| Bacterial Culture - Aerobic Isolates | $28 | N/A | $28 |
| Bacterial Culture - Swab | $32 | N/A | $32 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $36 | N/A | $36 |
| Blood Test - Cholesterol Test, Lipid Panel | $49 | N/A | $49 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $24 | N/A | $24 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Blood Test - Comprehensive Metabolic Panel | $39 | N/A | $39 |
| Blood Test - General Health Panel | $190 | N/A | $190 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $54 | N/A | $54 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $62 | N/A | $62 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $470 | N/A | $470 |
| Lab Test - Creatinine Level | $64 | N/A | $64 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $183 | N/A | $183 |
| Lab Test - Detection test for Influenza Virus | $34 | N/A | $34 |
| Office Visit - Basic | $111 | N/A | $111 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $401 | N/A | $401 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $462 | N/A | $462 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $368 | N/A | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $368 | N/A | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $399 | N/A | $399 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $321 | N/A | $321 |
| Office Visit - Established Patient, High Complexity | $364 | N/A | $364 |
| Office Visit - Established Patient, Low Complexity | $184 | N/A | $184 |
| Office Visit - Established Patient, Moderate Complexity | $272 | N/A | $272 |
| Office Visit - New Patient, Low Complexity | $273 | N/A | $273 |
| Office Visit - New Patient, Moderate Complexity | $417 | N/A | $417 |
| Pap Test, manual screening | $84 | N/A | $84 |
| Urine Test - Automated with Microscope Examination | $12 | N/A | $12 |
| Urine Test - Automated without Microscope | $6 | N/A | $6 |
| Urine Test - Bacterial Culture | $28 | N/A | $28 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $64 | N/A | $64 |
| Urine Test - Microalbumin (Protein) Level | $20 | N/A | $20 |
| Vaccine - Influenza for Injection into Muscle | $26 | N/A | $26 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $289 | N/A | $289 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $98 | N/A | $98 |
