| Blood Test - Complete Blood Cell Count and Automated WBC | $95 | N/A | $95 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $50 | N/A | $50 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $27 | N/A | $27 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $51 | N/A | $51 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $41 | N/A | $41 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $292 | N/A | $292 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $337 | N/A | $337 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $262 | N/A | $262 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $279 | N/A | $279 |
| Office Visit - Established Patient, Low Complexity | $161 | N/A | $161 |
| Office Visit - Established Patient, Moderate Complexity | $238 | N/A | $238 |
| Ultrasound - Pregnancy (outpatient) | $216 | N/A | $216 |
| Ultrasound - Pregnancy Follow-Up | $260 | N/A | $260 |
| Ultrasound - Transvaginal (non-maternity) | $519 | N/A | $519 |
| Urine Test - Chlamydia | $105 | N/A | $105 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $105 | N/A | $105 |
| Urine Test - Pregnancy | $19 | N/A | $19 |
| Urine Test - Urinalysis, Manual Test | $8 | N/A | $8 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $78 | N/A | $78 |
