| Acute myocardial infarction, discharged alive, with MCC | $46,440 | $9,937 | 467% | — | 8 |
| Bariatric (obesity) surgery, no CC/MCC | $43,669 | $8,272 | 528% | — | 8 |
| Basic metabolic panel | $162 | $8 | 1918% | ~$55 | 23 |
| COPD with MCC | $32,068 | $6,619 | 485% | — | 8 |
| CT abdomen and pelvis with contrast | $889 | $368 | 242% | ~$1,389 | 23 |
| CT head without contrast | $889 | $110 | 806% | ~$590 | 23 |
| CT pelvis with contrast | $889 | $185 | 480% | ~$505 | 23 |
| Cardiac arrhythmia, no CC/MCC | $16,389 | $3,042 | 539% | — | 8 |
| Cardiac stress test | $642 | $228 | 282% | $210 | 23 |
| Cardiac valve surgery with cardiac cath, with MCC | $283,217 | — | — | — | 8 |
| Cataract surgery with IOL insertion | $5,086 | $2,434 | 209% | — | 8 |
| Cellulitis, no MCC | $25,213 | $5,216 | 483% | — | 8 |
| Cervical spinal fusion, no CC/MCC | $70,677 | $16,343 | 432% | — | 8 |
| Cesarean section, no CC/MCC | $13,069 | — | — | — | 10 |
| Cesarean section, with CC | $13,069 | — | — | — | 10 |
| Chest pain | $20,844 | — | — | — | 8 |
| Colonoscopy with biopsy | $3,955 | $1,262 | 313% | $999 | 23 |
| Colonoscopy with endoscopic ultrasound | $2,893 | $1,262 | 229% | $731 | 23 |
| Colonoscopy with polyp removal | $3,955 | $1,262 | 313% | $999 | 23 |
| Colonoscopy, diagnostic | $1,955 | $981 | 199% | $526 | 23 |
| Complete blood count with differential | $176 | $8 | 2263% | ~$59 | 23 |
| Complete blood count, automated | $95 | $6 | 1474% | ~$32 | 23 |
| Comprehensive metabolic panel | $204 | $11 | 1929% | ~$69 | 23 |
| Coronary bypass without cardiac cath, no MCC | $121,268 | $30,878 | 393% | — | 8 |
| Diagnostic mammography, both breasts | $452 | — | — | ~$147 | 23 |
| Diagnostic mammography, one breast | $372 | — | — | ~$121 | 23 |
| ED visit, level 3 | $1,135 | $288 | 394% | $264 | 23 |
| ED visit, level 4 | $1,655 | $440 | 376% | $380 | 23 |
| ED visit, level 5 | $3,198 | $628 | 509% | $743 | 23 |
| Echocardiogram, complete | $2,451 | $576 | 425% | $800 | 23 |
| Electrocardiogram with interpretation | $115 | — | — | — | 5 |
| Epidural injection, lumbar/sacral, no imaging | $1,423 | $933 | 152% | $465 | 23 |
| Esophagitis/GI disorders, no MCC | $22,570 | $4,689 | 481% | — | 8 |
| Excision of breast lesion | $5,392 | $4,130 | 131% | — | 8 |
| Family psychotherapy, with patient | $386 | $187 | 206% | $129 | 21 |
| Family psychotherapy, without patient | $248 | $187 | 133% | $68 | 21 |
| Group psychotherapy | $272 | $107 | 254% | $87 | 21 |
| Heart failure and shock, with CC | $24,579 | $5,927 | 415% | — | 8 |
| Heart failure with MCC | $37,167 | $8,222 | 452% | — | 8 |
| Hip and femur procedures except major joint, with CC | $60,637 | $13,525 | 448% | — | 8 |
| Hysterectomy, no CC/MCC | $35,919 | $10,098 | 356% | — | 8 |
| Inguinal hernia repair, age 5+ | $5,867 | $3,777 | 155% | — | 8 |
| Kidney and urinary tract infections, no MCC | $23,435 | $5,032 | 466% | — | 8 |
| Kidney function panel | $110 | $9 | 1263% | ~$37 | 23 |
| Knee arthroscopy with meniscectomy | $6,027 | $3,452 | 175% | — | 8 |
| Laparoscopic cholecystectomy | $7,904 | $6,377 | 124% | — | 8 |
| Laparoscopic cholecystectomy, no CC/MCC | $39,541 | $8,977 | 440% | — | 8 |
| Laparoscopic radical prostatectomy | $9,678 | $11,213 | 86% | — | 6 |
| Left heart catheterization, diagnostic | $7,366 | $3,420 | 215% | $2,402 | 23 |
| Lipid panel | $192 | $13 | 1431% | ~$65 | 23 |
| Liver function panel | $168 | $8 | 2061% | ~$57 | 23 |
