| ACL Reconstruction (Arthroscopic) | $7,510$66$13k | $8,358 | $13,930 |
| Allergy Skin Testing | $17$3$1.5k | $14 | $24 |
| Basic Metabolic Panel | $43$8$217 | $145 | $241 |
| Bone Marrow Biopsy | $1,282$66$3.1k | $1,139 | $1,899 |
| Breast Biopsy (Ultrasound-guided) | $2,031$66$5.3k | $2,553 | $4,254 |
| Bunion Correction Surgery | $4,051$66$8.4k | $4,740 | $7,900 |
| Cardiac Ablation for Atrial Fibrillation | $33,439$11k$71k | $36,479 | $60,798 |
| Cardiac Catheterization (Left Heart) | $8,521$2.8k$26k | $17,212 | $28,686 |
| Carpal Tunnel Release Surgery | $2,572$66$6.3k | $3,899 | $6,499 |
| Cataract Surgery with Lens Implant | $3,041$66$12k | $4,302 | $7,169 |
| Cervical Spinal Fusion (Anterior) | $8,154$66$19k | $6,989 | $11,648 |
| Cesarean Delivery (Global Package) | $3,810$66$7.0k | $4,156 | $6,927 |
| Chemotherapy Infusion (First Hour) | $411$145$780 | $483 | $805 |
| Chest X-ray (2 Views) | $255$34$573 | $382 | $637 |
| Colonoscopy with Biopsy | $1,486$429$5.0k | — | — |
| Complete Abdominal Ultrasound | $355$93$746 | $498 | $829 |
| Complete Blood Count (CBC) with Differential | $38$7$93 | $62 | $104 |
| Comprehensive Metabolic Panel | $59$10$298 | $198 | $331 |
| Coronary Angioplasty with Stent | $12,159$3.6k$31k | $12,159 | $20,265 |
| Critical Care, First Hour | $2,636$754$10k | $3,329 | $5,549 |
| CT Abdomen and Pelvis with Contrast | $1,497$318$5.3k | $3,557 | $5,929 |
| CT Cardiac Calcium Scoring | $237$77$1.9k | $219 | $365 |
| CT Chest without Contrast | $509$93$1.9k | $1,080 | $1,801 |
| CT Head without Contrast | $509$93$2.7k | $1,828 | $3,047 |
| DEXA Bone Density Scan | $147$38$514 | $343 | $572 |
| Diagnostic Colonoscopy | $1,131$329$5.0k | — | — |
| Diagnostic Mammogram (Both Breasts) | $363$95$473 | $315 | $525 |
| Ear Tube Placement (Tympanostomy) | $2,026$66$8.4k | $3,341 | $5,568 |
| Echocardiogram (Complete with Doppler) | $777$385$3.9k | $2,590 | $4,316 |
| EKG (Electrocardiogram, 12-lead) | $123$39$892 | $130 | $216 |
| Emergency Room Visit (Level 3) | $880$242$2.7k | $960 | $1,600 |
| Group Therapy Session | $91$29$321 | $97 | $162 |
| Hemoglobin A1c (Diabetes Test) | $48$9$172 | $115 | $191 |
| HIV Antibody Test | $44$8$170 | $114 | $189 |
| Home Sleep Study | $295$133$2.0k | $789 | $1,315 |
| Individual Therapy Session (45 Minutes) | $168$60$301 | $201 | $334 |
| Inguinal Hernia Repair (Open) | $4,853$66$13k | $8,365 | $13,942 |
| Initial Psychiatric Diagnostic Evaluation | $243$95$475 | $317 | $528 |
| Initial Psychiatric Evaluation with Medication Management | $269$105$527 | $351 | $585 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $2,306$500$4.6k | $2,516 | $4,193 |
| IUD Insertion | $489$66$7.0k | $618 | $1,030 |
| IUD Removal | $392$51$3.5k | $512 | $853 |
| Knee Arthroscopy with Meniscectomy | $4,505$66$12k | $8,187 | $13,645 |
| Laparoscopic Appendectomy | $6,193$4.9k$15k | — | — |
| Laparoscopic Gallbladder Removal | $6,816$1.9k$15k | — | — |
| Laparoscopic Tubal Ligation | $7,154$66$14k | $9,568 | $15,946 |
| Lipid Panel (Cholesterol Test) | $28$7$258 | $28 | $47 |
