| Arthrocentesis (outpatient) | $228 | N/A | $228 |
| Blood Test - Basic Metabolic Panel | $28 | N/A | $28 |
| Blood Test - Blood Glucose (Sugar) Level | $16 | N/A | $16 |
| Blood Test - Blood Glucose Control (Hemoglobin A1C) | $33 | N/A | $33 |
| Blood Test - C-reactive Protein (CRP) Level | $18 | N/A | $18 |
| Blood Test - Cholesterol Test, Lipid Panel | $60 | N/A | $60 |
| Blood Test - Clotting Time | $49 | N/A | $49 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $57 | N/A | $57 |
| Blood Test - Complete Blood Cell Count and Automated WBC | $26 | N/A | $26 |
| Blood Test - Comprehensive Metabolic Panel | $35 | N/A | $35 |
| Blood Test - Ferritin (Blood Protein) Level | $45 | N/A | $45 |
| Blood Test - Folic Acid Level | $49 | N/A | $49 |
| Blood Test - General Health Panel | $104 | N/A | $104 |
| Blood Test - Hepatitis B Surface Antibody Level | $216 | N/A | $216 |
| Blood Test - Hepatitis C Antibody Level | $152 | N/A | $152 |
| Blood Test - Iron Binding Capacity | $29 | N/A | $29 |
| Blood Test - Iron Level | $22 | N/A | $22 |
| Blood Test - Lead Level | $128 | N/A | $128 |
| Blood Test - Lipase (fat enzyme) Level | $70 | N/A | $70 |
| Blood Test - Magnesium Level | $23 | N/A | $23 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | N/A | $61 |
| Blood Test - Thyroid Stimulating Hormone (TSH) Level | $56 | N/A | $56 |
| Blood Test - Thyroxine (Thyroid Chemical) Level, Free | $29 | N/A | $29 |
| Blood Test - Vitamin B-12 (Cyanocobalamin) Level | $49 | N/A | $49 |
| Blood Test - Vitamin D-3 Level | $99 | N/A | $99 |
| Electrocardiogram (ECG or EKG), Tracing | $313 | N/A | $313 |
| Electrocardiogram (ECG or EKG), with Report and Interpretation | $392 | N/A | $392 |
| Lab Test - Creatinine Level | $76 | N/A | $76 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $42 | N/A | $42 |
| Lab Test - Detection test for Coronavirus (COVID-19) | $106 | N/A | $106 |
| Lab Test - Detection test for Hepatitis B Surface Antigen | $89 | N/A | $89 |
| Lab Test - Detection test for HIV-1 and HIV-2 | $114 | N/A | $114 |
| Lab Test - Detection test for Influenza Virus | $50 | N/A | $50 |
| Mammogram (outpatient) | $1,154 | N/A | $1,154 |
| Office Visit - Basic | $118 | N/A | $118 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 1-4 Years Old | $292 | N/A | $292 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 12-17 Years Old | $359 | N/A | $359 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 18-39 Years Old | $318 | N/A | $318 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 40-64 Years Old | $402 | N/A | $402 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, 5-11 Years Old | $318 | N/A | $318 |
| Office Visit - Comprehensive Preventive Medicine Evaluation and Management, New Patient, Younger than 1 Year Old | $294 | N/A | $294 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 1-4 Years Old | $281 | N/A | $281 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 12-17 Years Old | $306 | N/A | $306 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $312 | N/A | $312 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $333 | N/A | $333 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 5-11 Years Old | $280 | N/A | $280 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, Younger than 1 Year Old | $264 | N/A | $264 |
| Office Visit - Established Patient, High Complexity | $314 | N/A | $314 |
| Office Visit - Established Patient, Low Complexity | $194 | N/A | $194 |
| Office Visit - Established Patient, Moderate Complexity | $286 | N/A | $286 |
| Office Visit - New Patient, Low Complexity | $289 | N/A | $289 |
| Office Visit - New Patient, Minor | $200 | N/A | $200 |
| Office Visit - New Patient, Moderate Complexity | $408 | N/A | $408 |
| Urine Test - Automated with Microscope Examination | $11 | N/A | $11 |
| Urine Test - Automated without Microscope | $7 | N/A | $7 |
| Urine Test - Bacterial Culture, Quantitative Colony Count | $26 | N/A | $26 |
| Urine Test - Chlamydia | $117 | N/A | $117 |
| Urine Test - Gonorrhoeae (Neisseria Gonorrhoeae Bacteria) | $117 | N/A | $117 |
| Urine Test - Microalbumin (Protein) Level | $19 | N/A | $19 |
| Urine Test - Pregnancy | $23 | N/A | $23 |
| Urine Test - Urinalysis, Manual Test | $9 | N/A | $9 |
| Vaccine - Influenza for Injection into Muscle | $53 | N/A | $53 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $439 | N/A | $439 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $95 | N/A | $95 |
