| Arthrocentesis (outpatient) | $1,097 | N/A | $1,097 |
| Bacterial Culture - Aerobic Isolates | $28 | N/A | $28 |
| Bacterial Culture - Swab | $46 | N/A | $46 |
| Biopsy - Breast | $3,365 | N/A | $3,365 |
| Biopsy - Endometrial (Uterus) | $1,081 | N/A | $1,081 |
| Blood Test - Basic Metabolic Panel | $30 | N/A | $30 |
| Blood Test - Blood Glucose (Sugar) Level | $39 | N/A | $39 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $34 | N/A | $34 |
| Blood Test - Blood Typing (Rh (D)) | $63 | N/A | $63 |
| Blood Test - C-reactive Protein (CRP) Level | $18 | N/A | $18 |
| Blood Test - Cholesterol Test, Lipid Panel | $82 | N/A | $82 |
| Blood Test - Clotting Time | $17 | N/A | $17 |
| Blood Test - Coagulation Assessment | $47 | N/A | $47 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $35 | N/A | $35 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $49 | N/A | $49 |
| Blood Test - Comprehensive Metabolic Panel | $37 | N/A | $37 |
| Blood Test - Creatinine Level | $33 | N/A | $33 |
| Blood Test - Electrolytes Panel | $50 | N/A | $50 |
| Blood Test - Ferritin (Blood Protein) Level | $85 | N/A | $85 |
| Blood Test - Folic Acid Level | $111 | N/A | $111 |
| Blood Test - General Health Panel | $198 | N/A | $198 |
| Blood Test - Hepatic (Liver) Function Panel | $65 | N/A | $65 |
| Blood Test - Hepatitis B Surface Antibody Level | $75 | N/A | $75 |
| Blood Test - Hepatitis C Antibody Level | $76 | N/A | $76 |
| Blood Test - Iron Binding Capacity | $56 | N/A | $56 |
| Blood Test - Iron Level | $44 | N/A | $44 |
| Blood Test - LDL Cholesterol Level | $57 | N/A | $57 |
| Blood Test - Lead Level | $82 | N/A | $82 |
| Blood Test - Lipase (fat enzyme) Level | $24 | N/A | $24 |
| Blood Test - Magnesium Level | $24 | N/A | $24 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $114 | N/A | $114 |
| Blood Test - Renal (Kidney) Function Panel | $97 | N/A | $97 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $93 | N/A | $93 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $112 | N/A | $112 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $62 | N/A | $62 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $97 | N/A | $97 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $57 | N/A | $57 |
| Blood Test - Vitamin D-3 Level | $151 | N/A | $151 |
| Bone Density Scan (outpatient) | $452 | N/A | $452 |
| Chiropractic Manipulative Treatment - Spinal, 3-4 Regions | $53 | 
Below Average
State Average: 4 | $53 |
| Colonoscopy - Diagnostic (outpatient) | $4,530 | N/A | $4,530 |
| Colonoscopy - With Biopsy (outpatient) | $5,403 | N/A | $5,403 |
| Colonoscopy - With Polyp Removal (outpatient) | $5,642 | N/A | $5,642 |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,146 | N/A | $2,146 |
| CT Scan - Chest, with Contrast (outpatient) | $1,817 | N/A | $1,817 |
| CT Scan - Head/Brain, without Contrast | $852 | N/A | $852 |
| Developmental Screening | $26 | N/A | $26 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $552 | N/A | $552 |
| Emergency Department Visit - Low Complexity (outpatient) | $219 | N/A | $219 |
| Emergency Department Visit - Minor (outpatient) | $205 | N/A | $205 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $324 | N/A | $324 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $39 | N/A | $39 |
| Fetal Non-Stress Test | $706 | N/A | $706 |
| Gall Bladder Surgery (outpatient) | $10,896 | N/A | $10,896 |
| Hydration Infusion | $105 | N/A | $105 |
| Lab Test - Creatinine Level | $24 | N/A | $24 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $131 | N/A | $131 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $64 | N/A | $64 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $71 | N/A | $71 |
