| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $35 | 0% | $35 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
| Blood Test - Clotting Time | $14 | 0% | $14 |
| Blood Test - Comprehensive Metabolic Panel | $48 | 0% | $48 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | 0% | $109 |
| Detection test for Human Papillomavirus (HPV) | $357 | 0% | $357 |
| Lab Test - Detection test for Influenza Virus | $40 | 0% | $40 |
| Office Visit - Basic | $111 | 0% | $111 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $244 | 0% | $244 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $284 | 0% | $284 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $228 | 0% | $228 |
| Office Visit - Established Patient, High Complexity | $359 | 0% | $359 |
| Office Visit - Established Patient, Low Complexity | $182 | 0% | $182 |
| Office Visit - Established Patient, Moderate Complexity | $263 | 0% | $263 |
| Office Visit - New Patient, Low Complexity | $268 | 0% | $268 |
| Office Visit - New Patient, Minor | $188 | 0% | $188 |
| Strep Test (Streptococcus, group A) | $41 | 0% | $41 |
| Urine Test - Automated without Microscope | $7 | 0% | $7 |
| Urine Test - Pregnancy | $23 | 0% | $23 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $307 | 0% | $307 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $77 | 0% | $77 |
