| Biopsy - Tangential Biopsy of Skin | $323 | 0% | $323 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $21 | 0% | $21 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
| Blood Test - Clotting Time | $11 | 0% | $11 |
| Blood Test - General Health Panel | $190 | 0% | $190 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | 0% | $109 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $123 | 0% | $123 |
| Destruction of Lesion (outpatient) | $381 | 0% | $381 |
| Detection test for Human Papillomavirus (HPV) | $342 | 0% | $342 |
| Lab Test - Detection test for Influenza Virus | $26 | 0% | $26 |
| Office Visit - Basic | $119 | 0% | $119 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $263 | 0% | $263 |
| 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 | $315 | 0% | $315 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $341 | 0% | $341 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $226 | 0% | $226 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $257 | 0% | $257 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $287 | 0% | $287 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $314 | 0% | $314 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $321 | 0% | $321 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $158 | 0% | $158 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $286 | 0% | $286 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $269 | 0% | $269 |
| Office Visit - Established Patient, High Complexity | $328 | 0% | $328 |
| Office Visit - Established Patient, Low Complexity | $196 | 0% | $196 |
| Office Visit - Established Patient, Moderate Complexity | $263 | 0% | $263 |
| Office Visit - New Patient, Low Complexity | $293 | 0% | $293 |
| Office Visit - New Patient, Minor | $203 | 0% | $203 |
| Office Visit - New Patient, Moderate Complexity | $341 | 0% | $341 |
| Psychotherapy - 30 Minutes | $169 | 0% | $169 |
| Psychotherapy - 45 Minutes | $175 | 0% | $175 |
| Strep Test (Streptococcus, group A) | $26 | 0% | $26 |
| Urine Test - Automated without Microscope | $4 | 0% | $4 |
| Urine Test - Chlamydia | $53 | 0% | $53 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $53 | 0% | $53 |
| Urine Test - Pregnancy | $11 | 0% | $11 |
| Urine Test - Urinalysis, Manual Test | $5 | 0% | $5 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $263 | 0% | $263 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $68 | 0% | $68 |
