| Arthrocentesis (outpatient) | $248 | N/A | $248 |
| Biopsy - Punch Biopsy of Skin | $407 | N/A | $407 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $21 | N/A | $21 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | N/A | $103 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Blood Test - Comprehensive Metabolic Panel | $48 | N/A | $48 |
| Blood Test - General Health Panel | $190 | N/A | $190 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $112 | N/A | $112 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | N/A | $109 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $26 | N/A | $26 |
| Office Visit - Basic | $79 | N/A | $79 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $231 | N/A | $231 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $210 | N/A | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $210 | N/A | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $221 | N/A | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $184 | N/A | $184 |
| Office Visit - Established Patient, High Complexity | $242 | N/A | $242 |
| Office Visit - Established Patient, Low Complexity | $126 | N/A | $126 |
| Office Visit - Established Patient, Moderate Complexity | $179 | N/A | $179 |
| Office Visit - New Patient, Low Complexity | $179 | N/A | $179 |
| Office Visit - New Patient, Minor | $126 | N/A | $126 |
| Office Visit - New Patient, Moderate Complexity | $273 | N/A | $273 |
| Urine Test - Automated without Microscope | $5 | N/A | $5 |
| Vaccine - Influenza for Injection into Muscle | $32 | N/A | $32 |
