| Arthrocentesis (outpatient) | $329 | 0% | $329 | 
High |
| Blood Test - Basic Metabolic Panel | $28 | 0% | $28 | 
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $33 | 0% | $33 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $60 | 0% | $60 |
Medium |
| Blood Test - Clotting Time | $13 | 0% | $13 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $22 | 0% | $22 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $26 | 0% | $26 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $35 | 0% | $35 |
Medium |
| Blood Test - Electrolytes Panel | $25 | 0% | $25 |
Medium |
| Blood Test - Folic Acid Level | $49 | 0% | $49 |
Medium |
| Blood Test - General Health Panel | $104 | 0% | $104 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $27 | 0% | $27 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $112 | 0% | $112 |
Medium |
| Blood Test - LDL Cholesterol Level | $32 | 0% | $32 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | 0% | $61 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $44 | 0% | $44 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $56 | 0% | $56 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $29 | 0% | $29 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $49 | 0% | $49 |
Medium |
| Blood Test - Vitamin D-3 Level | $99 | 0% | $99 |
Medium |
| Destruction of Lesion (outpatient) | $404 | 0% | $404 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $284 | 0% | $284 |
Medium |
| Laryngoscopy - Diagnostic | $457 | 0% | $457 |
Medium |
| Mammogram (outpatient) | $908 | 0% | $908 |
High |
| Nasal Endoscopy - Diagnostic | $667 | 0% | $667 |
Medium |
| Office Visit - Basic | $89 | 0% | $89 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $279 | 0% | $279 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $310 | 0% | $310 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $234 | 0% | $234 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $341 | 0% | $341 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $247 | 0% | $247 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $205 | 0% | $205 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $188 | 0% | $188 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $205 | 0% | $205 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $205 | 0% | $205 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $224 | 0% | $224 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $187 | 0% | $187 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $184 | 0% | $184 |
Medium |
| Office Visit - Established Patient, High Complexity | $318 | 0% | $318 |
Medium |
| Office Visit - Established Patient, Low Complexity | $147 | 0% | $147 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $237 | 0% | $237 |
Medium |
| Office Visit - New Patient, Low Complexity | $218 | 0% | $218 |
Medium |
| Office Visit - New Patient, Minor | $177 | 0% | $177 |
Medium |
| Pap Test | $128 | 0% | $128 |
Medium |
| Strep Test (Streptococcus, group A) | $42 | 0% | $42 |
Medium |
| Urine Test - Automated with Microscope Examination | $11 | 0% | $11 |
Medium |
| Urine Test - Automated without Microscope | $8 | 0% | $8 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $41 | 0% | $41 |
Medium |
| Urine Test - Chlamydia | $117 | 0% | $117 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $117 | 0% | $117 |
Medium |
| Urine Test - Pregnancy | $28 | 0% | $28 |
Medium |
