| Acute myocardial infarction, discharged alive, with MCC | $15,877 | $11,217 | 142% | — | 2 |
| Bariatric (obesity) surgery, no CC/MCC | $14,930 | $8,272 | 180% | — | 2 |
| Basic metabolic panel | $105 | $8 | 1241% | — | 18 |
| COPD with MCC | $10,964 | $7,377 | 149% | — | 2 |
| CT abdomen and pelvis with contrast | $3,509 | $356 | 984% | — | 18 |
| CT head without contrast | $1,969 | $107 | 1844% | — | 18 |
| CT pelvis with contrast | $1,836 | $179 | 1024% | — | 18 |
| Cardiac arrhythmia, no CC/MCC | $5,603 | $3,269 | 171% | — | 2 |
| Cardiac stress test | $1,044 | $221 | 473% | — | 18 |
| Cardiac valve surgery with cardiac cath, with MCC | $96,828 | — | — | — | 2 |
| Cataract surgery with IOL insertion | $2,434 | $2,358 | 103% | — | 3 |
| Cellulitis, no MCC | $8,620 | $5,675 | 152% | — | 2 |
| Cervical spinal fusion, no CC/MCC | $24,163 | $16,343 | 148% | — | 2 |
| Cesarean section, no CC/MCC | $9,490 | — | — | — | 2 |
| Cesarean section, with CC | $11,054 | — | — | — | 2 |
| Chest pain | $7,126 | — | — | — | 2 |
| Colonoscopy with biopsy | $1,262 | $1,223 | 103% | — | 3 |
| Colonoscopy with endoscopic ultrasound | $1,262 | $1,223 | 103% | — | 3 |
| Colonoscopy with polyp removal | $1,262 | $1,223 | 103% | — | 3 |
| Colonoscopy, diagnostic | $981 | $950 | 103% | — | 3 |
| Complete blood count with differential | $67 | $8 | 859% | — | 18 |
| Complete blood count, automated | $48 | $6 | 743% | — | 18 |
| Comprehensive metabolic panel | $125 | $11 | 1188% | — | 18 |
| Coronary bypass without cardiac cath, no MCC | $41,460 | $29,950 | 138% | — | 2 |
| Diagnostic mammography, both breasts | $515 | — | — | — | 18 |
| Diagnostic mammography, one breast | $466 | — | — | — | 18 |
| ED visit, level 3 | $556 | $279 | 199% | — | 18 |
| ED visit, level 4 | $980 | $426 | 230% | — | 18 |
| ED visit, level 5 | $1,505 | $608 | 247% | — | 18 |
| Echocardiogram, complete | $2,214 | $558 | 397% | — | 18 |
| Electrocardiogram with interpretation | $14 | — | — | — | 1 |
| Epidural injection, lumbar/sacral, no imaging | $999 | $904 | 111% | — | 18 |
| Esophagitis/GI disorders, no MCC | $7,716 | $4,899 | 158% | — | 2 |
| Excision of breast lesion | $4,130 | $4,000 | 103% | — | 3 |
| Family psychotherapy, with patient | $187 | $181 | 103% | — | 3 |
| Family psychotherapy, without patient | $187 | $181 | 103% | — | 3 |
| Group psychotherapy | $107 | $104 | 103% | — | 3 |
| Heart failure and shock, with CC | $8,403 | $5,927 | 142% | — | 2 |
| Heart failure with MCC | $12,707 | $8,962 | 142% | — | 2 |
| Hip and femur procedures except major joint, with CC | $20,731 | $13,876 | 149% | — | 2 |
| Hysterectomy, no CC/MCC | $12,280 | $10,098 | 122% | — | 2 |
| Inguinal hernia repair, age 5+ | $3,777 | $3,658 | 103% | — | 3 |
| Kidney and urinary tract infections, no MCC | $8,012 | $5,238 | 153% | — | 2 |
| Kidney function panel | $106 | $9 | 1220% | — | 18 |
| Knee arthroscopy with meniscectomy | $3,452 | $3,343 | 103% | — | 3 |
| Laparoscopic cholecystectomy | $6,377 | $6,176 | 103% | — | 3 |
| Laparoscopic cholecystectomy, no CC/MCC | $13,518 | $8,977 | 151% | — | 2 |
| Laparoscopic radical prostatectomy | $11,213 | $10,860 | 103% | — | 3 |
| Left heart catheterization, diagnostic | $3,420 | $3,312 | 103% | — | 3 |
| Lipid panel | $117 | $13 | 877% | — | 18 |
| Liver function panel | $136 | $8 | 1667% | — | 18 |
| Lumbar epidural steroid injection | $2,271 | $721 | 315% | — | 18 |
