| Arthrocentesis (outpatient) | $713 | N/A | $456 |
| Bacterial Culture - Aerobic Isolates | $54 | N/A | $34 |
| Bacterial Culture - Swab | $177 | N/A | $114 |
| Biopsy - Punch Biopsy of Skin | $665 | N/A | $425 |
| Biopsy - Tangential Biopsy of Skin | $478 | N/A | $306 |
| Blood Test - Basic Metabolic Panel | $105 | N/A | $67 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $57 | N/A | $36 |
| Blood Test - Blood Typing (ABO) | $56 | N/A | $36 |
| Blood Test - Blood Typing (Rh (D)) | $52 | N/A | $33 |
| Blood Test - C-reactive Protein (CRP) Level | $114 | N/A | $73 |
| Blood Test - Cholesterol Test, Lipid Panel | $156 | N/A | $100 |
| Blood Test - Clotting Time | $60 | N/A | $38 |
| Blood Test - Coagulation Assessment | $61 | N/A | $39 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $41 | N/A | $26 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $91 | N/A | $58 |
| Blood Test - Comprehensive Metabolic Panel | $149 | N/A | $95 |
| Blood Test - Creatinine Level | $98 | N/A | $62 |
| Blood Test - Electrolytes Panel | $56 | N/A | $36 |
| Blood Test - Ferritin (Blood Protein) Level | $110 | N/A | $71 |
| Blood Test - Folic Acid Level | $135 | N/A | $87 |
| Blood Test - General Health Panel | $427 | N/A | $274 |
| Blood Test - Hepatic (Liver) Function Panel | $146 | N/A | $93 |
| Blood Test - Hepatitis B Surface Antibody Level | $77 | N/A | $49 |
| Blood Test - Hepatitis C Antibody Level | $202 | N/A | $129 |
| Blood Test - Iron Binding Capacity | $55 | N/A | $35 |
| Blood Test - LDL Cholesterol Level | $103 | N/A | $66 |
| Blood Test - Lead Level | $71 | N/A | $46 |
| Blood Test - Lipase (fat enzyme) Level | $68 | N/A | $44 |
| Blood Test - Magnesium Level | $96 | N/A | $61 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $156 | N/A | $100 |
| Blood Test - Renal (Kidney) Function Panel | $92 | N/A | $59 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $85 | N/A | $54 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $201 | N/A | $128 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $135 | N/A | $87 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $241 | N/A | $154 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $100 | N/A | $64 |
| Blood Test - Vitamin D-3 Level | $227 | N/A | $145 |
| Bone Density Scan (outpatient) | $690 | N/A | $442 |
| Colonoscopy - Diagnostic (outpatient) | $6,281 | N/A | $4,020 |
| Colonoscopy - With Biopsy (outpatient) | $6,616 | N/A | $4,234 |
| Colonoscopy - With Polyp Removal (outpatient) | $9,014 | N/A | $5,769 |
| CT Scan - Abdomen and Pelvis, with Contrast | $5,277 | N/A | $3,377 |
| CT Scan - Chest, with Contrast (outpatient) | $2,729 | N/A | $1,747 |
| Destruction of Lesion (outpatient) | $200 | N/A | $128 |
| Developmental Screening | $18 | N/A | $11 |
| Electrocardiogram (ECG or EKG), Tracing | $527 | N/A | $337 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $503 | N/A | $322 |
| Emergency Department Visit - Low Complexity (outpatient) | $413 | N/A | $264 |
| Emergency Department Visit - Minor (outpatient) | $231 | N/A | $148 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $624 | N/A | $399 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $55 | N/A | $35 |
| Fetal Non-Stress Test | $759 | N/A | $486 |
| Hydration Infusion | $139 | N/A | $89 |
| Lab Test - Creatinine Level | $111 | N/A | $71 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $51 | N/A | $33 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $163 | N/A | $104 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $120 | N/A | $77 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $316 | N/A | $202 |
| Lab Test - Smear for Microorganism | $49 | N/A | $32 |
| Mammogram (outpatient) | $794 | N/A | $508 |
| MRI - Back (outpatient) | $3,655 | N/A | $2,339 |
| MRI - Brain (outpatient) | $6,984 | N/A | $4,469 |
| MRI - Knee (outpatient) | $3,154 | N/A | $2,019 |
| MRI - Shoulder, Elbow, or Wrist | $3,212 | N/A | $2,056 |
| Myocardial Imaging (outpatient) | $6,887 | N/A | $4,408 |
