| Blood Test - Blood Glucose (Sugar) Level | $15 | N/A | $15 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $41 | N/A | $41 |
| Blood Test - Clotting Time | $27 | N/A | $27 |
| Office Visit - Basic | $89 | N/A | $89 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $359 | N/A | $359 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $263 | N/A | $263 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $328 | N/A | $328 |
| Office Visit - Established Patient, High Complexity | $377 | N/A | $377 |
| Office Visit - Established Patient, Low Complexity | $180 | N/A | $180 |
| Office Visit - Established Patient, Moderate Complexity | $275 | N/A | $275 |
| Office Visit - New Patient, Low Complexity | $269 | N/A | $269 |
| Office Visit - New Patient, Moderate Complexity | $455 | N/A | $455 |
| Urine Test - Urinalysis, Manual Test | $15 | N/A | $15 |
| Vaccine - Influenza for Injection into Muscle | $39 | N/A | $39 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $88 | N/A | $88 |
