| Arthrocentesis (outpatient) | $1,563 | N/A | $1,563 |
| Blood Test - Cholesterol Test, Lipid Panel | $156 | N/A | $156 |
| Blood Test - Clotting Time | $7 | N/A | $7 |
| Blood Test - Comprehensive Metabolic Panel | $92 | N/A | $92 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $148 | N/A | $148 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $330 | N/A | $330 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $88 | N/A | $88 |
| Lab Test - Detection test for Influenza Virus | $84 | N/A | $84 |
| Office Visit - Basic | $69 | N/A | $69 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $232 | N/A | $232 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $270 | N/A | $270 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $213 | N/A | $213 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $227 | N/A | $227 |
| Office Visit - Established Patient, Low Complexity | $186 | N/A | $186 |
| Office Visit - Established Patient, Moderate Complexity | $219 | N/A | $219 |
| Office Visit - New Patient, Low Complexity | $300 | N/A | $300 |
| Office Visit - New Patient, Minor | $230 | N/A | $230 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $60 | N/A | $60 |
| Urine Test - Pregnancy | $106 | N/A | $106 |
| Urine Test - Urinalysis, Manual Test | $29 | N/A | $29 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $69 | N/A | $69 |
