| Arthrocentesis (outpatient) | $815 | N/A | $815 |
| Bacterial Culture - Swab | $187 | N/A | $187 |
| Biopsy - Punch Biopsy of Skin | $1,309 | N/A | $1,309 |
| Biopsy - Tangential Biopsy of Skin | $1,042 | N/A | $1,042 |
| Blood Test - Basic Metabolic Panel | $109 | N/A | $109 |
| Blood Test - Blood Glucose (Sugar) Level | $15 | N/A | $15 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $102 | N/A | $102 |
| Blood Test - Blood Typing (ABO) | $125 | N/A | $125 |
| Blood Test - Cholesterol Test, Lipid Panel | $101 | N/A | $101 |
| Blood Test - Clotting Time | $53 | N/A | $53 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $89 | N/A | $89 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $72 | N/A | $72 |
| Blood Test - Comprehensive Metabolic Panel | $48 | N/A | $48 |
| Blood Test - General Health Panel | $234 | N/A | $234 |
| Blood Test - Lead Level | $84 | N/A | $84 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $117 | N/A | $117 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $147 | N/A | $147 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $119 | N/A | $119 |
| Bone Density Scan (outpatient) | $709 | N/A | $709 |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,739 | N/A | $2,739 |
| CT Scan - Chest, with Contrast (outpatient) | $2,253 | N/A | $2,253 |
| Destruction of Lesion (outpatient) | $540 | N/A | $540 |
| Destruction of Lesions, up to 14 | $524 | N/A | $524 |
| Developmental Screening | $70 | N/A | $70 |
| Electrocardiogram (ECG or EKG), Tracing | $596 | N/A | $596 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $551 | N/A | $551 |
| Lab Test - Creatinine Level | $64 | N/A | $64 |
| 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 HIV-1 and HIV-2 | $114 | N/A | $114 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $249 | N/A | $249 |
| Lab Test - Detection test for Influenza Virus | $35 | N/A | $35 |
| Laryngoscopy - Diagnostic | $1,235 | N/A | $1,235 |
| Mammogram (outpatient) | $547 | N/A | $547 |
| MRI - Back (outpatient) | $3,539 | N/A | $3,539 |
| MRI - Brain (outpatient) | $7,203 | N/A | $7,203 |
| MRI - Knee (outpatient) | $3,288 | N/A | $3,288 |
| MRI - Pelvis (outpatient) | $6,569 | N/A | $6,569 |
| Nasal Endoscopy - Diagnostic | $1,290 | N/A | $1,290 |
| Office Visit - Basic | $168 | N/A | $168 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $406 | N/A | $406 |
| 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 | $408 | N/A | $408 |
| 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 | $260 | N/A | $260 |
| Office Visit - New Patient, Moderate Complexity | $544 | N/A | $544 |
| Pap Test, automated screening and manual rescreening | $236 | N/A | $236 |
| Psychotherapy - Group Session | $492 | 
Below Average
State Average: 5 | $492 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $53 | N/A | $53 |
| 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) | $572 | N/A | $572 |
| Urine Test - Automated with Microscope Examination | $175 | N/A | $175 |
| Urine Test - Automated without Microscope | $17 | N/A | $17 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $77 | N/A | $77 |
| Urine Test - Chlamydia | $133 | N/A | $133 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $133 | N/A | $133 |
| Urine Test - Microalbumin (Protein) Level | $60 | N/A | $60 |
| 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 - Chest (outpatient) | $606 | N/A | $606 |
| X-Ray - Foot (outpatient) | $574 | N/A | $574 |
| X-Ray - Knee (outpatient) | $658 | N/A | $658 |
| X-Ray - Shoulder (outpatient) | $611 | N/A | $611 |
