| Arthrocentesis (outpatient) | $312 | N/A | $187 |
| Bacterial Culture - Aerobic Isolates | $13 | N/A | $8 |
| Bacterial Culture - Swab | $17 | N/A | $10 |
| Biopsy - Breast | $6,140 | N/A | $3,684 |
| Biopsy - Endometrial (Uterus) | $770 | N/A | $462 |
| Biopsy - Punch Biopsy of Skin | $516 | N/A | $309 |
| Blood Test - Basic Metabolic Panel | $16 | N/A | $9 |
| Blood Test - Blood Glucose (Sugar) Level | $7 | N/A | $4 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $19 | N/A | $11 |
| Blood Test - Blood Typing (ABO) | $5 | N/A | $3 |
| Blood Test - Blood Typing (Rh (D)) | $5 | N/A | $3 |
| Blood Test - C-reactive Protein (CRP) Level | $9 | N/A | $6 |
| Blood Test - Cholesterol Test, Lipid Panel | $26 | N/A | $16 |
| Blood Test - Clotting Time | $7 | N/A | $4 |
| Blood Test - Coagulation Assessment | $12 | N/A | $7 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $13 | N/A | $8 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $15 | N/A | $9 |
| Blood Test - Comprehensive Metabolic Panel | $20 | N/A | $12 |
| Blood Test - Creatinine Level | $9 | N/A | $6 |
| Blood Test - Electrolytes Panel | $14 | N/A | $8 |
| Blood Test - Ferritin (Blood Protein) Level | $26 | N/A | $16 |
| Blood Test - Folic Acid Level | $28 | N/A | $17 |
| Blood Test - General Health Panel | $35 | N/A | $21 |
| Blood Test - Hepatic (Liver) Function Panel | $16 | N/A | $9 |
| Blood Test - Hepatitis C Antibody Level | $25 | N/A | $15 |
| Blood Test - Iron Binding Capacity | $17 | N/A | $10 |
| Blood Test - Iron Level | $13 | N/A | $8 |
| Blood Test - Lead Level | $19 | N/A | $11 |
| Blood Test - Lipase (fat enzyme) Level | $14 | N/A | $8 |
| Blood Test - Magnesium Level | $13 | N/A | $8 |
| Blood Test - Pregnancy (Obstetric) Panel | $191 | N/A | $115 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $28 | N/A | $17 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $26 | N/A | $16 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $33 | N/A | $20 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $17 | N/A | $10 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $32 | N/A | $19 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $23 | N/A | $14 |
| Blood Test - Vitamin D-3 Level | $56 | N/A | $33 |
| Bone Density Scan (outpatient) | $743 | N/A | $446 |
| Chiropractic Manipulative Treatment - Spinal, 1-2 Regions | $62 | 
Above Average
State Average: 2 | $37 |
| Colonoscopy - Diagnostic (outpatient) | $8,073 | N/A | $4,844 |
| Colonoscopy - With Biopsy (outpatient) | $8,715 | N/A | $5,229 |
| Colonoscopy - With Polyp Removal (outpatient) | $9,707 | N/A | $5,824 |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,044 | N/A | $1,226 |
| CT Scan - Chest, with Contrast (outpatient) | $2,459 | N/A | $1,475 |
| CT Scan - Head/Brain, without Contrast | $1,516 | N/A | $910 |
| Cystoscopy | $6,571 | N/A | $3,943 |
| Destruction of Lesion (outpatient) | $318 | N/A | $191 |
| Electrocardiogram (ECG or EKG), Tracing | $494 | N/A | $296 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $362 | N/A | $217 |
| Emergency Department Visit - Low Complexity (outpatient) | $716 | N/A | $430 |
| Emergency Department Visit - Minor (outpatient) | $426 | N/A | $256 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $1,838 | N/A | $1,103 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $17 | N/A | $10 |
| Hydration Infusion | $114 | N/A | $69 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $35 | N/A | $21 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $19 | N/A | $11 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $42 | N/A | $25 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $59 | N/A | $35 |
| Lab Test - Detection test for Influenza Virus | $20 | N/A | $12 |
| Lab Test - Smear for Microorganism | $8 | N/A | $5 |
| Laryngoscopy - Diagnostic | $557 | N/A | $334 |
| Mammogram (outpatient) | $819 | N/A | $491 |
| MRI - Back (outpatient) | $2,844 | N/A | $1,707 |
| MRI - Brain (outpatient) | $4,477 | N/A | $2,686 |
| MRI - Knee (outpatient) | $2,856 | N/A | $1,714 |
| MRI - Pelvis (outpatient) | $4,476 | N/A | $2,686 |
| MRI - Shoulder, Elbow, or Wrist | $2,844 | N/A | $1,707 |
| Myocardial Imaging (outpatient) | $9,866 | N/A | $5,919 |
| Nasal Endoscopy - Diagnostic | $670 | N/A | $402 |