| Lumbar Epidural Steroid Injection | $1,250$66$3.1k | $1,690 | $2,816 |
| Lumbar Puncture (Spinal Tap) | $942$66$3.1k | $1,229 | $2,048 |
| Lumbar Spinal Fusion (Posterior) | $12,401$66$28k | $10,629 | $17,715 |
| Lumpectomy (Partial Mastectomy) | $4,371$66$8.4k | $5,128 | $8,546 |
| MRI Abdomen with and without Contrast | $1,665$327$4.7k | $3,137 | $5,228 |
| MRI Brain with and without Contrast | $1,665$327$5.5k | $3,675 | $6,126 |
| MRI Brain with Contrast | $1,665$283$3.5k | $2,365 | $3,941 |
| MRI Brain without Contrast | $1,058$204$3.6k | $2,367 | $3,946 |
| MRI Cervical Spine (Neck) without Contrast | $1,058$198$3.5k | $2,351 | $3,919 |
| MRI Knee without Contrast | $1,058$208$3.1k | $2,090 | $3,484 |
| MRI Lower Back (Lumbar Spine) without Contrast | $1,058$199$2.9k | $1,913 | $3,188 |
| MRI Thoracic Spine (Mid-back) without Contrast | $1,058$198$3.0k | $2,030 | $3,384 |
| Newborn Circumcision | $1,909$66$3.7k | $1,991 | $3,319 |
| Nuclear Cardiac Stress Test | $1,899$438$6.0k | $4,016 | $6,694 |
| Pacemaker Insertion (Dual Chamber) | $16,441$6.5k$32k | $21,444 | $35,741 |
| PET/CT Scan, Whole Body | $4,909$1.3k$8.0k | $5,355 | $8,925 |
| Pregnancy Ultrasound (Second or Third Trimester) | $334$93$843 | $562 | $937 |
| Prostate Biopsy | $2,622$66$4.4k | $2,907 | $4,845 |
| PSA Prostate Cancer Screening | $90$11$236 | $157 | $262 |
| Pulmonary Function Test with Bronchodilator | $420$134$1.2k | $793 | $1,321 |
| Rotator Cuff Repair (Arthroscopic) | $6,399$66$12k | $4,881 | $8,134 |
| Screening Mammogram | $248$66$382 | $221 | $368 |
| Septoplasty (Deviated Septum Repair) | $3,414$66$10k | $3,652 | $6,087 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $5,959$66$12k | $5,107 | $8,512 |
| Skin Biopsy (Tangential) | $288$64$7.0k | $375 | $626 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $1,521$66$4.4k | $1,761 | $2,935 |
| Sleep Study (In-lab Polysomnography) | $1,648$888$6.5k | $4,314 | $7,190 |
| Spinal Cord Stimulator Trial | $6,625$66$16k | $10,927 | $18,211 |
| Spirometry (Breathing Test) | $397$133$939 | $626 | $1,043 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $3,408$66$12k | $3,638 | $6,064 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $5,238$66$8.6k | $4,556 | $7,593 |
| Total Hip Replacement | $13,933$5.4k$21k | — | — |
| Total Knee Replacement | $13,933$5.4k$21k | — | — |
| Total Mastectomy | $6,110$66$10k | $6,052 | $10,087 |
| TSH Thyroid Function Test | $42$11$246 | $100 | $167 |
| TURP (Transurethral Prostate Resection) | $5,780$66$10k | $7,000 | $11,667 |
| Umbilical Hernia Repair | $6,766$66$11k | $7,518 | $12,529 |
| Upper GI Endoscopy (EGD) | $1,163$335$4.4k | — | — |
| Urinalysis with Microscopy | $18$3$108 | $72 | $120 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $7,306$66$12k | $7,971 | $13,284 |
| Vaginal Delivery (Global Package) | $2,527$66$7.0k | $2,757 | $4,595 |
| Vaginal Hysterectomy | $5,584$66$15k | $8,216 | $13,694 |
| Vasectomy | $2,631$66$6.4k | $4,234 | $7,056 |
| Vitamin D Blood Test | $144$11$329 | $219 | $365 |