| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $69 | 0% | $69 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
| Blood Test - Comprehensive Metabolic Panel | $48 | 0% | $48 |
| Office Visit - Basic | $105 | 0% | $105 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $252 | 0% | $252 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $252 | 0% | $252 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $315 | 0% | $315 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $263 | 0% | $263 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $215 | 0% | $215 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $226 | 0% | $226 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $242 | 0% | $242 |
| Office Visit - Established Patient, High Complexity | $263 | 0% | $263 |
| Office Visit - Established Patient, Low Complexity | $158 | 0% | $158 |
| Office Visit - Established Patient, Moderate Complexity | $184 | 0% | $184 |
| Office Visit - New Patient, Low Complexity | $185 | 0% | $185 |
| Office Visit - New Patient, Minor | $131 | 0% | $131 |
| Office Visit - New Patient, Moderate Complexity | $258 | 0% | $258 |
| Strep Test (Streptococcus, group A) | $26 | 0% | $26 |
| Urine Test - Automated without Microscope | $45 | 0% | $45 |
| Urine Test - Urinalysis, Manual Test | $11 | 0% | $11 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $53 | 0% | $53 |
