| Arthrocentesis (outpatient) | $562 | 39% | $388 | 
Medium |
| Blood Test - Basic Metabolic Panel | $99 | 39% | $68 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | 39% | $62 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $155 | 39% | $107 |
Medium |
| Blood Test - Clotting Time | $59 | 39% | $41 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $90 | 39% | $62 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $102 | 39% | $70 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $153 | 39% | $106 |
Medium |
| Blood Test - Electrolytes Panel | $79 | 39% | $54 |
Medium |
| Blood Test - General Health Panel | $148 | 39% | $102 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $120 | 39% | $83 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $158 | 39% | $109 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $95 | 39% | $65 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $145 | 39% | $100 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $114 | 39% | $79 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $148 | 39% | $102 |
Medium |
| Blood Test - Vitamin D-3 Level | $209 | 39% | $144 |
Medium |
| Bone Density Scan (outpatient) | $557 | 39% | $384 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $5,384 | 39% | $3,715 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $6,174 | 39% | $4,260 | 
High |
| Colonoscopy - With Polyp Removal (outpatient) | $6,243 | 39% | $4,308 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $4,572 | 39% | $3,154 |
Medium |
| CT Scan - Chest, with Contrast (outpatient) | $2,981 | 39% | $2,057 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $441 | 39% | $304 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $257 | 39% | $178 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $690 | 39% | $476 |
Medium |
| Fetal Non-Stress Test | $654 | 39% | $451 |
Medium |
| Gall Bladder Surgery (outpatient) | $16,566 | 39% | $11,431 |
Medium |
| Mammogram (outpatient) | $1,028 | 39% | $709 |
Medium |
| MRI - Back (outpatient) | $3,529 | 39% | $2,435 |
Medium |
| MRI - Brain (outpatient) | $4,141 | 39% | $2,857 |
Medium |
| MRI - Knee (outpatient) | $3,436 | 39% | $2,371 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $2,794 | 39% | $1,928 |
Medium |
| Myocardial Imaging (outpatient) | $7,842 | 39% | $5,411 |
Medium |
| Office Visit - Basic | $83 | 39% | $57 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $249 | 39% | $172 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $254 | 39% | $175 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $278 | 39% | $192 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $336 | 39% | $232 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $226 | 39% | $156 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $255 | 39% | $176 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $239 | 39% | $165 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $231 | 39% | $159 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $245 | 39% | $169 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $306 | 39% | $211 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $239 | 39% | $165 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $183 | 39% | $126 |
Medium |
| Office Visit - Established Patient, High Complexity | $363 | 39% | $251 |
Medium |
| Office Visit - Established Patient, Low Complexity | $168 | 39% | $116 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $257 | 39% | $178 |
Medium |
| Office Visit - New Patient, Low Complexity | $251 | 39% | $173 |
Medium |
| Office Visit - New Patient, Minor | $165 | 39% | $114 |
Medium |
| Pap Test | $190 | 39% | $131 |
Medium |
| Physical Therapy - High Complexity Evaluation | $210 | 39% | $145 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $272 | 39% | $188 |
Medium |
| Physical Therapy - Manual Therapy | $65 | 39% | $45 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $210 | 39% | $145 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $65 | 39% | $45 |
Medium |
| Physical Therapy - Therapeutic Exercises | $149 | 39% | $103 |
Medium |
| Physical Therapy - Ultrasound Therapy | $65 | 39% | $45 |
Medium |
| Strep Test (Streptococcus, group A) | $76 | 39% | $52 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $64 | 39% | $44 |
Medium |
| Ultrasound - Abdominal, Complete | $1,325 | 39% | $914 |
Medium |
| Ultrasound - Abdominal, Limited | $946 | 39% | $653 |
Medium |
| Ultrasound - Breast (outpatient) | $1,514 | 39% | $1,045 |
Medium |
| Ultrasound - Head and Neck | $1,007 | 39% | $695 |
Medium |
| Ultrasound - Pelvic (outpatient) | $1,096 | 39% | $756 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $1,037 | 39% | $716 |
Medium |
| Ultrasound - Pregnancy Follow-Up | $677 | 39% | $467 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $1,170 | 39% | $807 |
Medium |
| Urine Test - Automated with Microscope Examination | $63 | 39% | $43 |
Medium |
| Urine Test - Automated without Microscope | $63 | 39% | $43 |
Medium |
| Urine Test - Bacterial Culture | $51 | 39% | $36 |
Medium |
| Urine Test - Chlamydia | $143 | 39% | $99 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $138 | 39% | $95 |
Medium |
| Urine Test - Pregnancy | $153 | 39% | $106 |
Medium |
| X-Ray - Abdomen | $582 | 39% | $402 |
Medium |
| X-Ray - Ankle (outpatient) | $400 | 39% | $276 |
Medium |
| X-Ray - Chest (outpatient) | $597 | 39% | $412 |
Medium |
| X-Ray - Foot (outpatient) | $667 | 39% | $460 |
Medium |
| X-Ray - Hand | $671 | 39% | $463 |
Medium |
| X-Ray - Hip | $494 | 39% | $341 |
Medium |
| X-Ray - Knee (outpatient) | $410 | 39% | $283 |
Medium |
| X-Ray - Middle Back, Thoracic Spine | $526 | 39% | $363 |
High |
| X-Ray - Neck, Cervical Spine | $422 | 39% | $291 |
Medium |
| X-Ray - Shoulder (outpatient) | $385 | 39% | $266 |
Medium |
| X-Ray - Spine (outpatient) | $583 | 39% | $402 |
Medium |
| X-Ray - Wrist (outpatient) | $552 | 39% | $381 |
Medium |
