| Bacterial Culture - Aerobic Isolates | $119 | 41% | $70 |
| Bacterial Culture - Swab | $91 | 41% | $54 |
| Blood Test - Basic Metabolic Panel | $66 | 41% | $39 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | 41% | $53 |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | 41% | $69 |
| Blood Test - Clotting Time | $53 | 41% | $31 |
| Blood Test - Coagulation Assessment | $65 | 41% | $38 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | 41% | $37 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | 41% | $39 |
| Blood Test - Comprehensive Metabolic Panel | $88 | 41% | $52 |
| Blood Test - Ferritin (Blood Protein) Level | $124 | 41% | $73 |
| Blood Test - Folic Acid Level | $134 | 41% | $79 |
| Blood Test - General Health Panel | $306 | 41% | $180 |
| Blood Test - Hepatic (Liver) Function Panel | $90 | 41% | $53 |
| Blood Test - Hepatitis C Antibody Level | $153 | 41% | $90 |
| Blood Test - Iron Level | $63 | 41% | $37 |
| Blood Test - LDL Cholesterol Level | $85 | 41% | $50 |
| Blood Test - Lipase (fat enzyme) Level | $63 | 41% | $37 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $139 | 41% | $82 |
| Blood Test - Renal (Kidney) Function Panel | $92 | 41% | $55 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | 41% | $89 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $83 | 41% | $49 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $156 | 41% | $92 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $111 | 41% | $66 |
| Blood Test - Vitamin D-3 Level | $306 | 41% | $180 |
| Bone Density Scan (outpatient) | $480 | 41% | $283 |
| Colonoscopy - With Biopsy (outpatient) | $7,320 | 41% | $4,319 |
| Colonoscopy - With Polyp Removal (outpatient) | $8,712 | 41% | $5,140 |
| CT Scan - Abdomen and Pelvis, with Contrast | $4,764 | 41% | $2,811 |
| Detection test for Human Papillomavirus (HPV) | $333 | 41% | $196 |
| Emergency Department Visit - Low Complexity (outpatient) | $543 | 41% | $320 |
| Emergency Department Visit - Minor (outpatient) | $216 | 41% | $128 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $727 | 41% | $429 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | 41% | $61 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $110 | 41% | $65 |
| Lab Test - Smear for Microorganism | $47 | 41% | $28 |
| Mammogram (outpatient) | $1,012 | 41% | $597 |
| MRI - Back (outpatient) | $1,736 | 41% | $1,024 |
| MRI - Knee (outpatient) | $1,776 | 41% | $1,048 |
| Office Visit - Basic | $105 | 41% | $62 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $158 | 41% | $93 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $158 | 41% | $93 |
| Office Visit - Established Patient, Low Complexity | $131 | 41% | $77 |
| Office Visit - Established Patient, Moderate Complexity | $184 | 41% | $108 |
| Office Visit - New Patient, Low Complexity | $158 | 41% | $93 |
| Office Visit - New Patient, Minor | $116 | 41% | $68 |
| Pap Test | $216 | 41% | $128 |
| Physical Therapy - High Complexity Evaluation | $345 | 41% | $204 |
| Physical Therapy - Low Complexity Evaluation | $345 | 41% | $204 |
| Physical Therapy - Manual Therapy | $148 | 41% | $87 |
| Physical Therapy - Moderate Complexity Evaluation | $345 | 41% | $204 |
| Physical Therapy - Therapeutic Exercises | $148 | 41% | $87 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $62 | 41% | $37 |
| Ultrasound - Abdominal, Complete | $1,397 | 41% | $824 |
| Ultrasound - Abdominal, Limited | $1,129 | 41% | $666 |
| Ultrasound - Breast (outpatient) | $679 | 41% | $401 |
| Ultrasound - Head and Neck | $944 | 41% | $557 |
| Ultrasound - Transvaginal (non-maternity) | $1,419 | 41% | $837 |
| Urine Test - Automated with Microscope Examination | $47 | 41% | $28 |
| Urine Test - Automated without Microscope | $41 | 41% | $24 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | 41% | $41 |
| Urine Test - Pregnancy | $16 | 41% | $9 |
| X-Ray - Ankle (outpatient) | $366 | 41% | $216 |
| X-Ray - Chest (outpatient) | $342 | 41% | $202 |
| X-Ray - Foot (outpatient) | $440 | 41% | $260 |
| X-Ray - Hand | $366 | 41% | $216 |
| X-Ray - Hip | $502 | 41% | $296 |
| X-Ray - Shoulder (outpatient) | $659 | 41% | $389 |
| X-Ray - Spine (outpatient) | $1,116 | 41% | $659 |
