| Blood Test - Basic Metabolic Panel | $51 | 0% | $51 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $78 | 0% | $78 |
| Blood Test - Cholesterol Test, Lipid Panel | $123 | 0% | $123 |
| Blood Test - Clotting Time | $32 | 0% | $32 |
| Blood Test - Coagulation Assessment | $38 | 0% | $38 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $41 | 0% | $41 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $48 | 0% | $48 |
| Blood Test - Comprehensive Metabolic Panel | $65 | 0% | $65 |
| Blood Test - Ferritin (Blood Protein) Level | $84 | 0% | $84 |
| Blood Test - Folic Acid Level | $91 | 0% | $91 |
| Blood Test - General Health Panel | $214 | 0% | $214 |
| Blood Test - Hepatic (Liver) Function Panel | $50 | 0% | $50 |
| Blood Test - Hepatitis C Antibody Level | $80 | 0% | $80 |
| Blood Test - Iron Level | $41 | 0% | $41 |
| Blood Test - LDL Cholesterol Level | $26 | 0% | $26 |
| Blood Test - Lipase (fat enzyme) Level | $42 | 0% | $42 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $113 | 0% | $113 |
| Blood Test - Renal (Kidney) Function Panel | $76 | 0% | $76 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $104 | 0% | $104 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $56 | 0% | $56 |
| Blood Test - Triiodothyronine (T3) Thyroid Hormone Measurement | $105 | 0% | $105 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $95 | 0% | $95 |
| Blood Test - Vitamin D-3 Level | $184 | 0% | $184 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $32 | 0% | $32 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $63 | 0% | $63 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $149 | 0% | $149 |
| Lab Test - Detection test for Influenza Virus | $74 | 0% | $74 |
| Office Visit - Basic | $188 | 0% | $188 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $426 | 0% | $426 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $494 | 0% | $494 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $361 | 0% | $361 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $343 | 0% | $343 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $374 | 0% | $374 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $381 | 0% | $381 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $406 | 0% | $406 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $342 | 0% | $342 |
| Office Visit - Established Patient, High Complexity | $466 | 0% | $466 |
| Office Visit - Established Patient, Low Complexity | $212 | 0% | $212 |
| Office Visit - Established Patient, Moderate Complexity | $349 | 0% | $349 |
| Office Visit - New Patient, Low Complexity | $340 | 0% | $340 |
| Strep Test (Streptococcus, group A) | $53 | 0% | $53 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $25 | 0% | $25 |
| Urine Test - Automated with Microscope Examination | $9 | 0% | $9 |
| Urine Test - Automated without Microscope | $19 | 0% | $19 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $32 | 0% | $32 |
| Urine Test - Chlamydia | $196 | 0% | $196 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $78 | 0% | $78 |
| Urine Test - Microalbumin (Protein) Level | $36 | 0% | $36 |
| Urine Test - Pregnancy | $29 | 0% | $29 |
| Urine Test - Urinalysis, Manual Test | $26 | 0% | $26 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $271 | 0% | $271 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $65 | 0% | $65 |
