| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $56 | 0% | $56 |
| Blood Test - Cholesterol Test, Lipid Panel | $55 | 0% | $55 |
| Blood Test - Clotting Time | $40 | 0% | $40 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $32 | 0% | $32 |
| Blood Test - Comprehensive Metabolic Panel | $29 | 0% | $29 |
| Blood Test - Hepatic (Liver) Function Panel | $41 | 0% | $41 |
| Blood Test - Hepatitis C Antibody Level | $79 | 0% | $79 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $74 | 0% | $74 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $57 | 0% | $57 |
| Lab Test - Detection test for Influenza Virus | $32 | 0% | $32 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $304 | 0% | $304 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $259 | 0% | $259 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $274 | 0% | $274 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $294 | 0% | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $316 | 0% | $316 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $246 | 0% | $246 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $223 | 0% | $223 |
| Office Visit - Established Patient, High Complexity | $386 | 0% | $386 |
| Office Visit - Established Patient, Moderate Complexity | $285 | 0% | $285 |
| Office Visit - New Patient, Low Complexity | $274 | 0% | $274 |
| Office Visit - New Patient, Minor | $169 | 0% | $169 |
| Office Visit - New Patient, Moderate Complexity | $367 | 0% | $367 |
| Urine Test - Automated with Microscope Examination | $26 | 0% | $26 |
| Urine Test - Automated without Microscope | $19 | 0% | $19 |
| Urine Test - Pregnancy | $40 | 0% | $40 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $74 | 0% | $74 |
