| Bacterial Culture - Aerobic Isolates | $119 | N/A | $70 |
| Bacterial Culture - Swab | $91 | N/A | $54 |
| Blood Test - Basic Metabolic Panel | $66 | N/A | $39 |
| Blood Test - Blood Glucose (Sugar) Level | $37 | N/A | $22 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | N/A | $53 |
| Blood Test - Blood Typing (ABO) | $37 | N/A | $22 |
| Blood Test - C-reactive Protein (CRP) Level | $59 | N/A | $35 |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | N/A | $69 |
| Blood Test - Clotting Time | $53 | N/A | $31 |
| Blood Test - Coagulation Assessment | $65 | N/A | $38 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | N/A | $37 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | N/A | $39 |
| Blood Test - Comprehensive Metabolic Panel | $88 | N/A | $52 |
| Blood Test - Creatinine Level | $47 | N/A | $28 |
| Blood Test - Ferritin (Blood Protein) Level | $124 | N/A | $73 |
| Blood Test - Folic Acid Level | $134 | N/A | $79 |
| Blood Test - General Health Panel | $306 | N/A | $180 |
| Blood Test - Hepatic (Liver) Function Panel | $90 | N/A | $53 |
| Blood Test - Hepatitis B Surface Antibody Level | $123 | N/A | $72 |
| Blood Test - Hepatitis C Antibody Level | $153 | N/A | $90 |
| Blood Test - Iron Level | $63 | N/A | $37 |
| Blood Test - LDL Cholesterol Level | $85 | N/A | $50 |
| Blood Test - Lipase (fat enzyme) Level | $63 | N/A | $37 |
| Blood Test - Magnesium Level | $64 | N/A | $38 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $139 | N/A | $82 |
| Blood Test - Renal (Kidney) Function Panel | $92 | N/A | $55 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $160 | N/A | $94 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | N/A | $89 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $83 | N/A | $49 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $156 | N/A | $92 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $111 | N/A | $66 |
| Blood Test - Vitamin D-3 Level | $306 | N/A | $180 |
| Bone Density Scan (outpatient) | $480 | N/A | $283 |
| Emergency Department Visit - Low Complexity (outpatient) | $543 | N/A | $320 |
| Emergency Department Visit - Minor (outpatient) | $216 | N/A | $128 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $727 | N/A | $429 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | N/A | $61 |
| Hydration Infusion | $356 | N/A | $210 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $299 | N/A | $177 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $110 | N/A | $65 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $333 | N/A | $196 |
| Lab Test - Smear for Microorganism | $47 | N/A | $28 |
| Mammogram (outpatient) | $1,012 | N/A | $597 |
| MRI - Back (outpatient) | $1,736 | N/A | $1,024 |
| MRI - Knee (outpatient) | $1,929 | N/A | $1,138 |
| Office Visit - Basic | $105 | N/A | $62 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $158 | N/A | $93 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $158 | N/A | $93 |
| Office Visit - Established Patient, Low Complexity | $131 | N/A | $77 |
| Office Visit - Established Patient, Moderate Complexity | $184 | N/A | $108 |
| Office Visit - New Patient, Low Complexity | $158 | N/A | $93 |
| Office Visit - New Patient, Minor | $116 | N/A | $68 |
| Pap Test, automated screening and manual rescreening | $216 | N/A | $128 |
| Pap Test, manual screening | $130 | N/A | $77 |
| Physical Therapy - High Complexity Evaluation | $391 | 
Near Average
State Average: 1 | $230 |
| Physical Therapy - Low Complexity Evaluation | $368 |
Near Average
State Average: 1 | $217 |
| Physical Therapy - Manual Therapy | $148 | 
Below Average
State Average: 4 | $87 |
| Physical Therapy - Moderate Complexity Evaluation | $391 |
Near Average
State Average: 1 | $230 |
| Physical Therapy - Therapeutic Activities | $148 |
Below Average
State Average: 3 | $87 |
| Physical Therapy - Therapeutic Exercises | $148 |
Near Average
State Average: 4 | $87 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $62 | N/A | $37 |
| Ultrasound - Abdominal, Limited | $1,037 | N/A | $612 |
| Ultrasound - Breast (outpatient) | $1,328 | N/A | $784 |
| Ultrasound - Head and Neck | $944 | N/A | $557 |
| Ultrasound - Transvaginal (non-maternity) | $1,367 | N/A | $807 |
| Urine Test - Automated with Microscope Examination | $47 | N/A | $28 |
| Urine Test - Automated without Microscope | $41 | N/A | $24 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | N/A | $41 |
| Urine Test - Pregnancy | $87 | N/A | $51 |
| Vaccine - Influenza for Injection into Muscle | $26 | N/A | $15 |
| X-Ray - Ankle (outpatient) | $425 | N/A | $251 |
| X-Ray - Chest (outpatient) | $342 | N/A | $202 |
| X-Ray - Foot (outpatient) | $440 | N/A | $260 |
| X-Ray - Hand | $531 | N/A | $313 |
| X-Ray - Hip | $501 | N/A | $296 |
| X-Ray - Shoulder (outpatient) | $664 | N/A | $392 |
| X-Ray - Spine (outpatient) | $654 | N/A | $386 |
