| Blood Test - Basic Metabolic Panel | $109 | N/A | $109 |
| Blood Test - Blood Glucose (Sugar) Level | $12 | N/A | $12 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $28 | N/A | $28 |
| Blood Test - Cholesterol Test, Lipid Panel | $173 | N/A | $173 |
| Blood Test - Clotting Time | $19 | N/A | $19 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $107 | N/A | $107 |
| Blood Test - Comprehensive Metabolic Panel | $137 | N/A | $137 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $362 | N/A | $362 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $44 | N/A | $44 |
| Office Visit - Basic | $126 | N/A | $126 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $231 | N/A | $231 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $242 | N/A | $242 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $389 | N/A | $389 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $468 | N/A | $468 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $231 | N/A | $231 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $221 | N/A | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $210 | N/A | $210 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $221 | N/A | $221 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $305 | N/A | $305 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $326 | N/A | $326 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $215 | N/A | $215 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $189 | N/A | $189 |
| Office Visit - Established Patient, Low Complexity | $158 | N/A | $158 |
| Office Visit - Established Patient, Moderate Complexity | $231 | N/A | $231 |
| Office Visit - New Patient, Low Complexity | $313 | N/A | $313 |
| Office Visit - New Patient, Minor | $189 | N/A | $189 |
| Office Visit - New Patient, Moderate Complexity | $499 | N/A | $499 |
| Urine Test - Automated without Microscope | $8 | N/A | $8 |
| Urine Test - Microalbumin (Protein) Level | $75 | N/A | $75 |
| Urine Test - Pregnancy | $21 | N/A | $21 |
| Vaccine - Influenza for Injection into Muscle | $25 | N/A | $25 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $53 | N/A | $53 |
