| Bacterial Culture Swab | $172 | 0% | $172 | 
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $55 | 0% | $55 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $40 | 0% | $40 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $88 | 0% | $88 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $195 | 0% | $195 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $194 | 0% | $194 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $131 | 0% | $131 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $342 | 0% | $342 |
Medium |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $55 | 0% | $55 |
Medium |
| Mammogram (outpatient) | $964 | 0% | $964 |
Medium |
| Office Visit - Basic | $90 | 0% | $90 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $249 | 0% | $249 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $298 | 0% | $298 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $247 | 0% | $247 |
Medium |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $263 | 0% | $263 |
Medium |
| Office Visit - Established Patient, High Complexity | $215 | 0% | $215 |
Medium |
| Office Visit - Established Patient, Low Complexity | $158 | 0% | $158 |
Medium |
| Office Visit - Established Patient, Moderate Complexity | $210 | 0% | $210 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $35 | 0% | $35 |
Medium |
| Ultrasound - Pelvic (outpatient) | $420 | 0% | $420 |
Medium |
| Ultrasound - Pregnancy (outpatient) | $305 | 0% | $305 |
Medium |
| Ultrasound - Pregnancy Follow-Up | $410 | 0% | $410 |
Medium |
| Ultrasound - Transvaginal (non-maternity) | $664 | 0% | $664 |
Medium |
| Urine Test - Automated without Microscope | $30 | 0% | $30 |
Medium |
| Urine Test - Pregnancy | $29 | 0% | $29 |
Medium |
