| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $28 | N/A | $28 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | N/A | $103 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Blood Test - Comprehensive Metabolic Panel | $48 | N/A | $48 |
| Blood Test - Hepatitis C Antibody Level | $112 | N/A | $112 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $112 | N/A | $112 |
| Developmental Screening | $23 | N/A | $23 |
| Lab Test - Creatinine Level | $42 | N/A | $42 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $43 | N/A | $43 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $401 | N/A | $401 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | N/A | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $236 | N/A | $236 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $394 | N/A | $394 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $205 | N/A | $205 |
| Office Visit - Established Patient, Low Complexity | $219 | N/A | $219 |
| Office Visit - Established Patient, Moderate Complexity | $319 | N/A | $319 |
| Urine Test - Urinalysis, Manual Test | $11 | N/A | $11 |
| Vaccine - Influenza for Injection into Muscle | $50 | N/A | $50 |
