| Basic metabolic panel | $15 | $8 | 175% | — | 14 |
| CT abdomen and pelvis with contrast | $828 | $368 | 225% | — | 6 |
| CT head without contrast | $245 | $110 | 222% | — | 6 |
| CT pelvis with contrast | $402 | $185 | 217% | — | 6 |
| Cardiac stress test | $246 | $228 | 108% | — | 2 |
| Cataract surgery with IOL insertion | $2,452 | $2,434 | 101% | — | 15 |
| Colonoscopy with biopsy | $1,495 | $1,262 | 118% | — | 15 |
| Colonoscopy with endoscopic ultrasound | $1,495 | $1,262 | 118% | — | 15 |
| Colonoscopy with polyp removal | $1,495 | $1,262 | 118% | — | 15 |
| Colonoscopy, diagnostic | $1,425 | $981 | 145% | — | 15 |
| Complete blood count with differential | $14 | $8 | 175% | — | 14 |
| Complete blood count, automated | $11 | $6 | 175% | — | 14 |
| Comprehensive metabolic panel | $18 | $11 | 175% | — | 14 |
| Diagnostic mammography, both breasts | $263 | — | — | — | 6 |
| Diagnostic mammography, one breast | $206 | — | — | — | 6 |
| ED visit, level 3 | $328 | $288 | 114% | — | 2 |
| ED visit, level 4 | $512 | $440 | 116% | — | 2 |
| ED visit, level 5 | $734 | $628 | 117% | — | 2 |
| Echocardiogram, complete | $650 | $576 | 113% | — | 2 |
| Electrocardiogram with interpretation | $26 | — | — | — | 1 |
| Epidural injection, lumbar/sacral, no imaging | $1,165 | $933 | 125% | — | 15 |
| Excision of breast lesion | $1,800 | $4,130 | 44% | — | 15 |
| Family psychotherapy, with patient | $267 | $187 | 142% | — | 2 |
| Family psychotherapy, without patient | $263 | $187 | 140% | — | 2 |
| Group psychotherapy | $121 | $107 | 113% | — | 2 |
| Inguinal hernia repair, age 5+ | $2,521 | $3,777 | 67% | — | 15 |
| Kidney function panel | $15 | $9 | 175% | — | 14 |
| Knee arthroscopy with meniscectomy | $2,521 | $3,452 | 73% | — | 15 |
| Laparoscopic cholecystectomy | $4,443 | $6,377 | 70% | — | 15 |
| Laparoscopic radical prostatectomy | $4,012 | $11,213 | 36% | — | 15 |
| Left heart catheterization, diagnostic | $4,124 | $3,420 | 121% | — | 15 |
| Lipid panel | $23 | $13 | 175% | — | 14 |
| Liver function panel | $14 | $8 | 175% | — | 14 |
| Lumbar epidural steroid injection | $1,165 | $745 | 156% | — | 15 |
| MRI brain with and without contrast | $828 | $368 | 225% | — | 6 |
| MRI lower extremity joint (knee) | $518 | $252 | 206% | — | 6 |
| MRI lumbar spine without contrast | $518 | $252 | 206% | — | 6 |
| OB global care, VBAC delivery | $3,281 | — | — | — | 10 |
| OB global care, cesarean delivery | $3,281 | — | — | — | 10 |
| OB global care, vaginal delivery | $3,281 | — | — | — | 10 |
| OB ultrasound, 14+ weeks | $245 | $110 | 222% | — | 6 |
| Obstetric blood test panel | $84 | $48 | 175% | — | 14 |
| Office visit, established patient, level 3 | $116 | — | — | — | 1 |
| Office visit, established patient, level 4 | $171 | — | — | — | 1 |
| Office visit, new patient, level 3 | $144 | — | — | — | 1 |
| Office visit, new patient, level 4 | $235 | — | — | — | 1 |
| Office visit, new patient, level 5 | $320 | — | — | — | 1 |
| PSA (prostate specific antigen), total | $32 | $18 | 175% | — | 14 |
| Partial thromboplastin time | $11 | $6 | 175% | — | 14 |
| Physical therapy, therapeutic exercise | $54 | — | — | — | 2 |
| Prostate biopsy | $1,460 | — | — | — | 14 |
| Prothrombin time | $8 | $4 | 175% | — | 14 |
| Psychotherapy, 30 minutes | $236 | $187 | 126% | — | 2 |
| Psychotherapy, 45 minutes | $256 | $187 | 137% | — | 2 |
| Psychotherapy, 60 minutes | $296 | $187 | 158% | — | 2 |
| Screening mammography, bilateral | $217 | — | — | — | 6 |
| Shoulder arthroscopy, subacromial decompression | $1,691 | — | — | — | 14 |
| Sleep study (polysomnography) | $1,309 | $906 | 144% | — | 2 |
| Thyroid stimulating hormone (TSH) | $29 | $17 | 175% | — | 14 |
| Tonsillectomy and adenoidectomy, under age 12 | $1,800 | $6,245 | 29% | — | 15 |
| Transforaminal epidural, lumbar/sacral | $1,165 | $933 | 125% | — | 15 |
| Ultrasound, abdomen, complete | $245 | $110 | 222% | — | 6 |
| Ultrasound, transvaginal | $245 | $110 | 222% | — | 6 |
| Upper GI endoscopy with biopsy | $1,425 | $957 | 149% | — | 15 |
| Upper GI endoscopy, diagnostic | $1,165 | $957 | 122% | — | 15 |
| Urinalysis, automated, with microscopy | $6 | $3 | 175% | — | 14 |
| Urinalysis, automated, without microscopy | $4 | $2 | 175% | — | 14 |
| Urinalysis, manual, with microscopy | $7 | $4 | 175% | — | 14 |
| Urinalysis, manual, without microscopy | $6 | $3 | 175% | — | 14 |
| X-ray, lower back, 4+ views | $245 | $110 | 222% | — | 6 |
| YAG laser capsulotomy (secondary cataract) | $1,368 | $580 | 236% | — | 15 |