| Bacterial Culture - Aerobic Isolates | $54 | 0% | $54 |
| Blood Test - Basic Metabolic Panel | $30 | 0% | $30 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $35 | 0% | $35 |
| Blood Test - Cholesterol Test, Lipid Panel | $48 | 0% | $48 |
| Blood Test - Clotting Time | $14 | 0% | $14 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $23 | 0% | $23 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $27 | 0% | $27 |
| Blood Test - Comprehensive Metabolic Panel | $38 | 0% | $38 |
| Blood Test - Ferritin (Blood Protein) Level | $48 | 0% | $48 |
| Blood Test - Folic Acid Level | $53 | 0% | $53 |
| Blood Test - General Health Panel | $125 | 0% | $125 |
| Blood Test - Hepatic (Liver) Function Panel | $29 | 0% | $29 |
| Blood Test - Hepatitis C Antibody Level | $34 | 0% | $34 |
| Blood Test - Iron Level | $23 | 0% | $23 |
| Blood Test - LDL Cholesterol Level | $33 | 0% | $33 |
| Blood Test - Lipase (fat enzyme) Level | $24 | 0% | $24 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $66 | 0% | $66 |
| Blood Test - Renal (Kidney) Function Panel | $32 | 0% | $32 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $60 | 0% | $60 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $33 | 0% | $33 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $54 | 0% | $54 |
| Blood Test - Vitamin D-3 Level | $106 | 0% | $106 |
| Destruction of Lesion (outpatient) | $431 | 0% | $431 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $55 | 0% | $55 |
| Lab Test - Detection test for Influenza Virus | $41 | 0% | $41 |
| Office Visit - Basic | $113 | 0% | $113 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $299 | 0% | $299 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $344 | 0% | $344 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $400 | 0% | $400 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $278 | 0% | $278 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $305 | 0% | $305 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $311 | 0% | $311 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $331 | 0% | $331 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $277 | 0% | $277 |
| Office Visit - Established Patient, High Complexity | $259 | 0% | $259 |
| Office Visit - Established Patient, Low Complexity | $191 | 0% | $191 |
| Office Visit - Established Patient, Moderate Complexity | $281 | 0% | $281 |
| Office Visit - New Patient, Low Complexity | $281 | 0% | $281 |
| Office Visit - New Patient, Minor | $195 | 0% | $195 |
| Office Visit - New Patient, Moderate Complexity | $431 | 0% | $431 |
| Physical Therapy - Application of Blood Vessel Compression or Decompression Device | $53 | 0% | $53 |
| Physical Therapy - Application of Mechanical Traction | $53 | 0% | $53 |
| Physical Therapy - Electrical Stimulation Therapy | $53 | 0% | $53 |
| Physical Therapy - High Complexity Evaluation | $210 | 0% | $210 |
| Physical Therapy - Manual Therapy | $74 | 0% | $74 |
| Physical Therapy - Moderate Complexity Evaluation | $210 | 0% | $210 |
| Physical Therapy - Neuromuscular Reeducation | $89 | 0% | $89 |
| Physical Therapy - Re-Evaluation | $95 | 0% | $95 |
| Physical Therapy - Self-care or Home Management Training | $79 | 0% | $79 |
| Physical Therapy - Therapeutic Exercises | $91 | 0% | $91 |
| Strep Test (Streptococcus, group A) | $44 | 0% | $44 |
| Urine Test - Automated with Microscope Examination | $12 | 0% | $12 |
| Urine Test - Automated without Microscope | $8 | 0% | $8 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $29 | 0% | $29 |
| Urine Test - Chlamydia | $170 | 0% | $170 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $170 | 0% | $170 |
| Urine Test - Microalbumin (Protein) Level | $19 | 0% | $19 |
| Urine Test - Pregnancy | $23 | 0% | $23 |
| Urine Test - Urinalysis, Manual Test | $20 | 0% | $20 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $210 | 0% | $210 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $87 | 0% | $87 |
