| Abdominal Hysterectomy | $1,677$1.3k$2.1k | $1,677 | $1,677 |
| ACL Reconstruction (Arthroscopic) | $6,945$1.3k$13k | $6,945 | $6,945 |
| Allergy Skin Testing | $9$5$13 | $9 | $9 |
| Anesthesia for Screening Colonoscopy | $22 | $22 | $22 |
| Anesthesia for Upper Endoscopy | $22 | $22 | $22 |
| Basic Metabolic Panel | $63 | $63 | $63 |
| Bone Marrow Biopsy | $871$89$1.7k | $871 | $871 |
| Breast Biopsy (Ultrasound-guided) | $987$189$1.8k | $987 | $987 |
| Bunion Correction Surgery | $3,012$672$5.4k | $3,012 | $3,012 |
| Cardiac Stress Test (Treadmill) | $154$98$324 | $154 | $154 |
| Carpal Tunnel Release Surgery | $1,675$584$2.8k | $1,675 | $1,675 |
| Cataract Surgery with Lens Implant | $2,108$713$3.5k | $2,108 | $2,108 |
| Cervical Spinal Fusion (Anterior) | $1,911$1.7k$2.1k | $1,911 | $1,911 |
| Cesarean Delivery (Global Package) | $4,055$3.3k$4.8k | $4,055 | $4,055 |
| Chest X-ray (2 Views) | $83$46$119 | $83 | $83 |
| Colonoscopy with Biopsy | $915$250$1.6k | $915 | $915 |
| Complete Abdominal Ultrasound | $215$160$270 | $215 | $215 |
| Complete Blood Count (CBC) with Differential | $8 | $8 | $8 |
| Comprehensive Metabolic Panel | $80 | $80 | $80 |
| Critical Care, First Hour | $788$264$1.3k | $788 | $788 |
| CT Abdomen and Pelvis with Contrast | $767$433$1.1k | $767 | $767 |
| CT Chest without Contrast | $393$187$598 | $393 | $393 |
| CT Head without Contrast | $195$149$240 | $195 | $195 |
| DEXA Bone Density Scan | $122$54$190 | $122 | $122 |
| Diagnostic Colonoscopy | $1,579$230$1.6k | $1,579 | $1,579 |
| Diagnostic Mammogram (Both Breasts) | $217$215$220 | $217 | $217 |
| Ear Tube Placement (Tympanostomy) | $1,372$212$2.5k | $1,372 | $1,372 |
| Echocardiogram (Complete with Doppler) | $872$271$1.5k | $872 | $872 |
| EKG (Electrocardiogram, 12-lead) | $55$19$1.3k | $55 | $55 |
| Emergency Room Visit (Level 3) | $537$87$987 | $537 | $537 |
| Group Therapy Session | $81$30$132 | $81 | $81 |
| Hemoglobin A1c (Diabetes Test) | $56$26$85 | $56 | $56 |
| HIV Antibody Test | $255 | $255 | $255 |
| Holter Monitor (24-48 Hour Heart Monitor) | $175$100$250 | $175 | $175 |
| Home Sleep Study | $241$128$353 | $241 | $241 |
| Individual Therapy Session (45 Minutes) | $187$114$261 | $187 | $187 |
| Inguinal Hernia Repair (Open) | $3,003$658$5.3k | $3,003 | $3,003 |
| Initial Hospital Admission (Level 1) | $83$63$103 | $83 | $83 |
| Initial Psychiatric Diagnostic Evaluation | $290$186$394 | $290 | $290 |
| Initial Psychiatric Evaluation with Medication Management | $327$213$441 | $327 | $327 |
| IUD Insertion | $103 | $103 | $103 |
| IUD Removal | $267$82$452 | $267 | $267 |
| Knee Arthroscopy with Meniscectomy | $2,506$711$4.3k | $2,506 | $2,506 |
| Laparoscopic Appendectomy | $753$324$7.6k | $753 | $753 |
| Laparoscopic Gallbladder Removal | $823$648$7.6k | $823 | $823 |
| Laparoscopic Tubal Ligation | $4,189$822$7.6k | $4,189 | $4,189 |
| Lipid Panel (Cholesterol Test) | $13 | $13 | $13 |
