| Arthrocentesis (outpatient) | $248 | 0% | $248 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $21 | 0% | $21 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | 0% | $103 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | 0% | $33 |
| Blood Test - Comprehensive Metabolic Panel | $48 | 0% | $48 |
| Blood Test - General Health Panel | $190 | 0% | $190 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $112 | 0% | $112 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $109 | 0% | $109 |
| Office Visit - Basic | $79 | 0% | $79 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $228 | 0% | $228 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $231 | 0% | $231 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $182 | 0% | $182 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $221 | 0% | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $182 | 0% | $182 |
| Office Visit - Established Patient, High Complexity | $242 | 0% | $242 |
| Office Visit - Established Patient, Low Complexity | $126 | 0% | $126 |
| Office Visit - Established Patient, Moderate Complexity | $179 | 0% | $179 |
| Office Visit - New Patient, Low Complexity | $165 | 0% | $165 |
| Office Visit - New Patient, Minor | $126 | 0% | $126 |
| Office Visit - New Patient, Moderate Complexity | $249 | 0% | $249 |
| Strep Test (Streptococcus, group A) | $26 | 0% | $26 |
| Urine Test - Automated without Microscope | $5 | 0% | $5 |
