| Arthrocentesis (outpatient) | $407 | 37% | $257 | 
Medium |
| Bacterial Culture Swab | $82 | 37% | $52 |
Medium |
| Blood Test - Basic Metabolic Panel | $66 | 37% | $42 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | 37% | $57 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | 37% | $74 |
Medium |
| Blood Test - Clotting Time | $53 | 37% | $33 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | 37% | $39 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | 37% | $42 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $88 | 37% | $56 |
Medium |
| Blood Test - Electrolytes Panel | $57 | 37% | $36 |
Medium |
| Blood Test - Folic Acid Level | $120 | 37% | $75 |
Medium |
| Blood Test - General Health Panel | $306 | 37% | $192 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $67 | 37% | $42 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $129 | 37% | $81 |
Medium |
| Blood Test - LDL Cholesterol Level | $75 | 37% | $47 |
Medium |
| Blood Test - Lipase (fat enzyme) Level | $56 | 37% | $35 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $118 | 37% | $74 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $70 | 37% | $44 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | 37% | $95 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $71 | 37% | $45 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $130 | 37% | $82 |
Medium |
| Blood Test - Vitamin D-3 Level | $306 | 37% | $192 |
Medium |
| Bone Density Scan (outpatient) | $567 | 37% | $357 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $5,124 | 37% | $3,228 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $6,430 | 37% | $4,051 |
Medium |
| Colonoscopy - With Polyp Removal (outpatient) | $6,438 | 37% | $4,056 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $5,019 | 37% | $3,162 |
Medium |
| CT Scan - Chest, with Contrast (outpatient) | $3,256 | 37% | $2,051 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $309 | 37% | $194 |
Medium |
| Electrocardiogram (ECG or EKG) | $368 | 37% | $232 | 
High |
| Emergency Department Visit - Low Complexity (outpatient) | $336 | 37% | $212 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $243 | 37% | $153 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $488 | 37% | $308 |
Medium |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | 37% | $65 |
Medium |
| Fetal Non-Stress Test | $342 | 37% | $216 |
Medium |
| Laryngoscopy - Diagnostic | $381 | 37% | $240 |
Medium |
| Mammogram (outpatient) | $947 | 37% | $597 |
Medium |
| MRI - Back (outpatient) | $3,403 | 37% | $2,144 |
Medium |
| MRI - Brain (outpatient) | $5,804 | 37% | $3,656 |
Medium |
| MRI - Knee (outpatient) | $2,727 | 37% | $1,718 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $2,779 | 37% | $1,751 |
Medium |
| Myocardial Imaging (outpatient) | $6,511 | 37% | $4,102 |
Medium |
| Nasal Endoscopy - Diagnostic | $566 | 37% | $357 |
Medium |
| Office Visit - Basic | $105 | 37% | $66 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $251 | 37% | $158 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | 37% | $139 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $279 | 37% | $176 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $247 | 37% | $155 |
Medium |
| Office Visit - Established Patient, High Complexity | $254 | 37% | $160 |
Medium |
| Office Visit - Established Patient, Low Complexity | $145 | 37% | $91 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $179 | 37% | $112 |
Medium |
| Office Visit - New Patient, Low Complexity | $175 | 37% | $110 |
Medium |
| Office Visit - New Patient, Minor | $188 | 37% | $118 |
Medium |
| Pap Test | $239 | 37% | $151 |
Medium |
| Physical Therapy - High Complexity Evaluation | $276 | 37% | $174 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $276 | 37% | $174 |
Medium |
| Physical Therapy - Manual Therapy | $149 | 37% | $94 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $271 | 37% | $171 |
Medium |
| Physical Therapy - Therapeutic Exercises | $161 | 37% | $101 |
Medium |
| Physical Therapy - Ultrasound Therapy | $45 | 37% | $28 |
Medium |
| Strep Test (Streptococcus, group A) | $41 | 37% | $26 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $54 | 37% | $34 |
Medium |
| Tonsillectomy with Adenoidectomy (outpatient) | $13,759 | 37% | $8,668 |
Medium |
| Ultrasound - Abdominal, Complete | $725 | 37% | $456 |
Medium |
| Ultrasound - Abdominal, Limited | $698 | 37% | $440 |
Medium |
| Ultrasound - Breast (outpatient) | $1,353 | 37% | $853 |
Medium |
| Ultrasound - Head and Neck | $696 | 37% | $439 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $744 | 37% | $469 |
High |
| Ultrasound - Pregnancy Follow-Up | $509 | 37% | $321 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $984 | 37% | $620 |
Medium |
| Urine Test - Automated with Microscope Examination | $47 | 37% | $30 |
Medium |
| Urine Test - Automated without Microscope | $16 | 37% | $10 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | 37% | $44 |
Medium |
| Urine Test - Chlamydia | $247 | 37% | $155 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $247 | 37% | $155 |
Medium |
| Urine Test - Pregnancy | $53 | 37% | $33 |
Medium |
| X-Ray - Abdomen | $320 | 37% | $202 |
Medium |
| X-Ray - Ankle (outpatient) | $436 | 37% | $275 |
Medium |
| X-Ray - Chest (outpatient) | $491 | 37% | $310 |
Medium |
| X-Ray - Foot (outpatient) | $416 | 37% | $262 |
Medium |
| X-Ray - Hand | $459 | 37% | $289 |
Medium |
| X-Ray - Hip | $318 | 37% | $200 |
Medium |
| X-Ray - Knee (outpatient) | $322 | 37% | $203 |
Medium |
| X-Ray - Neck, Cervical Spine | $323 | 37% | $204 |
Medium |
| X-Ray - Shoulder (outpatient) | $322 | 37% | $203 |
Medium |
| X-Ray - Spine (outpatient) | $436 | 37% | $275 |
Medium |
| X-Ray - Wrist (outpatient) | $320 | 37% | $202 |
Medium |