| Lumbar epidural steroid injection | $1,819 | $745 | 244% | $490 | 23 |
| MRI brain with and without contrast | $1,187 | $368 | 323% | ~$881 | 23 |
| MRI lower extremity joint (knee) | $1,187 | $252 | 472% | ~$550 | 23 |
| MRI lumbar spine without contrast | $1,187 | $252 | 472% | ~$644 | 23 |
| Major joint replacement (hip/knee), no MCC | $55,843 | $13,045 | 428% | — | 8 |
| Major joint replacement (hip/knee), with MCC | $87,813 | $22,346 | 393% | — | 8 |
| Major small and large bowel procedures, with CC | $69,400 | $16,194 | 429% | — | 8 |
| Medical back problems, no MCC | $27,830 | $5,450 | 511% | — | 8 |
| OB global care, VBAC delivery | $15,952 | — | — | — | 6 |
| OB global care, cesarean delivery | $16,923 | — | — | — | 6 |
| OB global care, vaginal delivery | $15,290 | — | — | — | 6 |
| OB ultrasound, 14+ weeks | $752 | $110 | 682% | ~$246 | 23 |
| Obstetric blood test panel | $106 | $48 | 221% | ~$35 | 23 |
| Office visit, established patient, level 3 | $522 | — | — | — | 5 |
| Office visit, established patient, level 4 | $768 | — | — | — | 5 |
| Office visit, new patient, level 3 | $647 | — | — | — | 5 |
| Office visit, new patient, level 4 | $1,055 | — | — | — | 5 |
| Office visit, new patient, level 5 | $1,435 | — | — | — | 5 |
| PSA (prostate specific antigen), total | $236 | $18 | 1283% | ~$80 | 23 |
| Partial thromboplastin time | $73 | $6 | 1218% | ~$25 | 23 |
| Physical therapy, therapeutic exercise | $102 | — | — | $26 | 23 |
| Prostate biopsy | $2,901 | — | — | $881 | 23 |
| Prothrombin time | $77 | $4 | 1790% | ~$26 | 23 |
| Psychotherapy, 30 minutes | $272 | $187 | 145% | — | 5 |
| Psychotherapy, 45 minutes | $321 | $187 | 171% | $107 | 21 |
| Psychotherapy, 60 minutes | $383 | $187 | 205% | $128 | 21 |
| Renal failure, with CC | $25,355 | $5,509 | 460% | — | 8 |
| Screening mammography, bilateral | $331 | — | — | ~$108 | 23 |
| Sepsis with MCC | $56,236 | $12,483 | 450% | — | 8 |
| Shoulder arthroscopy, subacromial decompression | $1,364 | — | — | — | 7 |
| Simple pneumonia and pleurisy, with CC | $23,331 | $5,038 | 463% | — | 8 |
| Sleep study (polysomnography) | $5,134 | $906 | 567% | $1,677 | 23 |
| Stroke (hemorrhage/infarction), no CC/MCC | $19,814 | $3,679 | 539% | — | 8 |
| Stroke (hemorrhage/infarction), with CC or tPA | $29,249 | $6,286 | 465% | — | 8 |
| Thyroid stimulating hormone (TSH) | $289 | $17 | 1718% | ~$97 | 23 |
| Tonsillectomy and adenoidectomy, under age 12 | $6,288 | $6,245 | 101% | — | 8 |
| Transforaminal epidural, lumbar/sacral | $2,378 | $933 | 255% | $775 | 23 |
| Ultrasound, abdomen, complete | $752 | $110 | 682% | ~$246 | 23 |
| Ultrasound, transvaginal | $752 | $110 | 682% | ~$246 | 23 |
| Upper GI endoscopy with biopsy | $2,691 | $957 | 281% | $680 | 23 |
| Upper GI endoscopy, diagnostic | $2,396 | $957 | 250% | $605 | 23 |
| Urinalysis, automated, with microscopy | $31 | $3 | 977% | ~$10 | 23 |
| Urinalysis, automated, without microscopy | $51 | $2 | 2284% | ~$17 | 23 |
| Urinalysis, manual, with microscopy | $5 | $4 | 127% | — | 8 |
| Urinalysis, manual, without microscopy | $59 | $3 | 1690% | ~$20 | 23 |
| Vaginal delivery, no sterilization, no CC/MCC | $8,080 | — | — | — | 10 |
| Vaginal delivery, no sterilization, with CC | $8,080 | — | — | — | 10 |
| X-ray, lower back, 4+ views | $561 | $110 | 509% | ~$183 | 23 |
| YAG laser capsulotomy (secondary cataract) | $2,909 | $580 | 501% | — | 8 |