| Arthrocentesis (outpatient) | $380 | 0% | $380 | 
Medium |
| Biopsy - Skin Lesion | $735 | 0% | $735 |
Medium |
| Blood Test - Basic Metabolic Panel | $28 | 0% | $28 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $35 | 0% | $35 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $60 | 0% | $60 |
Medium |
| Blood Test - Clotting Time | $11 | 0% | $11 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $26 | 0% | $26 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $35 | 0% | $35 |
Medium |
| Blood Test - General Health Panel | $104 | 0% | $104 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $27 | 0% | $27 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | 0% | $61 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $56 | 0% | $56 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $27 | 0% | $27 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $49 | 0% | $49 |
Medium |
| Blood Test - Vitamin D-3 Level | $99 | 0% | $99 |
Medium |
| Destruction of Lesion (outpatient) | $404 | 0% | $404 |
Medium |
| Destruction of Lesions, up to 14 | $396 | 0% | $396 |
Medium |
| Mammogram (outpatient) | $937 | 0% | $937 |
Medium |
| Office Visit - Basic | $92 | 0% | $92 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $228 | 0% | $228 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $256 | 0% | $256 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $275 | 0% | $275 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $307 | 0% | $307 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $227 | 0% | $227 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $224 | 0% | $224 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $200 | 0% | $200 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $239 | 0% | $239 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $240 | 0% | $240 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $263 | 0% | $263 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $195 | 0% | $195 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $195 | 0% | $195 |
Medium |
| Office Visit - Established Patient, High Complexity | $307 | 0% | $307 |
Medium |
| Office Visit - Established Patient, Low Complexity | $153 | 0% | $153 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $228 | 0% | $228 |
Medium |
| Office Visit - New Patient, Low Complexity | $228 | 0% | $228 |
Medium |
| Office Visit - New Patient, Minor | $159 | 0% | $159 |
Medium |
| Pap Test | $202 | 0% | $202 |
Medium |
| Physical Therapy - Therapeutic Exercises | $127 | 0% | $127 |
Medium |
| Psychiatric Diagnostic Evaluation | $255 | 0% | $255 |
Medium |
| Psychotherapy - 30 Minutes | $137 | 0% | $137 |
Medium |
| Psychotherapy - 45 Minutes | $184 | 0% | $184 |
Medium |
| Psychotherapy - 60 Minutes | $152 | 0% | $152 |
Medium |
| Psychotherapy - Family Session | $192 | 0% | $192 |
Medium |
| Psychotherapy - Group Session | $63 | 0% | $63 |
Medium |
| Strep Test (Streptococcus, group A) | $44 | 0% | $44 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $67 | 0% | $67 |
Medium |
| Urine Test - Automated with Microscope Examination | $10 | 0% | $10 |
Medium |
| Urine Test - Automated without Microscope | $17 | 0% | $17 |
Medium |
| Urine Test - Bacterial Culture | $68 | 0% | $68 |
Medium |
| Urine Test - Chlamydia | $105 | 0% | $105 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $105 | 0% | $105 |
Medium |
| Urine Test - Pregnancy | $18 | 0% | $18 |
Medium |
