| Blood Test - Complete Blood Cell Count and Automated WBC | $29 | 0% | $29 |
| Blood Test - Comprehensive Metabolic Panel | $89 | 0% | $89 |
| Lab Test - Detection test for Influenza Virus | $75 | 0% | $75 |
| Office Visit - Basic | $226 | 0% | $226 |
| Office Visit - Established Patient, High Complexity | $298 | 0% | $298 |
| Office Visit - Established Patient, Low Complexity | $186 | 0% | $186 |
| Office Visit - Established Patient, Moderate Complexity | $222 | 0% | $222 |
| Office Visit - New Patient, Low Complexity | $224 | 0% | $224 |
| Office Visit - New Patient, Minor | $158 | 0% | $158 |
| Office Visit - New Patient, Moderate Complexity | $342 | 0% | $342 |
| Psychiatric Diagnostic Evaluation | $263 | 0% | $263 |
| Psychotherapy - 30 Minutes | $105 | 0% | $105 |
| Psychotherapy - 45 Minutes | $168 | 0% | $168 |
| Psychotherapy - Family Session | $189 | 0% | $189 |
| Strep Test (Streptococcus, group A) | $69 | 0% | $69 |
| Urine Test - Automated without Microscope | $53 | 0% | $53 |
| Urine Test - Pregnancy | $42 | 0% | $42 |
| Urine Test - Urinalysis, Manual Test | $27 | 0% | $27 |
| X-Ray - Abdomen | $385 | 0% | $385 |
| X-Ray - Ankle (outpatient) | $300 | 0% | $300 |
| X-Ray - Chest (outpatient) | $340 | 0% | $340 |
| X-Ray - Foot (outpatient) | $294 | 0% | $294 |
| X-Ray - Hand | $339 | 0% | $339 |
| X-Ray - Hip | $316 | 0% | $316 |
| X-Ray - Knee (outpatient) | $369 | 0% | $369 |
| X-Ray - Middle Back, Thoracic Spine | $231 | 0% | $231 |
| X-Ray - Neck, Cervical Spine | $313 | 0% | $313 |
| X-Ray - Pelvis | $277 | 0% | $277 |
| X-Ray - Shoulder (outpatient) | $332 | 0% | $332 |
| X-Ray - Spine (outpatient) | $318 | 0% | $318 |
| X-Ray - Wrist (outpatient) | $360 | 0% | $360 |
