| Blood Test - Prostate Specific Antigen (PSA) Level | $117 | N/A | $117 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $108 | N/A | $108 |
| Office Visit - Basic | $168 | N/A | $168 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $545 | N/A | $545 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $324 | N/A | $324 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $387 | N/A | $387 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $422 | N/A | $422 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $461 | N/A | $461 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $324 | N/A | $324 |
| Office Visit - Established Patient, Low Complexity | $235 | N/A | $235 |
| Office Visit - Established Patient, Moderate Complexity | $358 | N/A | $358 |
| Office Visit - New Patient, Low Complexity | $360 | N/A | $360 |
| Urine Test - Urinalysis, Manual Test | $57 | N/A | $57 |
| Vaccine - Influenza for Injection into Muscle | $62 | N/A | $62 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $144 | N/A | $144 |
