| Arthrocentesis (outpatient) | $462 | N/A | $462 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $32 | N/A | $32 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $152 | N/A | $152 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Office Visit - Basic | $105 | N/A | $105 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $242 | N/A | $242 |
| 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, 18-39 Years Old | $242 | N/A | $242 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $284 | N/A | $284 |
| Office Visit - Established Patient, Low Complexity | $147 | N/A | $147 |
| Office Visit - Established Patient, Moderate Complexity | $200 | N/A | $200 |
| Office Visit - New Patient, Low Complexity | $210 | N/A | $210 |
| Office Visit - New Patient, Moderate Complexity | $294 | N/A | $294 |
| Urine Test - Urinalysis, Manual Test | $32 | N/A | $32 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $105 | N/A | $105 |
