| Electrocardiogram (ECG or EKG), with Report and Interpretation | $733 | N/A | $733 |
| Office Visit - Basic | $126 | N/A | $126 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $311 | N/A | $311 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $311 | N/A | $311 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $352 | N/A | $352 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $273 | N/A | $273 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $233 | N/A | $233 |
| Office Visit - Established Patient, High Complexity | $359 | N/A | $359 |
| Office Visit - Established Patient, Low Complexity | $212 | N/A | $212 |
| Office Visit - Established Patient, Moderate Complexity | $315 | N/A | $315 |
| Office Visit - New Patient, Low Complexity | $257 | N/A | $257 |
| Office Visit - New Patient, Minor | $173 | N/A | $173 |
| Office Visit - New Patient, Moderate Complexity | $453 | N/A | $453 |
| Physical Therapy - Electrical Stimulation Therapy | $53 | 
Below Average
State Average: 3 | $53 |
| Physical Therapy - Low Complexity Evaluation | $126 | 
Near Average
State Average: 1 | $126 |
| Physical Therapy - Manual Therapy | $80 |
Below Average
State Average: 4 | $80 |
| Physical Therapy - Moderate Complexity Evaluation | $179 |
Near Average
State Average: 1 | $179 |
| Physical Therapy - Neuromuscular Reeducation | $80 |
Below Average
State Average: 4 | $80 |
| Physical Therapy - Therapeutic Activities | $80 |
Below Average
State Average: 3 | $80 |
| Physical Therapy - Therapeutic Exercises | $80 |
Below Average
State Average: 4 | $80 |
| Vaccine - Influenza for Injection into Muscle | $67 | N/A | $67 |
