| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $69 | N/A | $69 |
| Blood Test - Cholesterol Test, Lipid Panel | $98 | N/A | $98 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $112 | N/A | $112 |
| Blood Test - Vitamin D-3 Level | $287 | N/A | $287 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $53 | N/A | $53 |
| Office Visit - Basic | $79 | N/A | $79 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $263 | N/A | $263 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $194 | N/A | $194 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $200 | N/A | $200 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $221 | N/A | $221 |
| Office Visit - Established Patient, High Complexity | $260 | N/A | $260 |
| Office Visit - Established Patient, Low Complexity | $126 | N/A | $126 |
| Office Visit - Established Patient, Moderate Complexity | $190 | N/A | $190 |
| Office Visit - New Patient, Moderate Complexity | $263 | N/A | $263 |
| Urine Test - Automated without Microscope | $19 | N/A | $19 |
| Vaccine - Influenza for Injection into Muscle | $44 | N/A | $44 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $68 | N/A | $68 |
