| Bacterial Culture Swab | $140 | 0% | $140 | 
Medium |
| Blood Test - Basic Metabolic Panel | $44 | 0% | $44 |
Medium |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $84 | 0% | $84 |
Medium |
| Blood Test - Cholesterol Test, Lipid Panel | $165 | 0% | $165 |
Medium |
| Blood Test - Clotting Time | $65 | 0% | $65 |
Medium |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $100 | 0% | $100 |
Medium |
| Blood Test - Complete Blood Cell Count and Automated WBC | $25 | 0% | $25 |
Medium |
| Blood Test - Comprehensive Metabolic Panel | $160 | 0% | $160 |
Medium |
| Blood Test - General Health Panel | $261 | 0% | $261 |
Medium |
| Blood Test - Hepatic (Liver) Function Panel | $143 | 0% | $143 |
Medium |
| Blood Test - Hepatitis C Antibody Level | $29 | 0% | $29 |
Medium |
| Blood Test - LDL Cholesterol Level | $84 | 0% | $84 |
Medium |
| Blood Test - Lipase (fat enzyme) Level | $72 | 0% | $72 |
Medium |
| Blood Test - Pregnancy (Obstetric) Panel | $480 | 0% | $480 |
Medium |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | 0% | $61 |
Medium |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $61 | 0% | $61 |
Medium |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $132 | 0% | $132 |
Medium |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $159 | 0% | $159 |
Medium |
| Blood Test - Vitamin D-3 Level | $207 | 0% | $207 |
Medium |
| Colonoscopy - Diagnostic (outpatient) | $6,207 | 0% | $6,207 |
Medium |
| Detection Test for Human Papillomavirus (HPV) | $152 | 0% | $152 |
Medium |
| Emergency Department Visit - Low Complexity (outpatient) | $348 | 0% | $348 |
Medium |
| Emergency Department Visit - Minor (outpatient) | $348 | 0% | $348 |
Medium |
| Emergency Department Visit - Moderate Complexity (outpatient) | $623 | 0% | $623 |
Medium |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $132 | 0% | $132 |
Medium |
| Fetal Non-Stress Test | $901 | 0% | $901 |
Medium |
| Mammogram (outpatient) | $1,313 | 0% | $1,313 |
Medium |
| MRI - Back (outpatient) | $3,764 | 0% | $3,764 |
Medium |
| Physical Therapy - Low Complexity Evaluation | $139 | 0% | $139 |
Medium |
| Physical Therapy - Manual Therapy | $104 | 0% | $104 |
Medium |
| Physical Therapy - Moderate Complexity Evaluation | $427 | 0% | $427 |
Medium |
| Physical Therapy - Neuromuscular Reeducation | $104 | 0% | $104 |
Medium |
| Physical Therapy - Therapeutic Exercises | $52 | 0% | $52 |
Medium |
| Physical Therapy - Ultrasound Therapy | $101 | 0% | $101 |
Medium |
| Strep Test (Streptococcus, group A) | $78 | 0% | $78 |
Medium |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $22 | 0% | $22 |
Medium |
| Urine Test - Automated with Microscope Examination | $76 | 0% | $76 |
Medium |
| Urine Test - Automated without Microscope | $29 | 0% | $29 |
Medium |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $88 | 0% | $88 |
Medium |
| Urine Test - Chlamydia | $70 | 0% | $70 |
Medium |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $70 | 0% | $70 |
Medium |
| Urine Test - Pregnancy | $48 | 0% | $48 |
Medium |
| X-Ray - Chest (outpatient) | $849 | 0% | $849 |
Medium |
| X-Ray - Hand | $581 | 0% | $581 |
Medium |
| X-Ray - Knee (outpatient) | $937 | 0% | $937 |
Medium |
| X-Ray - Shoulder (outpatient) | $801 | 0% | $801 |
Medium |
