| Arthroscopic Shoulder Surgery | $64,745 | N/A | $64,745 |
| Blood Test - C-reactive Protein (CRP) Level | $84 | N/A | $84 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $131 | N/A | $131 |
| MRI - Back (outpatient) | $3,419 | N/A | $3,419 |
| MRI - Knee (outpatient) | $3,231 | N/A | $3,231 |
| MRI - Shoulder, Elbow, or Wrist | $3,213 | N/A | $3,213 |
| Office Visit - Established Patient, Low Complexity | $167 | N/A | $167 |
| Office Visit - Established Patient, Moderate Complexity | $242 | N/A | $242 |
| Office Visit - New Patient, Low Complexity | $274 | N/A | $274 |
| Office Visit - New Patient, Minor | $210 | N/A | $210 |
| Office Visit - New Patient, Moderate Complexity | $390 | N/A | $390 |
| Physical Therapy - Application of Blood Vessel Compression or Decompression Device | $79 | 
Near Average
State Average: 3 | $79 |
| Physical Therapy - Application of Hot or Cold Pack | $56 | 
Above Average
State Average: 3 | $56 |
| Physical Therapy - Application of Mechanical Traction | $63 | 
Below Average
State Average: 3 | $63 |
| Physical Therapy - Electrical Stimulation Therapy | $62 |
Near Average
State Average: 3 | $62 |
| Physical Therapy - High Complexity Evaluation | $311 |
Above Average
State Average: 1 | $311 |
| Physical Therapy - Low Complexity Evaluation | $311 |
Near Average
State Average: 1 | $311 |
| Physical Therapy - Manual Therapy | $80 |
Near Average
State Average: 4 | $80 |
| Physical Therapy - Moderate Complexity Evaluation | $311 |
Near Average
State Average: 1 | $311 |
| Physical Therapy - Neuromuscular Reeducation | $101 |
Near Average
State Average: 4 | $101 |
| Physical Therapy - Re-Evaluation | $174 |
Near Average
State Average: 1 | $174 |
| Physical Therapy - Self-care or Home Management Training | $110 |
Near Average
State Average: 1 | $110 |
| Physical Therapy - Therapeutic Activities | $116 |
Below Average
State Average: 3 | $116 |
| Physical Therapy - Therapeutic Exercises | $104 |
Near Average
State Average: 4 | $104 |
| Physical Therapy - Ultrasound Therapy | $83 |
Below Average
State Average: 3 | $83 |
| X-Ray - Ankle (outpatient) | $417 | N/A | $417 |
| X-Ray - Foot (outpatient) | $413 | N/A | $413 |
| X-Ray - Hand | $450 | N/A | $450 |
| X-Ray - Hip | $490 | N/A | $490 |
| X-Ray - Knee (outpatient) | $648 | N/A | $648 |
| X-Ray - Middle Back, Thoracic Spine | $453 | N/A | $453 |
| X-Ray - Neck, Cervical Spine | $450 | N/A | $450 |
| X-Ray - Shoulder (outpatient) | $485 | N/A | $485 |
| X-Ray - Spine (outpatient) | $456 | N/A | $456 |
