| Arthrocentesis (outpatient) | $511 | N/A | $342 |
| Bacterial Culture - Aerobic Isolates | $82 | N/A | $55 |
| Bacterial Culture - Swab | $61 | N/A | $41 |
| Biopsy - Punch Biopsy of Skin | $1,095 | N/A | $733 |
| Blood Test - Basic Metabolic Panel | $89 | N/A | $60 |
| Blood Test - Blood Glucose (Sugar) Level | $40 | N/A | $27 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $104 | N/A | $69 |
| Blood Test - Blood Typing (ABO) | $32 | N/A | $21 |
| Blood Test - Blood Typing (Rh (D)) | $32 | N/A | $21 |
| Blood Test - C-reactive Protein (CRP) Level | $55 | N/A | $37 |
| Blood Test - Cholesterol Test, Lipid Panel | $143 | N/A | $96 |
| Blood Test - Clotting Time | $45 | N/A | $30 |
| Blood Test - Coagulation Assessment | $61 | N/A | $41 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $68 | N/A | $46 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $80 | N/A | $54 |
| Blood Test - Comprehensive Metabolic Panel | $114 | N/A | $76 |
| Blood Test - Creatinine Level | $53 | N/A | $35 |
| Blood Test - Ferritin (Blood Protein) Level | $144 | N/A | $97 |
| Blood Test - Folic Acid Level | $157 | N/A | $105 |
| Blood Test - General Health Panel | $372 | N/A | $249 |
| Blood Test - Hepatic (Liver) Function Panel | $83 | N/A | $56 |
| Blood Test - Hepatitis B Surface Antibody Level | $159 | N/A | $106 |
| Blood Test - Hepatitis C Antibody Level | $141 | N/A | $95 |
| Blood Test - Iron Binding Capacity | $31 | N/A | $21 |
| Blood Test - Iron Level | $68 | N/A | $46 |
| Blood Test - LDL Cholesterol Level | $105 | N/A | $70 |
| Blood Test - Lead Level | $123 | N/A | $82 |
| Blood Test - Lipase (fat enzyme) Level | $74 | N/A | $49 |
| Blood Test - Magnesium Level | $67 | N/A | $45 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $147 | N/A | $98 |
| Blood Test - Renal (Kidney) Function Panel | $90 | N/A | $61 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $142 | N/A | $95 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $178 | N/A | $119 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $97 | N/A | $65 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $179 | N/A | $120 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $128 | N/A | $86 |
| Blood Test - Vitamin D-3 Level | $249 | N/A | $167 |
| Bone Density Scan (outpatient) | $835 | N/A | $559 |
| Colonoscopy - Diagnostic (outpatient) | $4,373 | N/A | $2,930 |
| Colonoscopy - With Biopsy (outpatient) | $5,035 | N/A | $3,373 |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,223 | N/A | $1,489 |
| CT Scan - Chest, with Contrast (outpatient) | $2,326 | N/A | $1,558 |
| Destruction of Lesion (outpatient) | $482 | N/A | $323 |
| Electrocardiogram (ECG or EKG), Tracing | $266 | N/A | $178 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $402 | N/A | $269 |
| Emergency Department Visit - Low Complexity (outpatient) | $221 | N/A | $148 |
| Emergency Department Visit - Minor (outpatient) | $165 | N/A | $111 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $441 | N/A | $295 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $88 | N/A | $59 |
| Fetal Non-Stress Test | $422 | N/A | $283 |
| Hydration Infusion | $83 | N/A | $55 |
| Lab Test - Creatinine Level | $55 | N/A | $37 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $28 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $369 | N/A | $247 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $111 | N/A | $75 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $194 | N/A | $130 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $239 | N/A | $160 |
| Lab Test - Detection test for Influenza Virus | $41 | N/A | $27 |
| Lab Test - Smear for Microorganism | $43 | N/A | $29 |
| Mammogram (outpatient) | $1,311 | N/A | $878 |
| MRI - Back (outpatient) | $3,739 | N/A | $2,505 |
| MRI - Brain (outpatient) | $7,521 | N/A | $5,039 |
| MRI - Knee (outpatient) | $3,265 | N/A | $2,187 |
| MRI - Shoulder, Elbow, or Wrist | $3,265 | N/A | $2,187 |
| Myocardial Imaging (outpatient) | $4,370 | N/A | $2,928 |
