| Arthrocentesis (outpatient) | $489 | N/A | $245 |
| Blood Test - Basic Metabolic Panel | $107 | N/A | $54 |
| Blood Test - Blood Typing (ABO) | $85 | N/A | $43 |
| Blood Test - Blood Typing (Rh (D)) | $85 | N/A | $43 |
| Blood Test - C-reactive Protein (CRP) Level | $107 | N/A | $54 |
| Blood Test - Cholesterol Test, Lipid Panel | $116 | N/A | $58 |
| Blood Test - Clotting Time | $49 | N/A | $25 |
| Blood Test - Coagulation Assessment | $140 | N/A | $70 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $57 | N/A | $28 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $68 | N/A | $34 |
| Blood Test - Comprehensive Metabolic Panel | $90 | N/A | $45 |
| Blood Test - Ferritin (Blood Protein) Level | $155 | N/A | $78 |
| Blood Test - Folic Acid Level | $153 | N/A | $77 |
| Blood Test - General Health Panel | $306 | N/A | $153 |
| Blood Test - Hepatic (Liver) Function Panel | $92 | N/A | $46 |
| Blood Test - Hepatitis B Surface Antibody Level | $216 | N/A | $108 |
| Blood Test - Lead Level | $128 | N/A | $64 |
| Blood Test - Lipase (fat enzyme) Level | $124 | N/A | $62 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $201 | N/A | $100 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $147 | N/A | $74 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $163 | N/A | $81 |
| Blood Test - Vitamin D-3 Level | $252 | N/A | $126 |
| Bone Density Scan (outpatient) | $547 | N/A | $274 |
| Colonoscopy - With Biopsy (outpatient) | $7,153 | N/A | $3,576 |
| Colonoscopy - With Polyp Removal (outpatient) | $7,233 | N/A | $3,617 |
| CT Scan - Abdomen and Pelvis, with Contrast | $5,381 | N/A | $2,691 |
| CT Scan - Chest, with Contrast (outpatient) | $2,403 | N/A | $1,202 |
| Developmental Screening | $25 | N/A | $13 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $479 | N/A | $240 |
| Emergency Department Visit - Low Complexity (outpatient) | $340 | N/A | $170 |
| Emergency Department Visit - Minor (outpatient) | $205 | N/A | $102 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $676 | N/A | $338 |
| Hydration Infusion | $171 | N/A | $86 |
| Lab Test - Creatinine Level | $76 | N/A | $38 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $21 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $331 | N/A | $165 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $116 | N/A | $58 |
| Lab Test - Detection test for Influenza Virus | $50 | N/A | $25 |
| Mammogram (outpatient) | $1,263 | N/A | $632 |
| MRI - Back (outpatient) | $2,225 | N/A | $1,112 |
| MRI - Brain (outpatient) | $3,834 | N/A | $1,917 |
| MRI - Knee (outpatient) | $2,115 | N/A | $1,057 |
| MRI - Shoulder, Elbow, or Wrist | $2,115 | N/A | $1,057 |
| Myocardial Imaging (outpatient) | $7,316 | N/A | $3,658 |
| Office Visit - Basic | $118 | N/A | $59 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $306 | N/A | $153 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $359 | N/A | $180 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $359 | N/A | $180 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $402 | N/A | $201 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $318 | N/A | $159 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $294 | N/A | $147 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $281 | N/A | $141 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $306 | N/A | $153 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $312 | N/A | $156 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $333 | N/A | $166 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $280 | N/A | $140 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $264 | N/A | $132 |
| Office Visit - Established Patient, High Complexity | $381 | N/A | $191 |
| Office Visit - Established Patient, Low Complexity | $194 | N/A | $97 |
| Office Visit - Established Patient, Moderate Complexity | $286 | N/A | $143 |
| Office Visit - New Patient, Low Complexity | $289 | N/A | $144 |
| Office Visit - New Patient, Minor | $200 | N/A | $100 |
| Office Visit - New Patient, Moderate Complexity | $438 | N/A | $219 |
| Pap Test, automated screening and manual rescreening | $207 | N/A | $103 |
| Pap Test, manual screening | $198 | N/A | $99 |
| Physical Therapy - High Complexity Evaluation | $275 | 
Near Average
State Average: 1 | $138 |
| Physical Therapy - Low Complexity Evaluation | $287 |
Near Average
State Average: 1 | $143 |
| Physical Therapy - Manual Therapy | $139 | 
Above Average
State Average: 4 | $69 |
| Physical Therapy - Moderate Complexity Evaluation | $287 |
Near Average
State Average: 1 | $143 |
| Physical Therapy - Therapeutic Activities | $139 | 
Below Average
State Average: 3 | $69 |
| Physical Therapy - Therapeutic Exercises | $139 |
Above Average
State Average: 4 | $69 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $69 | N/A | $35 |
| Ultrasound - Abdominal, Complete | $863 | N/A | $432 |
| Ultrasound - Abdominal, Limited | $634 | N/A | $317 |
| Ultrasound - Breast (outpatient) | $1,246 | N/A | $623 |
| Ultrasound - Head and Neck | $714 | N/A | $357 |
| Ultrasound - Pelvic (outpatient) | $1,173 | N/A | $586 |
| Urine Test - Automated with Microscope Examination | $159 | N/A | $79 |
| Urine Test - Automated without Microscope | $42 | N/A | $21 |
| Urine Test - Chlamydia | $236 | N/A | $118 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $236 | N/A | $118 |
| Urine Test - Pregnancy | $23 | N/A | $12 |
| Urine Test - Urinalysis, Manual Test | $9 | N/A | $5 |
| Vaccine - Influenza for Injection into Muscle | $53 | N/A | $26 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $95 | N/A | $47 |
| X-Ray - Abdomen | $390 | N/A | $195 |
| X-Ray - Ankle (outpatient) | $631 | N/A | $316 |
| X-Ray - Chest (outpatient) | $790 | N/A | $395 |
| X-Ray - Foot (outpatient) | $648 | N/A | $324 |
| X-Ray - Hand | $648 | N/A | $324 |
| X-Ray - Hip | $644 | N/A | $322 |
| X-Ray - Knee (outpatient) | $637 | N/A | $318 |
| X-Ray - Neck, Cervical Spine | $708 | N/A | $354 |
| X-Ray - Shoulder (outpatient) | $672 | N/A | $336 |
| X-Ray - Spine (outpatient) | $573 | N/A | $287 |
| X-Ray - Wrist (outpatient) | $631 | N/A | $316 |
