| Abdominal Hysterectomy | $4,879$1.1k$12k | — | — |
| ACL Reconstruction (Arthroscopic) | $14,579$6.3k$41k | $46,294 | $46,294 |
| Allergy Skin Testing | $2,231$1.2k$5.6k | — | — |
| Basic Metabolic Panel | $22$8$41 | $597 | $597 |
| Bone Marrow Biopsy | $773$118$3.3k | $4,896 | $4,896 |
| Breast Biopsy (Ultrasound-guided) | $3,291$1.4k$9.5k | $5,176 | $5,176 |
| Bunion Correction Surgery | $6,574$2.9k$19k | $21,550 | $21,550 |
| Cardiac Ablation for Atrial Fibrillation | $49,004$14k$141k | $94,818 | $94,818 |
| Cardiac Catheterization (Left Heart) | $6,834$5.9k$20k | $21,091 | $21,091 |
| Cardiac Stress Test (Treadmill) | $188$99$442 | — | — |
| Carpal Tunnel Release Surgery | $4,123$1.8k$12k | $14,170 | $14,170 |
| Cataract Surgery with Lens Implant | $4,781$2.1k$14k | $19,267 | $19,267 |
| Cervical Spinal Fusion (Anterior) | $25,682$13k$82k | $57,208 | $57,208 |
| Cesarean Delivery (Global Package) | $5,501$2.5k$17k | — | — |
| Chemotherapy Infusion (First Hour) | $390$196$874 | $1,082 | $1,082 |
| Chest X-ray (2 Views) | $210$175$521 | $810 | $810 |
| Colonoscopy with Biopsy | $2,408$1.1k$6.9k | $8,896 | $8,896 |
| Complete Abdominal Ultrasound | $294$210$731 | $1,618 | $1,618 |
| Complete Blood Count (CBC) with Differential | $20$8$38 | $265 | $265 |
| Comprehensive Metabolic Panel | $28$11$51 | $794 | $794 |
| Coronary Angioplasty with Stent | $21,383$16k$68k | $35,781 | $35,781 |
| Critical Care, First Hour | $1,660$914$4.1k | $6,887 | $6,887 |
| CT Abdomen and Pelvis with Contrast | $1,432$701$2.2k | $10,563 | $10,563 |
| CT Cardiac Calcium Scoring | $210$175$521 | $634 | $634 |
| CT Chest without Contrast | $420$210$657 | $3,004 | $3,004 |
| CT Head without Contrast | $420$210$657 | $3,938 | $3,938 |
| DEXA Bone Density Scan | $89$71$210 | $1,126 | $1,126 |
| Diagnostic Colonoscopy | $1,868$807$5.3k | $8,608 | $8,608 |
| Diagnostic Mammogram (Both Breasts) | $316$210$785 | $1,072 | $1,072 |
| Ear Tube Placement (Tympanostomy) | $3,117$1.4k$9.3k | $12,886 | $12,886 |
| Echocardiogram (Complete with Doppler) | $370$186$1.1k | $3,321 | $3,321 |
| EKG (Electrocardiogram, 12-lead) | $36$27$84 | — | — |
| Emergency Room Visit (Level 3) | $548$306$1.4k | $1,293 | $1,293 |
| Group Therapy Session | — | $572 | $572 |
| Hemodialysis Treatment | — | $2,755 | $2,755 |
| Hemoglobin A1c (Diabetes Test) | $25$10$47 | $224 | $224 |
| HIV Antibody Test | $23$9$43 | $341 | $341 |
| Holter Monitor (24-48 Hour Heart Monitor) | $234$124$553 | — | — |
| Home Sleep Study | $245$123$548 | — | — |
| Individual Therapy Session (45 Minutes) | — | $928 | $928 |
| Inguinal Hernia Repair (Open) | $7,456$3.3k$21k | $22,863 | $22,863 |
| Initial Hospital Admission (Level 1) | $267$141$630 | — | — |
| Initial Psychiatric Diagnostic Evaluation | — | $682 | $682 |
| Initial Psychiatric Evaluation with Medication Management | — | $840 | $840 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $3,600$1.0k$6.0k | $5,296 | $5,296 |
| IUD Insertion | $258$59$1.6k | $2,515 | $2,515 |
| IUD Removal | $361$55$1.6k | $1,806 | $1,806 |
| Knee Arthroscopy with Meniscectomy | $6,574$2.9k$19k | $21,427 | $21,427 |
| Laparoscopic Appendectomy | $12,146$5.1k$33k | — | — |
| Laparoscopic Gallbladder Removal | $12,146$5.1k$33k | $40,023 | $40,023 |
