| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $47 | N/A | $47 |
| Blood Test - C-reactive Protein (CRP) Level | $67 | N/A | $67 |
| Blood Test - Cholesterol Test, Lipid Panel | $173 | N/A | $173 |
| Blood Test - Clotting Time | $20 | N/A | $20 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $73 | N/A | $73 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $107 | N/A | $107 |
| Blood Test - Comprehensive Metabolic Panel | $137 | N/A | $137 |
| Blood Test - Ferritin (Blood Protein) Level | $176 | N/A | $176 |
| Blood Test - General Health Panel | $462 | N/A | $462 |
| Blood Test - Iron Binding Capacity | $113 | N/A | $113 |
| Blood Test - Iron Level | $84 | N/A | $84 |
| Blood Test - Lead Level | $34 | N/A | $34 |
| Blood Test - Lipase (fat enzyme) Level | $89 | N/A | $89 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $218 | N/A | $218 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $117 | N/A | $117 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $75 | N/A | $75 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $147 | N/A | $147 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $53 | N/A | $53 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $249 | N/A | $249 |
| Office Visit - Basic | $142 | N/A | $142 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $414 | N/A | $414 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $389 | N/A | $389 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $449 | N/A | $449 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $364 | N/A | $364 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $286 | N/A | $286 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $296 | N/A | $296 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $317 | N/A | $317 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $339 | N/A | $339 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $290 | N/A | $290 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $265 | N/A | $265 |
| Office Visit - Established Patient, High Complexity | $432 | N/A | $432 |
| Office Visit - Established Patient, Low Complexity | $226 | N/A | $226 |
| Office Visit - Established Patient, Moderate Complexity | $305 | N/A | $305 |
| Office Visit - New Patient, Moderate Complexity | $432 | N/A | $432 |
| Urine Test - Automated with Microscope Examination | $43 | N/A | $43 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $64 | N/A | $64 |
| Urine Test - Microalbumin (Protein) Level | $75 | N/A | $75 |
| Urine Test - Pregnancy | $29 | N/A | $29 |
| Urine Test - Urinalysis, Manual Test | $24 | N/A | $24 |
| Vaccine - Influenza for Injection into Muscle | $25 | N/A | $25 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $93 | N/A | $93 |
