| Acute myocardial infarction, discharged alive, with MCC | $39,610 | $11,217 | 353% | — | 5 |
| Bariatric (obesity) surgery, no CC/MCC | $23,082 | $8,272 | 279% | — | 5 |
| Basic metabolic panel | $21 | $8 | 251% | ~$10 | 16 |
| COPD with MCC | $27,100 | $7,667 | 353% | — | 5 |
| CT abdomen and pelvis with contrast | $721 | $368 | 196% | ~$496 | 16 |
| CT head without contrast | $594 | $110 | 539% | ~$413 | 16 |
| CT pelvis with contrast | $594 | $185 | 321% | ~$468 | 16 |
| Cardiac arrhythmia, no CC/MCC | $13,502 | $3,269 | 413% | — | 5 |
| Cardiac valve surgery with cardiac cath, with MCC | $152,391 | — | — | — | 5 |
| Cataract surgery with IOL insertion | $19,688 | $2,434 | 809% | — | 2 |
| Cellulitis, no MCC | $21,255 | $5,675 | 375% | — | 5 |
| Cervical spinal fusion, no CC/MCC | $37,381 | $16,343 | 229% | — | 5 |
| Cesarean section, no CC/MCC | $5,595 | — | — | — | 4 |
| Cesarean section, with CC | $5,595 | — | — | — | 4 |
| Chest pain | $17,216 | — | — | — | 5 |
| Colonoscopy with biopsy | $10,954 | $1,262 | 868% | — | 2 |
| Colonoscopy with endoscopic ultrasound | $10,954 | $1,262 | 868% | — | 2 |
| Colonoscopy with polyp removal | $10,954 | $1,262 | 868% | — | 2 |
| Colonoscopy, diagnostic | $8,956 | $981 | 913% | — | 2 |
| Complete blood count with differential | $20 | $8 | 252% | ~$9 | 16 |
| Complete blood count, automated | $16 | $6 | 252% | ~$7 | 16 |
| Comprehensive metabolic panel | $26 | $11 | 247% | ~$12 | 16 |
| Coronary bypass without cardiac cath, no MCC | $64,930 | $29,950 | 217% | — | 5 |
| Echocardiogram, complete | $1,462 | $576 | 254% | $705 | 16 |
| Epidural injection, lumbar/sacral, no imaging | $1,756 | $933 | 188% | $758 | 12 |
| Esophagitis/GI disorders, no MCC | $18,830 | $4,899 | 384% | — | 5 |
| Excision of breast lesion | $17,518 | $4,130 | 424% | — | 2 |
| Heart failure and shock, with CC | $20,782 | $5,927 | 351% | — | 5 |
| Heart failure with MCC | $31,487 | $8,748 | 360% | — | 5 |
| Hip and femur procedures except major joint, with CC | $32,763 | $13,876 | 236% | — | 5 |
| Hysterectomy, no CC/MCC | $18,927 | $10,098 | 187% | — | 5 |
| Inguinal hernia repair, age 5+ | $21,038 | $3,777 | 557% | — | 2 |
| Kidney and urinary tract infections, no MCC | $19,368 | $5,238 | 370% | — | 5 |
| Kidney function panel | $22 | $9 | 254% | ~$10 | 16 |
| Knee arthroscopy with meniscectomy | $25,030 | $3,452 | 725% | — | 2 |
| Laparoscopic cholecystectomy | $27,672 | $6,377 | 434% | — | 2 |
| Laparoscopic cholecystectomy, no CC/MCC | $20,805 | $8,977 | 232% | — | 5 |
| Laparoscopic radical prostatectomy | $37,366 | $11,213 | 333% | — | 2 |
| Left heart catheterization, diagnostic | $9,541 | $3,420 | 279% | $4,144 | 16 |
| Lipid panel | $50 | $13 | 375% | ~$23 | 16 |
| Liver function panel | $20 | $8 | 250% | ~$9 | 16 |
| Lumbar epidural steroid injection | $2,230 | $745 | 299% | $963 | 12 |
| Major joint replacement (hip/knee), no MCC | $29,772 | $13,045 | 228% | — | 5 |
| Major joint replacement (hip/knee), with MCC | $51,613 | $22,346 | 231% | — | 5 |
| Major small and large bowel procedures, with CC | $37,323 | $16,202 | 230% | — | 5 |
| Medical back problems, no MCC | $23,258 | $6,142 | 379% | — | 5 |
| Office visit, established patient, level 3 | $144 | — | — | $62 | 14 |
| Office visit, established patient, level 4 | $183 | — | — | $79 | 14 |
| Office visit, new patient, level 3 | $259 | — | — | $112 | 14 |
| Office visit, new patient, level 4 | $357 | — | — | $154 | 14 |
| Office visit, new patient, level 5 | $484 | — | — | $209 | 14 |
| PSA (prostate specific antigen), total | $46 | $18 | 249% | ~$21 | 16 |
| Partial thromboplastin time | $30 | $6 | 496% | ~$13 | 16 |
| Physical therapy, therapeutic exercise | $113 | — | — | $49 | 15 |
| Prostate biopsy | $2,848 | — | — | $1,168 | 12 |
| Prothrombin time | $26 | $4 | 609% | ~$12 | 16 |
| Renal failure, with CC | $21,451 | $5,892 | 364% | — | 5 |
| Sepsis with MCC | $47,349 | $11,947 | 396% | — | 5 |
| Shoulder arthroscopy, subacromial decompression | $22,491 | — | — | — | 1 |
| Simple pneumonia and pleurisy, with CC | $19,788 | $5,177 | 382% | — | 5 |
| Stroke (hemorrhage/infarction), no CC/MCC | $16,610 | $3,679 | 451% | — | 5 |
| Stroke (hemorrhage/infarction), with CC or tPA | $24,540 | $6,559 | 374% | — | 5 |
| Thyroid stimulating hormone (TSH) | $43 | $17 | 255% | ~$19 | 16 |
| Tonsillectomy and adenoidectomy, under age 12 | $20,370 | $6,245 | 326% | — | 2 |
| Transforaminal epidural, lumbar/sacral | $1,279 | $933 | 137% | $552 | 11 |
| Upper GI endoscopy with biopsy | $8,956 | $957 | 936% | — | 2 |
| Upper GI endoscopy, diagnostic | $6,279 | $957 | 656% | — | 2 |
| Urinalysis, automated, with microscopy | $8 | $3 | 257% | ~$4 | 16 |
| Urinalysis, automated, without microscopy | $6 | $2 | 254% | ~$3 | 16 |
| Urinalysis, manual, without microscopy | $9 | $3 | 258% | ~$4 | 16 |
| Vaginal delivery, no sterilization, no CC/MCC | $3,500 | — | — | — | 3 |
| Vaginal delivery, no sterilization, with CC | $3,500 | — | — | — | 3 |
| X-ray, lower back, 4+ views | $178 | $110 | 161% | ~$77 | 13 |
| YAG laser capsulotomy (secondary cataract) | $1,490 | $580 | 257% | $643 | 12 |