| Office Visit - Basic | $97 | N/A | $65 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $303 | N/A | $203 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $285 | N/A | $191 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $323 | N/A | $217 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $268 | N/A | $179 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $247 | N/A | $165 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $237 | N/A | $159 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $252 | N/A | $169 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $264 | N/A | $177 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $281 | N/A | $189 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $236 | N/A | $158 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $222 | N/A | $148 |
| Office Visit - Established Patient, High Complexity | $476 | N/A | $319 |
| Office Visit - Established Patient, Low Complexity | $140 | N/A | $94 |
| Office Visit - Established Patient, Moderate Complexity | $205 | N/A | $137 |
| Office Visit - New Patient, Low Complexity | $217 | N/A | $146 |
| Office Visit - New Patient, Minor | $161 | N/A | $108 |
| Office Visit - New Patient, Moderate Complexity | $343 | N/A | $230 |
| Pap Test, manual screening | $58 | N/A | $39 |
| Physical Therapy - Application of Mechanical Traction | $43 | 
Above Average
State Average: 3 | $29 |
| Physical Therapy - High Complexity Evaluation | $257 | 
Near Average
State Average: 1 | $172 |
| Physical Therapy - Low Complexity Evaluation | $257 |
Near Average
State Average: 1 | $172 |
| Physical Therapy - Manual Therapy | $78 | 
Below Average
State Average: 4 | $52 |
| Physical Therapy - Moderate Complexity Evaluation | $257 |
Near Average
State Average: 1 | $172 |
| Physical Therapy - Neuromuscular Reeducation | $85 |
Below Average
State Average: 4 | $57 |
| Physical Therapy - Self-care or Home Management Training | $88 |
Above Average
State Average: 1 | $59 |
| Physical Therapy - Therapeutic Activities | $87 |
Below Average
State Average: 3 | $58 |
| Physical Therapy - Therapeutic Exercises | $82 |
Below Average
State Average: 4 | $55 |
| Physical Therapy - Ultrasound Therapy | $37 |
Below Average
State Average: 3 | $25 |
| Ultrasound - Abdominal, Complete | $986 | N/A | $660 |
| Ultrasound - Abdominal, Limited | $693 | N/A | $464 |
| Ultrasound - Breast (outpatient) | $1,685 | N/A | $1,129 |
| Ultrasound - Head and Neck | $723 | N/A | $485 |
| Ultrasound - Pelvic (outpatient) | $760 | N/A | $509 |
| Ultrasound - Pregnancy (outpatient) | $1,104 | N/A | $740 |
| Ultrasound - Transvaginal (non-maternity) | $846 | N/A | $567 |
| Urine Capacity Measurement | $228 | N/A | $153 |
| Urine Test - Automated with Microscope Examination | $35 | N/A | $24 |
| Urine Test - Automated without Microscope | $20 | N/A | $13 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $68 | N/A | $46 |
| Urine Test - Chlamydia | $264 | N/A | $177 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $264 | N/A | $177 |
| Urine Test - Microalbumin (Protein) Level | $57 | N/A | $38 |
| Urine Test - Pregnancy | $27 | N/A | $18 |
| Urine Test - Urinalysis, Manual Test | $21 | N/A | $14 |
| Vaccine - Influenza for Injection into Muscle | $30 | N/A | $20 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $298 | N/A | $200 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $58 | N/A | $39 |
| X-Ray - Abdomen | $257 | N/A | $172 |
| X-Ray - Ankle (outpatient) | $379 | N/A | $254 |
| X-Ray - Chest (outpatient) | $488 | N/A | $327 |
| X-Ray - Foot (outpatient) | $513 | N/A | $344 |
| X-Ray - Hand | $262 | N/A | $176 |
| X-Ray - Hip | $422 | N/A | $283 |
| X-Ray - Knee (outpatient) | $453 | N/A | $304 |
| X-Ray - Middle Back, Thoracic Spine | $544 | N/A | $364 |
| X-Ray - Neck, Cervical Spine | $448 | N/A | $300 |
| X-Ray - Shoulder (outpatient) | $415 | N/A | $278 |
| X-Ray - Spine (outpatient) | $337 | N/A | $226 |
| X-Ray - Wrist (outpatient) | $262 | N/A | $176 |
