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