| Blood Test - Basic Metabolic Panel | $102 | N/A | $102 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $55 | N/A | $55 |
| Blood Test - C-reactive Protein (CRP) Level | $111 | N/A | $111 |
| Blood Test - Cholesterol Test, Lipid Panel | $152 | N/A | $152 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $40 | N/A | $40 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $88 | N/A | $88 |
| Blood Test - Comprehensive Metabolic Panel | $145 | N/A | $145 |
| Blood Test - Lipase (fat enzyme) Level | $66 | N/A | $66 |
| Blood Test - Magnesium Level | $92 | N/A | $92 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $194 | N/A | $194 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $131 | N/A | $131 |
| Blood Test - Vitamin D-3 Level | $227 | N/A | $227 |
| Developmental Screening | $70 | N/A | $70 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $51 | N/A | $51 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $406 | N/A | $406 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $227 | N/A | $227 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $264 | N/A | $264 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $427 | N/A | $427 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $385 | N/A | $385 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $324 | N/A | $324 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $387 | N/A | $387 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $422 | N/A | $422 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $217 | N/A | $217 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $324 | N/A | $324 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $302 | N/A | $302 |
| Office Visit - Established Patient, High Complexity | $512 | N/A | $512 |
| Office Visit - Established Patient, Low Complexity | $135 | N/A | $135 |
| Office Visit - Established Patient, Moderate Complexity | $198 | N/A | $198 |
| Office Visit - New Patient, Low Complexity | $186 | N/A | $186 |
| Vaccine - Influenza for Injection into Muscle | $62 | N/A | $62 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $79 | N/A | $79 |
