| Bacterial Culture - Aerobic Isolates | $20 | N/A | $20 |
| Blood Test - Basic Metabolic Panel | $28 | N/A | $28 |
| Blood Test - Blood Glucose (Sugar) Level | $13 | N/A | $13 |
| 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 | $13 | N/A | $13 |
| Blood Test - Complete Blood Cell Count (Hemoglobin) | $22 | N/A | $22 |
| 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 - Hepatic (Liver) Function Panel | $32 | N/A | $32 |
| Blood Test - Iron Binding Capacity | $29 | N/A | $29 |
| Blood Test - Iron Level | $22 | N/A | $22 |
| Blood Test - Magnesium Level | $23 | N/A | $23 |
| Blood Test - Prostate Specific Antigen (PSA) Level | $61 | N/A | $61 |
| Blood Test - Renal (Kidney) Function Panel | $44 | N/A | $44 |
| 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 |
| Evaluation of Antimicrobial Drug (antibiotic, antifungal, antiviral) | $21 | N/A | $21 |
| Lab Test - Detection for Strep (Streptococcus, group A) | $40 | N/A | $40 |
| Lab Test - Detection test for Influenza Virus | $40 | N/A | $40 |
| Office Visit - Basic | $109 | N/A | $109 |
| 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 | $370 | N/A | $370 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 18-39 Years Old | $292 | N/A | $292 |
| Office Visit - Comprehensive Preventive Medicine Reevaluation and Management, 40-64 Years Old | $312 | N/A | $312 |
| Office Visit - Established Patient, High Complexity | $361 | N/A | $361 |
| Office Visit - Established Patient, Low Complexity | $172 | N/A | $172 |
| Office Visit - Established Patient, Moderate Complexity | $268 | N/A | $268 |
| Office Visit - New Patient, Low Complexity | $270 | N/A | $270 |
| 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 | $21 | N/A | $21 |
| Urine Test - Urinalysis, Manual Test | $8 | N/A | $8 |
| Vaccine - Influenza for Injection into Muscle | $37 | N/A | $37 |
| Vaccine - Pneumococcal Conjugate for Injection into Muscle | $396 | N/A | $396 |
| Vaccine - Tetanus, Diptheria Toxoids, and Acellular Pertussis (Whooping Cough) for Injection into Muscle | $78 | N/A | $78 |
