| Basic metabolic panel | $205 | $8 | 2423% | — | 85 |
| CT abdomen and pelvis with contrast | $5,358 | $356 | 1503% | — | 85 |
| CT head without contrast | $2,252 | $107 | 2108% | — | 85 |
| CT pelvis with contrast | $2,602 | $179 | 1452% | — | 85 |
| Cardiac stress test | $705 | $221 | 320% | — | 85 |
| Cataract surgery with IOL insertion | $2,815 | $2,358 | 119% | — | 85 |
| Colonoscopy with biopsy | $2,112 | $1,223 | 173% | — | 84 |
| Colonoscopy with polyp removal | $2,402 | $1,223 | 196% | — | 84 |
| Colonoscopy, diagnostic | $1,760 | $950 | 185% | — | 84 |
| Complete blood count with differential | $119 | $8 | 1532% | — | 85 |
| Complete blood count, automated | $87 | $6 | 1345% | — | 85 |
| Comprehensive metabolic panel | $253 | $11 | 2396% | — | 85 |
| Diagnostic mammography, both breasts | $521 | — | — | — | 85 |
| Diagnostic mammography, one breast | $434 | — | — | — | 85 |
| ED visit, level 3 | $1,018 | $279 | 365% | — | 84 |
| ED visit, level 4 | $1,643 | $426 | 385% | — | 84 |
| ED visit, level 5 | $2,176 | $608 | 358% | — | 84 |
| Echocardiogram, complete | $1,366 | $558 | 245% | — | 85 |
| Excision of breast lesion | $2,184 | $4,000 | 55% | — | 84 |
| Inguinal hernia repair, age 5+ | $3,023 | $3,658 | 83% | — | 84 |
| Kidney function panel | $393 | $9 | 4528% | — | 85 |
| Laparoscopic cholecystectomy | $4,462 | $6,176 | 72% | — | 84 |
| Lipid panel | $206 | $13 | 1542% | — | 85 |
| Liver function panel | $156 | $8 | 1909% | — | 85 |
| Lumbar epidural steroid injection | $1,728 | $721 | 240% | — | 85 |
| MRI brain with and without contrast | $4,277 | $356 | 1200% | — | 85 |
| MRI lower extremity joint (knee) | $3,759 | $244 | 1542% | — | 85 |
| MRI lumbar spine without contrast | $3,537 | $244 | 1451% | — | 85 |
| OB ultrasound, 14+ weeks | $1,192 | $107 | 1116% | — | 85 |
| Obstetric blood test panel | $508 | $48 | 1063% | — | 85 |
| Office consultation, comprehensive | $985 | — | — | — | 81 |
| Office consultation, moderate | $655 | — | — | — | 81 |
| Office visit, established patient, level 3 | $367 | — | — | — | 84 |
| Office visit, established patient, level 4 | $588 | — | — | — | 84 |
| Office visit, new patient, level 3 | $603 | — | — | — | 84 |
| Office visit, new patient, level 4 | $863 | — | — | — | 84 |
| Office visit, new patient, level 5 | $1,103 | — | — | — | 84 |
| PSA (prostate specific antigen), total | $267 | $18 | 1452% | — | 85 |
| Partial thromboplastin time | $60 | $6 | 998% | — | 85 |
| Physical therapy, therapeutic exercise | $140 | — | — | — | 85 |
| Prothrombin time | $54 | $4 | 1247% | — | 85 |
| Screening mammography, bilateral | $301 | — | — | — | 85 |
| Sleep study (polysomnography) | $3,193 | $877 | 364% | — | 85 |
| Thyroid stimulating hormone (TSH) | $150 | $17 | 890% | — | 85 |
| Tonsillectomy and adenoidectomy, under age 12 | $1,562 | $6,048 | 26% | — | 84 |
| Transforaminal epidural, lumbar/sacral | $2,898 | $904 | 321% | — | 85 |
| Ultrasound, abdomen, complete | $1,050 | $107 | 983% | — | 85 |
| Ultrasound, transvaginal | $1,028 | $107 | 962% | — | 85 |
| Upper GI endoscopy with biopsy | $1,646 | $927 | 178% | — | 84 |
| Upper GI endoscopy, diagnostic | $1,481 | $927 | 160% | — | 84 |
| Urinalysis, automated, with microscopy | $96 | $3 | 3028% | — | 85 |
| Urinalysis, automated, without microscopy | $52 | $2 | 2311% | — | 85 |
| X-ray, lower back, 4+ views | $899 | $107 | 842% | — | 85 |