| Laparoscopic Tubal Ligation | $12,146$5.1k$33k | $36,352 | $36,352 |
| Lipid Panel (Cholesterol Test) | $35$13$65 | $503 | $503 |
| Lumbar Epidural Steroid Injection | $1,499$660$4.3k | $1,219 | $1,219 |
| Lumbar Puncture (Spinal Tap) | $1,499$660$4.3k | $3,132 | $3,132 |
| Lumbar Spinal Fusion (Posterior) | $25,682$13k$82k | — | — |
| Lumpectomy (Partial Mastectomy) | $6,538$3.2k$21k | — | — |
| MRI Abdomen with and without Contrast | $1,432$701$2.2k | $5,661 | $5,661 |
| MRI Brain with and without Contrast | $1,432$701$2.2k | $5,412 | $5,412 |
| MRI Brain with Contrast | $1,432$701$2.2k | $4,419 | $4,419 |
| MRI Brain without Contrast | $874$479$1.4k | $3,430 | $3,430 |
| MRI Cervical Spine (Neck) without Contrast | $874$479$1.4k | $5,117 | $5,117 |
| MRI Knee without Contrast | $874$479$1.4k | $4,238 | $4,238 |
| MRI Lower Back (Lumbar Spine) without Contrast | $874$479$1.4k | $5,117 | $5,117 |
| MRI Thoracic Spine (Mid-back) without Contrast | $874$479$1.4k | $4,252 | $4,252 |
| Newborn Circumcision | $4,248$1.9k$12k | $10,263 | $10,263 |
| Nuclear Cardiac Stress Test | $1,195$942$2.7k | $8,730 | $8,730 |
| Office Visit, Established Patient (Level 3) | $135$71$317 | $567 | $567 |
| Office Visit, New Patient (Level 3) | $201$106$473 | $696 | $696 |
| Pacemaker Insertion (Dual Chamber) | $20,999$11k$71k | $50,930 | $50,930 |
| PET/CT Scan, Whole Body | $5,159$2.9k$8.1k | $10,953 | $10,953 |
| Pregnancy Ultrasound (Second or Third Trimester) | $240$210$597 | $2,386 | $2,386 |
| Prostate Biopsy | $3,715$1.9k$12k | $2,439 | $2,439 |
| PSA Prostate Cancer Screening | $48$18$89 | $296 | $296 |
| Pulmonary Function Test with Bronchodilator | $129$65$750 | $1,373 | $1,373 |
| Rotator Cuff Repair (Arthroscopic) | $14,579$6.3k$41k | $39,900 | $39,900 |
| Screening Mammogram | $261$166$649 | $1,204 | $1,204 |
| Septoplasty (Deviated Septum Repair) | $6,245$2.8k$18k | $16,277 | $16,277 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $11,871$5.7k$38k | $30,796 | $30,796 |
| Skin Biopsy (Tangential) | $523$80$1.6k | $735 | $735 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $613$94$3.3k | $9,243 | $9,243 |
| Sleep Study (In-lab Polysomnography) | $1,367$687$3.1k | $6,453 | $6,453 |
| Spinal Cord Stimulator Trial | $14,837$6.5k$43k | $5,395 | $5,395 |
| Spirometry (Breathing Test) | $377$190$845 | $1,042 | $1,042 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $6,245$2.8k$18k | $20,753 | $20,753 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $10,467$4.8k$33k | $30,179 | $30,179 |
| Total Hip Replacement | $25,682$13k$82k | — | — |
| Total Knee Replacement | $25,682$13k$82k | — | — |
| Total Mastectomy | $11,871$5.5k$36k | — | — |
| TSH Thyroid Function Test | $44$17$81 | $470 | $470 |
| TURP (Transurethral Prostate Resection) | $10,772$4.5k$29k | — | — |
| Upper GI Endoscopy (EGD) | $1,885$830$5.4k | $7,273 | $7,273 |
| Urinalysis with Microscopy | $8$3$15 | $223 | $223 |
| Vaginal Birth After Cesarean (VBAC) Global Package | $5,206$2.4k$16k | — | — |
| Vaginal Delivery (Global Package) | $4,961$2.3k$15k | — | — |
| Vaginal Hysterectomy | $10,050$4.5k$29k | — | — |
| Vasectomy | $4,248$1.9k$12k | $10,160 | $10,160 |
| Vitamin D Blood Test | $73$30$143 | $622 | $622 |