| Abdominal Hysterectomy | $17,346$9.9k$26k | — | — |
| ACL Reconstruction (Arthroscopic) | $13,752$6.5k$16k | — | — |
| Basic Metabolic Panel | $24$7$200 | $66 | $133 |
| Bone Marrow Biopsy | $2,462$507$4.4k | $590 | $1,180 |
| Breast Biopsy (Ultrasound-guided) | $2,976$1.6k$9.6k | $1,910 | $3,820 |
| Bunion Correction Surgery | $9,882$6.5k$12k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $37,390$14k$53k | — | — |
| Cardiac Catheterization (Left Heart) | $10,357$8.0k$13k | — | — |
| Carpal Tunnel Release Surgery | $7,344$3.1k$8.8k | — | — |
| Cataract Surgery with Lens Implant | $3,350$2.8k$20k | — | — |
| Cervical Spinal Fusion (Anterior) | $17,638$9.6k$23k | — | — |
| Cesarean Delivery (Global Package) | $17,638$5.7k$21k | — | — |
| Chemotherapy Infusion (First Hour) | $663$470$1.8k | $470 | $940 |
| Chest X-ray (2 Views) | $322$200$460 | $240 | $480 |
| Colonoscopy with Biopsy | $2,976$2.0k$6.8k | — | — |
| Complete Abdominal Ultrasound | $512$300$1.5k | $885 | $1,770 |
| Complete Blood Count (CBC) with Differential | $22$6$119 | $70 | $140 |
| Comprehensive Metabolic Panel | $29$8$268 | $158 | $315 |
| Coronary Angioplasty with Stent | $15,454$11k$21k | — | — |
| Critical Care, First Hour | $3,128$2.0k$3.9k | $2,085 | $4,170 |
| CT Abdomen and Pelvis with Contrast | $942$475$5.3k | $3,140 | $6,280 |
| CT Chest without Contrast | $942$475$2.5k | $1,470 | $2,940 |
| CT Head without Contrast | $942$475$2.5k | $1,470 | $2,940 |
| DEXA Bone Density Scan | $329$200$761 | $448 | $895 |
| Diagnostic Colonoscopy | $2,976$2.0k$6.8k | — | — |
| Diagnostic Mammogram (Both Breasts) | $309$200$808 | $379 | $758 |
| Ear Tube Placement (Tympanostomy) | $2,976$2.0k$9.6k | — | — |
| Echocardiogram (Complete with Doppler) | $3,576$2.1k$5.1k | $2,928 | $5,855 |
| Emergency Room Visit (Level 3) | $1,098$732$2.2k | $620 | $1,240 |
| Group Therapy Session | $147$123$208 | $123 | $245 |
| Hemoglobin A1c (Diabetes Test) | $29$8$140 | $55 | $110 |
| HIV Antibody Test | $25$7$64 | $38 | $75 |
| Home Sleep Study | $546$440$765 | — | — |
| Inguinal Hernia Repair (Open) | $9,953$8.0k$15k | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $4,332$2.0k$6.1k | $3,610 | $7,220 |
| IUD Insertion | $884$65$2.3k | $570 | $1,140 |
| IUD Removal | $1,580$140$3.5k | $163 | $325 |
| Knee Arthroscopy with Meniscectomy | $9,953$8.0k$15k | — | — |
| Laparoscopic Appendectomy | $13,851$6.5k$16k | — | — |
| Laparoscopic Gallbladder Removal | $13,851$8.5k$24k | — | — |
| Laparoscopic Tubal Ligation | $13,851$8.5k$17k | — | — |
| Lipid Panel (Cholesterol Test) | $40$11$213 | $109 | $218 |
| Lumbar Epidural Steroid Injection | $2,115$1.2k$3.5k | — | — |
| Lumbar Puncture (Spinal Tap) | $1,748$499$3.5k | $580 | $1,160 |
| Lumbar Spinal Fusion (Posterior) | $15,454$9.6k$21k | — | — |
| Lumpectomy (Partial Mastectomy) | $8,450$5.7k$12k | — | — |
| MRI Abdomen with and without Contrast | $1,237$650$5.6k | $3,265 | $6,530 |
| MRI Brain with and without Contrast | $1,237$650$5.6k | $3,265 | $6,530 |
| MRI Brain with Contrast | $1,237$650$3.8k | $2,210 | $4,420 |
| MRI Brain without Contrast | $1,237$650$3.6k | $2,110 | $4,220 |
| MRI Cervical Spine (Neck) without Contrast | $1,237$650$3.6k | $2,110 | $4,220 |
| MRI Knee without Contrast | $1,352$650$7.2k | $3,165 | $6,330 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,237$650$3.6k | $2,110 | $4,220 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,237$650$3.6k | $2,110 | $4,220 |
| Newborn Circumcision | $5,951$103$8.8k | $120 | $240 |
| Nuclear Cardiac Stress Test | $3,258$2.0k$4.6k | $2,715 | $5,430 |
| Office Visit, Established Patient (Level 3) | $89$65$332 | $195 | $390 |
| Office Visit, New Patient (Level 3) | $89$65$332 | $195 | $390 |
| Pacemaker Insertion (Dual Chamber) | $18,306$11k$23k | — | — |
| PET/CT Scan, Whole Body | $3,761$2.3k$6.9k | $4,060 | $8,120 |
| Pregnancy Ultrasound (Second or Third Trimester) | $512$300$1.1k | $660 | $1,320 |
| Prostate Biopsy | $5,951$2.0k$8.8k | — | — |
| PSA Prostate Cancer Screening | $51$15$153 | $90 | $180 |
| Pulmonary Function Test with Bronchodilator | $613$468$1.6k | $468 | $935 |
| Rotator Cuff Repair (Arthroscopic) | $13,851$8.5k$17k | — | — |
| Screening Mammogram | $300$200$378 | $203 | $405 |
| Septoplasty (Deviated Septum Repair) | $7,649$5.5k$15k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $10,057$5.7k$17k | — | — |
| Skin Biopsy (Tangential) | $1,580$198$19k | $230 | $460 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $2,727$2.0k$4.4k | — | — |
| Sleep Study (In-lab Polysomnography) | $2,581$2.1k$3.9k | — | — |
| Spinal Cord Stimulator Trial | $12,000$3.1k$24k | $6,500 | $13,000 |
| Spirometry (Breathing Test) | $384$265$1.6k | $265 | $530 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $7,649$5.5k$17k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $7,640$5.5k$9.6k | — | — |
| Total Hip Replacement | $19,631$9.6k$26k | — | — |
| Total Knee Replacement | $19,631$9.6k$26k | — | — |
| Total Mastectomy | $10,700$8.2k$15k | — | — |
| TSH Thyroid Function Test | $47$13$179 | $78 | $155 |
| TURP (Transurethral Prostate Resection) | $11,200$8.2k$15k | — | — |
| Upper GI Endoscopy (EGD) | $2,955$1.9k$4.4k | — | — |
| Urinalysis with Microscopy | $10$3$98 | $50 | $100 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $17,638$5.7k$21k | — | — |
| Vaginal Delivery (Global Package) | $10,865$5.7k$14k | — | — |
| Vaginal Hysterectomy | $11,750$8.5k$24k | — | — |
| Vasectomy | $7,344$3.1k$8.8k | — | — |
| Vitamin D Blood Test | $83$24$255 | $150 | $300 |