| Basic metabolic panelCPT 80048 | $19 | $8 | 225% | — | 20 |
| CT abdomen and pelvis with contrastCPT 74177 | $794 | $356 | 223% | — | 20 |
| CT head without contrastCPT 70450 | $681 | $107 | 637% | — | 20 |
| CT pelvis with contrastCPT 72193 | $790 | $179 | 441% | — | 20 |
| Cardiac stress testCPT 93017 | $329 | $221 | 149% | — | 20 |
| Colonoscopy with biopsyCPT 45380 | $1,674 | $1,223 | 137% | — | 20 |
| Complete blood count with differentialCPT 85025 | $17 | $8 | 224% | — | 20 |
| Complete blood count, automatedCPT 85027 | $14 | $6 | 223% | — | 20 |
| Comprehensive metabolic panelCPT 80053 | $23 | $11 | 218% | — | 20 |
| Diagnostic mammography, both breastsCPT 77066 | $135 | — | — | — | 19 |
| Diagnostic mammography, one breastCPT 77065 | $117 | — | — | — | 19 |
| ED visit, level 3CPT 99283 | $456 | $279 | 163% | — | 20 |
| ED visit, level 4CPT 99284 | $915 | $426 | 215% | — | 20 |
| ED visit, level 5CPT 99285 | $1,431 | $608 | 235% | — | 20 |
| Echocardiogram, completeCPT 93306 | $707 | $558 | 127% | — | 20 |
| Family psychotherapy, with patientCPT 90847 | $135 | $181 | 75% | — | 17 |
| Family psychotherapy, without patientCPT 90846 | $128 | $181 | 71% | — | 17 |
| Group psychotherapyCPT 90853 | $82 | $104 | 79% | — | 17 |
| Kidney function panelCPT 80069 | $19 | $9 | 223% | — | 20 |
| Lipid panelCPT 80061 | $30 | $13 | 226% | — | 20 |
| Liver function panelCPT 80076 | $18 | $8 | 222% | — | 20 |
| MRI brain with and without contrastCPT 70553 | $1,039 | $356 | 291% | — | 20 |
| MRI lower extremity joint (knee)CPT 73721 | $942 | $244 | 386% | — | 20 |
| MRI lumbar spine without contrastCPT 72148 | $933 | $244 | 383% | — | 20 |
| OB ultrasound, 14+ weeksCPT 76805 | $239 | $107 | 224% | — | 20 |
| Obstetric blood test panelCPT 80055 | $92 | $48 | 193% | — | 20 |
| Office visit, established patient, level 3CPT 99213 | $60 | — | — | — | 18 |
| Office visit, established patient, level 4CPT 99214 | $69 | — | — | — | 18 |
| Office visit, new patient, level 3CPT 99203 | $71 | — | — | — | 18 |
| Office visit, new patient, level 4CPT 99204 | $94 | — | — | — | 18 |
| Office visit, new patient, level 5CPT 99205 | $120 | — | — | — | 18 |
| PSA (prostate specific antigen), totalCPT 84153 | $41 | $18 | 225% | — | 20 |
| Partial thromboplastin timeCPT 85730 | $14 | $6 | 225% | — | 20 |
| Physical therapy, therapeutic exerciseCPT 97110 | $51 | — | — | — | 20 |
| Prothrombin timeCPT 85610 | $9 | $4 | 203% | — | 20 |
| Psychotherapy, 30 minutesCPT 90832 | $75 | $181 | 41% | — | 17 |
| Psychotherapy, 45 minutesCPT 90834 | $92 | $181 | 51% | — | 17 |
| Psychotherapy, 60 minutesCPT 90837 | $99 | $181 | 55% | — | 17 |
| Screening mammography, bilateralCPT 77067 | $108 | — | — | — | 19 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $38 | $17 | 225% | — | 20 |
| Ultrasound, abdomen, completeCPT 76700 | $290 | $107 | 271% | — | 20 |
| Ultrasound, transvaginalCPT 76830 | $236 | $107 | 220% | — | 20 |
| Upper GI endoscopy with biopsyCPT 43239 | $589 | $927 | 64% | — | 17 |
| Upper GI endoscopy, diagnosticCPT 43235 | $637 | $927 | 69% | — | 17 |
| Urinalysis, automated, with microscopyCPT 81001 | $7 | $3 | 233% | — | 20 |
| Urinalysis, automated, without microscopyCPT 81003 | $5 | $2 | 232% | — | 20 |
| Urinalysis, manual, without microscopyCPT 81002 | $6 | $3 | 164% | — | 20 |
| X-ray, lower back, 4+ viewsCPT 72110 | $105 | $107 | 98% | — | 20 |