| Blood Test - Basic Metabolic Panel | $44 | N/A | $44 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $23 | N/A | $23 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $153 | N/A | $153 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $28 | N/A | $28 |
| Office Visit - Basic | $109 | N/A | $109 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $326 | N/A | $326 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $378 | N/A | $378 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $294 | N/A | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $313 | N/A | $313 |
| Office Visit - Established Patient, Low Complexity | $183 | N/A | $183 |
| Office Visit - Established Patient, Moderate Complexity | $268 | N/A | $268 |
| Office Visit - New Patient, Low Complexity | $267 | N/A | $267 |
| Urine Test - Automated with Microscope Examination | $64 | N/A | $64 |
| Urine Test - Pregnancy | $16 | N/A | $16 |
| Urine Test - Urinalysis, Manual Test | $5 | N/A | $5 |
| Vaccine - Influenza for Injection into Muscle | $41 | N/A | $41 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $296 | N/A | $296 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $70 | N/A | $70 |
