| Arthrocentesis (outpatient) | $460 | 38% | $285 | 
Medium |
| Arthroscopic Knee Surgery (outpatient) | $14,249 | 38% | $8,835 |
Medium |
| Bacterial Culture Swab | $17 | 38% | $10 |
Medium |
| Biopsy - Endometrial (Uterus) | $785 | 38% | $487 |
Medium |
| Blood Test - Basic Metabolic Panel | $16 | 38% | $10 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $19 | 38% | $12 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $26 | 38% | $16 |
Medium |
| Blood Test - Clotting Time | $7 | 38% | $5 |
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 - Folic Acid Level | $28 | 38% | $18 |
Medium |
| Blood Test - General Health Panel | $67 | 38% | $42 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $16 | 38% | $10 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $25 | 38% | $16 |
Medium |
| Blood Test - Lipase (fat enzyme) Level | $14 | 38% | $8 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $28 | 38% | $18 |
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% | $35 |
Medium |
| Bone Density Scan (outpatient) | $743 | 38% | $461 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $7,903 | 38% | $4,900 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $9,235 | 38% | $5,726 |
Medium |
| Colonoscopy - With Polyp Removal (outpatient) | $10,076 | 38% | $6,247 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,057 | 38% | $1,276 |
Medium |
| CT Scan - Chest, with Contrast (outpatient) | $2,459 | 38% | $1,525 |
Medium |
| Cystoscopy | $6,296 | 38% | $3,903 |
Medium |
| Destruction of Lesion (outpatient) | $356 | 38% | $221 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $59 | 38% | $36 |
Medium |
| Electrocardiogram (ECG or EKG) | $431 | 38% | $267 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $716 | 38% | $444 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $426 | 38% | $264 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $1,838 | 38% | $1,139 |
Medium |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $17 | 38% | $10 |
Medium |
| Fetal Non-Stress Test | $529 | 38% | $328 | 
High |
| Hernia Repair - Laparoscopic (outpatient) | $20,207 | 38% | $12,528 |
Medium |
| Laryngoscopy - Diagnostic | $585 | 38% | $363 |
High |
| Mammogram (outpatient) | $761 | 38% | $472 |
Medium |
| MRI - Back (outpatient) | $2,844 | 38% | $1,764 |
Medium |
| MRI - Brain (outpatient) | $4,509 | 38% | $2,795 |
Medium |
| MRI - Knee (outpatient) | $2,856 | 38% | $1,771 |
Medium |
| MRI - Pelvis (outpatient) | $4,476 | 38% | $2,775 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $2,844 | 38% | $1,764 |
Medium |
| Myocardial Imaging (outpatient) | $9,272 | 38% | $5,748 |
Medium |
| Nasal Endoscopy - Diagnostic | $699 | 38% | $433 |
Medium |
| Office Visit - Basic | $97 | 38% | $60 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $328 | 38% | $203 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $258 | 38% | $160 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $251 | 38% | $156 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $290 | 38% | $180 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $284 | 38% | $176 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $211 | 38% | $131 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $203 | 38% | $126 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | 38% | $137 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $225 | 38% | $139 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $240 | 38% | $149 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $202 | 38% | $125 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $190 | 38% | $118 |
Medium |
| Office Visit - Established Patient, High Complexity | $317 | 38% | $197 |
Medium |
| Office Visit - Established Patient, Low Complexity | $160 | 38% | $99 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $235 | 38% | $146 |
Medium |
| Office Visit - New Patient, Low Complexity | $236 | 38% | $146 |
Medium |
| Office Visit - New Patient, Minor | $149 | 38% | $93 |
Medium |
| Pap Test | $175 | 38% | $109 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $36 | 38% | $22 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $378 | 38% | $234 |
Medium |
| Physical Therapy - Manual Therapy | $90 | 38% | $56 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $378 | 38% | $234 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $90 | 38% | $56 |
Medium |
| Physical Therapy - Re-Evaluation | $202 | 38% | $125 |
Medium |
| Physical Therapy - Therapeutic Activities | $90 | 38% | $56 |
Medium |
| Physical Therapy - Therapeutic Exercises | $90 | 38% | $56 |
Medium |
| Physical Therapy - Ultrasound Therapy | $90 | 38% | $56 |
Medium |
| Strep Test (Streptococcus, group A) | $22 | 38% | $14 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $12 | 38% | $7 |
Medium |
| Tonsillectomy with Adenoidectomy (outpatient) | $12,463 | 38% | $7,727 |
Medium |
| Ultrasound - Abdominal, Complete | $775 | 38% | $480 |
Medium |
| Ultrasound - Abdominal, Limited | $728 | 38% | $451 |
Medium |
| Ultrasound - Breast (outpatient) | $868 | 38% | $538 |
High |
| Ultrasound - Head and Neck | $720 | 38% | $447 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $814 | 38% | $505 |
Medium |
| Ultrasound - Pregnancy Follow-Up | $515 | 38% | $319 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $748 | 38% | $464 |
Medium |
| Upper Gastrointestinal Endoscopy - Diagnostic | $7,627 | 38% | $4,729 |
Medium |
| Upper Gastrointestinal Endoscopy - With Biopsy | $9,267 | 38% | $5,745 |
Medium |
| Urine Capacity Measurement | $286 | 38% | $177 |
High |
| Urine Test - Automated with Microscope Examination | $6 | 38% | $4 |
Medium |
| Urine Test - Automated without Microscope | $3 | 38% | $2 |
Medium |
| Urine Test - Bacterial Culture | $8 | 38% | $5 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $13 | 38% | $8 |
Medium |
| Urine Test - Chlamydia | $48 | 38% | $30 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $49 | 38% | $31 |
Medium |
| Urine Test - Pregnancy | $13 | 38% | $8 |
Medium |
| X-Ray - Abdomen | $373 | 38% | $231 |
Medium |
| X-Ray - Ankle (outpatient) | $341 | 38% | $212 |
Medium |
| X-Ray - Chest (outpatient) | $354 | 38% | $219 |
Medium |
| X-Ray - Foot (outpatient) | $354 | 38% | $219 |
Medium |
| X-Ray - Hand | $393 | 38% | $243 |
High |
| X-Ray - Hip | $366 | 38% | $227 |
Medium |
| X-Ray - Knee (outpatient) | $428 | 38% | $266 |
Medium |
| X-Ray - Middle Back, Thoracic Spine | $315 | 38% | $195 |
Medium |
| X-Ray - Neck, Cervical Spine | $440 | 38% | $273 |
Medium |
| X-Ray - Pelvis | $410 | 38% | $254 |
High |
| X-Ray - Shoulder (outpatient) | $419 | 38% | $260 |
Medium |
| X-Ray - Spine (outpatient) | $477 | 38% | $296 |
Medium |
| X-Ray - Wrist (outpatient) | $364 | 38% | $226 |
Medium |
