| Bacterial Culture - Aerobic Isolates | $19 | N/A | $19 |
| Bacterial Culture - Swab | $63 | N/A | $63 |
| Blood Test - Basic Metabolic Panel | $141 | N/A | $141 |
| Blood Test - Blood Glucose (Sugar) Level | $13 | N/A | $13 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $44 | N/A | $44 |
| Blood Test - Blood Typing (ABO) | $130 | N/A | $130 |
| Blood Test - Blood Typing (Rh (D)) | $54 | N/A | $54 |
| Blood Test - C-reactive Protein (CRP) Level | $59 | N/A | $59 |
| Blood Test - Cholesterol Test, Lipid Panel | $47 | N/A | $47 |
| Blood Test - Clotting Time | $66 | N/A | $66 |
| Blood Test - Coagulation Assessment | $101 | N/A | $101 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $105 | N/A | $105 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $25 | N/A | $25 |
| Blood Test - Comprehensive Metabolic Panel | $174 | N/A | $174 |
| Blood Test - Creatinine Level | $84 | N/A | $84 |
| Blood Test - Ferritin (Blood Protein) Level | $102 | N/A | $102 |
| Blood Test - Folic Acid Level | $56 | N/A | $56 |
| Blood Test - General Health Panel | $175 | N/A | $175 |
| Blood Test - Hepatic (Liver) Function Panel | $152 | N/A | $152 |
| Blood Test - Hepatitis C Antibody Level | $30 | N/A | $30 |
| Blood Test - Iron Binding Capacity | $41 | N/A | $41 |
| Blood Test - Iron Level | $70 | N/A | $70 |
| Blood Test - LDL Cholesterol Level | $84 | N/A | $84 |
| Blood Test - Lipase (fat enzyme) Level | $78 | N/A | $78 |
| Blood Test - Magnesium Level | $112 | N/A | $112 |
| Blood Test - Pregnancy (Obstetric) Panel | $504 | N/A | $504 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | N/A | $61 |
| Blood Test - Renal (Kidney) Function Panel | $141 | N/A | $141 |
| Blood Test - Thyroglobulin (Thyroid Protein) Antibody Level | $200 | N/A | $200 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $61 | N/A | $61 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $140 | N/A | $140 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $114 | N/A | $114 |
| Blood Test - Vitamin D-3 Level | $100 | N/A | $100 |
| Emergency Department Visit - Low Complexity (outpatient) | $390 | N/A | $390 |
| Emergency Department Visit - Moderate Complexity (outpatient) | $697 | N/A | $697 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $142 | N/A | $142 |
| Hydration Infusion | $179 | N/A | $179 |
| Lab Test - Creatinine Level | $21 | N/A | $21 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $84 | N/A | $84 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $30 | N/A | $30 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $36 | N/A | $36 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $152 | N/A | $152 |
| Lab Test - Smear for Microorganism | $72 | N/A | $72 |
| Mammogram (outpatient) | $1,402 | N/A | $1,402 |
| Pap Test, manual screening | $79 | N/A | $79 |
| Physical Therapy - Low Complexity Evaluation | $144 | 
Near Average
State Average: 1 | $144 |
| Physical Therapy - Manual Therapy | $104 | 
Above Average
State Average: 4 | $104 |
| Physical Therapy - Moderate Complexity Evaluation | $443 |
Near Average
State Average: 1 | $443 |
| Physical Therapy - Neuromuscular Reeducation | $55 | 
Below Average
State Average: 4 | $55 |
| Physical Therapy - Therapeutic Exercises | $104 |
Below Average
State Average: 4 | $104 |
| Physical Therapy - Ultrasound Therapy | $27 |
Above Average
State Average: 3 | $27 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $72 | N/A | $72 |
| Ultrasound - Pregnancy Follow-Up | $689 | N/A | $689 |
| Urine Test - Automated without Microscope | $32 | N/A | $32 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $32 | N/A | $32 |
| Urine Test - Chlamydia | $70 | N/A | $70 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $70 | N/A | $70 |
| Urine Test - Microalbumin (Protein) Level | $21 | N/A | $21 |
| Urine Test - Pregnancy | $53 | N/A | $53 |
| X-Ray - Chest (outpatient) | $812 | N/A | $812 |
