| Blood Test - Blood Glucose (Sugar) Level | $24 | N/A | $24 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $47 | N/A | $47 |
| Blood Test - Clotting Time | $55 | N/A | $55 |
| Developmental Screening | $38 | N/A | $38 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $328 | N/A | $328 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $355 | N/A | $355 |
| Lab Test - Detection test for Influenza Virus | $42 | N/A | $42 |
| Office Visit - Basic | $95 | N/A | $95 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $236 | N/A | $236 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $268 | N/A | $268 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $210 | N/A | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $205 | N/A | $205 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | N/A | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $242 | N/A | $242 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $257 | N/A | $257 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $205 | N/A | $205 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $189 | N/A | $189 |
| Office Visit - Established Patient, High Complexity | $289 | N/A | $289 |
| Office Visit - Established Patient, Low Complexity | $155 | N/A | $155 |
| Office Visit - Established Patient, Moderate Complexity | $201 | N/A | $201 |
| Office Visit - New Patient, Low Complexity | $215 | N/A | $215 |
| Office Visit - New Patient, Minor | $147 | N/A | $147 |
| Office Visit - New Patient, Moderate Complexity | $315 | N/A | $315 |
| Pap Test, automated screening and manual rescreening | $275 | N/A | $275 |
| Psychiatric Diagnostic Evaluation | $168 | 
Near Average
State Average: 1 | $168 |
| Psychotherapy - 30 Minutes | $116 | 
Above Average
State Average: 1 | $116 |
| Psychotherapy - 45 Minutes | $147 | 
Below Average
State Average: 4 | $147 |
| Psychotherapy - 60 Minutes | $173 |
Below Average
State Average: 5 | $173 |
| Psychotherapy - Family Session | $158 |
Below Average
State Average: 3 | $158 |
| Psychotherapy - Group Session | $58 |
Above Average
State Average: 5 | $58 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $62 | N/A | $62 |
| Urine Test - Automated with Microscope Examination | $47 | N/A | $47 |
| Urine Test - Automated without Microscope | $18 | N/A | $18 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $72 | N/A | $72 |
| Urine Test - Pregnancy | $33 | N/A | $33 |
| Urine Test - Urinalysis, Manual Test | $17 | N/A | $17 |
| Vaccine - Influenza for Injection into Muscle | $34 | N/A | $34 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $79 | N/A | $79 |
