| Blood Test - Basic Metabolic Panel | $44 | N/A | $44 |
| Blood Test - Blood Glucose (Sugar) Level | $54 | N/A | $54 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $37 | N/A | $37 |
| Blood Test - Cholesterol Test, Lipid Panel | $103 | N/A | $103 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $33 | N/A | $33 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $33 | N/A | $33 |
| Blood Test - Comprehensive Metabolic Panel | $48 | N/A | $48 |
| Blood Test - General Health Panel | $190 | N/A | $190 |
| Blood Test - Hepatic (Liver) Function Panel | $43 | N/A | $43 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $112 | N/A | $112 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $123 | N/A | $123 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $481 | N/A | $481 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $63 | N/A | $63 |
| Lab Test - Detection test for Influenza Virus | $47 | N/A | $47 |
| Office Visit - Basic | $87 | N/A | $87 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $243 | N/A | $243 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $341 | N/A | $341 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $236 | N/A | $236 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $315 | N/A | $315 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $284 | N/A | $284 |
| Office Visit - Established Patient, High Complexity | $289 | N/A | $289 |
| Office Visit - Established Patient, Low Complexity | $168 | N/A | $168 |
| Office Visit - Established Patient, Moderate Complexity | $273 | N/A | $273 |
| Office Visit - New Patient, Low Complexity | $221 | N/A | $221 |
| Office Visit - New Patient, Minor | $129 | N/A | $129 |
| Test for Disease-Causing (Pathogenic) Organisms, Not Limited to a Specific Condition | $51 | N/A | $51 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $76 | N/A | $76 |
| Urine Test - Pregnancy | $21 | N/A | $21 |
| Urine Test - Urinalysis, Manual Test | $5 | N/A | $5 |
| Vaccine - Influenza for Injection into Muscle | $42 | N/A | $42 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $294 | N/A | $294 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $84 | N/A | $84 |
| X-Ray - Foot (outpatient) | $328 | N/A | $328 |
