| Arthrocentesis (outpatient) | $433 | N/A | $242 |
| Bacterial Culture - Aerobic Isolates | $119 | N/A | $66 |
| Bacterial Culture - Swab | $77 | N/A | $43 |
| Biopsy - Punch Biopsy of Skin | $1,182 | N/A | $662 |
| Blood Test - Basic Metabolic Panel | $66 | N/A | $37 |
| Blood Test - Blood Glucose (Sugar) Level | $35 | N/A | $19 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $90 | N/A | $51 |
| Blood Test - C-reactive Protein (CRP) Level | $46 | N/A | $26 |
| Blood Test - Cholesterol Test, Lipid Panel | $118 | N/A | $66 |
| Blood Test - Clotting Time | $53 | N/A | $29 |
| Blood Test - Coagulation Assessment | $54 | N/A | $30 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $62 | N/A | $35 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $66 | N/A | $37 |
| Blood Test - Comprehensive Metabolic Panel | $88 | N/A | $49 |
| Blood Test - Creatinine Level | $45 | N/A | $25 |
| Blood Test - Ferritin (Blood Protein) Level | $119 | N/A | $66 |
| Blood Test - Folic Acid Level | $129 | N/A | $72 |
| Blood Test - General Health Panel | $306 | N/A | $171 |
| Blood Test - Hepatic (Liver) Function Panel | $71 | N/A | $40 |
| Blood Test - Hepatitis B Surface Antibody Level | $96 | N/A | $54 |
| Blood Test - Hepatitis C Antibody Level | $119 | N/A | $66 |
| Blood Test - Iron Binding Capacity | $78 | N/A | $44 |
| Blood Test - Iron Level | $57 | N/A | $32 |
| Blood Test - LDL Cholesterol Level | $81 | N/A | $45 |
| Blood Test - Lead Level | $85 | N/A | $48 |
| Blood Test - Lipase (fat enzyme) Level | $61 | N/A | $34 |
| Blood Test - Magnesium Level | $64 | N/A | $36 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $127 | N/A | $71 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $151 | N/A | $85 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $81 | N/A | $45 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $151 | N/A | $85 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $105 | N/A | $59 |
| Blood Test - Vitamin D-3 Level | $306 | N/A | $171 |
| Bone Density Scan (outpatient) | $401 | N/A | $225 |
| Colonoscopy - Diagnostic (outpatient) | $3,924 | N/A | $2,198 |
| Colonoscopy - With Polyp Removal (outpatient) | $5,620 | N/A | $3,147 |
| CT Scan - Abdomen and Pelvis, with Contrast | $2,524 | N/A | $1,414 |
| Developmental Screening | $48 | N/A | $27 |
| Electrocardiogram (ECG or EKG), Tracing | $373 | N/A | $209 |
| Emergency Department Visit - Low Complexity (outpatient) | $564 | N/A | $316 |
| Emergency Department Visit - Minor (outpatient) | $321 | N/A | $180 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $1,026 | N/A | $574 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $104 | N/A | $58 |
| Hydration Infusion | $106 | N/A | $59 |
| Lab Test - Creatinine Level | $46 | N/A | $26 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $101 | N/A | $56 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $216 | N/A | $121 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $92 | N/A | $52 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $152 | N/A | $85 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $185 | N/A | $103 |
| Lab Test - Detection test for Influenza Virus | $100 | N/A | $56 |
| Lab Test - Smear for Microorganism | $38 | N/A | $21 |
| Mammogram (outpatient) | $437 | N/A | $245 |
| MRI - Back (outpatient) | $3,395 | N/A | $1,901 |
| MRI - Brain (outpatient) | $5,583 | N/A | $3,126 |
| MRI - Knee (outpatient) | $1,929 | N/A | $1,080 |
| MRI - Shoulder, Elbow, or Wrist | $1,926 | N/A | $1,078 |
| Myocardial Imaging (outpatient) | $8,867 | N/A | $4,966 |