| Office Visit - Basic | $97 | N/A | $58 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $273 | N/A | $164 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $320 | N/A | $192 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $311 | N/A | $186 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $361 | N/A | $217 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $284 | N/A | $170 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $261 | N/A | $157 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $251 | N/A | $151 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $274 | N/A | $164 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $279 | N/A | $168 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $298 | N/A | $179 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $250 | N/A | $150 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $234 | N/A | $140 |
| Office Visit - Established Patient, High Complexity | $317 | N/A | $190 |
| Office Visit - Established Patient, Low Complexity | $160 | N/A | $96 |
| Office Visit - Established Patient, Moderate Complexity | $235 | N/A | $141 |
| Office Visit - New Patient, Low Complexity | $236 | N/A | $142 |
| Office Visit - New Patient, Minor | $165 | N/A | $99 |
| Office Visit - New Patient, Moderate Complexity | $359 | N/A | $215 |
| Physical Therapy - Low Complexity Evaluation | $378 | 
Near Average
State Average: 1 | $227 |
| Physical Therapy - Manual Electrical Stimulation Therapy, 15 minutes | $79 | 
Below Average
State Average: 3 | $47 |
| Physical Therapy - Manual Therapy | $90 |
Below Average
State Average: 4 | $54 |
| Physical Therapy - Moderate Complexity Evaluation | $378 |
Near Average
State Average: 1 | $227 |
| Physical Therapy - Neuromuscular Reeducation | $90 |
Below Average
State Average: 4 | $54 |
| Physical Therapy - Re-Evaluation | $202 |
Near Average
State Average: 1 | $121 |
| Physical Therapy - Therapeutic Activities | $90 |
Below Average
State Average: 3 | $54 |
| Physical Therapy - Therapeutic Exercises | $90 |
Below Average
State Average: 4 | $54 |
| Physical Therapy - Ultrasound Therapy | $90 |
Near Average
State Average: 3 | $54 |
| Physical Therapy - Walking Training, 15 minutes | $84 |
Near Average
State Average: 1 | $50 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $12 | N/A | $7 |
| Tonsillectomy with Adenoidectomy (outpatient) | $13,839 | N/A | $8,303 |
| Ultrasound - Abdominal, Complete | $775 | N/A | $465 |
| Ultrasound - Abdominal, Limited | $728 | N/A | $437 |
| Ultrasound - Breast (outpatient) | $441 | N/A | $265 |
| Ultrasound - Head and Neck | $720 | N/A | $432 |
| Ultrasound - Pregnancy (outpatient) | $814 | N/A | $488 |
| Ultrasound - Pregnancy Follow-Up | $515 | N/A | $309 |
| Ultrasound - Transvaginal (non-maternity) | $2,051 | N/A | $1,230 |
| Upper Gastrointestinal Endoscopy - Diagnostic | $7,312 | N/A | $4,387 |
| Upper Gastrointestinal Endoscopy - With Biopsy | $8,584 | N/A | $5,150 |
| Urine Capacity Measurement | $286 | N/A | $171 |
| Urine Test - Automated with Microscope Examination | $6 | N/A | $4 |
| Urine Test - Automated without Microscope | $3 | N/A | $2 |
| Urine Test - Bacterial Culture | $8 | N/A | $5 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $8 | N/A | $5 |
| Urine Test - Chlamydia | $48 | N/A | $29 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $49 | N/A | $30 |
| Urine Test - Microalbumin (Protein) Level | $11 | N/A | $6 |
| Urine Test - Pregnancy | $11 | N/A | $6 |
| Urine Test - Urinalysis, Manual Test | $4 | N/A | $3 |
| Vaccine - Influenza for Injection into Muscle | $39 | N/A | $23 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $397 | N/A | $238 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $64 | N/A | $38 |
| X-Ray - Abdomen | $431 | N/A | $259 |
| X-Ray - Ankle (outpatient) | $341 | N/A | $205 |
| X-Ray - Chest (outpatient) | $402 | N/A | $241 |
| X-Ray - Foot (outpatient) | $364 | N/A | $219 |
| X-Ray - Hand | $418 | N/A | $251 |
| X-Ray - Hip | $337 | N/A | $202 |
| X-Ray - Knee (outpatient) | $437 | N/A | $262 |
| X-Ray - Middle Back, Thoracic Spine | $413 | N/A | $248 |
| X-Ray - Neck, Cervical Spine | $448 | N/A | $269 |
| X-Ray - Pelvis | $274 | N/A | $164 |
| X-Ray - Shoulder (outpatient) | $411 | N/A | $246 |
| X-Ray - Spine (outpatient) | $485 | N/A | $291 |
| X-Ray - Wrist (outpatient) | $229 | N/A | $137 |
