| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $69 | 0% | $69 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $33 | 0% | $33 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $138 | 0% | $138 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $89 | 0% | $89 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $168 | 0% | $168 |
| Detection test for Human Papillomavirus (HPV) | $249 | 0% | $249 |
| Office Visit - Basic | $128 | 0% | $128 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $404 | 0% | $404 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $462 | 0% | $462 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $362 | 0% | $362 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $383 | 0% | $383 |
| Office Visit - Established Patient, High Complexity | $420 | 0% | $420 |
| Office Visit - Established Patient, Low Complexity | $211 | 0% | $211 |
| Office Visit - Established Patient, Moderate Complexity | $312 | 0% | $312 |
| Ultrasound - Pelvic (outpatient) | $326 | 0% | $326 |
| Ultrasound - Pregnancy (outpatient) | $421 | 0% | $421 |
| Ultrasound - Pregnancy Follow-Up | $341 | 0% | $341 |
| Ultrasound - Transvaginal (non-maternity) | $572 | 0% | $572 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $76 | 0% | $76 |
| Urine Test - Pregnancy | $28 | 0% | $28 |
| Urine Test - Urinalysis, Manual Test | $16 | 0% | $16 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $80 | 0% | $80 |
