| MRI, lower back (no contrast) CPT Code: 72148 | $3,462 | — | $364 | unverified |
| Speech therapy (language evaluation) CPT Code: 92507 | $231 | — | $80 | — |
| Speech therapy (group session) CPT Code: 92508 | $28 | — | $26 | — |
| Blood transfusion CPT Code: 36430 | $834 | — | $372 | — |
| Hepatitis C antibody test CPT Code: 86803 | $141 | — | $26 | — |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $28,934 | — | — | — |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $117 | — | $13 | unverified |
| CT scan, sinuses CPT Code: 70486 | $3,128 | — | $186 | unverified |
| Blood test, average blood sugar (A1c) CPT Code: 83036 | $135 | — | $17 | unverified |
| Office visit, established patient (30-39 min) CPT Code: 99214 | $767 | — | $110 | unverified |
| Blood test, magnesium CPT Code: 83735 | $69 | — | $11 | — |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $11,694 | — | — | — |
| Blood test, lipase CPT Code: 83690 | $128 | — | $12 | unverified |
| Blood test, amylase CPT Code: 82150 | $129 | — | $10 | unverified |
| X-ray, lower back CPT Code: 72110 | $569 | — | $109 | unverified |
| Occupational therapy (self-care training) CPT Code: 97535 | $80 | — | $34 | — |
| Blood test, urea nitrogen (BUN, kidney) CPT Code: 84520 | $56 | — | $7 | — |
| MRI, knee or other leg joint CPT Code: 73721 | $2,192 | — | $344 | unverified |
| X-ray, shoulder CPT Code: 73030 | $305 | — | $83 | — |
| Physical therapy (functional capacity test) CPT Code: 97750 | $113 | — | $34 | — |
| Physical therapy (manual therapy) CPT Code: 97140 | $213 | — | $30 | unverified |
| Blood test, ferritin (iron stores) CPT Code: 82728 | $135 | — | $26 | — |
| Occupational therapy (therapeutic activities) CPT Code: 97530 | $221 | — | $39 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $4,679 | — | $322 | unverified |
| Blood test, clotting time (PT/INR) CPT Code: 85610 | $60 | — | $7 | unverified |
| X-ray, hand CPT Code: 73130 | $246 | — | $84 | — |
| Screening mammogram (both breasts) CPT Code: 77067 | $211 | — | $123 | — |
| CT scan, head (with contrast) CPT Code: 70460 | $2,854 | — | $254 | unverified |
| Orthotic fitting and training CPT Code: 97760 | $217 | — | $50 | — |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $481 | — | $167 | — |
| Electrocardiogram (EKG, tracing only) CPT Code: 93005 | $243 | — | $61 | — |
| Ultrasound, pelvis CPT Code: 76856 | $781 | — | $141 | unverified |
| Drug screening test HCPCS Code: G0480 | $221 | — | $126 | — |
| Blood test, clotting time (PTT) CPT Code: 85730 | $68 | — | $10 | — |
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $48,456 | — | — | — |
| Blood test, liver function panel CPT Code: 80076 | $233 | — | $16 | unverified |
| Blood test, PSA (prostate screen) CPT Code: 84153 | $179 | — | $33 | — |
| CT scan, chest (no contrast) CPT Code: 71250 | $1,991 | — | $183 | unverified |
| X-ray, hip CPT Code: 73502 | $315 | — | $95 | — |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $78 | — | $5 | unverified |
| Blood test, thyroid (TSH) CPT Code: 84443 | $211 | — | $28 | — |
| Physical therapy (gait training) CPT Code: 97116 | $137 | — | $30 | — |
| X-ray, pelvis CPT Code: 72170 | $323 | — | $89 | — |
| X-ray, ankle CPT Code: 73610 | $294 | — | $84 | — |
| CT scan, pelvis CPT Code: 72192 | $2,311 | — | $180 | unverified |
| Blood test, vitamin B12 CPT Code: 82607 | $152 | — | $26 | — |
| Physical therapy (therapeutic exercise) CPT Code: 97110 | $124 | — | $30 | — |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $29,138 | — | — | — |
| Blood test, potassium CPT Code: 84132 | $53 | — | $8 | — |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $2,311 | — | $178 | unverified |
| Physical therapy (neuromuscular re-education) CPT Code: 97112 | $221 | — | $37 | unverified |
| Blood test, hemoglobin CPT Code: 85018 | $24 | — | $4 | — |
| Blood test, vitamin D CPT Code: 82306 | $312 | — | $38 | — |
| X-ray, neck (cervical spine) CPT Code: 72040 | $315 | — | $93 | — |
| Prostate cancer screening (blood test) HCPCS Code: G0103 | $82 | — | $30 | — |
| Culture, bacterial CPT Code: 87070 | $100 | — | $16 | — |
| MRI, brain (no contrast) CPT Code: 70551 | $3,462 | — | $368 | unverified |
| Culture, blood CPT Code: 87040 | $170 | — | $21 | unverified |
| Blood test, calcium CPT Code: 82310 | $52 | — | $8 | — |
| CT scan, head (with and without contrast) CPT Code: 70470 | $2,684 | — | $265 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $650 | — | $137 | unverified |
| Blood test, glucose (blood sugar) CPT Code: 82947 | $47 | — | $7 | — |
| Breathing treatment (nebulizer) CPT Code: 94640 | $100 | — | $95 | — |
| Blood test, creatinine (kidney) CPT Code: 82565 | $82 | — | $8 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,691 | — | $443 | — |
| MRI, brain (with and without contrast) CPT Code: 70553 | $4,472 | — | $518 | unverified |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $26,445 | — | — | — |
| CT scan, head (no contrast) CPT Code: 70450 | $2,718 | — | $179 | unverified |
| Electrocardiogram (ECG/EKG) CPT Code: 93000 | $514 | — | $29 | unverified |
| Office visit, established patient (20-29 min) CPT Code: 99213 | $175 | — | $73 | — |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $793 | — | $143 | unverified |
| Blood antibody screen CPT Code: 86850 | $132 | — | $27 | — |
| X-ray, chest (single view) CPT Code: 71045 | $313 | — | $86 | — |
| Blood test, basic metabolic panel CPT Code: 80048 | $232 | — | $17 | unverified |
| Blood test, comprehensive metabolic panel CPT Code: 80053 | $280 | — | $20 | unverified |
| X-ray, foot CPT Code: 73630 | $305 | — | $83 | — |
| Ultrasound, thyroid and neck CPT Code: 76536 | $1,391 | — | $138 | unverified |
| Blood test, sodium CPT Code: 84295 | $62 | — | $8 | — |
| CT scan, neck (cervical spine) CPT Code: 72125 | $4,906 | — | $180 | unverified |
| Prosthetic fitting and training CPT Code: 97761 | $146 | — | $42 | — |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $4,670 | — | $422 | unverified |
| Blood test, cholesterol (lipid panel) CPT Code: 80061 | $226 | — | $25 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $810 | — | $301 | — |
| Electrical stimulation therapy HCPCS Code: G0283 | $107 | — | $20 | — |
| X-ray, chest (two views) CPT Code: 71046 | $319 | — | $93 | — |