| Office Visit - Basic | $87 | N/A | $56 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $210 | N/A | $134 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $234 | N/A | $150 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $227 | N/A | $145 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $264 | N/A | $169 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $208 | N/A | $133 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $195 | N/A | $125 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $184 | N/A | $118 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $200 | N/A | $128 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $204 | N/A | $130 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $217 | N/A | $139 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $182 | N/A | $116 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $171 | N/A | $110 |
| Office Visit - Established Patient, High Complexity | $259 | N/A | $166 |
| Office Visit - Established Patient, Low Complexity | $135 | N/A | $87 |
| Office Visit - Established Patient, Moderate Complexity | $198 | N/A | $127 |
| Office Visit - New Patient, Low Complexity | $186 | N/A | $119 |
| Office Visit - New Patient, Minor | $129 | N/A | $83 |
| Office Visit - New Patient, Moderate Complexity | $284 | N/A | $181 |
| Pap Test, automated screening and manual rescreening | $127 | N/A | $81 |
| Physical Therapy - Application of Blood Vessel Compression or Decompression Device | $88 | 
Below Average
State Average: 3 | $56 |
| Physical Therapy - High Complexity Evaluation | $379 | 
Near Average
State Average: 1 | $243 |
| Physical Therapy - Low Complexity Evaluation | $351 |
Near Average
State Average: 1 | $224 |
| Physical Therapy - Moderate Complexity Evaluation | $362 |
Near Average
State Average: 1 | $232 |
| Physical Therapy - Self-care or Home Management Training | $133 |
Near Average
State Average: 1 | $85 |
| Physical Therapy - Therapeutic Activities | $137 |
Below Average
State Average: 3 | $87 |
| Physical Therapy - Therapeutic Exercises | $147 | 
Above Average
State Average: 4 | $94 |
| Physical Therapy - Ultrasound Therapy | $81 |
Near Average
State Average: 3 | $52 |
| Psychiatric Diagnostic Evaluation | $269 |
Near Average
State Average: 1 | $172 |
| Psychotherapy - 30 Minutes | $112 |
Near Average
State Average: 1 | $72 |
| Psychotherapy - 45 Minutes | $150 |
Below Average
State Average: 4 | $96 |
| Psychotherapy - 60 Minutes | $194 |
Below Average
State Average: 5 | $124 |
| Psychotherapy - Family Session | $190 |
Below Average
State Average: 3 | $122 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $36 | N/A | $23 |
| Ultrasound - Abdominal, Complete | $1,410 | N/A | $902 |
| Ultrasound - Abdominal, Limited | $772 | N/A | $494 |
| Ultrasound - Breast (outpatient) | $1,190 | N/A | $761 |
| Ultrasound - Head and Neck | $1,033 | N/A | $661 |
| Ultrasound - Pelvic (outpatient) | $1,016 | N/A | $650 |
| Ultrasound - Pregnancy Follow-Up | $393 | N/A | $251 |
| Ultrasound - Transvaginal (non-maternity) | $1,332 | N/A | $853 |
| Urine Test - Automated with Microscope Examination | $46 | N/A | $30 |
| Urine Test - Automated without Microscope | $32 | N/A | $20 |
| Urine Test - Chlamydia | $175 | N/A | $112 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $175 | N/A | $112 |
| Urine Test - Pregnancy | $30 | N/A | $19 |
| Urine Test - Urinalysis, Manual Test | $20 | N/A | $13 |
| Vaccine - Influenza for Injection into Muscle | $29 | N/A | $19 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $317 | N/A | $203 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $79 | N/A | $51 |
| X-Ray - Abdomen | $712 | N/A | $456 |
| X-Ray - Ankle (outpatient) | $465 | N/A | $298 |
| X-Ray - Chest (outpatient) | $803 | N/A | $514 |
| X-Ray - Foot (outpatient) | $691 | N/A | $442 |
| X-Ray - Hand | $749 | N/A | $479 |
| X-Ray - Hip | $881 | N/A | $564 |
| X-Ray - Knee (outpatient) | $784 | N/A | $502 |
| X-Ray - Middle Back, Thoracic Spine | $753 | N/A | $482 |
| X-Ray - Pelvis | $865 | N/A | $553 |
| X-Ray - Shoulder (outpatient) | $920 | N/A | $589 |
| X-Ray - Spine (outpatient) | $575 | N/A | $368 |
| X-Ray - Wrist (outpatient) | $566 | N/A | $362 |
