| Arthrocentesis (outpatient) | $415 | N/A | $261 |
| Bacterial Culture - Aerobic Isolates | $119 | N/A | $75 |
| Bacterial Culture - Swab | $95 | N/A | $60 |
| Blood Test - Basic Metabolic Panel | $69 | N/A | $44 |
| Blood Test - Blood Glucose (Sugar) Level | $33 | N/A | $21 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $93 | N/A | $59 |
| Blood Test - Blood Typing (ABO) | $25 | N/A | $16 |
| Blood Test - Blood Typing (Rh (D)) | $25 | N/A | $16 |
| Blood Test - C-reactive Protein (CRP) Level | $55 | N/A | $34 |
| Blood Test - Cholesterol Test, Lipid Panel | $122 | N/A | $77 |
| Blood Test - Clotting Time | $55 | N/A | $34 |
| Blood Test - Coagulation Assessment | $58 | N/A | $36 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $64 | N/A | $40 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $69 | N/A | $44 |
| Blood Test - Comprehensive Metabolic Panel | $91 | N/A | $58 |
| Blood Test - Creatinine Level | $49 | N/A | $31 |
| Blood Test - Electrolytes Panel | $66 | N/A | $42 |
| Blood Test - Ferritin (Blood Protein) Level | $127 | N/A | $80 |
| Blood Test - Folic Acid Level | $138 | N/A | $87 |
| Blood Test - General Health Panel | $318 | N/A | $200 |
| Blood Test - Hepatic (Liver) Function Panel | $78 | N/A | $49 |
| Blood Test - Hepatitis B Surface Antibody Level | $98 | N/A | $62 |
| Blood Test - Hepatitis C Antibody Level | $147 | N/A | $93 |
| Blood Test - Iron Binding Capacity | $83 | N/A | $52 |
| Blood Test - Iron Level | $62 | N/A | $39 |
| Blood Test - LDL Cholesterol Level | $86 | N/A | $54 |
| Blood Test - Lead Level | $113 | N/A | $71 |
| Blood Test - Lipase (fat enzyme) Level | $65 | N/A | $41 |
| Blood Test - Magnesium Level | $66 | N/A | $42 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $135 | N/A | $85 |
| Blood Test - Renal (Kidney) Function Panel | $81 | N/A | $51 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $146 | N/A | $92 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $158 | N/A | $99 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $83 | N/A | $52 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $159 | N/A | $100 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $135 | N/A | $85 |
| Blood Test - Vitamin D-3 Level | $306 | N/A | $192 |
| Bone Density Scan (outpatient) | $575 | N/A | $363 |
| Colonoscopy - Diagnostic (outpatient) | $5,120 | N/A | $3,226 |
| Colonoscopy - With Biopsy (outpatient) | $7,093 | N/A | $4,468 |
| CT Scan - Abdomen and Pelvis, with Contrast | $4,969 | N/A | $3,130 |
| Electrocardiogram (ECG or EKG), Tracing | $572 | N/A | $361 |
| Emergency Department Visit - Low Complexity (outpatient) | $350 | N/A | $220 |
| Emergency Department Visit - Minor (outpatient) | $252 | N/A | $159 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $508 | N/A | $320 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | N/A | $65 |
| Fetal Non-Stress Test | $342 | N/A | $216 |
| Hydration Infusion | $72 | N/A | $46 |
| Lab Test - Creatinine Level | $49 | N/A | $31 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $41 | N/A | $26 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $119 | N/A | $75 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $111 | N/A | $70 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $201 | N/A | $126 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $355 | N/A | $224 |
| Lab Test - Detection test for Influenza Virus | $119 | N/A | $75 |
| Lab Test - Smear for Microorganism | $44 | N/A | $28 |
