| Basic metabolic panelCPT 80048 | $17 | $8 | 200% | — | 5 |
| CT abdomen and pelvis with contrastCPT 74177 | $781 | $369 | 211% | — | 2 |
| CT head without contrastCPT 70450 | $231 | $111 | 209% | — | 2 |
| CT pelvis with contrastCPT 72193 | $382 | $186 | 206% | — | 2 |
| Cardiac stress testCPT 93017 | $457 | $228 | 200% | — | 1 |
| Cataract surgery with IOL insertionCPT 66984 | $4,883 | $2,442 | 200% | — | 1 |
| Colonoscopy with biopsyCPT 45380 | $2,532 | $1,266 | 200% | — | 1 |
| Colonoscopy with endoscopic ultrasoundCPT 45391 | $2,532 | $1,266 | 200% | — | 1 |
| Colonoscopy with polyp removalCPT 45385 | $2,532 | $1,266 | 200% | — | 1 |
| Colonoscopy, diagnosticCPT 45378 | $1,968 | $984 | 200% | — | 1 |
| Complete blood count with differentialCPT 85025 | $16 | $8 | 200% | — | 5 |
| Complete blood count, automatedCPT 85027 | $13 | $6 | 200% | — | 5 |
| Comprehensive metabolic panelCPT 80053 | $21 | $11 | 200% | — | 5 |
| Diagnostic mammography, both breastsCPT 77066 | $225 | — | — | — | 2 |
| Diagnostic mammography, one breastCPT 77065 | $176 | — | — | — | 2 |
| ED visit, level 3CPT 99283 | $578 | $289 | 200% | — | 1 |
| ED visit, level 4CPT 99284 | $883 | $441 | 200% | — | 1 |
| ED visit, level 5CPT 99285 | $1,260 | $630 | 200% | — | 1 |
| Echocardiogram, completeCPT 93306 | $1,156 | $578 | 200% | — | 1 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $1,872 | $936 | 200% | — | 1 |
| Excision of breast lesionCPT 19120 | $8,285 | $4,143 | 200% | — | 1 |
| Family psychotherapy, with patientCPT 90847 | $376 | $188 | 200% | — | 1 |
| Family psychotherapy, without patientCPT 90846 | $376 | $188 | 200% | — | 1 |
| Group psychotherapyCPT 90853 | $215 | $107 | 200% | — | 1 |
| Inguinal hernia repair, age 5+CPT 49505 | $7,576 | $3,788 | 200% | — | 1 |
| Kidney function panelCPT 80069 | $17 | $9 | 200% | — | 5 |
| Knee arthroscopy with meniscectomyCPT 29881 | $6,924 | $3,462 | 200% | — | 1 |
| Laparoscopic cholecystectomyCPT 47562 | $12,792 | $6,396 | 200% | — | 1 |
| Laparoscopic radical prostatectomyCPT 55866 | $22,493 | $11,246 | 200% | — | 1 |
| Lipid panelCPT 80061 | $27 | $13 | 200% | — | 5 |
| Liver function panelCPT 80076 | $16 | $8 | 200% | — | 5 |
| Lumbar epidural steroid injectionCPT 62323 | $1,494 | $747 | 200% | — | 1 |
| MRI brain with and without contrastCPT 70553 | $781 | $369 | 211% | — | 2 |
| MRI lower extremity joint (knee)CPT 73721 | $566 | $252 | 224% | — | 2 |
| MRI lumbar spine without contrastCPT 72148 | $504 | $252 | 199% | — | 2 |
| OB ultrasound, 14+ weeksCPT 76805 | $236 | $111 | 213% | — | 2 |
| Obstetric blood test panelCPT 80055 | $96 | $48 | 200% | — | 5 |
| PSA (prostate specific antigen), totalCPT 84153 | $37 | $18 | 200% | — | 5 |
| Partial thromboplastin timeCPT 85730 | $12 | $6 | 200% | — | 5 |
| Physical therapy, therapeutic exerciseCPT 97110 | $39 | — | — | — | 2 |
| Prothrombin timeCPT 85610 | $8 | $4 | 186% | — | 5 |
| Psychotherapy, 30 minutesCPT 90832 | $376 | $188 | 200% | — | 1 |
| Psychotherapy, 45 minutesCPT 90834 | $376 | $188 | 200% | — | 1 |
| Psychotherapy, 60 minutesCPT 90837 | $376 | $188 | 200% | — | 1 |
| Screening mammography, bilateralCPT 77067 | $186 | — | — | — | 2 |
| Sleep study (polysomnography)CPT 95810 | $1,817 | $909 | 200% | — | 1 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $34 | $17 | 200% | — | 5 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $12,526 | $6,263 | 200% | — | 1 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $1,872 | $936 | 200% | — | 1 |
| Ultrasound, abdomen, completeCPT 76700 | $236 | $111 | 213% | — | 2 |
| Ultrasound, transvaginalCPT 76830 | $236 | $111 | 213% | — | 2 |
| Upper GI endoscopy with biopsyCPT 43239 | $1,919 | $960 | 200% | — | 1 |
| Upper GI endoscopy, diagnosticCPT 43235 | $1,919 | $960 | 200% | — | 1 |
| Urinalysis, automated, with microscopyCPT 81001 | $6 | $3 | 200% | — | 5 |
| Urinalysis, automated, without microscopyCPT 81003 | $4 | $2 | 200% | — | 5 |
| Urinalysis, manual, with microscopyCPT 81000 | $7 | $4 | 165% | — | 5 |
| Urinalysis, manual, without microscopyCPT 81002 | $6 | $3 | 164% | — | 5 |
| X-ray, lower back, 4+ viewsCPT 72110 | $236 | $111 | 213% | — | 2 |