| Bacterial Culture - Aerobic Isolates | $31 | N/A | $31 |
| Blood Test - Basic Metabolic Panel | $51 | N/A | $51 |
| Blood Test - Blood Glucose (Sugar) Level | $32 | N/A | $32 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $78 | N/A | $78 |
| Blood Test - C-reactive Protein (CRP) Level | $33 | N/A | $33 |
| Blood Test - Cholesterol Test, Lipid Panel | $123 | N/A | $123 |
| Blood Test - Clotting Time | $32 | N/A | $32 |
| Blood Test - Coagulation Assessment | $38 | N/A | $38 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $61 | N/A | $61 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $48 | N/A | $48 |
| Blood Test - Comprehensive Metabolic Panel | $65 | N/A | $65 |
| Blood Test - Ferritin (Blood Protein) Level | $84 | N/A | $84 |
| Blood Test - Folic Acid Level | $91 | N/A | $91 |
| Blood Test - General Health Panel | $217 | N/A | $217 |
| Blood Test - Hepatic (Liver) Function Panel | $50 | N/A | $50 |
| Blood Test - Hepatitis B Surface Antibody Level | $66 | N/A | $66 |
| Blood Test - Hepatitis C Antibody Level | $80 | N/A | $80 |
| Blood Test - Iron Binding Capacity | $54 | N/A | $54 |
| Blood Test - Iron Level | $41 | N/A | $41 |
| Blood Test - LDL Cholesterol Level | $59 | N/A | $59 |
| Blood Test - Lipase (fat enzyme) Level | $42 | N/A | $42 |
| Blood Test - Magnesium Level | $42 | N/A | $42 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $113 | N/A | $113 |
| Blood Test - Renal (Kidney) Function Panel | $111 | N/A | $111 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $104 | N/A | $104 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $56 | N/A | $56 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $105 | N/A | $105 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $95 | N/A | $95 |
| Blood Test - Vitamin D-3 Level | $184 | N/A | $184 |
| Developmental Screening | $47 | N/A | $47 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $636 | N/A | $636 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $32 | N/A | $32 |
| Lab Test - Creatinine Level | $33 | N/A | $33 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $80 | N/A | $80 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $158 | N/A | $158 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $63 | N/A | $63 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $134 | N/A | $134 |
| Lab Test - Detection test for Human Papillomavirus (HPV) | $276 | N/A | $276 |
| Lab Test - Detection test for Influenza Virus | $96 | N/A | $96 |
| Office Visit - Basic | $197 | N/A | $197 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $319 | N/A | $319 |
| Office Visit - Established Patient, High Complexity | $419 | N/A | $419 |
| Office Visit - Established Patient, Low Complexity | $216 | N/A | $216 |
| Office Visit - Established Patient, Moderate Complexity | $311 | N/A | $311 |
| Office Visit - New Patient, Low Complexity | $340 | N/A | $340 |
| Pap Test, automated screening and manual rescreening | $275 | N/A | $275 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $41 | N/A | $41 |
| Urine Test - Automated with Microscope Examination | $25 | N/A | $25 |
| Urine Test - Automated without Microscope | $19 | N/A | $19 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $31 | N/A | $31 |
| Urine Test - Chlamydia | $207 | N/A | $207 |
| Urine Test - Microalbumin (Protein) Level | $36 | N/A | $36 |
| Urine Test - Pregnancy | $53 | N/A | $53 |
| Urine Test - Urinalysis, Manual Test | $26 | N/A | $26 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $65 | N/A | $65 |
