k$21k17 plans | — | — |
| Septoplasty (Deviated Septum Repair) | $4,166$2.5k$7.8k7 plans | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $7,398$5.0k$13k7 plansshared rate · 2 | — | — |
| Skin Biopsy (Tangential) | $1,887$302$3.3k6 plansshared rate · 2 | $590 | $1,072 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,959$1.2k$4.1k6 plansshared rate · 4 | $3,408 | $6,196 |
| Sleep Study (In-lab Polysomnography) | $858$637$1.6k4 plansshared rate · 2 | $3,568 | $6,487 |
| Spinal Cord Stimulator Trial | $9,356$4.7k$18k6 plans | — | — |
| Spirometry (Breathing Test) | $216$160$4124 plansshared rate · 2 | $172 | $313 |
| Stroke (with Complications) Inpatient | $13,518$5.5k$21k17 plans | — | — |
| Stroke (with Major Complications) Inpatient | $26,907$11k$41k17 plans | — | — |
| Stroke (without Complications) Inpatient | $9,157$3.8k$14k17 plans | — | — |
| Syncope and Collapse Inpatient | $11,662$4.8k$18k17 plans | — | — |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,106$2.5k$7.8k6 plansshared rate · 3 | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,914$4.2k$11k7 plans | — | — |
| Total Hip Replacement | $12,826$6.8k$28k7 plansshared rate · 2 | — | — |
| Total Knee Replacement | $12,826$7.6k$28k7 plansshared rate · 2 | — | — |
| Total Mastectomy | $7,398$4.9k$13k6 plansshared rate · 2 | — | — |
| TSH Thyroid Function Test | $21$13$347 plans | $139 | $252 |
| TURP (Transurethral Prostate Resection) | $5,441$4.0k$16k6 plansshared rate · 2 | — | — |
| Umbilical Hernia Repair | $5,4151 plan | — | — |
| Upper GI Endoscopy (EGD) | $2,995$673$4.8k7 plansshared rate · 2 | $361 | $657 |
| Urinalysis with Microscopy | $4$2$67 plans | $58 | $105 |
| Uterine and Adnexa Surgery, Non-cancer (without Complications) Inpatient | $16,600$6.8k$26k17 plans | — | — |
| Vaginal Birth After Cesarean (VBAC) Global Package | $4,589$3.7k$4.6k1 planshared rate · 6 | — | — |
| Vaginal Delivery (Global Package) | $4,589$3.7k$4.6k1 planshared rate · 6 | — | — |
| Vaginal Hysterectomy | $5,441$3.7k$9.5k6 plansshared rate · 2 | — | — |
| Vasectomy | $4,106$1.6k$7.8k6 plansshared rate · 3 | — | — |
| Vitamin D Blood Test | $37$22$607 plans | $232 | $422 |