| Arthrocentesis (outpatient) | $666 | N/A | $386 |
| Arthroscopic Knee Surgery (outpatient) | $14,814 | N/A | $8,592 |
| Bacterial Culture - Aerobic Isolates | $119 | N/A | $69 |
| Bacterial Culture - Swab | $130 | N/A | $76 |
| Biopsy - Punch Biopsy of Skin | $1,521 | N/A | $882 |
| Biopsy - Tangential Biopsy of Skin | $1,502 | N/A | $871 |
| Blood Test - Basic Metabolic Panel | $71 | N/A | $41 |
| Blood Test - Blood Glucose (Sugar) Level | $46 | N/A | $27 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | N/A | $52 |
| Blood Test - Blood Typing (ABO) | $60 | N/A | $35 |
| Blood Test - Blood Typing (Rh (D)) | $75 | N/A | $43 |
| Blood Test - C-reactive Protein (CRP) Level | $96 | N/A | $55 |
| Blood Test - Cholesterol Test, Lipid Panel | $127 | N/A | $74 |
| Blood Test - Clotting Time | $57 | N/A | $33 |
| Blood Test - Coagulation Assessment | $67 | N/A | $39 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $67 | N/A | $39 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $71 | N/A | $41 |
| Blood Test - Comprehensive Metabolic Panel | $96 | N/A | $55 |
| Blood Test - Creatinine Level | $48 | N/A | $28 |
| Blood Test - Electrolytes Panel | $53 | N/A | $30 |
| Blood Test - Ferritin (Blood Protein) Level | $139 | N/A | $80 |
| Blood Test - Folic Acid Level | $126 | N/A | $73 |
| Blood Test - General Health Panel | $318 | N/A | $185 |
| Blood Test - Hepatic (Liver) Function Panel | $60 | N/A | $35 |
| Blood Test - Hepatitis B Surface Antibody Level | $114 | N/A | $66 |
| Blood Test - Hepatitis C Antibody Level | $143 | N/A | $83 |
| Blood Test - Iron Level | $66 | N/A | $38 |
| Blood Test - LDL Cholesterol Level | $105 | N/A | $61 |
| Blood Test - Lead Level | $91 | N/A | $53 |
| Blood Test - Lipase (fat enzyme) Level | $64 | N/A | $37 |
| Blood Test - Magnesium Level | $64 | N/A | $37 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $131 | N/A | $76 |
| Blood Test - Renal (Kidney) Function Panel | $65 | N/A | $38 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $149 | N/A | $86 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | N/A | $88 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $131 | N/A | $76 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $247 | N/A | $143 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $130 | N/A | $76 |
| Blood Test - Vitamin D-3 Level | $306 | N/A | $177 |
| Bone Density Scan (outpatient) | $554 | N/A | $322 |
| Colonoscopy - Diagnostic (outpatient) | $3,763 | N/A | $2,183 |
| Colonoscopy - With Biopsy (outpatient) | $4,864 | N/A | $2,821 |
| Colonoscopy - With Polyp Removal (outpatient) | $4,943 | N/A | $2,867 |
| CT Scan - Abdomen and Pelvis, with Contrast | $4,454 | N/A | $2,583 |
| CT Scan - Chest, with Contrast (outpatient) | $2,518 | N/A | $1,460 |
| Destruction of Lesion (outpatient) | $666 | N/A | $386 |
| Destruction of Lesions, up to 14 | $429 | N/A | $249 |
| Developmental Screening | $16 | N/A | $9 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $314 | N/A | $182 |
| Emergency Department Visit - Low Complexity (outpatient) | $347 | N/A | $201 |
| Emergency Department Visit - Minor (outpatient) | $250 | N/A | $145 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $503 | N/A | $292 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | N/A | $60 |
| Fetal Non-Stress Test | $457 | N/A | $265 |
| Gall Bladder Surgery (outpatient) | $19,904 | N/A | $11,544 |
| Hydration Infusion | $104 | N/A | $60 |
| Lab Test - Creatinine Level | $54 | N/A | $31 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $24 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $158 | N/A | $91 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $106 | N/A | $62 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $200 | N/A | $116 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $152 | N/A | $88 |
| Lab Test - Detection test for Influenza Virus | $32 | N/A | $18 |
| Lab Test - Smear for Microorganism | $62 | N/A | $36 |
| Laryngoscopy - Diagnostic | $508 | N/A | $295 |
| Mammogram (outpatient) | $942 | N/A | $546 |
| MRI - Back (outpatient) | $3,373 | N/A | $1,956 |
