| Basic metabolic panel | $61 | $8 | 723% | ~$26 | 18 |
| CT abdomen and pelvis with contrast | $1,888 | $368 | 513% | ~$831 | 18 |
| CT head without contrast | $1,144 | $110 | 1037% | ~$466 | 18 |
| CT pelvis with contrast | $1,203 | $185 | 650% | ~$506 | 18 |
| Cardiac stress test | $503 | $228 | 221% | $211 | 18 |
| Cataract surgery with IOL insertion | $4,053 | $2,434 | 166% | $1,448 | 18 |
| Colonoscopy with biopsy | $5,722 | $1,262 | 453% | — | 6 |
| Colonoscopy with endoscopic ultrasound | $5,722 | $1,262 | 453% | — | 6 |
| Colonoscopy with polyp removal | $5,722 | $1,262 | 453% | — | 6 |
| Colonoscopy, diagnostic | $2,602 | $981 | 265% | — | 6 |
| Complete blood count with differential | $47 | $8 | 609% | ~$20 | 18 |
| Complete blood count, automated | $33 | $6 | 517% | ~$14 | 18 |
| Comprehensive metabolic panel | $69 | $11 | 657% | ~$29 | 18 |
| Diagnostic mammography, both breasts | $394 | — | — | ~$166 | 18 |
| Diagnostic mammography, one breast | $372 | — | — | ~$163 | 18 |
| ED visit, level 3 | $1,131 | $288 | 393% | $404 | 18 |
| ED visit, level 4 | $2,368 | $440 | 538% | $846 | 18 |
| ED visit, level 5 | $3,369 | $628 | 536% | $1,204 | 18 |
| Echocardiogram, complete | $1,909 | $576 | 331% | $802 | 18 |
| Epidural injection, lumbar/sacral, no imaging | $2,602 | $933 | 279% | — | 6 |
| Excision of breast lesion | $6,764 | $4,130 | 164% | — | 6 |
| Inguinal hernia repair, age 5+ | $6,764 | $3,777 | 179% | — | 6 |
| Kidney function panel | $53 | $9 | 611% | ~$22 | 18 |
| Knee arthroscopy with meniscectomy | $6,764 | $3,452 | 196% | — | 6 |
| Laparoscopic cholecystectomy | $10,404 | $6,377 | 163% | — | 6 |
| Laparoscopic radical prostatectomy | $14,566 | $11,213 | 130% | — | 6 |
| Left heart catheterization, diagnostic | $6,764 | $3,420 | 198% | — | 6 |
| Lipid panel | $70 | $13 | 526% | ~$30 | 18 |
| Liver function panel | $55 | $8 | 669% | ~$23 | 18 |
| Lumbar epidural steroid injection | $1,059 | $745 | 142% | $378 | 18 |
| MRI brain with and without contrast | $1,419 | $368 | 386% | ~$596 | 18 |
| MRI lower extremity joint (knee) | $976 | $252 | 388% | ~$358 | 18 |
| MRI lumbar spine without contrast | $976 | $252 | 388% | ~$358 | 18 |
| OB global care, VBAC delivery | $6,764 | — | — | — | 6 |
| OB global care, cesarean delivery | $6,764 | — | — | — | 6 |
| OB global care, vaginal delivery | $6,764 | — | — | — | 6 |
| OB ultrasound, 14+ weeks | $390 | $110 | 353% | ~$148 | 18 |
| PSA (prostate specific antigen), total | $172 | $18 | 936% | ~$72 | 18 |
| Partial thromboplastin time | $65 | $6 | 1084% | ~$27 | 18 |
| Physical therapy, therapeutic exercise | $85 | — | — | $36 | 18 |
| Prostate biopsy | $5,722 | — | — | — | 6 |
| Prothrombin time | $25 | $4 | 590% | ~$11 | 18 |
| Screening mammography, bilateral | $354 | — | — | ~$149 | 18 |
| Sleep study (polysomnography) | $3,057 | $906 | 337% | $1,285 | 18 |
| Thyroid stimulating hormone (TSH) | $111 | $17 | 661% | ~$47 | 18 |
| Tonsillectomy and adenoidectomy, under age 12 | $8,844 | $6,245 | 142% | — | 6 |
| Transforaminal epidural, lumbar/sacral | $1,167 | $933 | 125% | $417 | 18 |
| Ultrasound, abdomen, complete | $465 | $110 | 422% | ~$196 | 18 |
| Ultrasound, transvaginal | $465 | $110 | 422% | ~$196 | 18 |
| Upper GI endoscopy with biopsy | $2,602 | $957 | 272% | — | 6 |
| Upper GI endoscopy, diagnostic | $2,602 | $957 | 272% | — | 6 |
| Urinalysis, automated, with microscopy | $33 | $3 | 1055% | ~$14 | 18 |
| Urinalysis, automated, without microscopy | $23 | $2 | 1015% | ~$10 | 18 |
| Urinalysis, manual, without microscopy | $33 | $3 | 961% | ~$14 | 18 |
| X-ray, lower back, 4+ views | $422 | $110 | 382% | ~$186 | 18 |
| YAG laser capsulotomy (secondary cataract) | $2,602 | $580 | 448% | — | 6 |