| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $37 | N/A | $37 |
| Blood Test - Cholesterol Test, Lipid Panel | $53 | N/A | $53 |
| Developmental Screening | $47 | N/A | $47 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $43 | N/A | $43 |
| Lab Test - Detection test for Influenza Virus | $37 | N/A | $37 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $341 | N/A | $341 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $288 | N/A | $288 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $309 | N/A | $309 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $314 | N/A | $314 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $319 | N/A | $319 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $284 | N/A | $284 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $233 | N/A | $233 |
| Office Visit - Established Patient, High Complexity | $420 | N/A | $420 |
| Office Visit - Established Patient, Low Complexity | $216 | N/A | $216 |
| Office Visit - Established Patient, Moderate Complexity | $311 | N/A | $311 |
| Office Visit - New Patient, Low Complexity | $305 | N/A | $305 |
| Urine Test - Pregnancy | $19 | N/A | $19 |
| Urine Test - Urinalysis, Manual Test | $19 | N/A | $19 |
| Vaccine - Influenza for Injection into Muscle | $35 | N/A | $35 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $74 | N/A | $74 |
