| Arthrocentesis (outpatient) | $641 | 42% | $397 | 
Medium |
| Arthroscopic Knee Surgery (outpatient) | $12,729 | 42% | $7,892 | 
Low |
| Biopsy - Skin Lesion | $1,340 | 42% | $831 |
Medium |
| Blood Test - Basic Metabolic Panel | $66 | 42% | $41 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | 42% | $56 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | 42% | $73 |
Medium |
| Blood Test - Clotting Time | $53 | 42% | $33 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | 42% | $38 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | 42% | $41 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $88 | 42% | $55 |
Medium |
| Blood Test - Electrolytes Panel | $53 | 42% | $33 |
Medium |
| Blood Test - General Health Panel | $310 | 42% | $192 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $60 | 42% | $37 |
Medium |
| Blood Test - Pregnancy (Obstetric) Panel | $366 | 42% | $227 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $124 | 42% | $77 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $60 | 42% | $37 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | 42% | $94 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $131 | 42% | $81 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $130 | 42% | $81 |
Medium |
| Blood Test - Vitamin D-3 Level | $306 | 42% | $189 |
Medium |
| Bone Density Scan (outpatient) | $586 | 42% | $363 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $3,324 | 42% | $2,061 | 
High |
| Colonoscopy - With Biopsy (outpatient) | $4,431 | 42% | $2,747 |
Medium |
| Colonoscopy - With Polyp Removal (outpatient) | $5,470 | 42% | $3,391 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $4,440 | 42% | $2,753 |
High |
| CT Scan - Chest, with Contrast (outpatient) | $2,569 | 42% | $1,593 |
Medium |
| Destruction of Lesion (outpatient) | $584 | 42% | $362 |
Medium |
| Destruction of Lesions, up to 14 | $392 | 42% | $243 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $336 | 42% | $208 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $243 | 42% | $150 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $488 | 42% | $303 |
Medium |
| Fetal Non-Stress Test | $446 | 42% | $277 |
Medium |
| Gall Bladder Surgery (outpatient) | $19,088 | 42% | $11,835 |
Medium |
| Laryngoscopy - Diagnostic | $488 | 42% | $303 |
Medium |
| Mammogram (outpatient) | $532 | 42% | $330 |
Medium |
| MRI - Back (outpatient) | $3,516 | 42% | $2,180 |
Medium |
| MRI - Brain (outpatient) | $5,674 | 42% | $3,518 |
Medium |
| MRI - Knee (outpatient) | $3,351 | 42% | $2,077 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $3,368 | 42% | $2,088 |
Medium |
| Myocardial Imaging (outpatient) | $6,459 | 42% | $4,004 |
Medium |
| Office Visit - Basic | $76 | 42% | $47 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $263 | 42% | $163 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $282 | 42% | $175 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $266 | 42% | $165 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $289 | 42% | $179 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $261 | 42% | $162 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $205 | 42% | $127 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $225 | 42% | $139 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $245 | 42% | $152 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $246 | 42% | $152 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $237 | 42% | $147 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $226 | 42% | $140 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $206 | 42% | $128 |
Medium |
| Office Visit - Established Patient, High Complexity | $343 | 42% | $213 |
Medium |
| Office Visit - Established Patient, Low Complexity | $169 | 42% | $105 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $216 | 42% | $134 |
Medium |
| Office Visit - New Patient, Low Complexity | $209 | 42% | $130 |
Medium |
| Office Visit - New Patient, Minor | $133 | 42% | $83 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $84 | 42% | $52 |
Medium |
| Physical Therapy - High Complexity Evaluation | $467 | 42% | $290 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $312 | 42% | $193 |
Medium |
| Physical Therapy - Manual Therapy | $149 | 42% | $92 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $390 | 42% | $242 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $102 | 42% | $63 |
Medium |
| Physical Therapy - Therapeutic Activities | $134 | 42% | $83 |
Medium |
| Physical Therapy - Therapeutic Exercises | $161 | 42% | $100 |
Medium |
| Physical Therapy - Ultrasound Therapy | $75 | 42% | $46 |
Medium |
| Strep Test (Streptococcus, group A) | $42 | 42% | $26 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $88 | 42% | $55 |
Medium |
| Ultrasound - Abdominal, Complete | $1,062 | 42% | $658 |
Medium |
| Ultrasound - Abdominal, Limited | $660 | 42% | $409 |
Medium |
| Ultrasound - Breast (outpatient) | $631 | 42% | $391 |
Medium |
| Ultrasound - Head and Neck | $855 | 42% | $530 |
High |
| Ultrasound - Pelvic (outpatient) | $891 | 42% | $553 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $1,034 | 42% | $641 |
Medium |
| Ultrasound - Pregnancy Follow-Up | $677 | 42% | $420 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $903 | 42% | $560 |
Medium |
| Urine Capacity Measurement | $289 | 42% | $179 |
Medium |
| Urine Test - Automated with Microscope Examination | $47 | 42% | $29 |
Medium |
| Urine Test - Automated without Microscope | $37 | 42% | $23 |
Medium |
| Urine Test - Bacterial Culture | $69 | 42% | $43 |
Medium |
| Urine Test - Chlamydia | $195 | 42% | $121 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $195 | 42% | $121 |
Medium |
| Urine Test - Pregnancy | $22 | 42% | $14 |
Medium |
| X-Ray - Abdomen | $551 | 42% | $342 |
High |
| X-Ray - Ankle (outpatient) | $518 | 42% | $321 |
Medium |
| X-Ray - Chest (outpatient) | $575 | 42% | $357 |
Medium |
| X-Ray - Foot (outpatient) | $481 | 42% | $298 |
Medium |
| X-Ray - Hand | $518 | 42% | $321 |
Medium |
| X-Ray - Hip | $521 | 42% | $323 |
Medium |
| X-Ray - Knee (outpatient) | $674 | 42% | $418 |
Medium |
| X-Ray - Neck, Cervical Spine | $676 | 42% | $419 |
Medium |
| X-Ray - Shoulder (outpatient) | $515 | 42% | $319 |
Medium |
| X-Ray - Spine (outpatient) | $688 | 42% | $426 |
Medium |
| X-Ray - Wrist (outpatient) | $599 | 42% | $371 |
Medium |