| Lumbar Puncture (Spinal Tap) | $411$77$745 | $411 | $411 |
| Lumbar Spinal Fusion (Posterior) | $11,207$2.0k$20k | $11,207 | $11,207 |
| Lumpectomy (Partial Mastectomy) | $1,422$827$2.0k | $1,422 | $1,422 |
| MRI Abdomen with and without Contrast | $724$482$966 | $724 | $724 |
| MRI Brain with and without Contrast | $709$452$966 | $709 | $709 |
| MRI Brain with Contrast | $619$385$854 | $619 | $619 |
| MRI Brain without Contrast | $425$278$573 | $425 | $425 |
| MRI Cervical Spine (Neck) without Contrast | $421$270$573 | $421 | $421 |
| MRI Knee without Contrast | $430$288$573 | $430 | $430 |
| MRI Lower Back (Lumbar Spine) without Contrast | $422$270$573 | $422 | $422 |
| MRI Thoracic Spine (Mid-back) without Contrast | $421$269$573 | $421 | $421 |
| Newborn Circumcision | $1,871$119$3.6k | $1,871 | $1,871 |
| Nuclear Cardiac Stress Test | $2,280$608$2.3k | $2,280 | $2,280 |
| Office Visit, Established Patient (Level 3) | $83$68$129 | $83 | $83 |
| Office Visit, New Patient (Level 3) | $103$84$822 | $103 | $103 |
| Pacemaker Insertion (Dual Chamber) | $9,804$629$19k | $9,804 | $9,804 |
| Pregnancy Ultrasound (Second or Third Trimester) | $228$187$270 | $228 | $228 |
| Prostate Biopsy | $1,542$161$2.9k | $1,542 | $1,542 |
| PSA Prostate Cancer Screening | $92$50$134 | $92 | $92 |
| Pulmonary Function Test with Bronchodilator | $264$54$474 | $264 | $264 |
| Rotator Cuff Repair (Arthroscopic) | $5,029$1.4k$8.7k | $5,029 | $5,029 |
| Screening Mammogram | $224$178$270 | $224 | $224 |
| Septoplasty (Deviated Septum Repair) | $2,399$908$3.9k | $2,399 | $2,399 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $3,272$404$6.1k | $3,272 | $3,272 |
| Skin Biopsy (Tangential) | $48$39$116 | $48 | $48 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $740$110$1.7k | $740 | $740 |
| Sleep Study (In-lab Polysomnography) | $1,291$874$1.7k | $1,291 | $1,291 |
| Spinal Cord Stimulator Trial | $5,553$529$11k | $5,553 | $5,553 |
| Spirometry (Breathing Test) | $32$27$38 | $32 | $32 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $2,145$399$3.9k | $2,145 | $2,145 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $2,136$382$3.9k | $2,136 | $2,136 |
| Total Hip Replacement | $2,214$1.6k$2.8k | $2,214 | $2,214 |
| Total Knee Replacement | $2,213$1.6k$2.8k | $2,213 | $2,213 |
| Total Mastectomy | $2,157$1.2k$3.1k | $2,157 | $2,157 |
| TSH Thyroid Function Test | $98$69$127 | $98 | $98 |
| TURP (Transurethral Prostate Resection) | $3,572$918$6.2k | $3,572 | $3,572 |
| Umbilical Hernia Repair | $5,349 | $5,349 | $5,349 |
| Upper GI Endoscopy (EGD) | $1,296$154$1.5k | $1,296 | $1,296 |
| Urinalysis with Microscopy | $27$13$40 | $27 | $27 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $3,835$3.1k$4.5k | $3,835 | $3,835 |
| Vaginal Delivery (Global Package) | $3,673$3.0k$4.3k | $3,673 | $3,673 |
| Vaginal Hysterectomy | $4,510$1.1k$8.0k | $4,510 | $4,510 |
| Vasectomy | $1,962$301$3.6k | $1,962 | $1,962 |
| Vitamin D Blood Test | $255 | $255 | $255 |