| Basic metabolic panelCPT 80048 | $76 | $8 | 894% | — | 10 |
| CT abdomen and pelvis with contrastCPT 74177 | $2,236 | $356 | 627% | — | 10 |
| CT head without contrastCPT 70450 | $1,552 | $107 | 1453% | — | 10 |
| CT pelvis with contrastCPT 72193 | $1,971 | $179 | 1100% | — | 10 |
| Cardiac stress testCPT 93017 | $418 | $221 | 190% | — | 10 |
| Colonoscopy with biopsyCPT 45380 | $254 | $1,223 | 21% | — | 4 |
| Colonoscopy with polyp removalCPT 45385 | $144 | $1,223 | 12% | — | 4 |
| Colonoscopy, diagnosticCPT 45378 | $200 | $950 | 21% | — | 4 |
| Complete blood count with differentialCPT 85025 | $69 | $8 | 892% | — | 10 |
| Complete blood count, automatedCPT 85027 | $58 | $6 | 904% | — | 10 |
| Comprehensive metabolic panelCPT 80053 | $84 | $11 | 793% | — | 10 |
| Diagnostic mammography, both breastsCPT 77066 | $621 | — | — | — | 10 |
| Diagnostic mammography, one breastCPT 77065 | $497 | — | — | — | 10 |
| ED visit, level 3CPT 99283 | $691 | $279 | 248% | — | 10 |
| ED visit, level 4CPT 99284 | $1,149 | $426 | 270% | — | 10 |
| ED visit, level 5CPT 99285 | $1,262 | $608 | 207% | — | 10 |
| Echocardiogram, completeCPT 93306 | $1,663 | $558 | 298% | — | 10 |
| Electrocardiogram with interpretationCPT 93000 | $8 | — | — | — | 4 |
| Epidural injection, lumbar/sacral, no imagingCPT 62322 | $759 | $904 | 84% | — | 10 |
| Excision of breast lesionCPT 19120 | $306 | $4,000 | 8% | — | 4 |
| Inguinal hernia repair, age 5+CPT 49505 | $304 | $3,658 | 8% | — | 4 |
| Kidney function panelCPT 80069 | $78 | $9 | 902% | — | 10 |
| Knee arthroscopy with meniscectomyCPT 29881 | $322 | $3,343 | 10% | — | 4 |
| Laparoscopic cholecystectomyCPT 47562 | $381 | $6,176 | 6% | — | 4 |
| Lipid panelCPT 80061 | $82 | $13 | 612% | — | 10 |
| Liver function panelCPT 80076 | $74 | $8 | 903% | — | 10 |
| Lumbar epidural steroid injectionCPT 62323 | $1,228 | $721 | 170% | — | 10 |
| MRI brain with and without contrastCPT 70553 | $3,906 | $356 | 1096% | — | 10 |
| MRI lower extremity joint (knee)CPT 73721 | $1,862 | $244 | 764% | — | 10 |
| MRI lumbar spine without contrastCPT 72148 | $2,317 | $244 | 950% | — | 10 |
| OB global care, VBAC deliveryCPT 59610 | $2,513 | — | — | — | 4 |
| OB global care, cesarean deliveryCPT 59510 | $2,406 | — | — | — | 4 |
| OB global care, vaginal deliveryCPT 59400 | $2,406 | — | — | — | 4 |
| OB ultrasound, 14+ weeksCPT 76805 | $817 | $107 | 765% | — | 10 |
| Office consultation, comprehensiveCPT 99244 | $77 | — | — | — | 4 |
| Office consultation, moderateCPT 99243 | $66 | — | — | — | 4 |
| Office visit, established patient, level 3CPT 99213 | $45 | — | — | — | 4 |
| Office visit, established patient, level 4CPT 99214 | $91 | — | — | — | 4 |
| Office visit, new patient, level 3CPT 99203 | $56 | — | — | — | 4 |
| Office visit, new patient, level 4CPT 99204 | $92 | — | — | — | 4 |
| Office visit, new patient, level 5CPT 99205 | $156 | — | — | — | 4 |
| PSA (prostate specific antigen), totalCPT 84153 | $90 | $18 | 489% | — | 10 |
| Partial thromboplastin timeCPT 85730 | $116 | $6 | 1932% | — | 10 |
| Physical therapy, therapeutic exerciseCPT 97110 | $154 | — | — | — | 10 |
| Preventive visit, new patient, 18-39CPT 99385 | $262 | — | — | — | 4 |
| Preventive visit, new patient, 40-64CPT 99386 | $318 | — | — | — | 4 |
| Prostate biopsyCPT 55700 | $141 | — | — | — | 4 |
| Prothrombin timeCPT 85610 | $36 | $4 | 839% | — | 10 |
| Psychotherapy, 30 minutesCPT 90832 | $144 | $181 | 79% | — | 10 |
| Psychotherapy, 45 minutesCPT 90834 | $190 | $181 | 105% | — | 10 |
| Psychotherapy, 60 minutesCPT 90837 | $284 | $181 | 157% | — | 10 |
| Screening mammography, bilateralCPT 77067 | $432 | — | — | — | 10 |
| Shoulder arthroscopy, subacromial decompressionCPT 29826 | $98 | — | — | — | 4 |
| Thyroid stimulating hormone (TSH)CPT 84443 | $72 | $17 | 429% | — | 10 |
| Tonsillectomy and adenoidectomy, under age 12CPT 42820 | $172 | $6,048 | 3% | — | 4 |
| Transforaminal epidural, lumbar/sacralCPT 64483 | $64 | $904 | 7% | — | 4 |
| Ultrasound, abdomen, completeCPT 76700 | $817 | $107 | 765% | — | 10 |
| Ultrasound, transvaginalCPT 76830 | $755 | $107 | 707% | — | 10 |
| Upper GI endoscopy with biopsyCPT 43239 | $79 | $927 | 9% | — | 4 |
| Upper GI endoscopy, diagnosticCPT 43235 | $963 | $927 | 104% | — | 10 |
| Urinalysis, automated, with microscopyCPT 81001 | $29 | $3 | 909% | — | 10 |
| Urinalysis, automated, without microscopyCPT 81003 | $31 | $2 | 1360% | — | 10 |
| Urinalysis, manual, without microscopyCPT 81002 | $20 | $3 | 569% | — | 10 |
| X-ray, lower back, 4+ viewsCPT 72110 | $354 | $107 | 331% | — | 10 |