| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $85 | 0% | $85 |
| Blood Test - Cholesterol Test, Lipid Panel | $111 | 0% | $111 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $87 | 0% | $87 |
| Blood Test - Comprehensive Metabolic Panel | $88 | 0% | $88 |
| Blood Test - General Health Panel | $316 | 0% | $316 |
| Blood Test - Hepatitis C Antibody Level | $123 | 0% | $123 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $141 | 0% | $141 |
| Lab Test - Detection test for Influenza Virus | $66 | 0% | $66 |
| Office Visit - Basic | $104 | 0% | $104 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $348 | 0% | $348 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $348 | 0% | $348 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $413 | 0% | $413 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $328 | 0% | $328 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $305 | 0% | $305 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $254 | 0% | $254 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $323 | 0% | $323 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $328 | 0% | $328 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $389 | 0% | $389 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $229 | 0% | $229 |
| Office Visit - Established Patient, High Complexity | $306 | 0% | $306 |
| Office Visit - Established Patient, Low Complexity | $148 | 0% | $148 |
| Office Visit - Established Patient, Moderate Complexity | $233 | 0% | $233 |
| Office Visit - New Patient, Low Complexity | $268 | 0% | $268 |
| Office Visit - New Patient, Minor | $177 | 0% | $177 |
| Office Visit - New Patient, Moderate Complexity | $347 | 0% | $347 |
| Strep Test (Streptococcus, group A) | $100 | 0% | $100 |
| Urine Test - Automated without Microscope | $18 | 0% | $18 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $219 | 0% | $219 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $98 | 0% | $98 |
