| Diagnostic mammogram (both breasts) CPT Code: 77066 | $538 | — | $142 | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $5,621 | — | $376 | unverified |
| Hospital observation (per hour) HCPCS Code: G0378 | $105 | — | $59 | — |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $4,866 | — | $286 | unverified |
| Blood transfusion CPT Code: 36430 | $1,197 | — | $216 | — |
| CT scan, sinuses CPT Code: 70486 | $2,335 | — | $177 | unverified |
| Hepatitis C antibody test CPT Code: 86803 | $161 | — | $35 | — |
| CT scan, neck (cervical spine) CPT Code: 72125 | $2,947 | — | $178 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $4,163 | — | $289 | unverified |
| Blood test, liver function panel CPT Code: 80076 | $180 | — | $26 | — |
| X-ray, chest (two views) CPT Code: 71046 | $443 | — | $56 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $3,225 | — | $281 | — |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,822 | — | $265 | — |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $128 | — | $57 | — |
| Inguinal hernia repair CPT Code: 49505 | $14,691 | — | $583 | unverified |
| X-ray, chest (single view) CPT Code: 71045 | $350 | — | $53 | — |
| CT scan, chest (no contrast) CPT Code: 71250 | $2,900 | — | $178 | unverified |
| Upper endoscopy with biopsy CPT Code: 43239 | $6,210 | — | $238 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $2,786 | — | $247 | unverified |
| Pneumonia vaccine injection HCPCS Code: G0009 | $68 | — | $39 | — |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $112 | — | $28 | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $370 | — | $51 | — |
| Physical therapy (gait training) CPT Code: 97116 | $118 | — | $46 | — |
| Total knee replacement CPT Code: 27447 | $53,962 | — | $2,093 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,903 | — | $180 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $819 | — | $111 | unverified |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $215 | — | $37 | — |
| Occupational therapy (self-care training) CPT Code: 97535 | $123 | — | $53 | — |
| Blood test, vitamin D CPT Code: 82306 | $232 | — | $44 | — |
| Blood test, clotting time (PT/INR) CPT Code: 85610 | $72 | — | $13 | — |
| MRI, brain (with and without contrast) CPT Code: 70553 | $5,173 | — | $404 | unverified |
| Blood test, clotting time (PTT) CPT Code: 85730 | $131 | — | $17 | unverified |
| Blood test, creatinine (kidney) CPT Code: 82565 | $86 | — | $12 | — |
| Blood antibody screen CPT Code: 86850 | $154 | — | $26 | — |
| X-ray, hand CPT Code: 73130 | $430 | — | $60 | — |
| Speech therapy (language evaluation) CPT Code: 92507 | $368 | — | $100 | — |
| Blood test, basic metabolic panel CPT Code: 80048 | $184 | — | $31 | — |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $144 | — | $61 | — |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $53,962 | — | — | — |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $195 | — | $120 | — |
| New patient office visit (30-44 min) CPT Code: 99203 | $263 | — | $93 | — |
| Culture, blood CPT Code: 87040 | $328 | — | $32 | unverified |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $134 | — | $84 | — |
| CT scan, head (no contrast) CPT Code: 70450 | $2,519 | — | $180 | unverified |
| Blood test, thyroid (TSH) CPT Code: 84443 | $157 | — | $38 | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $455 | — | $54 | unverified |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $128 | — | $52 | — |
| X-ray, lower back CPT Code: 72110 | $682 | — | $72 | unverified |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $170 | — | $34 | — |
| Blood test, magnesium CPT Code: 83735 | $118 | — | $17 | — |
| X-ray, hip CPT Code: 73502 | $636 | — | $65 | — |
| Blood test, cholesterol (lipid panel) CPT Code: 80061 | $164 | — | $41 | — |
| Colonoscopy with biopsy CPT Code: 45380 | $5,161 | — | $312 | unverified |
| Blood test, glucose (blood sugar) CPT Code: 82947 | $68 | — | $11 | — |
| CT scan, head (with and without contrast) CPT Code: 70470 | $3,087 | — | $272 | — |
| Blood test, vitamin B12 CPT Code: 82607 | $196 | — | $33 | — |
| MRI, brain (no contrast) CPT Code: 70551 | $4,616 | — | $284 | unverified |
| Orthotic fitting and training CPT Code: 97760 | $134 | — | $63 | — |
| Blood test, calcium CPT Code: 82310 | $86 | — | $13 | — |
| X-ray, foot CPT Code: 73630 | $443 | — | $64 | — |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $14,257 | — | $644 | unverified |
| Screening mammogram (both breasts) CPT Code: 77067 | $526 | — | $124 | — |
| Blood test, PSA (prostate screen) CPT Code: 84153 | $175 | — | $38 | — |
| Culture, bacterial CPT Code: 87070 | $173 | — | $25 | — |
| X-ray, shoulder CPT Code: 73030 | $462 | — | $57 | unverified |
| Physical therapy (manual therapy) CPT Code: 97140 | $135 | — | $50 | — |
| MRI, lower back (no contrast) CPT Code: 72148 | $4,262 | — | $299 | unverified |
| X-ray, pelvis CPT Code: 72170 | $425 | — | $54 | — |
| Blood test, urea nitrogen (BUN, kidney) CPT Code: 84520 | $78 | — | $11 | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $388 | — | $56 | unverified |
| Ultrasound, pelvis CPT Code: 76856 | $963 | — | $188 | — |
| Ultrasound, thyroid and neck CPT Code: 76536 | $759 | — | $135 | — |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $82 | — | $10 | unverified |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $20,249 | — | $895 | unverified |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $137 | — | $23 | — |
| Sleep study (overnight, in lab) CPT Code: 95810 | $4,946 | — | $665 | unverified |
| Flu vaccine injection HCPCS Code: G0008 | $68 | — | $36 | — |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,710 | — | $310 | — |
| Blood test, hemoglobin CPT Code: 85018 | $63 | — | $7 | — |
| Blood test, potassium CPT Code: 84132 | $82 | — | $13 | — |
| X-ray, ankle CPT Code: 73610 | $422 | — | $63 | — |
| Prostate cancer screening (blood test) HCPCS Code: G0103 | $185 | — | $41 | — |
| Blood test, sodium CPT Code: 84295 | $105 | — | $12 | unverified |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $1,060 | — | $130 | unverified |
| Blood test, amylase CPT Code: 82150 | $131 | — | $18 | — |
| CT scan, pelvis CPT Code: 72192 | $2,819 | — | $186 | unverified |
| Physical therapy (functional capacity test) CPT Code: 97750 | $128 | — | $56 | — |
| Blood test, lipase CPT Code: 83690 | $165 | — | $18 | unverified |