| Blood Test - Blood Glucose (Sugar) Level | $17 | N/A | $17 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $56 | N/A | $56 |
| Blood Test - Cholesterol Test, Lipid Panel | $55 | N/A | $55 |
| Blood Test - Clotting Time | $40 | N/A | $40 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $32 | N/A | $32 |
| Blood Test - Comprehensive Metabolic Panel | $29 | N/A | $29 |
| Blood Test - Creatinine Level | $30 | N/A | $30 |
| Blood Test - General Health Panel | $240 | N/A | $240 |
| Blood Test - Hepatic (Liver) Function Panel | $41 | N/A | $41 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $74 | N/A | $74 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $455 | N/A | $455 |
| Lab Test - Creatinine Level | $30 | N/A | $30 |
| Lab Test - Detection test for Influenza Virus | $32 | N/A | $32 |
| Office Visit - Basic | $132 | N/A | $132 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $259 | N/A | $259 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $274 | N/A | $274 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $294 | N/A | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $316 | N/A | $316 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $246 | N/A | $246 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $223 | N/A | $223 |
| Office Visit - Established Patient, High Complexity | $386 | N/A | $386 |
| Office Visit - Established Patient, Moderate Complexity | $295 | N/A | $295 |
| Office Visit - New Patient, Low Complexity | $274 | N/A | $274 |
| Office Visit - New Patient, Minor | $169 | N/A | $169 |
| Office Visit - New Patient, Moderate Complexity | $367 | N/A | $367 |
| Urine Test - Automated with Microscope Examination | $26 | N/A | $26 |
| Urine Test - Automated without Microscope | $19 | N/A | $19 |
| Urine Test - Pregnancy | $40 | N/A | $40 |
| Vaccine - Influenza for Injection into Muscle | $53 | N/A | $53 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $74 | N/A | $74 |