| Office Visit - Basic | $92 | N/A | $52 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $320 | N/A | $179 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $348 | N/A | $195 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $348 | N/A | $195 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $404 | N/A | $226 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $319 | N/A | $179 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $296 | N/A | $166 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $278 | N/A | $156 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $302 | N/A | $169 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $303 | N/A | $170 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $332 | N/A | $186 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $277 | N/A | $155 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $251 | N/A | $141 |
| Office Visit - Established Patient, High Complexity | $290 | N/A | $162 |
| Office Visit - Established Patient, Low Complexity | $150 | N/A | $84 |
| Office Visit - Established Patient, Moderate Complexity | $219 | N/A | $123 |
| Office Visit - New Patient, Low Complexity | $216 | N/A | $121 |
| Office Visit - New Patient, Minor | $150 | N/A | $84 |
| Office Visit - New Patient, Moderate Complexity | $332 | N/A | $186 |
| Physical Therapy - Electrical Stimulation Therapy | $68 | 
Above Average
State Average: 3 | $38 |
| Physical Therapy - High Complexity Evaluation | $355 | 
Near Average
State Average: 1 | $199 |
| Physical Therapy - Low Complexity Evaluation | $396 |
Near Average
State Average: 1 | $222 |
| Physical Therapy - Manual Therapy | $156 |
Above Average
State Average: 4 | $88 |
| Physical Therapy - Moderate Complexity Evaluation | $355 |
Near Average
State Average: 1 | $199 |
| Physical Therapy - Therapeutic Exercises | $161 | 
Below Average
State Average: 4 | $90 |
| Physical Therapy - Ultrasound Therapy | $72 |
Below Average
State Average: 3 | $41 |
| Psychiatric Diagnostic Evaluation | $264 |
Near Average
State Average: 1 | $148 |
| Psychotherapy - 30 Minutes | $134 |
Above Average
State Average: 1 | $75 |
| Psychotherapy - 45 Minutes | $167 |
Below Average
State Average: 4 | $93 |
| Psychotherapy - 60 Minutes | $168 |
Below Average
State Average: 5 | $94 |
| Psychotherapy - Group Session | $55 |
Above Average
State Average: 5 | $31 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $50 | N/A | $28 |
| Ultrasound - Abdominal, Complete | $967 | N/A | $542 |
| Ultrasound - Abdominal, Limited | $757 | N/A | $424 |
| Ultrasound - Head and Neck | $862 | N/A | $483 |
| Ultrasound - Transvaginal (non-maternity) | $878 | N/A | $492 |
| Urine Test - Automated with Microscope Examination | $47 | N/A | $26 |
| Urine Test - Automated without Microscope | $21 | N/A | $12 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $69 | N/A | $39 |
| Urine Test - Chlamydia | $232 | N/A | $130 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $232 | N/A | $130 |
| Urine Test - Microalbumin (Protein) Level | $47 | N/A | $26 |
| Urine Test - Pregnancy | $56 | N/A | $31 |
| Urine Test - Urinalysis, Manual Test | $23 | N/A | $13 |
| Vaccine - Influenza for Injection into Muscle | $1 | N/A | $1 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $374 | N/A | $209 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $75 | N/A | $42 |
| X-Ray - Abdomen | $215 | N/A | $121 |
| X-Ray - Ankle (outpatient) | $269 | N/A | $151 |
| X-Ray - Chest (outpatient) | $571 | N/A | $320 |
| X-Ray - Foot (outpatient) | $322 | N/A | $181 |
| X-Ray - Hand | $467 | N/A | $262 |
| X-Ray - Hip | $566 | N/A | $317 |
| X-Ray - Knee (outpatient) | $303 | N/A | $170 |
| X-Ray - Neck, Cervical Spine | $296 | N/A | $166 |
| X-Ray - Shoulder (outpatient) | $422 | N/A | $236 |
| X-Ray - Spine (outpatient) | $477 | N/A | $267 |
| X-Ray - Wrist (outpatient) | $401 | N/A | $225 |
