| Basic metabolic panel | $152 | $8 | 1797% | — | 15 |
| CT abdomen and pelvis with contrast | $347 | $356 | 97% | — | 15 |
| CT head without contrast | $162 | $107 | 152% | — | 15 |
| CT pelvis with contrast | $193 | $179 | 108% | — | 15 |
| Cardiac stress test | $115 | $221 | 52% | — | 15 |
| Cataract surgery with IOL insertion | $2,657 | $2,358 | 113% | — | 15 |
| Colonoscopy with biopsy | $1,759 | $1,223 | 144% | — | 15 |
| Colonoscopy with polyp removal | $1,992 | $1,223 | 163% | — | 15 |
| Colonoscopy, diagnostic | $1,604 | $950 | 169% | — | 15 |
| Complete blood count with differential | $102 | $8 | 1308% | — | 15 |
| Complete blood count, automated | $98 | $6 | 1512% | — | 15 |
| Comprehensive metabolic panel | $165 | $11 | 1565% | — | 15 |
| Diagnostic mammography, both breasts | $218 | — | — | — | 15 |
| Diagnostic mammography, one breast | $180 | — | — | — | 15 |
| ED visit, level 3 | $282 | $279 | 101% | — | 15 |
| ED visit, level 4 | $525 | $426 | 123% | — | 15 |
| ED visit, level 5 | $777 | $608 | 128% | — | 15 |
| Echocardiogram, complete | $2,719 | $558 | 487% | — | 15 |
| Electrocardiogram with interpretation | $287 | — | — | — | 15 |
| Epidural injection, lumbar/sacral, no imaging | $393 | $904 | 44% | — | 15 |
| Excision of breast lesion | $1,175 | $4,000 | 29% | — | 15 |
| Inguinal hernia repair, age 5+ | $1,605 | $3,658 | 44% | — | 15 |
| Kidney function panel | $104 | $9 | 1204% | — | 15 |
| Knee arthroscopy with meniscectomy | $1,707 | $3,343 | 51% | — | 15 |
| Laparoscopic cholecystectomy | $2,167 | $6,176 | 35% | — | 15 |
| Lipid panel | $209 | $13 | 1561% | — | 15 |
| Liver function panel | $198 | $8 | 2419% | — | 15 |
| Lumbar epidural steroid injection | $393 | $721 | 55% | — | 15 |
| MRI brain with and without contrast | $380 | $356 | 107% | — | 15 |
| MRI lower extremity joint (knee) | $227 | $244 | 93% | — | 15 |
| MRI lumbar spine without contrast | $247 | $244 | 101% | — | 15 |
| OB global care, VBAC delivery | $4,459 | — | — | — | 15 |
| OB global care, cesarean delivery | $5,079 | — | — | — | 15 |
| OB global care, vaginal delivery | $4,575 | — | — | — | 15 |
| OB ultrasound, 14+ weeks | $231 | $107 | 216% | — | 15 |
| Office consultation, comprehensive | $656 | — | — | — | 15 |
| Office consultation, moderate | $387 | — | — | — | 15 |
| Office visit, established patient, level 3 | $160 | — | — | — | 15 |
| Office visit, established patient, level 4 | $246 | — | — | — | 15 |
| Office visit, new patient, level 3 | $351 | — | — | — | 15 |
| Office visit, new patient, level 4 | $458 | — | — | — | 15 |
| Office visit, new patient, level 5 | $542 | — | — | — | 15 |
| PSA (prostate specific antigen), total | $203 | $18 | 1105% | — | 15 |
| Partial thromboplastin time | $108 | $6 | 1802% | — | 15 |
| Physical therapy, therapeutic exercise | $111 | — | — | — | 15 |
| Preventive visit, new patient, 18-39 | $320 | — | — | — | 15 |
| Preventive visit, new patient, 40-64 | $372 | — | — | — | 15 |
| Prothrombin time | $73 | $4 | 1705% | — | 15 |
| Psychotherapy, 30 minutes | $225 | $181 | 124% | — | 15 |
| Psychotherapy, 45 minutes | $296 | $181 | 163% | — | 15 |
| Psychotherapy, 60 minutes | $440 | $181 | 243% | — | 15 |
| Screening mammography, bilateral | $366 | — | — | — | 15 |
| Shoulder arthroscopy, subacromial decompression | $707 | — | — | — | 15 |
| Sleep study (polysomnography) | $352 | $877 | 40% | — | 15 |
| Thyroid stimulating hormone (TSH) | $165 | $17 | 984% | — | 15 |
| Transforaminal epidural, lumbar/sacral | $2,328 | $904 | 258% | — | 15 |
| Ultrasound, abdomen, complete | $194 | $107 | 181% | — | 15 |
| Ultrasound, transvaginal | $165 | $107 | 155% | — | 15 |
| Upper GI endoscopy with biopsy | $692 | $927 | 75% | — | 15 |
| Upper GI endoscopy, diagnostic | $1,126 | $927 | 121% | — | 15 |
| Urinalysis, automated, with microscopy | $95 | $3 | 2997% | — | 15 |
| Urinalysis, automated, without microscopy | $64 | $2 | 2829% | — | 15 |
| Urinalysis, manual, with microscopy | $26 | $4 | 638% | — | 15 |
| Urinalysis, manual, without microscopy | $23 | $3 | 655% | — | 15 |
| X-ray, lower back, 4+ views | $75 | $107 | 70% | — | 15 |
| YAG laser capsulotomy (secondary cataract) | $1,300 | $562 | 231% | — | 15 |