| Lab Test - Detection test for Influenza Virus | $47 | N/A | $47 |
| Lab Test - Smear for Microorganism | $23 | N/A | $23 |
| Mammogram (outpatient) | $767 | N/A | $767 |
| Office Visit - Basic | $139 | N/A | $139 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $368 | N/A | $368 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $457 | N/A | $457 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $284 | N/A | $284 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $310 | N/A | $310 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $341 | N/A | $341 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $370 | N/A | $370 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $284 | N/A | $284 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $273 | N/A | $273 |
| Office Visit - Established Patient, High Complexity | $473 | N/A | $473 |
| Office Visit - Established Patient, Low Complexity | $221 | N/A | $221 |
| Office Visit - Established Patient, Moderate Complexity | $333 | N/A | $333 |
| Office Visit - New Patient, Low Complexity | $315 | N/A | $315 |
| Office Visit - New Patient, Minor | $197 | N/A | $197 |
| Physical Therapy - Low Complexity Evaluation | $289 | 
Near Average
State Average: 1 | $289 |
| Physical Therapy - Manual Therapy | $116 |
Near Average
State Average: 4 | $116 |
| Physical Therapy - Neuromuscular Reeducation | $42 |
Below Average
State Average: 4 | $42 |
| Physical Therapy - Therapeutic Activities | $137 |
Below Average
State Average: 3 | $137 |
| Physical Therapy - Therapeutic Exercises | $124 |
Below Average
State Average: 4 | $124 |
| Physical Therapy - Ultrasound Therapy | $49 |
Near Average
State Average: 3 | $49 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $45 | N/A | $45 |
| Ultrasound - Abdominal, Complete | $695 | N/A | $695 |
| Ultrasound - Abdominal, Limited | $528 | N/A | $528 |
| Ultrasound - Breast (outpatient) | $435 | N/A | $435 |
| Ultrasound - Head and Neck | $511 | N/A | $511 |
| Ultrasound - Pelvic (outpatient) | $699 | N/A | $699 |
| Ultrasound - Pregnancy (outpatient) | $432 | N/A | $432 |
| Ultrasound - Pregnancy Follow-Up | $459 | N/A | $459 |
| Ultrasound - Transvaginal (non-maternity) | $741 | N/A | $741 |
| Upper Gastrointestinal Endoscopy - With Biopsy | $4,490 | N/A | $4,490 |
| Urine Test - Automated with Microscope Examination | $33 | N/A | $33 |
| Urine Test - Automated without Microscope | $25 | N/A | $25 |
| Urine Test - Bacterial Culture | $53 | N/A | $53 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $32 | N/A | $32 |
| Urine Test - Chlamydia | $83 | N/A | $83 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $95 | N/A | $95 |
| Urine Test - Microalbumin (Protein) Level | $46 | N/A | $46 |
| Urine Test - Pregnancy | $30 | N/A | $30 |
| Urine Test - Urinalysis, Manual Test | $17 | N/A | $17 |
| Vaccine - Influenza for Injection into Muscle | $53 | N/A | $53 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $646 | N/A | $646 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $79 | N/A | $79 |
| X-Ray - Abdomen | $467 | N/A | $467 |
| X-Ray - Ankle (outpatient) | $589 | N/A | $589 |
| X-Ray - Chest (outpatient) | $576 | N/A | $576 |
| X-Ray - Foot (outpatient) | $284 | N/A | $284 |
| X-Ray - Hand | $524 | N/A | $524 |
| X-Ray - Hip | $518 | N/A | $518 |
| X-Ray - Knee (outpatient) | $599 | N/A | $599 |
| X-Ray - Shoulder (outpatient) | $481 | N/A | $481 |
| X-Ray - Spine (outpatient) | $663 | N/A | $663 |
| X-Ray - Wrist (outpatient) | $458 | N/A | $458 |
