| Arthrocentesis (outpatient) | $504 | 38% | $302 | 
Medium |
| Arthroscopic Knee Surgery (outpatient) | $15,323 | 38% | $9,194 | 
High |
| Biopsy - Endometrial (Uterus) | $858 | 38% | $515 |
Medium |
| Blood Test - Basic Metabolic Panel | $16 | 38% | $9 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $19 | 38% | $11 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $26 | 38% | $16 |
Medium |
| Blood Test - Clotting Time | $7 | 38% | $4 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $13 | 38% | $8 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $15 | 38% | $9 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $20 | 38% | $12 |
Medium |
| Blood Test - Electrolytes Panel | $14 | 38% | $8 |
Medium |
| Blood Test - General Health Panel | $67 | 38% | $40 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $16 | 38% | $9 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $28 | 38% | $17 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $17 | 38% | $10 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $33 | 38% | $20 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $17 | 38% | $10 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $23 | 38% | $14 |
Medium |
| Blood Test - Vitamin D-3 Level | $56 | 38% | $33 |
Medium |
| Bone Density Scan (outpatient) | $743 | 38% | $446 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $7,976 | 38% | $4,785 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $9,556 | 38% | $5,734 |
Medium |
| Colonoscopy - With Polyp Removal (outpatient) | $10,813 | 38% | $6,488 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,058 | 38% | $1,235 |
Medium |
| CT Scan - Chest, with Contrast (outpatient) | $2,459 | 38% | $1,475 |
Medium |
| CT Scan - Head/Brain, without Contrast | $1,516 | 38% | $910 |
High |
| Cystoscopy | $6,327 | 38% | $3,796 |
Medium |
| Destruction of Lesion (outpatient) | $433 | 38% | $260 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $716 | 38% | $430 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $426 | 38% | $256 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $1,838 | 38% | $1,103 |
Medium |
| Fetal Non-Stress Test | $492 | 38% | $295 |
Medium |
| Hernia Repair - Laparoscopic (outpatient) | $21,713 | 38% | $13,028 |
Medium |
| Laryngoscopy - Diagnostic | $537 | 38% | $322 |
Medium |
| Mammogram (outpatient) | $761 | 38% | $457 |
Medium |
| MRI - Back (outpatient) | $2,844 | 38% | $1,707 |
Medium |
| MRI - Brain (outpatient) | $4,509 | 38% | $2,705 |
Medium |
| MRI - Knee (outpatient) | $2,856 | 38% | $1,714 |
High |
| MRI - Shoulder, Elbow, or Wrist | $2,844 | 38% | $1,707 |
Medium |
| Myocardial Imaging (outpatient) | $9,256 | 38% | $5,554 |
Medium |
| Nasal Endoscopy - Diagnostic | $638 | 38% | $383 |
Medium |
| Office Visit - Basic | $147 | 38% | $88 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $258 | 38% | $155 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $251 | 38% | $151 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $290 | 38% | $174 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $229 | 38% | $137 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $211 | 38% | $127 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $203 | 38% | $122 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | 38% | $132 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $225 | 38% | $135 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $240 | 38% | $144 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $202 | 38% | $121 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $190 | 38% | $114 |
Medium |
| Office Visit - Established Patient, High Complexity | $273 | 38% | $164 |
Medium |
| Office Visit - Established Patient, Low Complexity | $173 | 38% | $104 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $204 | 38% | $122 |
Medium |
| Office Visit - New Patient, Low Complexity | $202 | 38% | $121 |
Medium |
| Office Visit - New Patient, Minor | $173 | 38% | $104 |
Medium |
| Pap Test | $175 | 38% | $105 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $36 | 38% | $21 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $378 | 38% | $227 |
Medium |
| Physical Therapy - Manual Therapy | $90 | 38% | $54 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $378 | 38% | $227 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $90 | 38% | $54 |
Medium |
| Physical Therapy - Re-Evaluation | $202 | 38% | $121 |
Medium |
| Physical Therapy - Therapeutic Activities | $90 | 38% | $54 |
Medium |
| Physical Therapy - Therapeutic Exercises | $90 | 38% | $54 |
Medium |
| Physical Therapy - Ultrasound Therapy | $90 | 38% | $54 |
Medium |
| Strep Test (Streptococcus, group A) | $22 | 38% | $13 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $12 | 38% | $7 |
Medium |
| Tonsillectomy with Adenoidectomy (outpatient) | $12,593 | 38% | $7,556 |
Medium |
| Ultrasound - Abdominal, Complete | $775 | 38% | $465 |
Medium |
| Ultrasound - Abdominal, Limited | $728 | 38% | $437 |
Medium |
| Ultrasound - Breast (outpatient) | $771 | 38% | $462 |
High |
| Ultrasound - Head and Neck | $720 | 38% | $432 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $814 | 38% | $488 |
Medium |
| Ultrasound - Pregnancy Follow-Up | $515 | 38% | $309 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $862 | 38% | $517 |
High |
| Upper Gastrointestinal Endoscopy - Diagnostic | $7,330 | 38% | $4,398 |
Medium |
| Upper Gastrointestinal Endoscopy - With Biopsy | $8,784 | 38% | $5,271 |
High |
| Urine Capacity Measurement | $289 | 38% | $173 |
Medium |
| Urine Test - Automated with Microscope Examination | $6 | 38% | $4 |
Medium |
| Urine Test - Automated without Microscope | $3 | 38% | $2 |
Medium |
| Urine Test - Bacterial Culture | $13 | 38% | $8 |
Medium |
| Urine Test - Chlamydia | $48 | 38% | $29 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $49 | 38% | $30 |
Medium |
| Urine Test - Pregnancy | $13 | 38% | $8 |
Medium |
| X-Ray - Abdomen | $404 | 38% | $243 |
Medium |
| X-Ray - Ankle (outpatient) | $355 | 38% | $213 |
High |
| X-Ray - Chest (outpatient) | $376 | 38% | $226 |
Medium |
| X-Ray - Foot (outpatient) | $354 | 38% | $212 |
Medium |
| X-Ray - Hand | $408 | 38% | $245 |
Medium |
| X-Ray - Hip | $366 | 38% | $220 |
Medium |
| X-Ray - Knee (outpatient) | $405 | 38% | $243 |
Medium |
| X-Ray - Middle Back, Thoracic Spine | $358 | 38% | $215 |
High |
| X-Ray - Neck, Cervical Spine | $440 | 38% | $264 |
Medium |
| X-Ray - Pelvis | $410 | 38% | $246 |
Medium |
| X-Ray - Shoulder (outpatient) | $411 | 38% | $246 |
Medium |
| X-Ray - Spine (outpatient) | $454 | 38% | $272 |
Medium |
| X-Ray - Wrist (outpatient) | $352 | 38% | $211 |
Medium |
