| Blood Test - Complete Blood Cell Count (Hemoglobin) | $33 | 0% | $33 | 
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | 0% | $33 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | 0% | $109 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $111 | 0% | $111 |
Medium |
| Mammogram (outpatient) | $830 | 0% | $830 | 
High |
| Office Visit - Basic | $79 | 0% | $79 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $399 | 0% | $399 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $446 | 0% | $446 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $315 | 0% | $315 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $341 | 0% | $341 |
Medium |
| Office Visit - Established Patient, High Complexity | $252 | 0% | $252 |
Medium |
| Office Visit - Established Patient, Low Complexity | $137 | 0% | $137 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $210 | 0% | $210 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $75 | 0% | $75 |
Medium |
| Ultrasound - Pelvic (outpatient) | $331 | 0% | $331 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $341 | 0% | $341 |
Medium |
| Ultrasound - Pregnancy Follow-Up | $236 | 0% | $236 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $495 | 0% | $495 |
Medium |
| Urine Test - Automated without Microscope | $115 | 0% | $115 |
Medium |
| Urine Test - Pregnancy | $12 | 0% | $12 |
Medium |
