| Abdominal Hysterectomy | $1,444$1.2k$8.2k | $7,051 | $7,051 |
| ACL Reconstruction (Arthroscopic) | $7,756$6.3k$15k | — | — |
| Allergy Skin Testing | $1,440$863$1.7k | — | — |
| Basic Metabolic Panel | $16$8$27 | $196 | $196 |
| Bone Marrow Biopsy | $1,515$121$3.3k | $3,544 | $3,544 |
| Breast Biopsy (Ultrasound-guided) | $1,874$1.5k$3.3k | $5,879 | $5,879 |
| Bunion Correction Surgery | $3,677$3.0k$8.2k | — | — |
| Cardiac Ablation for Atrial Fibrillation | $25,737$13k$53k | $92,250 | $92,250 |
| Cardiac Catheterization (Left Heart) | $7,344$3.3k$11k | $15,080 | $15,080 |
| Cardiac Stress Test (Treadmill) | $235$198$252 | — | — |
| Carpal Tunnel Release Surgery | $2,239$1.8k$5.3k | — | — |
| Cataract Surgery with Lens Implant | $2,670$2.2k$5.3k | — | — |
| Cervical Spinal Fusion (Anterior) | $13,220$7.7k$26k | — | — |
| Cesarean Delivery (Global Package) | $3,101$2.7k$3.3k | — | — |
| Chemotherapy Infusion (First Hour) | $467$332$664 | $1,174 | $1,174 |
| Chest X-ray (2 Views) | $171$87$212 | $657 | $657 |
| Colonoscopy with Biopsy | $1,302$1.0k$3.2k | — | — |
| Complete Abdominal Ultrasound | $258$105$390 | $1,556 | $1,556 |
| Complete Blood Count (CBC) with Differential | $15$8$25 | $129 | $129 |
| Comprehensive Metabolic Panel | $20$11$34 | $235 | $235 |
| Coronary Angioplasty with Stent | $22,054$7.7k$34k | $26,454 | $26,454 |
| Critical Care, First Hour | $1,747$830$2.3k | $5,425 | $5,425 |
| CT Abdomen and Pelvis with Contrast | $755$350$1.0k | $5,267 | $5,267 |
| CT Cardiac Calcium Scoring | $187$87$251 | $648 | $648 |
| CT Chest without Contrast | $288$105$462 | $3,843 | $3,843 |
| CT Head without Contrast | $288$105$462 | $3,232 | $3,232 |
| DEXA Bone Density Scan | $110$87$210 | $1,030 | $1,030 |
| Diagnostic Colonoscopy | $987$795$3.2k | — | — |
| Diagnostic Mammogram (Both Breasts) | $269$105$417 | $1,143 | $1,143 |
| Ear Tube Placement (Tympanostomy) | $1,609$1.3k$3.2k | — | — |
| Echocardiogram (Complete with Doppler) | $515$378$1.1k | $3,728 | $3,728 |
| EKG (Electrocardiogram, 12-lead) | $43$37$45 | — | — |
| Emergency Room Visit (Level 3) | $548$274$690 | $1,742 | $1,742 |
| Group Therapy Session | $146$102$204 | — | — |
| Hemoglobin A1c (Diabetes Test) | $18$10$32 | $165 | $165 |
| HIV Antibody Test | $17$9$29 | $127 | $127 |
| Holter Monitor (24-48 Hour Heart Monitor) | $300$253$321 | — | — |
| Home Sleep Study | $358$217$434 | — | — |
| Inguinal Hernia Repair (Open) | $4,047$3.3k$8.2k | — | — |
| Initial Hospital Admission (Level 1) | $334$281$357 | — | — |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $3,285$2.8k$3.5k | $6,615 | $6,615 |
| IUD Insertion | $77$62$705 | $1,054 | $1,054 |
| IUD Removal | $314$52$705 | $513 | $513 |
| Knee Arthroscopy with Meniscectomy | $3,677$3.0k$8.2k | — | — |
| Laparoscopic Appendectomy | $6,308$5.0k$12k | — | — |
| Laparoscopic Gallbladder Removal | $6,308$5.0k$12k | — | — |
| Laparoscopic Tubal Ligation | $6,308$5.0k$12k | — | — |
