| Basic metabolic panel | $105 | $8 | 1245% | — | 18 |
| CT abdomen and pelvis with contrast | $342 | $356 | 96% | — | 18 |
| CT head without contrast | $251 | $107 | 235% | — | 18 |
| CT pelvis with contrast | $322 | $179 | 180% | — | 18 |
| Cardiac stress test | $1,095 | $221 | 496% | — | 18 |
| Cataract surgery with IOL insertion | $513 | $2,358 | 22% | — | 18 |
| Colonoscopy with biopsy | $661 | $1,223 | 54% | — | 18 |
| Colonoscopy with polyp removal | $823 | $1,223 | 67% | — | 18 |
| Colonoscopy, diagnostic | $1,953 | $950 | 206% | — | 18 |
| Complete blood count with differential | $69 | $8 | 889% | — | 18 |
| Complete blood count, automated | $62 | $6 | 961% | — | 18 |
| Comprehensive metabolic panel | $140 | $11 | 1328% | — | 19 |
| Diagnostic mammography, both breasts | $138 | — | — | — | 18 |
| Diagnostic mammography, one breast | $340 | — | — | — | 18 |
| ED visit, level 3 | $459 | $279 | 165% | — | 19 |
| ED visit, level 4 | $670 | $426 | 157% | — | 19 |
| ED visit, level 5 | $724 | $608 | 119% | — | 19 |
| Echocardiogram, complete | $2,274 | $558 | 407% | — | 18 |
| Electrocardiogram with interpretation | $243 | — | — | — | 19 |
| Epidural injection, lumbar/sacral, no imaging | $198 | $904 | 22% | — | 18 |
| Family psychotherapy, with patient | $114 | $181 | 63% | — | 17 |
| Family psychotherapy, without patient | $114 | $181 | 63% | — | 17 |
| Group psychotherapy | $163 | $104 | 157% | — | 17 |
| Inguinal hernia repair, age 5+ | $2,999 | $3,658 | 82% | — | 17 |
| Kidney function panel | $135 | $9 | 1552% | — | 18 |
| Knee arthroscopy with meniscectomy | $3,815 | $3,343 | 114% | — | 18 |
| Laparoscopic cholecystectomy | $3,970 | $6,176 | 64% | — | 17 |
| Lipid panel | $123 | $13 | 922% | — | 18 |
| Liver function panel | $126 | $8 | 1543% | — | 18 |
| Lumbar epidural steroid injection | $1,286 | $721 | 178% | — | 18 |
| MRI brain with and without contrast | $490 | $356 | 138% | — | 18 |
| MRI lower extremity joint (knee) | $1,388 | $244 | 569% | — | 19 |
| MRI lumbar spine without contrast | $323 | $244 | 133% | — | 18 |
| OB global care, VBAC delivery | $6,190 | — | — | — | 17 |
| OB global care, cesarean delivery | $6,566 | — | — | — | 17 |
| OB global care, vaginal delivery | $3,970 | — | — | — | 17 |
| OB ultrasound, 14+ weeks | $346 | $107 | 324% | — | 18 |
| Office consultation, comprehensive | $419 | — | — | — | 14 |
| Office consultation, moderate | $283 | — | — | — | 14 |
| Office visit, established patient, level 3 | $212 | — | — | — | 19 |
| Office visit, established patient, level 4 | $262 | — | — | — | 19 |
| Office visit, new patient, level 3 | $261 | — | — | — | 19 |
| Office visit, new patient, level 4 | $335 | — | — | — | 19 |
| Office visit, new patient, level 5 | $429 | — | — | — | 19 |
| PSA (prostate specific antigen), total | $155 | $18 | 845% | — | 18 |
| Partial thromboplastin time | $87 | $6 | 1451% | — | 18 |
| Physical therapy, therapeutic exercise | $114 | — | — | — | 18 |
| Preventive visit, new patient, 18-39 | $247 | — | — | — | 14 |
| Preventive visit, new patient, 40-64 | $354 | — | — | — | 14 |
| Prothrombin time | $37 | $4 | 855% | — | 18 |
| Psychotherapy, 30 minutes | $67 | $181 | 37% | — | 17 |
| Psychotherapy, 45 minutes | $114 | $181 | 63% | — | 17 |
| Psychotherapy, 60 minutes | $146 | $181 | 80% | — | 17 |
| Screening mammography, bilateral | $230 | — | — | — | 18 |
| Shoulder arthroscopy, subacromial decompression | $450 | — | — | — | 18 |
| Sleep study (polysomnography) | $291 | $877 | 33% | — | 18 |
| Thyroid stimulating hormone (TSH) | $122 | $17 | 725% | — | 18 |
| Transforaminal epidural, lumbar/sacral | $1,263 | $904 | 140% | — | 18 |
| Ultrasound, abdomen, complete | $222 | $107 | 208% | — | 18 |
| Ultrasound, transvaginal | $310 | $107 | 291% | — | 18 |
| Upper GI endoscopy with biopsy | $450 | $927 | 49% | — | 18 |
| Upper GI endoscopy, diagnostic | $401 | $927 | 43% | — | 18 |
| Urinalysis, automated, with microscopy | $67 | $3 | 2124% | — | 18 |
| Urinalysis, automated, without microscopy | $35 | $2 | 1535% | — | 18 |
| Urinalysis, manual, without microscopy | $28 | $3 | 819% | — | 18 |
| X-ray, lower back, 4+ views | $93 | $107 | 87% | — | 18 |
| YAG laser capsulotomy (secondary cataract) | $697 | $562 | 124% | — | 18 |