| Bacterial Culture Swab | $91 | 41% | $54 | 
Medium |
| Blood Test - Basic Metabolic Panel | $66 | 41% | $39 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | 41% | $53 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | 41% | $69 |
Medium |
| Blood Test - Clotting Time | $53 | 41% | $31 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | 41% | $37 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | 41% | $39 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $88 | 41% | $52 |
Medium |
| Blood Test - Electrolytes Panel | $59 | 41% | $35 |
Medium |
| Blood Test - Folic Acid Level | $134 | 41% | $79 |
Medium |
| Blood Test - General Health Panel | $306 | 41% | $180 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $69 | 41% | $41 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $151 | 41% | $89 |
Medium |
| Blood Test - LDL Cholesterol Level | $85 | 41% | $50 |
Medium |
| Blood Test - Lipase (fat enzyme) Level | $63 | 41% | $37 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $139 | 41% | $82 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $88 | 41% | $52 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | 41% | $89 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $83 | 41% | $49 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $111 | 41% | $66 |
Medium |
| Blood Test - Vitamin D-3 Level | $306 | 41% | $180 |
Medium |
| Colonoscopy - With Biopsy (outpatient) | $7,500 | 41% | $4,425 |
Medium |
| CT Scan - Abdomen and Pelvis, with Contrast | $5,707 | 41% | $3,367 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $333 | 41% | $196 |
Medium |
| Electrocardiogram (ECG or EKG) | $517 | 41% | $305 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $543 | 41% | $320 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $216 | 41% | $128 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $727 | 41% | $429 |
Medium |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | 41% | $61 |
Medium |
| Mammogram (outpatient) | $823 | 41% | $486 |
Medium |
| MRI - Back (outpatient) | $1,736 | 41% | $1,024 |
Medium |
| MRI - Knee (outpatient) | $1,776 | 41% | $1,048 |
Medium |
| MRI - Shoulder, Elbow, or Wrist | $1,437 | 41% | $848 |
Medium |
| Office Visit - Basic | $105 | 41% | $62 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $158 | 41% | $93 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $184 | 41% | $108 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $184 | 41% | $108 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $236 | 41% | $139 |
Medium |
| Office Visit - Established Patient, Low Complexity | $131 | 41% | $77 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $184 | 41% | $108 |
Medium |
| Office Visit - New Patient, Low Complexity | $158 | 41% | $93 |
Medium |
| Office Visit - New Patient, Minor | $116 | 41% | $68 |
Medium |
| Pap Test | $216 | 41% | $128 |
Medium |
| Physical Therapy - High Complexity Evaluation | $345 | 41% | $204 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $334 | 41% | $197 |
Medium |
| Physical Therapy - Manual Therapy | $148 | 41% | $87 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $345 | 41% | $204 |
Medium |
| Physical Therapy - Re-Evaluation | $200 | 41% | $118 |
Medium |
| Physical Therapy - Therapeutic Exercises | $143 | 41% | $84 |
Medium |
| Strep Test (Streptococcus, group A) | $26 | 41% | $15 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $62 | 41% | $37 |
Medium |
| Ultrasound - Abdominal, Limited | $945 | 41% | $558 |
Medium |
| Ultrasound - Breast (outpatient) | $1,200 | 41% | $708 | 
High |
| Ultrasound - Head and Neck | $944 | 41% | $557 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $1,419 | 41% | $837 |
High |
| Urine Test - Automated with Microscope Examination | $47 | 41% | $28 |
Medium |
| Urine Test - Automated without Microscope | $41 | 41% | $24 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | 41% | $41 |
Medium |
| Urine Test - Pregnancy | $67 | 41% | $40 |
Medium |
| X-Ray - Ankle (outpatient) | $350 | 41% | $206 |
Medium |
| X-Ray - Chest (outpatient) | $342 | 41% | $202 |
Medium |
| X-Ray - Foot (outpatient) | $366 | 41% | $216 |
High |
| X-Ray - Hand | $476 | 41% | $281 |
Medium |
| X-Ray - Hip | $607 | 41% | $358 |
High |
| X-Ray - Shoulder (outpatient) | $663 | 41% | $391 |
Medium |
| X-Ray - Spine (outpatient) | $798 | 41% | $471 |
Medium |
| X-Ray - Wrist (outpatient) | $735 | 41% | $434 |
Medium |
