| Blood Test - Basic Metabolic Panel | $102 | 0% | $102 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $55 | 0% | $55 |
| Blood Test - Cholesterol Test, Lipid Panel | $152 | 0% | $152 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $40 | 0% | $40 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $88 | 0% | $88 |
| Blood Test - Comprehensive Metabolic Panel | $145 | 0% | $145 |
| Blood Test - Lipase (fat enzyme) Level | $66 | 0% | $66 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $194 | 0% | $194 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $131 | 0% | $131 |
| Blood Test - Vitamin D-3 Level | $227 | 0% | $227 |
| Office Visit - Basic | $87 | 0% | $87 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $406 | 0% | $406 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $468 | 0% | $468 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $226 | 0% | $226 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $253 | 0% | $253 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $427 | 0% | $427 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $368 | 0% | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $310 | 0% | $310 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $370 | 0% | $370 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $403 | 0% | $403 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $217 | 0% | $217 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $310 | 0% | $310 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $289 | 0% | $289 |
| Office Visit - Established Patient, High Complexity | $492 | 0% | $492 |
| Office Visit - Established Patient, Low Complexity | $135 | 0% | $135 |
| Office Visit - Established Patient, Moderate Complexity | $198 | 0% | $198 |
| Office Visit - New Patient, Low Complexity | $186 | 0% | $186 |
| Strep Test (Streptococcus, group A) | $51 | 0% | $51 |
| Urine Test - Automated without Microscope | $30 | 0% | $30 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $79 | 0% | $79 |