| MRI brain with and without contrast | $3,934 | $356 | 1104% | — | 18 |
| MRI lower extremity joint (knee) | $2,326 | $244 | 954% | — | 18 |
| MRI lumbar spine without contrast | $2,442 | $244 | 1002% | — | 18 |
| Major joint replacement (hip/knee), no MCC | $19,092 | $13,045 | 146% | — | 2 |
| Major joint replacement (hip/knee), with MCC | $30,022 | $22,346 | 134% | — | 2 |
| Major small and large bowel procedures, with CC | $23,727 | $16,202 | 146% | — | 2 |
| Medical back problems, no MCC | $9,515 | $6,142 | 155% | — | 2 |
| OB global care, VBAC delivery | $2,266 | — | — | — | 1 |
| OB global care, cesarean delivery | $2,395 | — | — | — | 1 |
| OB global care, vaginal delivery | $2,176 | — | — | — | 1 |
| OB ultrasound, 14+ weeks | $421 | $107 | 394% | — | 18 |
| Obstetric blood test panel | $78 | $48 | 162% | — | 2 |
| Office consultation, comprehensive | $138 | — | — | — | 1 |
| Office consultation, moderate | $86 | — | — | — | 1 |
| Office visit, established patient, level 3 | $60 | — | — | — | 16 |
| Office visit, established patient, level 4 | $157 | — | — | — | 16 |
| Office visit, new patient, level 3 | $60 | — | — | — | 16 |
| Office visit, new patient, level 4 | $96 | — | — | — | 16 |
| Office visit, new patient, level 5 | $168 | — | — | — | 1 |
| PSA (prostate specific antigen), total | $149 | $18 | 808% | — | 18 |
| Partial thromboplastin time | $72 | $6 | 1200% | — | 18 |
| Physical therapy, therapeutic exercise | $120 | — | — | — | 18 |
| Preventive visit, new patient, 18-39 | $88 | — | — | — | 1 |
| Preventive visit, new patient, 40-64 | $107 | — | — | — | 1 |
| Prostate biopsy | $118 | — | — | — | 1 |
| Prothrombin time | $50 | $4 | 1162% | — | 18 |
| Psychotherapy, 30 minutes | $187 | $181 | 103% | — | 3 |
| Psychotherapy, 45 minutes | $187 | $181 | 103% | — | 3 |
| Psychotherapy, 60 minutes | $187 | $181 | 103% | — | 3 |
| Renal failure, with CC | $8,668 | $5,892 | 147% | — | 2 |
| Screening mammography, bilateral | $471 | — | — | — | 18 |
| Sepsis with MCC | $19,226 | $13,837 | 139% | — | 2 |
| Shoulder arthroscopy, subacromial decompression | $158 | — | — | — | 1 |
| Simple pneumonia and pleurisy, with CC | $7,977 | $5,177 | 154% | — | 2 |
| Sleep study (polysomnography) | $3,011 | $877 | 343% | — | 18 |
| Stroke (hemorrhage/infarction), no CC/MCC | $6,774 | $3,679 | 184% | — | 2 |
| Stroke (hemorrhage/infarction), with CC or tPA | $10,000 | $6,559 | 152% | — | 2 |
| Thyroid stimulating hormone (TSH) | $80 | $17 | 477% | — | 18 |
| Tonsillectomy and adenoidectomy, under age 12 | $6,245 | $6,048 | 103% | — | 3 |
| Transforaminal epidural, lumbar/sacral | $933 | $904 | 103% | — | 3 |
| Ultrasound, abdomen, complete | $546 | $107 | 512% | — | 18 |
| Ultrasound, transvaginal | $405 | $107 | 379% | — | 18 |
| Upper GI endoscopy with biopsy | $957 | $927 | 103% | — | 3 |
| Upper GI endoscopy, diagnostic | $957 | $927 | 103% | — | 3 |
| Urinalysis, automated, with microscopy | $61 | $3 | 1937% | — | 18 |
| Urinalysis, automated, without microscopy | $32 | $2 | 1424% | — | 18 |
| Urinalysis, manual, with microscopy | $7 | $4 | 163% | — | 2 |
| Urinalysis, manual, without microscopy | $20 | $3 | 588% | — | 18 |
| Vaginal delivery, no sterilization, no CC/MCC | $6,673 | — | — | — | 2 |
| Vaginal delivery, no sterilization, with CC | $7,463 | — | — | — | 2 |
| X-ray, lower back, 4+ views | $539 | $107 | 504% | — | 18 |
| YAG laser capsulotomy (secondary cataract) | $580 | $562 | 103% | — | 3 |