| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $123 | 0% | $123 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $189 | 0% | $189 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $206 | 0% | $206 |
| 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 | $224 | 0% | $224 |
| Office Visit - Established Patient, Low Complexity | $131 | 0% | $131 |
| Office Visit - Established Patient, Moderate Complexity | $194 | 0% | $194 |
| Office Visit - New Patient, Low Complexity | $224 | 0% | $224 |
| Psychiatric Diagnostic Evaluation | $190 | 0% | $190 |
| Psychotherapy - 30 Minutes | $116 | 0% | $116 |
| Psychotherapy - 45 Minutes | $154 | 0% | $154 |
| Psychotherapy - 60 Minutes | $131 | 0% | $131 |
| Psychotherapy - Family Session | $131 | 0% | $131 |
| Strep Test (Streptococcus, group A) | $69 | 0% | $69 |
| Urine Test - Automated without Microscope | $53 | 0% | $53 |
| Urine Test - Urinalysis, Manual Test | $4 | 0% | $4 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $47 | 0% | $47 |
