| Bacterial Culture - Aerobic Isolates | $20 | N/A | $20 |
| Blood Test - Basic Metabolic Panel | $28 | N/A | $28 |
| Blood Test - Blood Glucose (Sugar) Level | $13 | N/A | $13 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $33 | N/A | $33 |
| Blood Test - C-reactive Protein (CRP) Level | $18 | N/A | $18 |
| Blood Test - Cholesterol Test, Lipid Panel | $60 | N/A | $60 |
| Blood Test - Clotting Time | $11 | N/A | $11 |
| Blood Test - Coagulation Assessment | $65 | N/A | $65 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $22 | N/A | $22 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $26 | N/A | $26 |
| Blood Test - Comprehensive Metabolic Panel | $35 | N/A | $35 |
| Blood Test - Creatinine Level | $18 | N/A | $18 |
| Blood Test - Ferritin (Blood Protein) Level | $45 | N/A | $45 |
| Blood Test - Folic Acid Level | $49 | N/A | $49 |
| Blood Test - General Health Panel | $104 | N/A | $104 |
| Blood Test - Hepatic (Liver) Function Panel | $36 | N/A | $36 |
| Blood Test - Hepatitis B Surface Antibody Level | $37 | N/A | $37 |
| Blood Test - Iron Binding Capacity | $29 | N/A | $29 |
| Blood Test - Iron Level | $22 | N/A | $22 |
| Blood Test - Lead Level | $40 | N/A | $40 |
| Blood Test - Lipase (fat enzyme) Level | $34 | N/A | $34 |
| Blood Test - Magnesium Level | $23 | N/A | $23 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | N/A | $61 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $55 | N/A | $55 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $56 | N/A | $56 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $29 | N/A | $29 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $230 | N/A | $230 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $49 | N/A | $49 |
| Blood Test - Vitamin D-3 Level | $99 | N/A | $99 |
| Destruction of Lesion (outpatient) | $554 | N/A | $554 |
| Developmental Screening | $42 | N/A | $42 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $343 | N/A | $343 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $21 | N/A | $21 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $25 | N/A | $25 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $100 | N/A | $100 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $183 | N/A | $183 |
| Lab Test - Detection test for Influenza Virus | $40 | N/A | $40 |
| Laryngoscopy - Diagnostic | $533 | N/A | $533 |
| Mammogram (outpatient) | $870 | N/A | $870 |
| Nasal Endoscopy - Diagnostic | $667 | N/A | $667 |
| Office Visit - Basic | $89 | N/A | $89 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $255 | N/A | $255 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $234 | N/A | $234 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $341 | N/A | $341 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $247 | N/A | $247 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $231 | N/A | $231 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $247 | N/A | $247 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $205 | N/A | $205 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $205 | N/A | $205 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $224 | N/A | $224 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $187 | N/A | $187 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $184 | N/A | $184 |
| Office Visit - Established Patient, High Complexity | $318 | N/A | $318 |
| Office Visit - Established Patient, Low Complexity | $147 | N/A | $147 |
| Office Visit - Established Patient, Moderate Complexity | $263 | N/A | $263 |
| Office Visit - New Patient, Low Complexity | $221 | N/A | $221 |
| Office Visit - New Patient, Minor | $186 | N/A | $186 |
| Office Visit - New Patient, Moderate Complexity | $341 | N/A | $341 |
| Pap Test, automated screening and manual rescreening | $126 | N/A | $126 |
| Psychotherapy - 30 Minutes | $89 | 
Near Average
State Average: 1 | $89 |
| Psychotherapy - 45 Minutes | $112 | 
Below Average
State Average: 4 | $112 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $53 | N/A | $53 |
| Urine Test - Automated with Microscope Examination | $11 | N/A | $11 |
| Urine Test - Automated without Microscope | $8 | N/A | $8 |
| Urine Test - Bacterial Culture | $38 | N/A | $38 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $26 | N/A | $26 |
| Urine Test - Chlamydia | $117 | N/A | $117 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $117 | N/A | $117 |
| Urine Test - Microalbumin (Protein) Level | $19 | N/A | $19 |
| Urine Test - Pregnancy | $26 | N/A | $26 |
| Urine Test - Urinalysis, Manual Test | $8 | N/A | $8 |
| Vaccine - Influenza for Injection into Muscle | $62 | N/A | $62 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $363 | N/A | $363 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $130 | N/A | $130 |
