| Blood Test - Cholesterol Test, Lipid Panel | $111 | N/A | $111 |
| Blood Test - Comprehensive Metabolic Panel | $88 | N/A | $88 |
| Blood Test - Lead Level | $48 | N/A | $48 |
| Developmental Screening | $56 | N/A | $56 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $75 | N/A | $75 |
| Office Visit - Basic | $165 | N/A | $165 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $352 | N/A | $352 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $273 | N/A | $273 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $277 | N/A | $277 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $320 | N/A | $320 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $320 | N/A | $320 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $352 | N/A | $352 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $277 | N/A | $277 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $237 | N/A | $237 |
| Office Visit - Established Patient, Low Complexity | $225 | N/A | $225 |
| Office Visit - Established Patient, Moderate Complexity | $332 | N/A | $332 |
| Office Visit - New Patient, Moderate Complexity | $410 | N/A | $410 |
| Urine Test - Automated without Microscope | $32 | N/A | $32 |
| Urine Test - Pregnancy | $32 | N/A | $32 |
| Vaccine - Influenza for Injection into Muscle | $67 | N/A | $67 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $83 | N/A | $83 |