| Laryngoscopy - Diagnostic | $384 | N/A | $242 |
| Mammogram (outpatient) | $988 | N/A | $622 |
| MRI - Back (outpatient) | $3,600 | N/A | $2,268 |
| MRI - Brain (outpatient) | $5,881 | N/A | $3,705 |
| MRI - Knee (outpatient) | $2,884 | N/A | $1,817 |
| MRI - Shoulder, Elbow, or Wrist | $2,884 | N/A | $1,817 |
| Myocardial Imaging (outpatient) | $6,732 | N/A | $4,241 |
| Nasal Endoscopy - Diagnostic | $566 | N/A | $357 |
| Office Visit - Basic | $105 | N/A | $66 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $229 | N/A | $144 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | N/A | $139 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $258 | N/A | $162 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $257 | N/A | $162 |
| Office Visit - Established Patient, High Complexity | $254 | N/A | $160 |
| Office Visit - Established Patient, Low Complexity | $147 | N/A | $93 |
| Office Visit - Established Patient, Moderate Complexity | $194 | N/A | $122 |
| Office Visit - New Patient, Low Complexity | $257 | N/A | $162 |
| Office Visit - New Patient, Minor | $188 | N/A | $118 |
| Office Visit - New Patient, Moderate Complexity | $315 | N/A | $198 |
| Pap Test, automated screening and manual rescreening | $275 | N/A | $173 |
| Physical Therapy - Electrical Stimulation Therapy | $62 | 
Below Average
State Average: 3 | $39 |
| Physical Therapy - Low Complexity Evaluation | $296 | 
Near Average
State Average: 1 | $187 |
| Physical Therapy - Manual Therapy | $155 |
Below Average
State Average: 4 | $98 |
| Physical Therapy - Moderate Complexity Evaluation | $296 |
Near Average
State Average: 1 | $187 |
| Physical Therapy - Self-care or Home Management Training | $130 |
Near Average
State Average: 1 | $82 |
| Physical Therapy - Therapeutic Activities | $131 |
Below Average
State Average: 3 | $83 |
| Physical Therapy - Therapeutic Exercises | $161 |
Below Average
State Average: 4 | $101 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $62 | N/A | $39 |
| Ultrasound - Abdominal, Complete | $725 | N/A | $456 |
| Ultrasound - Abdominal, Limited | $698 | N/A | $440 |
| Ultrasound - Breast (outpatient) | $1,353 | N/A | $853 |
| Ultrasound - Head and Neck | $696 | N/A | $439 |
| Ultrasound - Pregnancy (outpatient) | $631 | N/A | $398 |
| Ultrasound - Pregnancy Follow-Up | $509 | N/A | $321 |
| Ultrasound - Transvaginal (non-maternity) | $710 | N/A | $447 |
| Urine Test - Automated with Microscope Examination | $47 | N/A | $30 |
| Urine Test - Automated without Microscope | $18 | N/A | $11 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $72 | N/A | $46 |
| Urine Test - Chlamydia | $247 | N/A | $155 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $247 | N/A | $155 |
| Urine Test - Microalbumin (Protein) Level | $51 | N/A | $32 |
| Urine Test - Pregnancy | $57 | N/A | $36 |
| Urine Test - Urinalysis, Manual Test | $17 | N/A | $11 |
| Vaccine - Influenza for Injection into Muscle | $34 | N/A | $21 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $121 | N/A | $76 |
| X-Ray - Abdomen | $365 | N/A | $230 |
| X-Ray - Ankle (outpatient) | $365 | N/A | $230 |
| X-Ray - Chest (outpatient) | $361 | N/A | $228 |
| X-Ray - Foot (outpatient) | $363 | N/A | $229 |
| X-Ray - Hand | $600 | N/A | $378 |
| X-Ray - Hip | $366 | N/A | $231 |
| X-Ray - Knee (outpatient) | $368 | N/A | $232 |
| X-Ray - Shoulder (outpatient) | $368 | N/A | $232 |
| X-Ray - Spine (outpatient) | $358 | N/A | $225 |
| X-Ray - Wrist (outpatient) | $354 | N/A | $223 |
