How much is it for s puppy's vaccine and first visit?

Dogs  Rabies Vaccine: $12 Puppy Distemper /parvo/Lepto series: $20 each Booster Dappv/L4: $20  Leptospirosis Vaccine (4 strains) :$19 Kennel Cough: $20 Influenza Vaccine (Double strain): $40  Lyme vaccine :$30 Heartworm test : $28 Heartworm, Lyme, anaplasmosis, ehrlichiosis test  (Snap 4Dx Plus test) : $41 Fecal Idexx Antigen test : $32 Nail Trim: $15 Wellness exam: $31

All prices are listed on their website. But shots range from 15 to 24. Exam fee is around 30 to 48 dollars