| MRI - Brain (outpatient) | $5,222 | N/A | $3,029 |
| MRI - Knee (outpatient) | $3,520 | N/A | $2,041 |
| MRI - Shoulder, Elbow, or Wrist | $3,415 | N/A | $1,980 |
| Myocardial Imaging (outpatient) | $5,101 | N/A | $2,958 |
| Office Visit - Basic | $135 | N/A | $79 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $263 | N/A | $152 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $282 | N/A | $164 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $282 | N/A | $164 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $289 | N/A | $167 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $261 | N/A | $152 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $210 | N/A | $122 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $225 | N/A | $130 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $245 | N/A | $142 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $246 | N/A | $143 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $269 | N/A | $156 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $226 | N/A | $131 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $206 | N/A | $119 |
| Office Visit - Established Patient, High Complexity | $356 | N/A | $206 |
| Office Visit - Established Patient, Low Complexity | $169 | N/A | $98 |
| Office Visit - Established Patient, Moderate Complexity | $225 | N/A | $130 |
| Office Visit - New Patient, Low Complexity | $209 | N/A | $121 |
| Office Visit - New Patient, Moderate Complexity | $311 | N/A | $180 |
| Physical Therapy - High Complexity Evaluation | $471 | 
Near Average
State Average: 1 | $273 |
| Physical Therapy - Low Complexity Evaluation | $317 |
Near Average
State Average: 1 | $184 |
| Physical Therapy - Manual Therapy | $149 |
Near Average
State Average: 4 | $86 |
| Physical Therapy - Moderate Complexity Evaluation | $396 |
Near Average
State Average: 1 | $230 |
| Physical Therapy - Neuromuscular Reeducation | $102 | 
Below Average
State Average: 4 | $59 |
| Physical Therapy - Self-care or Home Management Training | $108 |
Near Average
State Average: 1 | $63 |
| Physical Therapy - Therapeutic Activities | $134 |
Below Average
State Average: 3 | $78 |
| Physical Therapy - Therapeutic Exercises | $161 |
Below Average
State Average: 4 | $93 |
| Physical Therapy - Ultrasound Therapy | $75 |
Near Average
State Average: 3 | $43 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $88 | N/A | $51 |
| Ultrasound - Abdominal, Complete | $1,093 | N/A | $634 |
| Ultrasound - Abdominal, Limited | $564 | N/A | $327 |
| Ultrasound - Breast (outpatient) | $859 | N/A | $498 |
| Ultrasound - Head and Neck | $880 | N/A | $510 |
| Ultrasound - Pelvic (outpatient) | $919 | N/A | $533 |
| Ultrasound - Pregnancy (outpatient) | $1,065 | N/A | $618 |
| Ultrasound - Pregnancy Follow-Up | $697 | N/A | $404 |
| Ultrasound - Transvaginal (non-maternity) | $792 | N/A | $459 |
| Urine Capacity Measurement | $383 | N/A | $222 |
| Urine Test - Automated with Microscope Examination | $51 | N/A | $30 |
| Urine Test - Automated without Microscope | $40 | N/A | $23 |
| Urine Test - Bacterial Culture | $63 | N/A | $37 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | N/A | $40 |
| Urine Test - Chlamydia | $247 | N/A | $143 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $247 | N/A | $143 |
| Urine Test - Microalbumin (Protein) Level | $86 | N/A | $50 |
| Urine Test - Pregnancy | $23 | N/A | $13 |
| Urine Test - Urinalysis, Manual Test | $11 | N/A | $6 |
| Vaccine - Influenza for Injection into Muscle | $24 | N/A | $14 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $84 | N/A | $49 |
| X-Ray - Abdomen | $428 | N/A | $248 |
| X-Ray - Ankle (outpatient) | $479 | N/A | $278 |
| X-Ray - Chest (outpatient) | $476 | N/A | $276 |
| X-Ray - Foot (outpatient) | $521 | N/A | $302 |
| X-Ray - Hand | $551 | N/A | $320 |
| X-Ray - Hip | $362 | N/A | $210 |
| X-Ray - Knee (outpatient) | $497 | N/A | $288 |
| X-Ray - Middle Back, Thoracic Spine | $552 | N/A | $320 |
| X-Ray - Shoulder (outpatient) | $511 | N/A | $297 |
| X-Ray - Spine (outpatient) | $698 | N/A | $405 |
| X-Ray - Wrist (outpatient) | $439 | N/A | $255 |
