| Arthrocentesis (outpatient) | $764 | 0% | $764 | 
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $141 | 0% | $141 |
Medium |
| MRI - Back (outpatient) | $2,828 | 0% | $2,828 |
Medium |
| MRI - Knee (outpatient) | $2,115 | 0% | $2,115 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $2,264 | 0% | $2,264 |
Medium |
| Office Visit - Basic | $65 | 0% | $65 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $232 | 0% | $232 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $213 | 0% | $213 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $215 | 0% | $215 |
Medium |
| Office Visit - Established Patient, High Complexity | $239 | 0% | $239 |
Medium |
| Office Visit - Established Patient, Low Complexity | $158 | 0% | $158 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $219 | 0% | $219 |
Medium |
| Physical Therapy - Electrical Stimulation Therapy | $84 | 0% | $84 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $274 | 0% | $274 |
Medium |
| Physical Therapy - Manual Therapy | $84 | 0% | $84 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $274 | 0% | $274 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $88 | 0% | $88 |
Medium |
| Physical Therapy - Re-Evaluation | $137 | 0% | $137 |
Medium |
| Physical Therapy - Self-care or Home Management Training | $80 | 0% | $80 |
Medium |
| Physical Therapy - Therapeutic Activities | $83 | 0% | $83 |
Medium |
| Physical Therapy - Therapeutic Exercises | $88 | 0% | $88 |
Medium |
| Physical Therapy - Ultrasound Therapy | $77 | 0% | $77 |
Medium |
| Strep Test (Streptococcus, group A) | $44 | 0% | $44 |
Medium |
| Urine Capacity Measurement | $376 | 0% | $376 |
Medium |
| Urine Test - Automated without Microscope | $19 | 0% | $19 |
Medium |
| Urine Test - Pregnancy | $29 | 0% | $29 |
Medium |
| X-Ray - Ankle (outpatient) | $400 | 0% | $400 |
Medium |
| X-Ray - Foot (outpatient) | $397 | 0% | $397 |
Medium |
| X-Ray - Hand | $525 | 0% | $525 |
Medium |
| X-Ray - Hip | $468 | 0% | $468 |
Medium |
| X-Ray - Knee (outpatient) | $505 | 0% | $505 |
Medium |
| X-Ray - Middle Back, Thoracic Spine | $683 | 0% | $683 | 
High |
| X-Ray - Neck, Cervical Spine | $401 | 0% | $401 |
Medium |
| X-Ray - Pelvis | $474 | 0% | $474 |
High |
| X-Ray - Shoulder (outpatient) | $566 | 0% | $566 |
Medium |
| X-Ray - Spine (outpatient) | $499 | 0% | $499 |
Medium |
| X-Ray - Wrist (outpatient) | $433 | 0% | $433 |
Medium |
