| Arthrocentesis (outpatient) | $1,043 | 44% | $584 | 
Medium |
| Blood Test - Basic Metabolic Panel | $128 | 44% | $72 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $129 | 44% | $72 |
Medium |
| Blood Test - Clotting Time | $61 | 44% | $34 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $65 | 44% | $36 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $62 | 44% | $35 |
Medium |
| Blood Test - General Health Panel | $386 | 44% | $216 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $118 | 44% | $66 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $131 | 44% | $74 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $110 | 44% | $62 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $108 | 44% | $61 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $132 | 44% | $74 |
Medium |
| Blood Test - Vitamin D-3 Level | $242 | 44% | $135 |
Medium |
| Bone Density Scan (outpatient) | $785 | 44% | $440 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $4,243 | 44% | $2,376 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $4,771 | 44% | $2,672 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,697 | 44% | $1,510 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $266 | 44% | $149 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $184 | 44% | $103 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $492 | 44% | $276 |
Medium |
| Mammogram (outpatient) | $1,268 | 44% | $710 |
Medium |
| MRI - Back (outpatient) | $3,327 | 44% | $1,863 |
Medium |
| MRI - Knee (outpatient) | $3,004 | 44% | $1,682 |
Medium |
| Myocardial Imaging (outpatient) | $5,986 | 44% | $3,352 | 
Low |
| Office Visit - Basic | $107 | 44% | $60 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $182 | 44% | $102 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $193 | 44% | $108 |
Medium |
| Office Visit - Established Patient, High Complexity | $236 | 44% | $132 |
Medium |
| Office Visit - Established Patient, Low Complexity | $122 | 44% | $68 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $189 | 44% | $106 |
Medium |
| Office Visit - New Patient, Low Complexity | $187 | 44% | $105 |
Medium |
| Pap Test | $158 | 44% | $88 |
Medium |
| Physical Therapy - High Complexity Evaluation | $420 | 44% | $235 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $282 | 44% | $158 |
Medium |
| Physical Therapy - Manual Therapy | $128 | 44% | $72 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $376 | 44% | $211 |
Medium |
| Physical Therapy - Re-Evaluation | $188 | 44% | $105 |
Medium |
| Physical Therapy - Therapeutic Activities | $128 | 44% | $72 |
Medium |
| Physical Therapy - Therapeutic Exercises | $125 | 44% | $70 |
Medium |
| Physical Therapy - Ultrasound Therapy | $75 | 44% | $42 |
Medium |
| Strep Test (Streptococcus, group A) | $68 | 44% | $38 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $119 | 44% | $66 |
Medium |
| Ultrasound - Abdominal, Complete | $1,184 | 44% | $663 |
Medium |
| Ultrasound - Abdominal, Limited | $475 | 44% | $266 |
Medium |
| Ultrasound - Breast (outpatient) | $1,240 | 44% | $694 |
Medium |
| Ultrasound - Head and Neck | $719 | 44% | $403 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $612 | 44% | $343 |
Medium |
| Urine Test - Automated with Microscope Examination | $57 | 44% | $32 |
Medium |
| Urine Test - Automated without Microscope | $33 | 44% | $18 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $224 | 44% | $125 |
Medium |
| Urine Test - Pregnancy | $68 | 44% | $38 |
Medium |
| X-Ray - Ankle (outpatient) | $439 | 44% | $246 |
Medium |
| X-Ray - Chest (outpatient) | $575 | 44% | $322 |
Medium |
| X-Ray - Foot (outpatient) | $506 | 44% | $283 |
Medium |
| X-Ray - Hand | $512 | 44% | $287 |
Medium |
| X-Ray - Hip | $446 | 44% | $250 | 
High |
| X-Ray - Knee (outpatient) | $688 | 44% | $385 |
High |
| X-Ray - Middle Back, Thoracic Spine | $1,030 | 44% | $577 |
Medium |
| X-Ray - Shoulder (outpatient) | $543 | 44% | $304 |
Medium |
| X-Ray - Spine (outpatient) | $569 | 44% | $318 |
Medium |
| X-Ray - Wrist (outpatient) | $476 | 44% | $266 |
Medium |
