| Bacterial Culture - Aerobic Isolates | $28 | 0% | $28 |
| Bacterial Culture - Swab | $32 | 0% | $32 |
| Blood Test - Basic Metabolic Panel | $44 | 0% | $44 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $36 | 0% | $36 |
| Blood Test - Cholesterol Test, Lipid Panel | $49 | 0% | $49 |
| Blood Test - Clotting Time | $15 | 0% | $15 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $24 | 0% | $24 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | 0% | $33 |
| Blood Test - Comprehensive Metabolic Panel | $39 | 0% | $39 |
| Blood Test - General Health Panel | $190 | 0% | $190 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $54 | 0% | $54 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $62 | 0% | $62 |
| Detection test for Human Papillomavirus (HPV) | $183 | 0% | $183 |
| Mammogram (outpatient) | $998 | 0% | $998 |
| Office Visit - Basic | $111 | 0% | $111 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $401 | 0% | $401 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $401 | 0% | $401 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $462 | 0% | $462 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $371 | 0% | $371 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $368 | 0% | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $368 | 0% | $368 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $399 | 0% | $399 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $321 | 0% | $321 |
| Office Visit - Established Patient, High Complexity | $364 | 0% | $364 |
| Office Visit - Established Patient, Low Complexity | $184 | 0% | $184 |
| Office Visit - Established Patient, Moderate Complexity | $272 | 0% | $272 |
| Office Visit - New Patient, Low Complexity | $273 | 0% | $273 |
| Office Visit - New Patient, Minor | $189 | 0% | $189 |
| Office Visit - New Patient, Moderate Complexity | $417 | 0% | $417 |
| Strep Test (Streptococcus, group A) | $42 | 0% | $42 |
| Urine Test - Automated with Microscope Examination | $12 | 0% | $12 |
| Urine Test - Automated without Microscope | $6 | 0% | $6 |
| Urine Test - Bacterial Culture | $28 | 0% | $28 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $64 | 0% | $64 |
| Urine Test - Microalbumin (Protein) Level | $20 | 0% | $20 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $289 | 0% | $289 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $98 | 0% | $98 |
