| Arthrocentesis (outpatient) | $891 | N/A | $891 |
| Blood Test - Clotting Time | $7 | N/A | $7 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $88 | N/A | $88 |
| Lab Test - Detection test for Influenza Virus | $84 | N/A | $84 |
| MRI - Back (outpatient) | $2,828 | N/A | $2,828 |
| MRI - Knee (outpatient) | $2,115 | N/A | $2,115 |
| MRI - Shoulder, Elbow, or Wrist | $2,264 | N/A | $2,264 |
| Office Visit - Basic | $143 | N/A | $143 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $232 | N/A | $232 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $270 | N/A | $270 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $213 | N/A | $213 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $227 | N/A | $227 |
| Office Visit - Established Patient, High Complexity | $252 | N/A | $252 |
| Office Visit - Established Patient, Low Complexity | $186 | N/A | $186 |
| Office Visit - Established Patient, Moderate Complexity | $219 | N/A | $219 |
| Office Visit - New Patient, Low Complexity | $300 | N/A | $300 |
| Office Visit - New Patient, Minor | $230 | N/A | $230 |
| Physical Therapy - Electrical Stimulation Therapy | $83 | 
Below Average
State Average: 3 | $83 |
| Physical Therapy - High Complexity Evaluation | $285 | 
Near Average
State Average: 1 | $285 |
| Physical Therapy - Manual Therapy | $87 |
Below Average
State Average: 4 | $87 |
| Physical Therapy - Moderate Complexity Evaluation | $285 |
Near Average
State Average: 1 | $285 |
| Physical Therapy - Neuromuscular Reeducation | $89 |
Below Average
State Average: 4 | $89 |
| Physical Therapy - Re-Evaluation | $142 |
Near Average
State Average: 1 | $142 |
| Physical Therapy - Self-care or Home Management Training | $92 | 
Above Average
State Average: 1 | $92 |
| Physical Therapy - Therapeutic Activities | $92 |
Above Average
State Average: 3 | $92 |
| Physical Therapy - Therapeutic Exercises | $87 |
Near Average
State Average: 4 | $87 |
| Physical Therapy - Ultrasound Therapy | $77 |
Below Average
State Average: 3 | $77 |
| Urine Test - Urinalysis, Manual Test | $29 | N/A | $29 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $197 | N/A | $197 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $69 | N/A | $69 |
| X-Ray - Ankle (outpatient) | $400 | N/A | $400 |
| X-Ray - Foot (outpatient) | $397 | N/A | $397 |
| X-Ray - Hand | $506 | N/A | $506 |
| X-Ray - Hip | $455 | N/A | $455 |
| X-Ray - Knee (outpatient) | $505 | N/A | $505 |
| X-Ray - Middle Back, Thoracic Spine | $686 | N/A | $686 |
| X-Ray - Neck, Cervical Spine | $401 | N/A | $401 |
| X-Ray - Pelvis | $477 | N/A | $477 |
| X-Ray - Shoulder (outpatient) | $476 | N/A | $476 |
| X-Ray - Spine (outpatient) | $502 | N/A | $502 |
| X-Ray - Wrist (outpatient) | $389 | N/A | $389 |
