| Arthrocentesis (outpatient) | $843 | N/A | $843 |
| Bacterial Culture - Aerobic Isolates | $105 | N/A | $105 |
| Biopsy - Punch Biopsy of Skin | $2,097 | N/A | $2,097 |
| Biopsy - Tangential Biopsy of Skin | $1,469 | N/A | $1,469 |
| Blood Test - Basic Metabolic Panel | $49 | N/A | $49 |
| Blood Test - Blood Glucose (Sugar) Level | $24 | N/A | $24 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $102 | N/A | $102 |
| Blood Test - Blood Typing (Rh (D)) | $16 | N/A | $16 |
| Blood Test - C-reactive Protein (CRP) Level | $167 | N/A | $167 |
| Blood Test - Cholesterol Test, Lipid Panel | $99 | N/A | $99 |
| Blood Test - Clotting Time | $53 | N/A | $53 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $67 | N/A | $67 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $70 | N/A | $70 |
| Blood Test - Comprehensive Metabolic Panel | $61 | N/A | $61 |
| Blood Test - Creatinine Level | $37 | N/A | $37 |
| Blood Test - Ferritin (Blood Protein) Level | $81 | N/A | $81 |
| Blood Test - Folic Acid Level | $101 | N/A | $101 |
| Blood Test - General Health Panel | $212 | N/A | $212 |
| Blood Test - Hepatic (Liver) Function Panel | $55 | N/A | $55 |
| Blood Test - Hepatitis B Surface Antibody Level | $91 | N/A | $91 |
| Blood Test - Hepatitis C Antibody Level | $136 | N/A | $136 |
| Blood Test - Iron Binding Capacity | $32 | N/A | $32 |
| Blood Test - Iron Level | $29 | N/A | $29 |
| Blood Test - Lead Level | $87 | N/A | $87 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $117 | N/A | $117 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $85 | N/A | $85 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $99 | N/A | $99 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $116 | N/A | $116 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $85 | N/A | $85 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $97 | N/A | $97 |
| Bone Density Scan (outpatient) | $781 | N/A | $781 |
| Chiropractic Manipulative Treatment - Spinal, 1-2 Regions | $47 | 
Near Average
State Average: 2 | $47 |
| Chiropractic Manipulative Treatment - Spinal, 3-4 Regions | $69 | 
Below Average
State Average: 4 | $69 |
| CT Scan - Abdomen and Pelvis, with Contrast | $3,673 | N/A | $3,673 |
| CT Scan - Chest, with Contrast (outpatient) | $3,256 | N/A | $3,256 |
| Destruction of Lesion (outpatient) | $628 | N/A | $628 |
| Destruction of Lesions, up to 14 | $693 | N/A | $693 |
| Electrocardiogram (ECG or EKG), Tracing | $837 | N/A | $837 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $410 | N/A | $410 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $155 | N/A | $155 |
| Lab Test - Creatinine Level | $29 | N/A | $29 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $107 | N/A | $107 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $195 | N/A | $195 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $195 | N/A | $195 |
| Lab Test - Detection test for Influenza Virus | $87 | N/A | $87 |
| Mammogram (outpatient) | $1,076 | N/A | $1,076 |
| MRI - Back (outpatient) | $3,600 | N/A | $3,600 |
| MRI - Brain (outpatient) | $6,747 | N/A | $6,747 |
| MRI - Knee (outpatient) | $3,033 | N/A | $3,033 |
| MRI - Pelvis (outpatient) | $6,345 | N/A | $6,345 |
| Office Visit - Basic | $158 | N/A | $158 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $442 | N/A | $442 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $537 | N/A | $537 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $407 | N/A | $407 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $354 | N/A | $354 |
| 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 | $403 | N/A | $403 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $439 | N/A | $439 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $369 | N/A | $369 |
| Office Visit - Established Patient, High Complexity | $501 | N/A | $501 |
| Office Visit - Established Patient, Low Complexity | $226 | N/A | $226 |
| Office Visit - Established Patient, Moderate Complexity | $357 | N/A | $357 |
| Office Visit - New Patient, Low Complexity | $163 | N/A | $163 |
| Office Visit - New Patient, Minor | $264 | N/A | $264 |
| Office Visit - New Patient, Moderate Complexity | $349 | N/A | $349 |
| Pap Test, automated screening and manual rescreening | $238 | N/A | $238 |
| Pap Test, manual screening | $58 | N/A | $58 |
| Physical Therapy - Moderate Complexity Evaluation | $309 |
Near Average
State Average: 1 | $309 |
| Physical Therapy - Therapeutic Exercises | $138 |
Below Average
State Average: 4 | $138 |
| Psychiatric Diagnostic Evaluation | $289 |
Near Average
State Average: 1 | $289 |
| Psychotherapy - 30 Minutes | $167 |
Near Average
State Average: 1 | $167 |
| Psychotherapy - 45 Minutes | $179 |
Near Average
State Average: 4 | $179 |
| Psychotherapy - 60 Minutes | $189 |
Below Average
State Average: 5 | $189 |
| Psychotherapy - Family Session | $135 |
Below Average
State Average: 3 | $135 |
| Psychotherapy - Group Session | $110 |
Below Average
State Average: 5 | $110 |
| Ultrasound - Breast (outpatient) | $1,203 | N/A | $1,203 |
| Ultrasound - Pelvic (outpatient) | $604 | N/A | $604 |
| Ultrasound - Pregnancy (outpatient) | $789 | N/A | $789 |
| Ultrasound - Pregnancy Follow-Up | $956 | N/A | $956 |
| Ultrasound - Transvaginal (non-maternity) | $683 | N/A | $683 |
| Urine Test - Automated with Microscope Examination | $171 | N/A | $171 |
| Urine Test - Automated without Microscope | $198 | N/A | $198 |
| Urine Test - Bacterial Culture | $31 | N/A | $31 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $90 | N/A | $90 |
| Urine Test - Chlamydia | $81 | N/A | $81 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $81 | N/A | $81 |
| Urine Test - Microalbumin (Protein) Level | $71 | N/A | $71 |
| Urine Test - Pregnancy | $32 | N/A | $32 |
| Urine Test - Urinalysis, Manual Test | $21 | N/A | $21 |
| 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) | $634 | N/A | $634 |
| X-Ray - Wrist (outpatient) | $550 | N/A | $550 |
