| Basic metabolic panelCPT 80048 | $45 | $8 | 526% | — | 29 |
| CT abdomen and pelvis with contrastCPT 74177 | $1,404 | $356 | 394% | — | 29 |
| CT head without contrastCPT 70450 | $489 | $107 | 458% | — | 29 |
| CT pelvis with contrastCPT 72193 | $798 | $179 | 445% | — | 29 |
| Cardiac stress testCPT 93017 | $1,641 | $221 | 744% | — | 29 |
| Cesarean section, no CC/MCCMS-DRG 788 | $4,068 | — | — | — | 2 |
| Cesarean section, with CCMS-DRG 787 | $4,068 | — | — | — | 2 |
| Colonoscopy with biopsyCPT 45380 | $199 | $1,223 | 16% | — | 26 |
| Colonoscopy with polyp removalCPT 45385 | $271 | $1,223 | 22% | — | 26 |
| Colonoscopy, diagnosticCPT 45378 | $208 | $950 | 22% | — | 26 |
| Complete blood count with differentialCPT 85025 | $19 | $8 | 241% | — | 29 |
| Complete blood count, automatedCPT 85027 | $24 | $6 | 370% | — | 29 |
| Comprehensive metabolic panelCPT 80053 | $54 | $11 | 509% | — | 29 |
| Diagnostic mammography, both breastsCPT 77066 | $168 | — | — | — | 29 |
| Diagnostic mammography, one breastCPT 77065 | $103 | — | — | — | 29 |
| ED visit, level 3CPT 99283 | $981 | $279 | 352% | — | 29 |
| ED visit, level 4CPT 99284 | $1,246 | $426 | 292% | — | 29 |
| ED visit, level 5CPT 99285 | $1,477 | $608 | 243% | — | 29 |
| Echocardiogram, completeCPT 93306 | $1,887 | $558 | 338% | — | 29 |
| Electrocardiogram with interpretationCPT 93000 | $14 | — | — | — | 27 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $91 | $904 | 10% | — | 26 |
| Excision of breast lesionCPT 19120 | $442 | $4,000 | 11% | — | 26 |
| Family psychotherapy, with patientCPT 90847 | $431 | $181 | 238% | — | 29 |
| Family psychotherapy, without patientCPT 90846 | $263 | $181 | 145% | — | 29 |
| Group psychotherapyCPT 90853 | $345 | $104 | 332% | — | 29 |
| Inguinal hernia repair, age 5+CPT 49505 | $467 | $3,658 | 13% | — | 26 |
| Kidney function panelCPT 80069 | $34 | $9 | 390% | — | 29 |
| Knee arthroscopy with meniscectomyCPT 29881 | $494 | $3,343 | 15% | — | 26 |
| Laparoscopic cholecystectomyCPT 47562 | $588 | $6,176 | 10% | — | 26 |
| Lipid panelCPT 80061 | $45 | $13 | 339% | — | 29 |
| Liver function panelCPT 80076 | $43 | $8 | 527% | — | 29 |
| Lumbar epidural steroid injectionCPT 62323 | $112 | $721 | 16% | — | 26 |
| MRI brain with and without contrastCPT 70553 | $1,410 | $356 | 396% | — | 29 |
| MRI lower extremity joint (knee)CPT 73721 | $1,203 | $244 | 494% | — | 29 |
| MRI lumbar spine without contrastCPT 72148 | $1,260 | $244 | 517% | — | 29 |
| OB global care, VBAC deliveryCPT 59610 | $2,207 | — | — | — | 26 |
| OB global care, cesarean deliveryCPT 59510 | $2,342 | — | — | — | 26 |
| OB global care, vaginal deliveryCPT 59400 | $2,123 | — | — | — | 26 |
| OB ultrasound, 14+ weeksCPT 76805 | $361 | $107 | 338% | — | 29 |
| Obstetric blood test panelCPT 80055 | $153 | $48 | 320% | — | 29 |
| Office consultation, comprehensiveCPT 99244 | $173 | — | — | — | 17 |
| Office consultation, moderateCPT 99243 | $119 | — | — | — | 17 |
| Office visit, established patient, level 3CPT 99213 | $118 | — | — | — | 29 |
| Office visit, established patient, level 4CPT 99214 | $176 | — | — | — | 29 |
| Office visit, new patient, level 3CPT 99203 | $176 | — | — | — | 29 |
| Office visit, new patient, level 4CPT 99204 | $268 | — | — | — | 29 |
| Office visit, new patient, level 5CPT 99205 | $338 | — | — | — | 29 |
| PSA (prostate specific antigen), totalCPT 84153 | $45 | $18 | 242% | — | 29 |
| Partial thromboplastin timeCPT 85730 | $40 | $6 | 671% | — | 29 |
| Physical therapy, therapeutic exerciseCPT 97110 | $201 | — | — | — | 29 |
| Preventive visit, new patient, 18-39CPT 99385 | $87 | — | — | — | 17 |
| Preventive visit, new patient, 40-64CPT 99386 | $138 | — | — | — | 17 |
| Prothrombin timeCPT 85610 | $16 | $4 | 376% | — | 29 |
| Psychotherapy, 30 minutesCPT 90832 | $156 | $181 | 86% | — | 29 |
| Psychotherapy, 45 minutesCPT 90834 | $206 | $181 | 113% | — | 29 |
| Psychotherapy, 60 minutesCPT 90837 | $336 | $181 | 185% | — | 29 |
| Screening mammography, bilateralCPT 77067 | $84 | — | — | — | 29 |
| Shoulder arthroscopy, subacromial decompressionCPT 29826 | $153 | — | — | — | 26 |
| Sleep study (polysomnography)CPT 95810 | $1,259 | $877 | 143% | — | 29 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $51 | $17 | 306% | — | 29 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $109 | $904 | 12% | — | 26 |
| Ultrasound, abdomen, completeCPT 76700 | $387 | $107 | 362% | — | 29 |
| Ultrasound, transvaginalCPT 76830 | $264 | $107 | 247% | — | 29 |
| Upper GI endoscopy with biopsyCPT 43239 | $141 | $927 | 15% | — | 26 |
| Upper GI endoscopy, diagnosticCPT 43235 | $126 | $927 | 14% | — | 26 |
| Urinalysis, automated, with microscopyCPT 81001 | $37 | $3 | 1159% | — | 29 |
| Urinalysis, automated, without microscopyCPT 81003 | $2 | $2 | 100% | — | 29 |
| Urinalysis, manual, with microscopyCPT 81000 | $4 | $4 | 100% | — | 27 |
| Urinalysis, manual, without microscopyCPT 81002 | $12 | $3 | 350% | — | 29 |
| Vaginal delivery, no sterilization, no CC/MCCMS-DRG 807 | $2,900 | — | — | — | 2 |
| Vaginal delivery, no sterilization, with CCMS-DRG 806 | $2,900 | — | — | — | 2 |
| X-ray, lower back, 4+ viewsCPT 72110 | $200 | $107 | 187% | — | 29 |