| Arthrocentesis (outpatient) | $1,161 | 0% | $1,161 | 
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $62 | 0% | $62 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
Medium |
| Blood Test - Clotting Time | $62 | 0% | $62 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $33 | 0% | $33 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $84 | 0% | $84 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $60 | 0% | $60 |
Medium |
| Blood Test - General Health Panel | $190 | 0% | $190 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $137 | 0% | $137 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $141 | 0% | $141 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | 0% | $109 |
Medium |
| Blood Test - Vitamin D-3 Level | $287 | 0% | $287 |
Medium |
| Destruction of Lesion (outpatient) | $568 | 0% | $568 | 
High |
| Electrocardiogram (ECG or EKG) | $530 | 0% | $530 |
Medium |
| Mammogram (outpatient) | $711 | 0% | $711 |
High |
| Office Visit - Basic | $65 | 0% | $65 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $227 | 0% | $227 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $232 | 0% | $232 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $270 | 0% | $270 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $344 | 0% | $344 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $194 | 0% | $194 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $191 | 0% | $191 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $198 | 0% | $198 |
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 | $227 | 0% | $227 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $181 | 0% | $181 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $233 | 0% | $233 |
Medium |
| Office Visit - Established Patient, High Complexity | $239 | 0% | $239 |
Medium |
| Office Visit - Established Patient, Low Complexity | $176 | 0% | $176 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $219 | 0% | $219 |
Medium |
| Office Visit - New Patient, Low Complexity | $286 | 0% | $286 |
Medium |
| Office Visit - New Patient, Minor | $218 | 0% | $218 |
Medium |
| Pap Test | $236 | 0% | $236 |
Medium |
| Strep Test (Streptococcus, group A) | $84 | 0% | $84 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $57 | 0% | $57 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $168 | 0% | $168 | 
Low |
| Ultrasound - Pregnancy Follow-Up | $294 | 0% | $294 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $1,890 | 0% | $1,890 |
High |
| Urine Test - Automated with Microscope Examination | $38 | 0% | $38 |
Medium |
| Urine Test - Automated without Microscope | $3 | 0% | $3 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $83 | 0% | $83 |
Medium |
| Urine Test - Pregnancy | $101 | 0% | $101 |
Medium |
| X-Ray - Chest (outpatient) | $641 | 0% | $641 |
High |
