| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $37 | 0% | $37 |
| Blood Test - Cholesterol Test, Lipid Panel | $47 | 0% | $47 |
| Blood Test - Clotting Time | $11 | 0% | $11 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $148 | 0% | $148 |
| Destruction of Lesion (outpatient) | $366 | 0% | $366 |
| Office Visit - Basic | $68 | 0% | $68 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $236 | 0% | $236 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $184 | 0% | $184 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $200 | 0% | $200 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $210 | 0% | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $226 | 0% | $226 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $184 | 0% | $184 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $184 | 0% | $184 |
| Office Visit - Established Patient, High Complexity | $221 | 0% | $221 |
| Office Visit - Established Patient, Low Complexity | $126 | 0% | $126 |
| Office Visit - Established Patient, Moderate Complexity | $179 | 0% | $179 |
| Office Visit - New Patient, Low Complexity | $158 | 0% | $158 |
| Office Visit - New Patient, Moderate Complexity | $289 | 0% | $289 |
| Strep Test (Streptococcus, group A) | $37 | 0% | $37 |
| Urine Test - Pregnancy | $24 | 0% | $24 |
| Urine Test - Urinalysis, Manual Test | $11 | 0% | $11 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $58 | 0% | $58 |
