| Bacterial Culture - Aerobic Isolates | $41 | 0% | $41 |
| Bacterial Culture - Swab | $77 | 0% | $77 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $87 | 0% | $87 |
| Blood Test - Cholesterol Test, Lipid Panel | $125 | 0% | $125 |
| Blood Test - Clotting Time | $46 | 0% | $46 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $63 | 0% | $63 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $69 | 0% | $69 |
| Blood Test - Comprehensive Metabolic Panel | $187 | 0% | $187 |
| Blood Test - Electrolytes Panel | $75 | 0% | $75 |
| Blood Test - General Health Panel | $374 | 0% | $374 |
| Blood Test - Hepatitis C Antibody Level | $106 | 0% | $106 |
| Blood Test - Iron Level | $54 | 0% | $54 |
| Blood Test - Lipase (fat enzyme) Level | $72 | 0% | $72 |
| Blood Test - Pregnancy (Obstetric) Panel | $152 | 0% | $152 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $129 | 0% | $129 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $129 | 0% | $129 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $124 | 0% | $124 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $126 | 0% | $126 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $102 | 0% | $102 |
| Blood Test - Vitamin D-3 Level | $86 | 0% | $86 |
| Detection test for Human Papillomavirus (HPV) | $88 | 0% | $88 |
| Emergency Department Visit - Low Complexity (outpatient) | $242 | 0% | $242 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $457 | 0% | $457 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $76 | 0% | $76 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $82 | 0% | $82 |
| Lab Test - Detection test for Influenza Virus | $30 | 0% | $30 |
| Lab Test - Smear for Microorganism | $38 | 0% | $38 |
| Office Visit - Basic | $120 | 0% | $120 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $230 | 0% | $230 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $265 | 0% | $265 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $192 | 0% | $192 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $195 | 0% | $195 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $216 | 0% | $216 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $199 | 0% | $199 |
| Office Visit - Established Patient, Low Complexity | $175 | 0% | $175 |
| Office Visit - Established Patient, Moderate Complexity | $240 | 0% | $240 |
| Office Visit - New Patient, Low Complexity | $268 | 0% | $268 |
| Office Visit - New Patient, Minor | $205 | 0% | $205 |
| Physical Therapy - Electrical Stimulation Therapy | $60 | 0% | $60 |
| Physical Therapy - Low Complexity Evaluation | $351 | 0% | $351 |
| Physical Therapy - Neuromuscular Reeducation | $99 | 0% | $99 |
| Physical Therapy - Therapeutic Activities | $135 | 0% | $135 |
| Physical Therapy - Therapeutic Exercises | $99 | 0% | $99 |
| Psychotherapy - 30 Minutes | $95 | 0% | $95 |
| Psychotherapy - 45 Minutes | $125 | 0% | $125 |
| Psychotherapy - 60 Minutes | $189 | 0% | $189 |
| Strep Test (Streptococcus, group A) | $42 | 0% | $42 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $75 | 0% | $75 |
| Urine Test - Automated with Microscope Examination | $39 | 0% | $39 |
| Urine Test - Automated without Microscope | $39 | 0% | $39 |
| Urine Test - Chlamydia | $54 | 0% | $54 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $60 | 0% | $60 |
| Urine Test - Microalbumin (Protein) Level | $98 | 0% | $98 |
| Urine Test - Pregnancy | $33 | 0% | $33 |
| Urine Test - Urinalysis, Manual Test | $23 | 0% | $23 |
