| Blood Test - Basic Metabolic Panel | $59 | 0% | $59 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $70 | 0% | $70 |
| Blood Test - Hepatitis C Antibody Level | $87 | 0% | $87 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $77 | 0% | $77 |
| Detection test for Human Papillomavirus (HPV) | $143 | 0% | $143 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $70 | 0% | $70 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $70 | 0% | $70 |
| Office Visit - Basic | $130 | 0% | $130 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $405 | 0% | $405 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $465 | 0% | $465 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $366 | 0% | $366 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $390 | 0% | $390 |
| Office Visit - Established Patient, High Complexity | $512 | 0% | $512 |
| Office Visit - Established Patient, Low Complexity | $216 | 0% | $216 |
| Office Visit - Established Patient, Moderate Complexity | $318 | 0% | $318 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $102 | 0% | $102 |
| Urine Test - Chlamydia | $69 | 0% | $69 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $69 | 0% | $69 |
| Urine Test - Pregnancy | $40 | 0% | $40 |
| Urine Test - Urinalysis, Manual Test | $16 | 0% | $16 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $144 | 0% | $144 |
