| Blood Test - Basic Metabolic Panel | $24 | 0% | $24 | 
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $30 | 0% | $30 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $41 | 0% | $41 |
Medium |
| Blood Test - Clotting Time | $19 | 0% | $19 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $17 | 0% | $17 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $23 | 0% | $23 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $27 | 0% | $27 |
Medium |
| Blood Test - Electrolytes Panel | $28 | 0% | $28 |
Medium |
| Blood Test - General Health Panel | $110 | 0% | $110 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $23 | 0% | $23 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $49 | 0% | $49 |
Medium |
| Blood Test - Renal (Kidney) Function Panel | $27 | 0% | $27 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $60 | 0% | $60 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $36 | 0% | $36 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $39 | 0% | $39 |
Medium |
| Blood Test - Vitamin D-3 Level | $108 | 0% | $108 |
Medium |
| Office Visit - Basic | $109 | 0% | $109 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $180 | 0% | $180 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $201 | 0% | $201 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $201 | 0% | $201 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $217 | 0% | $217 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $185 | 0% | $185 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $168 | 0% | $168 |
Medium |
| Office Visit - Established Patient, High Complexity | $212 | 0% | $212 |
Medium |
| Office Visit - Established Patient, Low Complexity | $140 | 0% | $140 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $173 | 0% | $173 |
Medium |
| Office Visit - New Patient, Low Complexity | $200 | 0% | $200 |
Medium |
| Office Visit - New Patient, Minor | $140 | 0% | $140 |
Medium |
| Pap Test | $126 | 0% | $126 |
Medium |
| Strep Test (Streptococcus, group A) | $46 | 0% | $46 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $28 | 0% | $28 |
Medium |
| Urine Test - Automated with Microscope Examination | $13 | 0% | $13 |
Medium |
| Urine Test - Automated without Microscope | $11 | 0% | $11 |
Medium |
| Urine Test - Bacterial Culture | $41 | 0% | $41 |
Medium |
| Urine Test - Chlamydia | $57 | 0% | $57 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $57 | 0% | $57 |
Medium |
| Urine Test - Pregnancy | $85 | 0% | $85 |
Medium |
| X-Ray - Chest (outpatient) | $670 | 0% | $670 | 
High |
| X-Ray - Hand | $349 | 0% | $349 |
Medium |
