| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $34 | 0% | $34 |
| Blood Test - Cholesterol Test, Lipid Panel | $37 | 0% | $37 |
| Blood Test - Clotting Time | $21 | 0% | $21 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $42 | 0% | $42 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $184 | 0% | $184 |
| Destruction of Lesion (outpatient) | $281 | 0% | $281 |
| Electrocardiogram (ECG or EKG) | $240 | 0% | $240 |
| Lab Test - Detection test for Influenza Virus | $40 | 0% | $40 |
| Mammogram (outpatient) | $1,022 | 0% | $1,022 |
| Office Visit - Basic | $89 | 0% | $89 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $265 | 0% | $265 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $302 | 0% | $302 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $302 | 0% | $302 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $334 | 0% | $334 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $265 | 0% | $265 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $246 | 0% | $246 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $233 | 0% | $233 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $252 | 0% | $252 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $258 | 0% | $258 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $277 | 0% | $277 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $233 | 0% | $233 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $208 | 0% | $208 |
| Office Visit - Established Patient, High Complexity | $289 | 0% | $289 |
| Office Visit - Established Patient, Low Complexity | $147 | 0% | $147 |
| Office Visit - Established Patient, Moderate Complexity | $215 | 0% | $215 |
| Office Visit - New Patient, Low Complexity | $236 | 0% | $236 |
| Office Visit - New Patient, Minor | $168 | 0% | $168 |
| Office Visit - New Patient, Moderate Complexity | $352 | 0% | $352 |
| Psychotherapy - 30 Minutes | $121 | 0% | $121 |
| Psychotherapy - 45 Minutes | $182 | 0% | $182 |
| Psychotherapy - Family Session | $214 | 0% | $214 |
| Strep Test (Streptococcus, group A) | $40 | 0% | $40 |
| Urine Test - Pregnancy | $26 | 0% | $26 |
| Urine Test - Urinalysis, Manual Test | $18 | 0% | $18 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $68 | 0% | $68 |
