| Basic metabolic panelCPT 80048 | $77 | $8 | 915% | — | 7 |
| COPD with MCCMS-DRG 190 | $50 | $7,377 | 1% | — | 1 |
| CT abdomen and pelvis with contrastCPT 74177 | $436 | $356 | 122% | — | 7 |
| CT head without contrastCPT 70450 | $148 | $107 | 139% | — | 7 |
| CT pelvis with contrastCPT 72193 | $329 | $179 | 184% | — | 7 |
| Cardiac stress testCPT 93017 | $43 | $221 | 19% | — | 4 |
| Cardiac valve surgery with cardiac cath, with MCCMS-DRG 216 | $50 | — | — | — | 1 |
| Cataract surgery with IOL insertionCPT 66984 | $625 | $2,358 | 27% | — | 4 |
| Colonoscopy with biopsyCPT 45380 | $602 | $1,223 | 49% | — | 7 |
| Colonoscopy with endoscopic ultrasoundCPT 45391 | $342 | $1,223 | 28% | — | 5 |
| Colonoscopy with polyp removalCPT 45385 | $344 | $1,223 | 28% | — | 5 |
| Colonoscopy, diagnosticCPT 45378 | $468 | $950 | 49% | — | 7 |
| Complete blood count with differentialCPT 85025 | $49 | $8 | 634% | — | 7 |
| Complete blood count, automatedCPT 85027 | $9 | $6 | 144% | — | 7 |
| Comprehensive metabolic panelCPT 80053 | $15 | $11 | 146% | — | 7 |
| Diagnostic mammography, both breastsCPT 77066 | $215 | — | — | — | 7 |
| Diagnostic mammography, one breastCPT 77065 | $170 | — | — | — | 7 |
| ED visit, level 3CPT 99283 | $91 | $279 | 33% | — | 7 |
| ED visit, level 4CPT 99284 | $154 | $426 | 36% | — | 7 |
| ED visit, level 5CPT 99285 | $223 | $608 | 37% | — | 7 |
| Echocardiogram, completeCPT 93306 | $299 | $558 | 54% | — | 7 |
| Electrocardiogram with interpretationCPT 93000 | $21 | — | — | — | 7 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $89 | $904 | 10% | — | 4 |
| Excision of breast lesionCPT 19120 | $533 | $4,000 | 13% | — | 5 |
| Family psychotherapy, with patientCPT 90847 | $108 | $181 | 60% | — | 4 |
| Family psychotherapy, without patientCPT 90846 | $104 | $181 | 57% | — | 4 |
| Group psychotherapyCPT 90853 | $27 | $104 | 26% | — | 4 |
| Inguinal hernia repair, age 5+CPT 49505 | $709 | $3,658 | 19% | — | 5 |
| Kidney function panelCPT 80069 | $81 | $9 | 933% | — | 7 |
| Knee arthroscopy with meniscectomyCPT 29881 | $701 | $3,343 | 21% | — | 5 |
| Laparoscopic cholecystectomyCPT 47562 | $895 | $6,176 | 14% | — | 5 |
| Laparoscopic radical prostatectomyCPT 55866 | $1,523 | $10,860 | 14% | — | 4 |
| Left heart catheterization, diagnosticCPT 93452 | $1,079 | $3,312 | 33% | — | 4 |
| Lipid panelCPT 80061 | $14 | $13 | 105% | — | 7 |
| Liver function panelCPT 80076 | $71 | $8 | 872% | — | 7 |
| Lumbar epidural steroid injectionCPT 62323 | $110 | $721 | 15% | — | 4 |
| MRI brain with and without contrastCPT 70553 | $453 | $356 | 127% | — | 7 |
| MRI lower extremity joint (knee)CPT 73721 | $287 | $244 | 118% | — | 7 |
| MRI lumbar spine without contrastCPT 72148 | $272 | $244 | 111% | — | 7 |
| Major joint replacement (hip/knee), no MCCMS-DRG 470 | $50 | $13,045 | 0% | — | 1 |
| OB global care, VBAC deliveryCPT 59610 | $2,610 | — | — | — | 4 |
| OB global care, cesarean deliveryCPT 59510 | $2,764 | — | — | — | 4 |
| OB global care, vaginal deliveryCPT 59400 | $3,220 | — | — | — | 7 |
| OB ultrasound, 14+ weeksCPT 76805 | $183 | $107 | 172% | — | 7 |
| Obstetric blood test panelCPT 80055 | $46 | $48 | 97% | — | 2 |
| Office consultation, comprehensiveCPT 99244 | $517 | — | — | — | 7 |
| Office consultation, moderateCPT 99243 | $395 | — | — | — | 7 |
| Office visit, established patient, level 3CPT 99213 | $115 | — | — | — | 7 |
| Office visit, established patient, level 4CPT 99214 | $162 | — | — | — | 7 |
| Office visit, new patient, level 3CPT 99203 | $142 | — | — | — | 7 |
| Office visit, new patient, level 4CPT 99204 | $211 | — | — | — | 7 |
| Office visit, new patient, level 5CPT 99205 | $280 | — | — | — | 7 |
| PSA (prostate specific antigen), totalCPT 84153 | $145 | $18 | 790% | — | 7 |
| Partial thromboplastin timeCPT 85730 | $54 | $6 | 893% | — | 7 |
| Physical therapy, therapeutic exerciseCPT 97110 | $29 | — | — | — | 7 |
| Preventive visit, new patient, 18-39CPT 99385 | $191 | — | — | — | 7 |
| Preventive visit, new patient, 40-64CPT 99386 | $221 | — | — | — | 7 |
| Prostate biopsyCPT 55700 | $148 | — | — | — | 4 |
| Prothrombin timeCPT 85610 | $40 | $4 | 944% | — | 7 |
| Psychotherapy, 30 minutesCPT 90832 | $69 | $181 | 38% | — | 4 |
| Psychotherapy, 45 minutesCPT 90834 | $103 | $181 | 57% | — | 4 |
| Psychotherapy, 60 minutesCPT 90837 | $137 | $181 | 76% | — | 4 |
| Screening mammography, bilateralCPT 77067 | $174 | — | — | — | 7 |
| Shoulder arthroscopy, subacromial decompressionCPT 29826 | $216 | — | — | — | 5 |
| Sleep study (polysomnography)CPT 95810 | $720 | $877 | 82% | — | 4 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $17 | $17 | 98% | — | 7 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $390 | $6,048 | 6% | — | 5 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $125 | $904 | 14% | — | 4 |
| Ultrasound, abdomen, completeCPT 76700 | $160 | $107 | 150% | — | 7 |
| Ultrasound, transvaginalCPT 76830 | $164 | $107 | 153% | — | 7 |
| Upper GI endoscopy with biopsyCPT 43239 | $188 | $927 | 20% | — | 5 |
| Upper GI endoscopy, diagnosticCPT 43235 | $167 | $927 | 18% | — | 5 |
| Urinalysis, automated, with microscopyCPT 81001 | $33 | $3 | 1027% | — | 7 |
| Urinalysis, automated, without microscopyCPT 81003 | $26 | $2 | 1173% | — | 7 |
| Urinalysis, manual, with microscopyCPT 81000 | $33 | $4 | 832% | — | 7 |
| Urinalysis, manual, without microscopyCPT 81002 | $27 | $3 | 784% | — | 7 |
| X-ray, lower back, 4+ viewsCPT 72110 | $69 | $107 | 65% | — | 7 |
| YAG laser capsulotomy (secondary cataract)CPT 66821 | $376 | $562 | 67% | — | 4 |