| Arthrocentesis (outpatient) | $410 | 37% | $258 |
| Bacterial Culture - Aerobic Isolates | $119 | 37% | $75 |
| Bacterial Culture - Swab | $82 | 37% | $52 |
| Blood Test - Basic Metabolic Panel | $66 | 37% | $42 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | 37% | $57 |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | 37% | $74 |
| Blood Test - Clotting Time | $53 | 37% | $33 |
| Blood Test - Coagulation Assessment | $50 | 37% | $32 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | 37% | $39 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | 37% | $42 |
| Blood Test - Comprehensive Metabolic Panel | $88 | 37% | $56 |
| Blood Test - Electrolytes Panel | $58 | 37% | $36 |
| Blood Test - Ferritin (Blood Protein) Level | $110 | 37% | $69 |
| Blood Test - Folic Acid Level | $120 | 37% | $75 |
| Blood Test - General Health Panel | $306 | 37% | $192 |
| Blood Test - Hepatic (Liver) Function Panel | $67 | 37% | $42 |
| Blood Test - Hepatitis C Antibody Level | $129 | 37% | $81 |
| Blood Test - Iron Level | $54 | 37% | $34 |
| Blood Test - LDL Cholesterol Level | $75 | 37% | $47 |
| Blood Test - Lipase (fat enzyme) Level | $57 | 37% | $36 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $118 | 37% | $74 |
| Blood Test - Renal (Kidney) Function Panel | $70 | 37% | $44 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | 37% | $95 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $72 | 37% | $46 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $138 | 37% | $87 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $130 | 37% | $82 |
| Blood Test - Vitamin D-3 Level | $306 | 37% | $192 |
| Bone Density Scan (outpatient) | $578 | 37% | $364 |
| Colonoscopy - Diagnostic (outpatient) | $5,124 | 37% | $3,228 |
| Colonoscopy - With Biopsy (outpatient) | $6,924 | 37% | $4,362 |
| CT Scan - Abdomen and Pelvis, with Contrast | $5,019 | 37% | $3,162 |
| Detection test for Human Papillomavirus (HPV) | $309 | 37% | $194 |
| Electrocardiogram (ECG or EKG) | $572 | 37% | $361 |
| Emergency Department Visit - Low Complexity (outpatient) | $336 | 37% | $212 |
| Emergency Department Visit - Minor (outpatient) | $243 | 37% | $153 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $488 | 37% | $308 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | 37% | $65 |
| Fetal Non-Stress Test | $342 | 37% | $216 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $97 | 37% | $61 |
| Lab Test - Detection test for Influenza Virus | $119 | 37% | $75 |
| Lab Test - Smear for Microorganism | $41 | 37% | $26 |
| Laryngoscopy - Diagnostic | $384 | 37% | $242 |
| Mammogram (outpatient) | $947 | 37% | $597 |
| MRI - Back (outpatient) | $3,468 | 37% | $2,185 |
| MRI - Brain (outpatient) | $5,881 | 37% | $3,705 |
| MRI - Knee (outpatient) | $2,884 | 37% | $1,817 |
| MRI - Shoulder, Elbow, or Wrist | $2,884 | 37% | $1,817 |
| Myocardial Imaging (outpatient) | $6,624 | 37% | $4,173 |
| Nasal Endoscopy - Diagnostic | $566 | 37% | $357 |
| Office Visit - Basic | $111 | 37% | $70 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $251 | 37% | $158 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | 37% | $139 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $258 | 37% | $162 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $252 | 37% | $159 |
| Office Visit - Established Patient, High Complexity | $254 | 37% | $160 |
| Office Visit - Established Patient, Low Complexity | $147 | 37% | $93 |
| Office Visit - Established Patient, Moderate Complexity | $179 | 37% | $112 |
| Office Visit - New Patient, Low Complexity | $175 | 37% | $110 |
| Office Visit - New Patient, Minor | $188 | 37% | $118 |
| Office Visit - New Patient, Moderate Complexity | $295 | 37% | $186 |
| Pap Test | $239 | 37% | $151 |
| Physical Therapy - Electrical Stimulation Therapy | $62 | 37% | $39 |
| Physical Therapy - High Complexity Evaluation | $276 | 37% | $174 |
| Physical Therapy - Low Complexity Evaluation | $276 | 37% | $174 |
| Physical Therapy - Manual Therapy | $149 | 37% | $94 |
| Physical Therapy - Moderate Complexity Evaluation | $276 | 37% | $174 |
| Physical Therapy - Therapeutic Activities | $131 | 37% | $83 |
| Physical Therapy - Therapeutic Exercises | $161 | 37% | $101 |
| Physical Therapy - Ultrasound Therapy | $45 | 37% | $28 |
| Strep Test (Streptococcus, group A) | $41 | 37% | $26 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $54 | 37% | $34 |
| Ultrasound - Abdominal, Complete | $725 | 37% | $456 |
| Ultrasound - Abdominal, Limited | $698 | 37% | $440 |
| Ultrasound - Breast (outpatient) | $1,353 | 37% | $853 |
| Ultrasound - Head and Neck | $696 | 37% | $439 |
| Ultrasound - Pregnancy Follow-Up | $509 | 37% | $321 |
| Ultrasound - Transvaginal (non-maternity) | $710 | 37% | $447 |
| Urine Test - Automated with Microscope Examination | $47 | 37% | $30 |
| Urine Test - Automated without Microscope | $16 | 37% | $10 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | 37% | $44 |
| Urine Test - Chlamydia | $247 | 37% | $155 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $247 | 37% | $155 |
| Urine Test - Microalbumin (Protein) Level | $45 | 37% | $28 |
| Urine Test - Pregnancy | $53 | 37% | $33 |
| Urine Test - Urinalysis, Manual Test | $17 | 37% | $11 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $100 | 37% | $63 |
| X-Ray - Abdomen | $320 | 37% | $202 |
| X-Ray - Ankle (outpatient) | $365 | 37% | $230 |
| X-Ray - Chest (outpatient) | $414 | 37% | $261 |
| X-Ray - Foot (outpatient) | $434 | 37% | $273 |
| X-Ray - Hand | $522 | 37% | $329 |
| X-Ray - Hip | $366 | 37% | $231 |
| X-Ray - Knee (outpatient) | $368 | 37% | $232 |
| X-Ray - Neck, Cervical Spine | $349 | 37% | $220 |
| X-Ray - Shoulder (outpatient) | $436 | 37% | $275 |
| X-Ray - Spine (outpatient) | $327 | 37% | $206 |
| X-Ray - Wrist (outpatient) | $320 | 37% | $202 |
