| Arthrocentesis (outpatient) | $428 | 33% | $287 | 
Medium |
| Arthroscopic Knee Surgery (outpatient) | $10,905 | 33% | $7,306 | 
High |
| Blood Test - Basic Metabolic Panel | $80 | 33% | $53 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $91 | 33% | $61 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $127 | 33% | $85 |
Medium |
| Blood Test - Clotting Time | $37 | 33% | $25 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $61 | 33% | $41 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $74 | 33% | $49 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $101 | 33% | $68 |
Medium |
| Blood Test - Electrolytes Panel | $66 | 33% | $44 |
Medium |
| Blood Test - General Health Panel | $333 | 33% | $223 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $78 | 33% | $52 |
Medium |
| Blood Test - Pregnancy (Obstetric) Panel | $481 | 33% | $322 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $138 | 33% | $92 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $82 | 33% | $55 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $159 | 33% | $106 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $85 | 33% | $57 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $113 | 33% | $76 |
Medium |
| Blood Test - Vitamin D-3 Level | $223 | 33% | $149 |
Medium |
| Bone Density Scan (outpatient) | $854 | 33% | $572 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $3,818 | 33% | $2,558 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $5,152 | 33% | $3,452 |
Medium |
| Colonoscopy - With Polyp Removal (outpatient) | $5,185 | 33% | $3,474 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,342 | 33% | $1,569 |
Medium |
| CT Scan - Chest, with Contrast (outpatient) | $2,629 | 33% | $1,762 |
Medium |
| Destruction of Lesion (outpatient) | $362 | 33% | $243 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $183 | 33% | $122 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $116 | 33% | $77 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $273 | 33% | $183 |
Medium |
| Fetal Non-Stress Test | $547 | 33% | $367 |
Medium |
| Gall Bladder Surgery (outpatient) | $15,421 | 33% | $10,332 |
Medium |
| Mammogram (outpatient) | $1,077 | 33% | $722 |
Medium |
| MRI - Back (outpatient) | $3,789 | 33% | $2,539 |
Medium |
| MRI - Brain (outpatient) | $7,499 | 33% | $5,024 |
High |
| MRI - Knee (outpatient) | $3,091 | 33% | $2,071 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $3,062 | 33% | $2,051 |
Medium |
| Myocardial Imaging (outpatient) | $4,460 | 33% | $2,989 |
Medium |
| Office Visit - Basic | $92 | 33% | $62 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $245 | 33% | $164 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $289 | 33% | $193 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $282 | 33% | $189 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $330 | 33% | $221 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $235 | 33% | $158 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $226 | 33% | $151 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $246 | 33% | $165 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $251 | 33% | $168 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $268 | 33% | $179 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $225 | 33% | $151 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $211 | 33% | $141 |
Medium |
| Office Visit - Established Patient, High Complexity | $263 | 33% | $176 |
Medium |
| Office Visit - Established Patient, Low Complexity | $133 | 33% | $89 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $205 | 33% | $137 |
Medium |
| Office Visit - New Patient, Low Complexity | $244 | 33% | $163 |
Medium |
| Office Visit - New Patient, Minor | $168 | 33% | $113 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $39 | 33% | $26 |
Medium |
| Physical Therapy - High Complexity Evaluation | $240 | 33% | $161 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $240 | 33% | $161 |
Medium |
| Physical Therapy - Manual Therapy | $72 | 33% | $49 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $240 | 33% | $161 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $80 | 33% | $53 |
Medium |
| Physical Therapy - Re-Evaluation | $107 | 33% | $72 |
Medium |
| Physical Therapy - Therapeutic Activities | $83 | 33% | $56 |
Medium |
| Physical Therapy - Therapeutic Exercises | $77 | 33% | $51 |
Medium |
| Physical Therapy - Ultrasound Therapy | $33 | 33% | $22 |
Medium |
| Strep Test (Streptococcus, group A) | $39 | 33% | $26 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $54 | 33% | $36 |
Medium |
| Ultrasound - Abdominal, Complete | $1,048 | 33% | $702 |
High |
| Ultrasound - Abdominal, Limited | $752 | 33% | $504 |
Medium |
| Ultrasound - Breast (outpatient) | $1,306 | 33% | $875 |
High |
| Ultrasound - Head and Neck | $738 | 33% | $495 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $844 | 33% | $566 | 
Low |
| Ultrasound - Transvaginal (non-maternity) | $1,516 | 33% | $1,016 |
Medium |
| Urine Capacity Measurement | $205 | 33% | $137 |
Medium |
| Urine Test - Automated with Microscope Examination | $30 | 33% | $20 |
Medium |
| Urine Test - Automated without Microscope | $17 | 33% | $11 |
Medium |
| Urine Test - Bacterial Culture | $61 | 33% | $41 |
Medium |
| Urine Test - Pregnancy | $60 | 33% | $40 |
Medium |
| X-Ray - Abdomen | $407 | 33% | $273 |
Medium |
| X-Ray - Ankle (outpatient) | $405 | 33% | $272 |
Medium |
| X-Ray - Chest (outpatient) | $483 | 33% | $324 |
High |
| X-Ray - Foot (outpatient) | $465 | 33% | $312 |
Medium |
| X-Ray - Hand | $477 | 33% | $319 |
High |
| X-Ray - Hip | $465 | 33% | $312 |
Medium |
| X-Ray - Knee (outpatient) | $501 | 33% | $336 |
Medium |
| X-Ray - Neck, Cervical Spine | $461 | 33% | $309 |
Medium |
| X-Ray - Shoulder (outpatient) | $475 | 33% | $318 |
Medium |
| X-Ray - Spine (outpatient) | $540 | 33% | $362 |
Medium |
| X-Ray - Wrist (outpatient) | $420 | 33% | $281 |
Medium |
