| Ambulance Service - Emergency Transport, Advanced Life Support | $1,183 | 0% | $1,183 | 
Medium |
| Ambulance Service - Emergency Transport, Basic Life Support | $996 | 0% | $996 |
Medium |
| Ambulance Service - Mileage Rate for Ambulance Transport | $18 | 0% | $18 |
Medium |
| Arthrocentesis (outpatient) | $508 | 0% | $508 |
Medium |
| Blood Test - Basic Metabolic Panel | $16 | 0% | $16 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $19 | 0% | $19 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $26 | 0% | $26 |
Medium |
| Blood Test - Clotting Time | $7 | 0% | $7 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $13 | 0% | $13 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $15 | 0% | $15 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $20 | 0% | $20 |
Medium |
| Blood Test - Electrolytes Panel | $14 | 0% | $14 |
Medium |
| Blood Test - General Health Panel | $67 | 0% | $67 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $16 | 0% | $16 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $28 | 0% | $28 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $17 | 0% | $17 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $33 | 0% | $33 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $17 | 0% | $17 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $23 | 0% | $23 |
Medium |
| Blood Test - Vitamin D-3 Level | $56 | 0% | $56 |
Medium |
| Laryngoscopy - Diagnostic | $592 | 0% | $592 |
Medium |
| Nasal Endoscopy - Diagnostic | $632 | 0% | $632 |
Medium |
| Office Visit - Basic | $147 | 0% | $147 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $219 | 0% | $219 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $258 | 0% | $258 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $251 | 0% | $251 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $290 | 0% | $290 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $229 | 0% | $229 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $211 | 0% | $211 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $203 | 0% | $203 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | 0% | $221 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $225 | 0% | $225 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $240 | 0% | $240 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $202 | 0% | $202 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $190 | 0% | $190 |
Medium |
| Office Visit - Established Patient, High Complexity | $289 | 0% | $289 |
Medium |
| Office Visit - Established Patient, Low Complexity | $173 | 0% | $173 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $204 | 0% | $204 |
Medium |
| Office Visit - New Patient, Low Complexity | $202 | 0% | $202 |
Medium |
| Office Visit - New Patient, Minor | $173 | 0% | $173 |
Medium |
| Strep Test (Streptococcus, group A) | $22 | 0% | $22 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $12 | 0% | $12 |
Medium |
| Urine Capacity Measurement | $379 | 0% | $379 |
Medium |
| Urine Test - Automated with Microscope Examination | $6 | 0% | $6 |
Medium |
| Urine Test - Automated without Microscope | $3 | 0% | $3 |
Medium |
| Urine Test - Bacterial Culture | $13 | 0% | $13 |
Medium |
| Urine Test - Chlamydia | $48 | 0% | $48 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $49 | 0% | $49 |
Medium |
| Urine Test - Pregnancy | $13 | 0% | $13 |
Medium |
| X-Ray - Ankle (outpatient) | $382 | 0% | $382 |
Medium |
| X-Ray - Chest (outpatient) | $434 | 0% | $434 |
Medium |
| X-Ray - Foot (outpatient) | $354 | 0% | $354 |
Medium |
| X-Ray - Hand | $401 | 0% | $401 | 
High |
| X-Ray - Hip | $331 | 0% | $331 |
High |
| X-Ray - Knee (outpatient) | $302 | 0% | $302 |
High |
| X-Ray - Pelvis | $511 | 0% | $511 |
Medium |
| X-Ray - Shoulder (outpatient) | $357 | 0% | $357 |
High |
| X-Ray - Spine (outpatient) | $452 | 0% | $452 |
High |
| X-Ray - Wrist (outpatient) | $378 | 0% | $378 |
High |
