| Basic metabolic panelCPT 80048 | $8 | $8 | 95% | — | 4 |
| CT abdomen and pelvis with contrastCPT 74177 | $374 | $435 | 86% | — | 2 |
| CT head without contrastCPT 70450 | $116 | $130 | 89% | — | 2 |
| CT pelvis with contrastCPT 72193 | $298 | $219 | 136% | — | 2 |
| Cardiac stress testCPT 93017 | $77 | $270 | 29% | — | 1 |
| Cataract surgery with IOL insertionCPT 66984 | $931 | $2,881 | 32% | — | 1 |
| Colonoscopy with biopsyCPT 45380 | $357 | $1,494 | 24% | — | 1 |
| Colonoscopy with endoscopic ultrasoundCPT 45391 | $455 | $1,494 | 30% | — | 1 |
| Colonoscopy with polyp removalCPT 45385 | $449 | $1,494 | 30% | — | 1 |
| Colonoscopy, diagnosticCPT 45378 | $330 | $1,161 | 28% | — | 1 |
| Complete blood count with differentialCPT 85025 | $7 | $8 | 96% | — | 4 |
| Complete blood count, automatedCPT 85027 | $6 | $6 | 96% | — | 4 |
| Comprehensive metabolic panelCPT 80053 | $10 | $11 | 96% | — | 4 |
| Diagnostic mammography, both breastsCPT 77066 | $191 | — | — | — | 2 |
| Diagnostic mammography, one breastCPT 77065 | $149 | — | — | — | 2 |
| ED visit, level 3CPT 99283 | $140 | $341 | 41% | — | 1 |
| ED visit, level 4CPT 99284 | $238 | $521 | 46% | — | 1 |
| ED visit, level 5CPT 99285 | $345 | $743 | 46% | — | 1 |
| Echocardiogram, completeCPT 93306 | $255 | $682 | 37% | — | 1 |
| Electrocardiogram with interpretationCPT 93000 | $31 | — | — | — | 1 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $149 | $1,104 | 14% | — | 1 |
| Excision of breast lesionCPT 19120 | $802 | $4,888 | 16% | — | 1 |
| Family psychotherapy, with patientCPT 90847 | $213 | $222 | 96% | — | 1 |
| Family psychotherapy, without patientCPT 90846 | $205 | $222 | 93% | — | 1 |
| Group psychotherapyCPT 90853 | $50 | $127 | 40% | — | 1 |
| Inguinal hernia repair, age 5+CPT 49505 | $997 | $4,469 | 22% | — | 1 |
| Kidney function panelCPT 80069 | $8 | $9 | 96% | — | 4 |
| Knee arthroscopy with meniscectomyCPT 29881 | $1,021 | $4,084 | 25% | — | 1 |
| Laparoscopic cholecystectomyCPT 47562 | $1,241 | $7,547 | 16% | — | 1 |
| Laparoscopic radical prostatectomyCPT 55866 | $2,169 | $13,269 | 16% | — | 1 |
| Left heart catheterization, diagnosticCPT 93452 | $1,276 | $4,047 | 32% | — | 1 |
| Lipid panelCPT 80061 | $13 | $13 | 96% | — | 4 |
| Liver function panelCPT 80076 | $8 | $8 | 96% | — | 4 |
| Lumbar epidural steroid injectionCPT 62323 | $180 | $881 | 20% | — | 1 |
| MRI brain with and without contrastCPT 70553 | $366 | $435 | 84% | — | 2 |
| MRI lower extremity joint (knee)CPT 73721 | $245 | $298 | 82% | — | 2 |
| MRI lumbar spine without contrastCPT 72148 | $213 | $298 | 72% | — | 2 |
| OB global care, VBAC deliveryCPT 59610 | $4,535 | — | — | — | 1 |
| OB global care, cesarean deliveryCPT 59510 | $4,815 | — | — | — | 1 |
| OB global care, vaginal deliveryCPT 59400 | $4,331 | — | — | — | 1 |
| OB ultrasound, 14+ weeksCPT 76805 | $153 | $130 | 118% | — | 2 |
| Obstetric blood test panelCPT 80055 | $44 | $48 | 92% | — | 4 |
| Office visit, established patient, level 3CPT 99213 | $117 | — | — | — | 1 |
| Office visit, established patient, level 4CPT 99214 | $172 | — | — | — | 1 |
| Office visit, new patient, level 3CPT 99203 | $144 | — | — | — | 1 |
| Office visit, new patient, level 4CPT 99204 | $236 | — | — | — | 1 |
| Office visit, new patient, level 5CPT 99205 | $323 | — | — | — | 1 |
| PSA (prostate specific antigen), totalCPT 84153 | $18 | $18 | 96% | — | 4 |
| Partial thromboplastin timeCPT 85730 | $6 | $6 | 96% | — | 4 |
| Physical therapy, therapeutic exerciseCPT 97110 | $43 | — | — | — | 3 |
| Prothrombin timeCPT 85610 | $4 | $4 | 94% | — | 4 |
| Psychotherapy, 30 minutesCPT 90832 | $144 | $222 | 65% | — | 1 |
| Psychotherapy, 45 minutesCPT 90834 | $190 | $222 | 86% | — | 1 |
| Psychotherapy, 60 minutesCPT 90837 | $281 | $222 | 127% | — | 1 |
| Screening mammography, bilateralCPT 77067 | $158 | — | — | — | 2 |
| Shoulder arthroscopy, subacromial decompressionCPT 29826 | $292 | — | — | — | 1 |
| Sleep study (polysomnography)CPT 95810 | $1,094 | $1,072 | 102% | — | 1 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $16 | $17 | 96% | — | 4 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $521 | $7,390 | 7% | — | 1 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $201 | $1,104 | 18% | — | 1 |
| Ultrasound, abdomen, completeCPT 76700 | $133 | $130 | 102% | — | 2 |
| Ultrasound, transvaginalCPT 76830 | $147 | $130 | 113% | — | 2 |
| Upper GI endoscopy with biopsyCPT 43239 | $248 | $1,132 | 22% | — | 1 |
| Upper GI endoscopy, diagnosticCPT 43235 | $222 | $1,132 | 20% | — | 1 |
| Urinalysis, automated, with microscopyCPT 81001 | $3 | $3 | 96% | — | 4 |
| Urinalysis, automated, without microscopyCPT 81003 | $2 | $2 | 96% | — | 4 |
| Urinalysis, manual, with microscopyCPT 81000 | $4 | $4 | 92% | — | 4 |
| Urinalysis, manual, without microscopyCPT 81002 | $3 | $3 | 92% | — | 4 |
| X-ray, lower back, 4+ viewsCPT 72110 | $70 | $130 | 54% | — | 2 |
| YAG laser capsulotomy (secondary cataract)CPT 66821 | $552 | $687 | 80% | — | 1 |