| Basic metabolic panelCPT 80048 | $18 | $8 | 208% | — | 6 |
| CT abdomen and pelvis with contrastCPT 74177 | $816 | $356 | 229% | — | 6 |
| CT head without contrastCPT 70450 | $240 | $107 | 224% | — | 6 |
| CT pelvis with contrastCPT 72193 | $390 | $179 | 217% | — | 6 |
| Cataract surgery with IOL insertionCPT 66984 | $5,941 | $2,358 | 252% | — | 1 |
| Colonoscopy with biopsyCPT 45380 | $5,941 | $1,223 | 486% | — | 1 |
| Colonoscopy with endoscopic ultrasoundCPT 45391 | $5,941 | $1,223 | 486% | — | 1 |
| Colonoscopy with polyp removalCPT 45385 | $5,941 | $1,223 | 486% | — | 1 |
| Colonoscopy, diagnosticCPT 45378 | $3,818 | $950 | 402% | — | 1 |
| Complete blood count with differentialCPT 85025 | $16 | $8 | 208% | — | 6 |
| Complete blood count, automatedCPT 85027 | $13 | $6 | 208% | — | 6 |
| Comprehensive metabolic panelCPT 80053 | $22 | $11 | 208% | — | 6 |
| Diagnostic mammography, both breastsCPT 77066 | $245 | — | — | — | 6 |
| Diagnostic mammography, one breastCPT 77065 | $192 | — | — | — | 6 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $3,818 | $904 | 423% | — | 1 |
| Excision of breast lesionCPT 19120 | $18,563 | $4,000 | 464% | — | 1 |
| Inguinal hernia repair, age 5+CPT 49505 | $18,563 | $3,658 | 507% | — | 1 |
| Kidney function panelCPT 80069 | $18 | $9 | 208% | — | 6 |
| Knee arthroscopy with meniscectomyCPT 29881 | $18,563 | $3,343 | 555% | — | 1 |
| Laparoscopic cholecystectomyCPT 47562 | $28,218 | $6,176 | 457% | — | 1 |
| Laparoscopic radical prostatectomyCPT 55866 | $37,127 | $10,860 | 342% | — | 1 |
| Left heart catheterization, diagnosticCPT 93452 | $18,563 | $3,312 | 560% | — | 1 |
| Lipid panelCPT 80061 | $38 | $13 | 284% | — | 6 |
| Liver function panelCPT 80076 | $17 | $8 | 208% | — | 6 |
| Lumbar epidural steroid injectionCPT 62323 | $3,818 | $721 | 529% | — | 1 |
| MRI brain with and without contrastCPT 70553 | $816 | $356 | 229% | — | 6 |
| MRI lower extremity joint (knee)CPT 73721 | $553 | $244 | 227% | — | 6 |
| MRI lumbar spine without contrastCPT 72148 | $498 | $244 | 204% | — | 6 |
| OB global care, VBAC deliveryCPT 59610 | $18,563 | — | — | — | 1 |
| OB global care, cesarean deliveryCPT 59510 | $18,563 | — | — | — | 1 |
| OB global care, vaginal deliveryCPT 59400 | $18,563 | — | — | — | 1 |
| OB ultrasound, 14+ weeksCPT 76805 | $247 | $107 | 232% | — | 6 |
| Obstetric blood test panelCPT 80055 | $99 | $48 | 208% | — | 6 |
| PSA (prostate specific antigen), totalCPT 84153 | $38 | $18 | 208% | — | 6 |
| Partial thromboplastin timeCPT 85730 | $12 | $6 | 208% | — | 6 |
| Prostate biopsyCPT 55700 | $5,941 | — | — | — | 1 |
| Prothrombin timeCPT 85610 | $8 | $4 | 193% | — | 6 |
| Screening mammography, bilateralCPT 77067 | $203 | — | — | — | 6 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $35 | $17 | 208% | — | 6 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $24,928 | $6,048 | 412% | — | 1 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $3,818 | $904 | 423% | — | 1 |
| Ultrasound, abdomen, completeCPT 76700 | $247 | $107 | 232% | — | 6 |
| Ultrasound, transvaginalCPT 76830 | $247 | $107 | 232% | — | 6 |
| Upper GI endoscopy with biopsyCPT 43239 | $3,818 | $927 | 412% | — | 1 |
| Upper GI endoscopy, diagnosticCPT 43235 | $3,818 | $927 | 412% | — | 1 |
| Urinalysis, automated, with microscopyCPT 81001 | $7 | $3 | 209% | — | 6 |
| Urinalysis, automated, without microscopyCPT 81003 | $5 | $2 | 208% | — | 6 |
| Urinalysis, manual, with microscopyCPT 81000 | $7 | $4 | 171% | — | 6 |
| Urinalysis, manual, without microscopyCPT 81002 | $6 | $3 | 171% | — | 6 |
| X-ray, lower back, 4+ viewsCPT 72110 | $247 | $107 | 232% | — | 6 |
| YAG laser capsulotomy (secondary cataract)CPT 66821 | $3,818 | $562 | 679% | — | 1 |