| Lipid Panel (Cholesterol Test) | $25$13$43 | $291 | $291 |
| Lumbar Epidural Steroid Injection | $755$609$1.7k | $1,701 | $1,701 |
| Lumbar Puncture (Spinal Tap) | $755$609$1.7k | $1,012 | $1,012 |
| Lumbar Spinal Fusion (Posterior) | $14,071$7.7k$35k | — | — |
| Lumpectomy (Partial Mastectomy) | $4,032$3.1k$7.9k | — | — |
| MRI Abdomen with and without Contrast | $1,081$350$1.8k | $9,053 | $9,053 |
| MRI Brain with and without Contrast | $1,081$350$1.8k | $9,065 | $9,065 |
| MRI Brain with Contrast | $755$350$1.0k | $5,568 | $5,568 |
| MRI Brain without Contrast | $611$240$939 | $6,083 | $6,083 |
| MRI Cervical Spine (Neck) without Contrast | $611$240$939 | $4,877 | $4,877 |
| MRI Knee without Contrast | $611$240$939 | $3,553 | $3,553 |
| MRI Lower Back (Lumbar Spine) without Contrast | $611$240$939 | $3,944 | $3,944 |
| MRI Thoracic Spine (Mid-back) without Contrast | $611$240$939 | $3,944 | $3,944 |
| Newborn Circumcision | $2,357$1.9k$5.3k | — | — |
| Nuclear Cardiac Stress Test | $1,583$1.3k$2.6k | $4,171 | $4,171 |
| Office Visit, Established Patient (Level 3) | $169$142$181 | $414 | $414 |
| Office Visit, New Patient (Level 3) | $252$213$270 | $508 | $508 |
| Pacemaker Insertion (Dual Chamber) | $13,193$10k$21k | $49,453 | $49,453 |
| PET/CT Scan, Whole Body | $3,633$1.4k$5.5k | $10,013 | $10,013 |
| Pregnancy Ultrasound (Second or Third Trimester) | $231$105$321 | $1,446 | $1,446 |
| Prostate Biopsy | $2,357$1.9k$3.2k | — | — |
| PSA Prostate Cancer Screening | $35$18$60 | $275 | $275 |
| Pulmonary Function Test with Bronchodilator | $271$132$750 | $439 | $439 |
| Rotator Cuff Repair (Arthroscopic) | $7,756$6.3k$15k | — | — |
| Screening Mammogram | $219$83$345 | $857 | $857 |
| Septoplasty (Deviated Septum Repair) | $3,414$2.5k$6.7k | — | — |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $6,925$5.4k$14k | — | — |
| Skin Biopsy (Tangential) | $419$83$817 | — | — |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,515$95$3.3k | — | — |
| Sleep Study (In-lab Polysomnography) | $1,550$863$1.8k | — | — |
| Spinal Cord Stimulator Trial | $8,068$6.4k$13k | — | — |
| Spirometry (Breathing Test) | $401$217$473 | $726 | $726 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,414$2.5k$6.7k | — | — |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,989$4.3k$12k | — | — |
| Total Hip Replacement | $10,127$1.6k$26k | — | — |
| Total Knee Replacement | $13,220$9.1k$26k | — | — |
| Total Mastectomy | $6,689$5.4k$13k | — | — |
| TSH Thyroid Function Test | $32$17$55 | $55 | $55 |
| TURP (Transurethral Prostate Resection) | $5,521$4.2k$11k | — | — |
| Upper GI Endoscopy (EGD) | $1,033$833$3.2k | — | — |
| Urinalysis with Microscopy | $6$3$10 | $94 | $94 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $2,943$2.5k$3.1k | — | — |
| Vaginal Delivery (Global Package) | $2,796$2.4k$3.0k | — | — |
| Vaginal Hysterectomy | $5,715$4.6k$10k | — | — |
| Vasectomy | $2,357$1.9k$5.3k | — | — |
| Vitamin D Blood Test | $56$30$96 | $415 | $415 |