| Basic metabolic panelCPT 80048 | $172 | $8 | 2038% | — | 17 |
| CT abdomen and pelvis with contrastCPT 74177 | $2,186 | $356 | 613% | — | 17 |
| CT head without contrastCPT 70450 | $969 | $107 | 907% | — | 17 |
| CT pelvis with contrastCPT 72193 | $1,176 | $179 | 656% | — | 17 |
| Cardiac stress testCPT 93017 | $938 | $221 | 425% | — | 16 |
| Cataract surgery with IOL insertionCPT 66984 | $2,250 | $2,358 | 95% | — | 16 |
| Colonoscopy with biopsyCPT 45380 | $698 | $1,223 | 57% | — | 16 |
| Colonoscopy with endoscopic ultrasoundCPT 45391 | $410 | $1,223 | 33% | — | 16 |
| Colonoscopy with polyp removalCPT 45385 | $825 | $1,223 | 67% | — | 16 |
| Colonoscopy, diagnosticCPT 45378 | $622 | $950 | 65% | — | 16 |
| Complete blood count with differentialCPT 85025 | $115 | $8 | 1483% | — | 17 |
| Complete blood count, automatedCPT 85027 | $79 | $6 | 1219% | — | 17 |
| Comprehensive metabolic panelCPT 80053 | $270 | $11 | 2553% | — | 17 |
| Diagnostic mammography, both breastsCPT 77066 | $353 | — | — | — | 17 |
| Diagnostic mammography, one breastCPT 77065 | $280 | — | — | — | 17 |
| ED visit, level 3CPT 99283 | $313 | $279 | 112% | — | 16 |
| ED visit, level 4CPT 99284 | $462 | $426 | 108% | — | 16 |
| ED visit, level 5CPT 99285 | $681 | $608 | 112% | — | 16 |
| Echocardiogram, completeCPT 93306 | $1,072 | $558 | 192% | — | 16 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $380 | $904 | 42% | — | 16 |
| Excision of breast lesionCPT 19120 | $778 | $4,000 | 19% | — | 16 |
| Family psychotherapy, with patientCPT 90847 | $135 | $181 | 74% | — | 16 |
| Family psychotherapy, without patientCPT 90846 | $115 | $181 | 63% | — | 16 |
| Group psychotherapyCPT 90853 | $45 | $104 | 43% | — | 16 |
| Inguinal hernia repair, age 5+CPT 49505 | $900 | $3,658 | 25% | — | 16 |
| Kidney function panelCPT 80069 | $206 | $9 | 2378% | — | 17 |
| Knee arthroscopy with meniscectomyCPT 29881 | $1,852 | $3,343 | 55% | — | 16 |
| Laparoscopic cholecystectomyCPT 47562 | $1,350 | $6,176 | 22% | — | 16 |
| Laparoscopic radical prostatectomyCPT 55866 | $2,580 | $10,860 | 24% | — | 16 |
| Left heart catheterization, diagnosticCPT 93452 | $1,027 | $3,312 | 31% | — | 16 |
| Lipid panelCPT 80061 | $251 | $13 | 1871% | — | 17 |
| Liver function panelCPT 80076 | $153 | $8 | 1874% | — | 17 |
| Lumbar epidural steroid injectionCPT 62323 | $1,469 | $721 | 204% | — | 16 |
| MRI brain with and without contrastCPT 70553 | $1,885 | $356 | 529% | — | 17 |
| MRI lower extremity joint (knee)CPT 73721 | $1,507 | $244 | 618% | — | 17 |
| MRI lumbar spine without contrastCPT 72148 | $1,403 | $244 | 576% | — | 17 |
| OB global care, VBAC deliveryCPT 59610 | $2,746 | — | — | — | 16 |
| OB global care, cesarean deliveryCPT 59510 | $2,905 | — | — | — | 16 |
| OB global care, vaginal deliveryCPT 59400 | $2,612 | — | — | — | 16 |
| OB ultrasound, 14+ weeksCPT 76805 | $390 | $107 | 365% | — | 17 |
| Office visit, established patient, level 3CPT 99213 | $71 | — | — | — | 16 |
| Office visit, established patient, level 4CPT 99214 | $91 | — | — | — | 16 |
| Office visit, new patient, level 3CPT 99203 | $135 | — | — | — | 16 |
| Office visit, new patient, level 4CPT 99204 | $204 | — | — | — | 16 |
| Office visit, new patient, level 5CPT 99205 | $256 | — | — | — | 16 |
| PSA (prostate specific antigen), totalCPT 84153 | $138 | $18 | 751% | — | 17 |
| Partial thromboplastin timeCPT 85730 | $83 | $6 | 1377% | — | 17 |
| Physical therapy, therapeutic exerciseCPT 97110 | $83 | — | — | — | 16 |
| Preventive visit, new patient, 18-39CPT 99385 | $83 | — | — | — | 16 |
| Preventive visit, new patient, 40-64CPT 99386 | $92 | — | — | — | 16 |
| Prostate biopsyCPT 55700 | $595 | — | — | — | 16 |
| Prothrombin timeCPT 85610 | $67 | $4 | 1568% | — | 17 |
| Psychotherapy, 30 minutesCPT 90832 | $78 | $181 | 43% | — | 16 |
| Psychotherapy, 45 minutesCPT 90834 | $114 | $181 | 63% | — | 16 |
| Psychotherapy, 60 minutesCPT 90837 | $169 | $181 | 93% | — | 16 |
| Screening mammography, bilateralCPT 77067 | $306 | — | — | — | 17 |
| Shoulder arthroscopy, subacromial decompressionCPT 29826 | $1,815 | — | — | — | 16 |
| Sleep study (polysomnography)CPT 95810 | $1,375 | $877 | 157% | — | 16 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $203 | $17 | 1210% | — | 17 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $536 | $6,048 | 9% | — | 16 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $1,198 | $904 | 133% | — | 16 |
| Ultrasound, abdomen, completeCPT 76700 | $660 | $107 | 618% | — | 17 |
| Ultrasound, transvaginalCPT 76830 | $444 | $107 | 415% | — | 17 |
| Upper GI endoscopy with biopsyCPT 43239 | $573 | $927 | 62% | — | 16 |
| Upper GI endoscopy, diagnosticCPT 43235 | $470 | $927 | 51% | — | 16 |
| Urinalysis, automated, with microscopyCPT 81001 | $75 | $3 | 2366% | — | 17 |
| Urinalysis, automated, without microscopyCPT 81003 | $51 | $2 | 2268% | — | 17 |
| Urinalysis, manual, with microscopyCPT 81000 | $36 | $4 | 889% | — | 17 |
| Urinalysis, manual, without microscopyCPT 81002 | $20 | $3 | 561% | — | 17 |
| X-ray, lower back, 4+ viewsCPT 72110 | $353 | $107 | 331% | — | 17 |
| YAG laser capsulotomy (secondary cataract)CPT 66821 | $825 | $562 | 147% | — | 16 |