| Bacterial Culture - Swab | $37 | N/A | $37 |
| Blood Test - Blood Glucose (Sugar) Level | $17 | N/A | $17 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $27 | N/A | $27 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Blood Test - Creatinine Level | $22 | N/A | $22 |
| Blood Test - Electrolytes Panel | $29 | N/A | $29 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $71 | N/A | $71 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $363 | N/A | $363 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $37 | N/A | $37 |
| Lab Test - Detection test for Influenza Virus | $51 | N/A | $51 |
| Lab Test - Smear for Microorganism | $18 | N/A | $18 |
| Office Visit - Basic | $147 | N/A | $147 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $232 | N/A | $232 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $270 | N/A | $270 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $326 | N/A | $326 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $336 | N/A | $336 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $368 | N/A | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $310 | N/A | $310 |
| Office Visit - Established Patient, High Complexity | $483 | N/A | $483 |
| Office Visit - Established Patient, Low Complexity | $186 | N/A | $186 |
| Office Visit - Established Patient, Moderate Complexity | $357 | N/A | $357 |
| Office Visit - New Patient, Low Complexity | $300 | N/A | $300 |
| Office Visit - New Patient, Moderate Complexity | $541 | N/A | $541 |
| Urine Test - Pregnancy | $27 | N/A | $27 |
| Vaccine - Influenza for Injection into Muscle | $58 | N/A | $58 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $53 | N/A | $53 |
