| Arthrocentesis (outpatient) | $897 | N/A | $897 |
| Bacterial Culture - Aerobic Isolates | $105 | N/A | $105 |
| Bacterial Culture - Swab | $194 | N/A | $194 |
| Biopsy - Punch Biopsy of Skin | $1,908 | N/A | $1,908 |
| Biopsy - Tangential Biopsy of Skin | $1,613 | N/A | $1,613 |
| Blood Test - Basic Metabolic Panel | $48 | N/A | $48 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $85 | N/A | $85 |
| Blood Test - Blood Typing (ABO) | $71 | N/A | $71 |
| Blood Test - Blood Typing (Rh (D)) | $71 | N/A | $71 |
| Blood Test - Cholesterol Test, Lipid Panel | $132 | N/A | $132 |
| Blood Test - Clotting Time | $53 | N/A | $53 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $55 | N/A | $55 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $74 | N/A | $74 |
| Blood Test - Comprehensive Metabolic Panel | $55 | N/A | $55 |
| Blood Test - Creatinine Level | $29 | N/A | $29 |
| Blood Test - Ferritin (Blood Protein) Level | $110 | N/A | $110 |
| Blood Test - General Health Panel | $253 | N/A | $253 |
| Blood Test - Hepatic (Liver) Function Panel | $54 | N/A | $54 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $117 | N/A | $117 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $104 | N/A | $104 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $111 | N/A | $111 |
| Bone Density Scan (outpatient) | $709 | N/A | $709 |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,739 | N/A | $2,739 |
| Destruction of Lesion (outpatient) | $693 | N/A | $693 |
| Destruction of Lesions, up to 14 | $736 | N/A | $736 |
| Developmental Screening | $70 | N/A | $70 |
| Electrocardiogram (ECG or EKG), Tracing | $551 | N/A | $551 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $551 | N/A | $551 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $155 | N/A | $155 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $108 | N/A | $108 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $107 | N/A | $107 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $65 | N/A | $65 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $195 | N/A | $195 |
| Mammogram (outpatient) | $547 | N/A | $547 |
| MRI - Back (outpatient) | $3,539 | N/A | $3,539 |
| MRI - Brain (outpatient) | $7,182 | N/A | $7,182 |
| MRI - Knee (outpatient) | $3,288 | N/A | $3,288 |
| Office Visit - Basic | $168 | N/A | $168 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $341 | N/A | $341 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $480 | N/A | $480 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $480 | N/A | $480 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $545 | N/A | $545 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $294 | N/A | $294 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $385 | N/A | $385 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $324 | N/A | $324 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $387 | N/A | $387 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $422 | N/A | $422 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $461 | N/A | $461 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $324 | N/A | $324 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $302 | N/A | $302 |
| Office Visit - Established Patient, High Complexity | $512 | N/A | $512 |
| Office Visit - Established Patient, Low Complexity | $235 | N/A | $235 |
| Office Visit - Established Patient, Moderate Complexity | $358 | N/A | $358 |
| Office Visit - New Patient, Low Complexity | $360 | N/A | $360 |
| Office Visit - New Patient, Minor | $273 | N/A | $273 |
| Office Visit - New Patient, Moderate Complexity | $544 | N/A | $544 |
| Pap Test, automated screening and manual rescreening | $236 | N/A | $236 |
| Physical Therapy - Therapeutic Exercises | $85 | 
Below Average
State Average: 4 | $85 |
| Psychotherapy - 30 Minutes | $169 | 
Above Average
State Average: 1 | $169 |
| Ultrasound - Breast (outpatient) | $864 | N/A | $864 |
| Ultrasound - Pelvic (outpatient) | $595 | N/A | $595 |
| Ultrasound - Pregnancy (outpatient) | $744 | N/A | $744 |
| Ultrasound - Pregnancy Follow-Up | $510 | N/A | $510 |
| Ultrasound - Transvaginal (non-maternity) | $1,418 | N/A | $1,418 |
| Urine Test - Automated with Microscope Examination | $179 | N/A | $179 |
| Urine Test - Automated without Microscope | $195 | N/A | $195 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $89 | N/A | $89 |
| Urine Test - Chlamydia | $164 | N/A | $164 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $164 | N/A | $164 |
| Urine Test - Pregnancy | $62 | N/A | $62 |
| Urine Test - Urinalysis, Manual Test | $57 | N/A | $57 |
| Vaccine - Influenza for Injection into Muscle | $62 | N/A | $62 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $654 | N/A | $654 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $144 | N/A | $144 |
| X-Ray - Ankle (outpatient) | $561 | N/A | $561 |
| X-Ray - Chest (outpatient) | $606 | N/A | $606 |
| X-Ray - Foot (outpatient) | $791 | N/A | $791 |
| X-Ray - Hand | $603 | N/A | $603 |
| X-Ray - Hip | $650 | N/A | $650 |
| X-Ray - Knee (outpatient) | $460 | N/A | $460 |
| X-Ray - Shoulder (outpatient) | $612 | N/A | $612 |
