| Basic metabolic panelCPT 80048 | $25 | $8 | 300% | ~$35 | 3 |
| CT abdomen and pelvis with contrastCPT 74177 | $931 | $368 | 253% | ~$296 | 3 |
| CT head without contrastCPT 70450 | $931 | $110 | 844% | ~$296 | 3 |
| CT pelvis with contrastCPT 72193 | $931 | $185 | 503% | ~$296 | 3 |
| Cesarean section, no CC/MCCMS-DRG 788 | $14,774 | — | — | — | 3 |
| Cesarean section, with CCMS-DRG 787 | $14,774 | — | — | — | 3 |
| Complete blood count with differentialCPT 85025 | $23 | $8 | 300% | ~$29 | 3 |
| Complete blood count, automatedCPT 85027 | $19 | $6 | 300% | ~$24 | 3 |
| Comprehensive metabolic panelCPT 80053 | $32 | $11 | 300% | ~$48 | 3 |
| Diagnostic mammography, both breastsCPT 77066 | $198 | — | — | ~$108 | 3 |
| Diagnostic mammography, one breastCPT 77065 | $198 | — | — | ~$85 | 3 |
| Kidney function panelCPT 80069 | $26 | $9 | 300% | ~$40 | 3 |
| Lipid panelCPT 80061 | $40 | $13 | 300% | ~$23 | 3 |
| Liver function panelCPT 80076 | $25 | $8 | 300% | ~$41 | 3 |
| MRI brain with and without contrastCPT 70553 | $1,035 | $368 | 281% | ~$296 | 3 |
| MRI lower extremity joint (knee)CPT 73721 | $1,035 | $252 | 411% | ~$296 | 3 |
| MRI lumbar spine without contrastCPT 72148 | $1,035 | $252 | 411% | ~$296 | 3 |
| Obstetric blood test panelCPT 80055 | $143 | $48 | 300% | ~$80 | 3 |
| PSA (prostate specific antigen), totalCPT 84153 | $55 | $18 | 300% | ~$48 | 3 |
| Partial thromboplastin timeCPT 85730 | $18 | $6 | 300% | ~$65 | 3 |
| Prothrombin timeCPT 85610 | $13 | $4 | 300% | ~$17 | 3 |
| Screening mammography, bilateralCPT 77067 | $198 | — | — | ~$90 | 3 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $50 | $17 | 300% | ~$47 | 3 |
| Urinalysis, automated, with microscopyCPT 81001 | $10 | $3 | 300% | ~$27 | 3 |
| Urinalysis, automated, without microscopyCPT 81003 | $7 | $2 | 300% | ~$24 | 3 |
| Urinalysis, manual, with microscopyCPT 81000 | $12 | $4 | 300% | ~$36 | 3 |
| Urinalysis, manual, without microscopyCPT 81002 | $10 | $3 | 300% | ~$30 | 3 |
| Vaginal delivery, no sterilization, no CC/MCCMS-DRG 807 | $8,531 | — | — | — | 3 |
| Vaginal delivery, no sterilization, with CCMS-DRG 806 | $8,531 | — | — | — | 3 |