| Arthrocentesis (outpatient) | $524 | 33% | $351 | 
Medium |
| Bacterial Culture Swab | $81 | 33% | $54 |
Medium |
| Blood Test - Basic Metabolic Panel | $85 | 33% | $57 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $91 | 33% | $61 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $137 | 33% | $91 |
Medium |
| Blood Test - Clotting Time | $42 | 33% | $28 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $65 | 33% | $44 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $77 | 33% | $51 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $108 | 33% | $72 |
Medium |
| Blood Test - Electrolytes Panel | $71 | 33% | $48 |
Medium |
| Blood Test - Folic Acid Level | $149 | 33% | $100 |
Medium |
| Blood Test - General Health Panel | $351 | 33% | $235 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $83 | 33% | $56 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $134 | 33% | $90 |
Medium |
| Blood Test - LDL Cholesterol Level | $92 | 33% | $62 |
Medium |
| Blood Test - Lipase (fat enzyme) Level | $70 | 33% | $47 |
Medium |
| Blood Test - Pregnancy (Obstetric) Panel | $508 | 33% | $340 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $145 | 33% | $97 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $88 | 33% | $59 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $169 | 33% | $113 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $90 | 33% | $61 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $122 | 33% | $82 |
Medium |
| Blood Test - Vitamin D-3 Level | $237 | 33% | $159 |
Medium |
| Bone Density Scan (outpatient) | $891 | 33% | $597 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $3,981 | 33% | $2,668 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $5,471 | 33% | $3,666 |
Medium |
| Colonoscopy - With Polyp Removal (outpatient) | $5,711 | 33% | $3,827 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,245 | 33% | $1,504 |
Medium |
| CT Scan - Chest, with Contrast (outpatient) | $2,732 | 33% | $1,831 |
Medium |
| Destruction of Lesion (outpatient) | $471 | 33% | $316 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $228 | 33% | $153 |
Medium |
| Electrocardiogram (ECG or EKG) | $331 | 33% | $222 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $210 | 33% | $141 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $122 | 33% | $82 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $287 | 33% | $192 |
Medium |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $86 | 33% | $58 |
Medium |
| Fetal Non-Stress Test | $422 | 33% | $283 |
Medium |
| Gall Bladder Surgery (outpatient) | $14,008 | 33% | $9,386 |
Medium |
| Mammogram (outpatient) | $1,130 | 33% | $757 |
Medium |
| MRI - Back (outpatient) | $3,954 | 33% | $2,649 |
Medium |
| MRI - Brain (outpatient) | $7,723 | 33% | $5,174 |
Medium |
| MRI - Knee (outpatient) | $3,228 | 33% | $2,163 |
Medium |
| MRI - Pelvis (outpatient) | $7,625 | 33% | $5,109 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $3,198 | 33% | $2,143 | 
High |
| Myocardial Imaging (outpatient) | $4,648 | 33% | $3,114 |
Medium |
| Office Visit - Basic | $97 | 33% | $65 |
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 Reevaluation and Management, 1-4 Years Old | $236 | 33% | $158 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $258 | 33% | $173 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $258 | 33% | $173 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $277 | 33% | $186 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $236 | 33% | $158 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $222 | 33% | $148 |
Medium |
| Office Visit - Established Patient, High Complexity | $276 | 33% | $185 |
Medium |
| Office Visit - Established Patient, Low Complexity | $140 | 33% | $94 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $205 | 33% | $137 |
Medium |
| Office Visit - New Patient, Low Complexity | $210 | 33% | $141 |
Medium |
| Office Visit - New Patient, Minor | $168 | 33% | $113 |
Medium |
| Physical Therapy - Application of Blood Vessel Compression or Decompression Device | $43 | 33% | $29 |
Medium |
| Physical Therapy - Application of Mechanical Traction | $43 | 33% | $29 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $42 | 33% | $28 |
Medium |
| Physical Therapy - High Complexity Evaluation | $257 | 33% | $172 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $257 | 33% | $172 |
Medium |
| Physical Therapy - Manual Therapy | $78 | 33% | $52 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $257 | 33% | $172 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $84 | 33% | $56 |
Medium |
| Physical Therapy - Re-Evaluation | $111 | 33% | $75 |
Medium |
| Physical Therapy - Self-care or Home Management Training | $86 | 33% | $58 |
Medium |
| Physical Therapy - Therapeutic Activities | $87 | 33% | $58 |
Medium |
| Physical Therapy - Therapeutic Exercises | $82 | 33% | $55 |
Medium |
| Physical Therapy - Ultrasound Therapy | $36 | 33% | $24 |
Medium |
| Strep Test (Streptococcus, group A) | $42 | 33% | $28 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $54 | 33% | $36 |
Medium |
| Ultrasound - Abdominal, Complete | $1,088 | 33% | $729 |
High |
| Ultrasound - Abdominal, Limited | $780 | 33% | $523 |
Medium |
| Ultrasound - Breast (outpatient) | $1,460 | 33% | $978 |
Medium |
| Ultrasound - Head and Neck | $767 | 33% | $514 |
Medium |
| Ultrasound - Pelvic (outpatient) | $879 | 33% | $589 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $887 | 33% | $594 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $1,175 | 33% | $787 |
Medium |
| Urine Capacity Measurement | $197 | 33% | $132 |
Medium |
| Urine Test - Automated with Microscope Examination | $33 | 33% | $22 |
Medium |
| Urine Test - Automated without Microscope | $19 | 33% | $13 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $64 | 33% | $43 |
Medium |
| Urine Test - Chlamydia | $247 | 33% | $165 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $247 | 33% | $165 |
Medium |
| Urine Test - Pregnancy | $60 | 33% | $40 |
Medium |
| X-Ray - Abdomen | $328 | 33% | $219 |
Medium |
| X-Ray - Ankle (outpatient) | $379 | 33% | $254 |
Medium |
| X-Ray - Chest (outpatient) | $498 | 33% | $334 |
High |
| X-Ray - Foot (outpatient) | $470 | 33% | $315 |
Medium |
| X-Ray - Hand | $474 | 33% | $317 |
Medium |
| X-Ray - Hip | $426 | 33% | $285 |
Medium |
| X-Ray - Knee (outpatient) | $483 | 33% | $324 |
Medium |
| X-Ray - Middle Back, Thoracic Spine | $481 | 33% | $322 |
Medium |
| X-Ray - Neck, Cervical Spine | $461 | 33% | $309 |
Medium |
| X-Ray - Shoulder (outpatient) | $445 | 33% | $298 |
High |
| X-Ray - Spine (outpatient) | $462 | 33% | $310 |
Medium |
| X-Ray - Wrist (outpatient) | $420 | 33% | $281 |
Medium |
