| Basic metabolic panelCPT 80048 | $8 | $8 | 100% | — | 3 |
| CT abdomen and pelvis with contrastCPT 74177 | $265 | $356 | 74% | — | 3 |
| CT head without contrastCPT 70450 | $113 | $107 | 106% | — | 3 |
| CT pelvis with contrastCPT 72193 | $265 | $179 | 148% | — | 3 |
| Cardiac stress testCPT 93017 | $105 | $221 | 48% | — | 2 |
| Cataract surgery with IOL insertionCPT 66984 | $1,711 | $2,358 | 73% | — | 3 |
| Colonoscopy with biopsyCPT 45380 | $1,148 | $1,223 | 94% | — | 3 |
| Colonoscopy with endoscopic ultrasoundCPT 45391 | $729 | $1,223 | 60% | — | 3 |
| Colonoscopy with polyp removalCPT 45385 | $1,298 | $1,223 | 106% | — | 3 |
| Colonoscopy, diagnosticCPT 45378 | $971 | $950 | 102% | — | 3 |
| Complete blood count with differentialCPT 85025 | $8 | $8 | 100% | — | 3 |
| Complete blood count, automatedCPT 85027 | $6 | $6 | 100% | — | 3 |
| Comprehensive metabolic panelCPT 80053 | $11 | $11 | 100% | — | 3 |
| Diagnostic mammography, both breastsCPT 77066 | $123 | — | — | — | 3 |
| Diagnostic mammography, one breastCPT 77065 | $96 | — | — | — | 3 |
| ED visit, level 3CPT 99283 | $121 | $279 | 44% | — | 2 |
| ED visit, level 4CPT 99284 | $198 | $426 | 46% | — | 2 |
| ED visit, level 5CPT 99285 | $303 | $608 | 50% | — | 2 |
| Echocardiogram, completeCPT 93306 | $319 | $558 | 57% | — | 2 |
| Electrocardiogram with interpretationCPT 93000 | $43 | — | — | — | 2 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $182 | $904 | 20% | — | 3 |
| Excision of breast lesionCPT 19120 | $1,037 | $4,000 | 26% | — | 3 |
| Family psychotherapy, with patientCPT 90847 | $207 | $181 | 114% | — | 2 |
| Family psychotherapy, without patientCPT 90846 | $178 | $181 | 98% | — | 2 |
| Group psychotherapyCPT 90853 | $57 | $104 | 55% | — | 2 |
| Inguinal hernia repair, age 5+CPT 49505 | $1,188 | $3,658 | 32% | — | 3 |
| Kidney function panelCPT 80069 | $9 | $9 | 100% | — | 3 |
| Knee arthroscopy with meniscectomyCPT 29881 | $1,529 | $3,343 | 46% | — | 3 |
| Laparoscopic cholecystectomyCPT 47562 | $1,686 | $6,176 | 27% | — | 3 |
| Laparoscopic radical prostatectomyCPT 55866 | $3,278 | $10,860 | 30% | — | 3 |
| Left heart catheterization, diagnosticCPT 93452 | $1,600 | $3,312 | 48% | — | 3 |
| Lipid panelCPT 80061 | $13 | $13 | 100% | — | 3 |
| Liver function panelCPT 80076 | $8 | $8 | 100% | — | 3 |
| Lumbar epidural steroid injectionCPT 62323 | $208 | $721 | 29% | — | 3 |
| MRI brain with and without contrastCPT 70553 | $427 | $356 | 120% | — | 3 |
| MRI lower extremity joint (knee)CPT 73721 | $226 | $244 | 93% | — | 3 |
| MRI lumbar spine without contrastCPT 72148 | $226 | $244 | 93% | — | 3 |
| OB global care, VBAC deliveryCPT 59610 | $3,382 | — | — | — | 2 |
| OB global care, cesarean deliveryCPT 59510 | $3,542 | — | — | — | 2 |
| OB global care, vaginal deliveryCPT 59400 | $3,266 | — | — | — | 2 |
| OB ultrasound, 14+ weeksCPT 76805 | $113 | $107 | 106% | — | 3 |
| Obstetric blood test panelCPT 80055 | $48 | $48 | 100% | — | 3 |
| Office consultation, comprehensiveCPT 99244 | $332 | — | — | — | 2 |
| Office consultation, moderateCPT 99243 | $231 | — | — | — | 2 |
| Office visit, established patient, level 3CPT 99213 | $100 | — | — | — | 2 |
| Office visit, established patient, level 4CPT 99214 | $165 | — | — | — | 2 |
| Office visit, new patient, level 3CPT 99203 | $190 | — | — | — | 2 |
| Office visit, new patient, level 4CPT 99204 | $277 | — | — | — | 2 |
| Office visit, new patient, level 5CPT 99205 | $350 | — | — | — | 2 |
| PSA (prostate specific antigen), totalCPT 84153 | $18 | $18 | 100% | — | 3 |
| Partial thromboplastin timeCPT 85730 | $6 | $6 | 100% | — | 3 |
| Physical therapy, therapeutic exerciseCPT 97110 | $48 | — | — | — | 3 |
| Preventive visit, new patient, 18-39CPT 99385 | $234 | — | — | — | 2 |
| Preventive visit, new patient, 40-64CPT 99386 | $274 | — | — | — | 2 |
| Prostate biopsyCPT 55700 | $560 | — | — | — | 3 |
| Prothrombin timeCPT 85610 | $4 | $4 | 100% | — | 3 |
| Psychotherapy, 30 minutesCPT 90832 | $84 | $181 | 47% | — | 2 |
| Psychotherapy, 45 minutesCPT 90834 | $121 | $181 | 67% | — | 2 |
| Psychotherapy, 60 minutesCPT 90837 | $183 | $181 | 101% | — | 2 |
| Screening mammography, bilateralCPT 77067 | $101 | — | — | — | 3 |
| Shoulder arthroscopy, subacromial decompressionCPT 29826 | $857 | — | — | — | 3 |
| Sleep study (polysomnography)CPT 95810 | $1,022 | $877 | 116% | — | 2 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $17 | $17 | 100% | — | 3 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $725 | $6,048 | 12% | — | 3 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $942 | $904 | 104% | — | 3 |
| Ultrasound, abdomen, completeCPT 76700 | $113 | $107 | 106% | — | 3 |
| Ultrasound, transvaginalCPT 76830 | $113 | $107 | 106% | — | 3 |
| Upper GI endoscopy with biopsyCPT 43239 | $842 | $927 | 91% | — | 3 |
| Upper GI endoscopy, diagnosticCPT 43235 | $741 | $927 | 80% | — | 3 |
| Urinalysis, automated, with microscopyCPT 81001 | $3 | $3 | 100% | — | 3 |
| Urinalysis, automated, without microscopyCPT 81003 | $2 | $2 | 100% | — | 3 |
| Urinalysis, manual, with microscopyCPT 81000 | $4 | $4 | 100% | — | 3 |
| Urinalysis, manual, without microscopyCPT 81002 | $3 | $3 | 100% | — | 3 |
| X-ray, lower back, 4+ viewsCPT 72110 | $90 | $107 | 84% | — | 3 |
| YAG laser capsulotomy (secondary cataract)CPT 66821 | $630 | $562 | 112% | — | 3 |