| Bacterial Culture - Aerobic Isolates | $62 | N/A | $6 |
| Bacterial Culture - Swab | $123 | N/A | $12 |
| Biopsy - Breast | $8,473 | N/A | $847 |
| Blood Test - Basic Metabolic Panel | $115 | N/A | $11 |
| Blood Test - Blood Glucose (Sugar) Level | $27 | N/A | $3 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $129 | N/A | $13 |
| Blood Test - Blood Typing (ABO) | $78 | N/A | $8 |
| Blood Test - Blood Typing (Rh (D)) | $78 | N/A | $8 |
| Blood Test - C-reactive Protein (CRP) Level | $71 | N/A | $7 |
| Blood Test - Cholesterol Test, Lipid Panel | $178 | N/A | $18 |
| Blood Test - Clotting Time | $56 | N/A | $6 |
| Blood Test - Coagulation Assessment | $174 | N/A | $17 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $95 | N/A | $9 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $107 | N/A | $11 |
| Blood Test - Comprehensive Metabolic Panel | $141 | N/A | $14 |
| Blood Test - Creatinine Level | $76 | N/A | $8 |
| Blood Test - Ferritin (Blood Protein) Level | $180 | N/A | $18 |
| Blood Test - Folic Acid Level | $196 | N/A | $20 |
| Blood Test - General Health Panel | $462 | N/A | $46 |
| Blood Test - Hepatic (Liver) Function Panel | $103 | N/A | $10 |
| Blood Test - Hepatitis B Surface Antibody Level | $362 | N/A | $36 |
| Blood Test - Hepatitis C Antibody Level | $204 | N/A | $20 |
| Blood Test - Iron Binding Capacity | $118 | N/A | $12 |
| Blood Test - Iron Level | $89 | N/A | $9 |
| Blood Test - Lipase (fat enzyme) Level | $87 | N/A | $9 |
| Blood Test - Magnesium Level | $95 | N/A | $10 |
| Blood Test - Renal (Kidney) Function Panel | $116 | N/A | $12 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $233 | N/A | $23 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $123 | N/A | $12 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $221 | N/A | $22 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $159 | N/A | $16 |
| Blood Test - Vitamin D-3 Level | $284 | N/A | $28 |
| Bone Density Scan (outpatient) | $930 | N/A | $93 |
| Colonoscopy - Diagnostic (outpatient) | $5,860 | N/A | $586 |
| Colonoscopy - With Biopsy (outpatient) | $9,126 | N/A | $913 |
| Colonoscopy - With Polyp Removal (outpatient) | $8,891 | N/A | $889 |
| CT Scan - Chest, with Contrast (outpatient) | $7,063 | N/A | $706 |
| CT Scan - Head/Brain, without Contrast | $4,187 | N/A | $419 |
| Emergency Department Visit - Low Complexity (outpatient) | $1,336 | N/A | $134 |
| Emergency Department Visit - Minor (outpatient) | $837 | N/A | $84 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $2,112 | N/A | $211 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $116 | N/A | $12 |
| Fetal Non-Stress Test | $3,135 | N/A | $314 |
| Hernia Repair - Laparoscopic (outpatient) | $47,472 | N/A | $4,747 |
| Hydration Infusion | $238 | N/A | $24 |
| Lab Test - Creatinine Level | $80 | N/A | $8 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $71 | N/A | $7 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $92 | N/A | $9 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $140 | N/A | $14 |
| Lab Test - Smear for Microorganism | $59 | N/A | $6 |
| Mammogram (outpatient) | $824 | N/A | $82 |
| MRI - Back (outpatient) | $5,203 | N/A | $520 |
| MRI - Brain (outpatient) | $7,009 | N/A | $701 |
| MRI - Knee (outpatient) | $4,714 | N/A | $471 |
| MRI - Pelvis (outpatient) | $7,503 | N/A | $750 |
| MRI - Shoulder, Elbow, or Wrist | $4,848 | N/A | $485 |
| Myocardial Imaging (outpatient) | $8,543 | N/A | $854 |
| Office Visit - Basic | $95 | N/A | $9 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $315 | N/A | $32 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $336 | N/A | $34 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $273 | N/A | $27 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $305 | N/A | $30 |
| Office Visit - Established Patient, Low Complexity | $163 | N/A | $16 |
| Office Visit - Established Patient, Moderate Complexity | $226 | N/A | $23 |
| Physical Therapy - High Complexity Evaluation | $472 | 
Near Average
State Average: 1 | $47 |
| Physical Therapy - Low Complexity Evaluation | $472 |
Near Average
State Average: 1 | $47 |
| Physical Therapy - Manual Therapy | $159 | 
Above Average
State Average: 4 | $16 |
| Physical Therapy - Moderate Complexity Evaluation | $472 |
Near Average
State Average: 1 | $47 |
| Physical Therapy - Self-care or Home Management Training | $159 |
Near Average
State Average: 1 | $16 |
| Physical Therapy - Therapeutic Activities | $96 | 
Below Average
State Average: 3 | $10 |
| Physical Therapy - Therapeutic Exercises | $159 |
Below Average
State Average: 4 | $16 |
| Physical Therapy - Ultrasound Therapy | $65 |
Above Average
State Average: 3 | $6 |
| Physical Therapy - Walking Training, 15 minutes | $159 |
Near Average
State Average: 1 | $16 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $91 | N/A | $9 |
| Ultrasound - Abdominal, Complete | $1,681 | N/A | $168 |
| Ultrasound - Abdominal, Limited | $607 | N/A | $61 |
| Ultrasound - Breast (outpatient) | $1,745 | N/A | $174 |
| Ultrasound - Head and Neck | $1,306 | N/A | $131 |
| Ultrasound - Pregnancy (outpatient) | $517 | N/A | $52 |
| Ultrasound - Pregnancy Follow-Up | $490 | N/A | $49 |
| Ultrasound - Transvaginal (non-maternity) | $1,317 | N/A | $132 |
| Upper Gastrointestinal Endoscopy - Diagnostic | $7,963 | N/A | $796 |
| Upper Gastrointestinal Endoscopy - With Biopsy | $11,140 | N/A | $1,114 |
| Urine Test - Automated with Microscope Examination | $152 | N/A | $15 |
| Urine Test - Automated without Microscope | $122 | N/A | $12 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $89 | N/A | $9 |
| Urine Test - Chlamydia | $146 | N/A | $15 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $146 | N/A | $15 |
| Urine Test - Pregnancy | $152 | N/A | $15 |
| Urine Test - Urinalysis, Manual Test | $34 | N/A | $3 |
| Vaccine - Influenza for Injection into Muscle | $53 | N/A | $5 |
| X-Ray - Abdomen | $535 | N/A | $53 |
| X-Ray - Ankle (outpatient) | $810 | N/A | $81 |
| X-Ray - Chest (outpatient) | $402 | N/A | $40 |
| X-Ray - Foot (outpatient) | $919 | N/A | $92 |
| X-Ray - Hand | $791 | N/A | $79 |
| X-Ray - Hip | $652 | N/A | $65 |
| X-Ray - Knee (outpatient) | $446 | N/A | $45 |
| X-Ray - Neck, Cervical Spine | $842 | N/A | $84 |
| X-Ray - Shoulder (outpatient) | $681 | N/A | $68 |
| X-Ray - Spine (outpatient) | $912 | N/A | $91 |
| X-Ray - Wrist (outpatient) | $863 | N/A | $86 |
