Clinic Pricing

99211 – Established Patient Office Visit, Level 1 – $38

99212 – Established Patient Office Visit, Level 2 – $74

99213 – Established Patient Office Visit, Level 3 – $120

99214 – Established Patient Office Visit, Level 4 – $170

99215 – Established Patient Office Visit, Level 5 – $237

99051 – Medical Services After Hours, Office – $31

99202 – New Patient Office Visit, Level 2 – $115

99203 – New Patient Office Visit, Level 3 – $170

99204 – New Patient Office Visit, Level 4 – $260

99205 – New Patient Office Visit, Level 5 – $325

29075 – Application of Forearm Cast – $160

27786 – Closed Treat Distal Fibular Fracture – $614

25600 – Closed Treatment, Distal Radial Fracture w/o manipulation – $633

26720 – Closed Treatment, Finger/Thumb Fracture w/o manipulation – $383

26605 – Closed Treatment, Metacarpal fracture w/o manipulation – $660

25500 – Closed Treatment, Radial Shaft Fracture w/o manipulation – $524

28470 – Treat Metatarsal Fracture – $429

99231 – Follow-up Hospital Care, brief – $65

99233 – Follow-up Hospital Care, extensive – $138

99232 – Follow-up Hospital Care, moderate – $96

99238 – Hospital Discharge, day care – $108

99460 – Initial Care, normal newborn – $208

99223 – Initial Hospital Care, high – $271

99222 – Initial Hospital Care, moderate – $184

99479 – Sub Intensive Care, ea day, low birth weight – $312

90620 – Bexsero Men-B (Meningococcal-B) – $239

90715 – Boostrix (TDaP) – $75

90746 – Engerix-B (Hep B adult) – $121

90744 – Engerix-B (Hep B pediatric) – $57

90653 – Fluad (Infuenza virus vaccine 65+) – $65

90686 – Flulaval (Influenza virus 3 years and up) – $30

90651 – Gardasil-9 (HPV) – $286

90632 – Havrix (Hep A adult) – $121

90633 – Havrix (Hep A pediatric) – $108

90648 – Hiberix (HIB) – $42

90471 – Immunization admin 1 vaccine – $35

90472 – Immunization admin ea additional vaccine – $22

90713 – Ipol (Polio) – $80

90696 – Kinrix (DTap-Polio) – $85

90707 – MMR (Measles Mumps Rubella) – $99

90734 – Menveo (Meningococcal), IM – $165

90723 – Pediarix – (DTaP – HEP B – IPV) – $123

90670 – Prevnar-13 (Pneumococcal) – $271

90681 – Rotateq (Rotavirus) – $116

90750 – Shingrix (Shingles) – $185

90716 – Varivax (Varicella) – $171

J1055 – Depo Provera 150 MG – $112

J7321 – Hyalgan Injection per dose – $200

J2270 – Morphine per 10mg – $10

J0696 – Rocephin Injection per 250 MG – $10

J7325 – Synvisc – $783

84443 – Assay Thyroid Stimulation Hormone (TSH) – $46

80048 – Basic Metabolic Panel (BMP) – $27

36415 – Blood Draw – $12

82947 – Blood Sugar-Quantitative, (Blood) – $17

87491 – Chlamydia – $67

85025 – Complete Blood Count (CBC) – $22

80053 – Comprehensive Metabolic Panel (CMP) – $44

80305 – Drug Screen – $51

82950 – Glucose test – $41

87591 – Gonorrhea – $67

86677 – H-Pylori – $56

86701 – HIV – $55

85018 – Hemoglobin – $16

83036 – Hemoglobin A1C – $31

86803 – Hepatitis C – $45

87804 – Influenza – Rapid – $45

87502 – Influenza- PCR – $125

80061 – Lipid Profile – $44

80076 – Liver Panel – $30

82043 – Microalbumin – Urine – $39

81025 – Pregnancy – Urine – $34

85610 – Pro-Time – $17

84154 – Prostate (PSA) – $50

85651 – Sed rate – $18

99000 – Specimen Handling – $20

87651 – Strep Screen – PCR – $71

87880 – Strep Screen – Rapid – $26

86580 – TB Test – $19

84403 – Testosterone – $95

84439 – Thyroid Function – $35

84479 – Thyroid Hormone T3 or T4 – $14

81003 – Urinalysis, automated w/o scope (Big Dip) – $11

81001 – Urinalysis, automated w/scope (UA Micro) – $15

81002 – Urinalysis, non-auto w/o scope (OB Dip) – $11

87086 – Urine Culture – $29

12015 – Repair superficial wounds, face – $300

12001 – Repair superficial wounds, trunk – $221

59426 – Ante partum care only, 7+ visits – $1,430

59514 – Caesarean delivery only – $1,774

80055 – Obstetric Profile – $95

59400 – Routine Obstetric Care – $3,360

59510 – Routine care and caesarean delivery – $3,780

59610 – VBAC delivery, routine obstetric care – $3,550

59409 – Vaginal delivery only – $1,460

95024 – Allergy Skin Tests, Percutaneous – $11 each

93015 – Cardiovascular stress test using Treadmill – $274

54150 – Circumcision, clamp procedure, newborn – $275

17000 – Destroy benign/premalignant lesion, 1st – $116

17110 – Destroy flat wart, up to 14 lesions – $189

10060 – Drain skin abscess, simple/single – $205

20605 – Drain/inject intermediate joint/bursa – $141

20610 – Drain/inject major joint or bursa – $145

93224 – ECG Monitor/24 hrs, Complete (Holter Monitor) – $274

93000 – EKG 12 Leads – $44

58100 – Endometrial Biopsy, w/o Cervical DI – $185

59025 – Fetal Non-Stress Test – $109

J7298 – IUD Mirena – $1,150

J7300 – IUD copper Para Guard – $1,061

58300 – Insert Intrauterine Device (IUD) – $154

J7307 – Nexplanon – $1,178

94640 – Non Pressurized Inhalation Treatment – $38

11750 – Permanent removal of nail bed – $371

69210 – Removal of impacted cerumen – $85

11200 – Removal of skin tags, up to 15 – $158

58301 – Remove Intrauterine Device (IUD) – $162

95806 – Sleep Study, Unattended – $350

94010 – Spirometer – $65

55450 – Vasectomy – $925

99392 – Preventive Checkup, established 1-4 yrs – $154

99394 – Preventive Checkup, established 12-17 yrs – $178

99395 – Preventive Checkup, established 18-39 yrs – $185

99396 – Preventive Checkup, established 40-64 yrs – $196

99393 – Preventive Checkup, established 5-11 yrs – $164

99391 – Preventive Checkup, established infant – $143

99397 – Preventive Checkup, established, 65+ – $228

99382 – Preventive Checkup, new, 1-4 yrs – $166

99384 – Preventive Checkup, new, 12-17 yrs – $197

99385 – Preventive Checkup, new, 18-39 yrs – $191

99386 – Preventive Checkup, new, 40-64 yrs – $230

99383 – Preventive Checkup, new, 5-11 yrs – $181

99387 – Preventive Checkup, new, 65+ – $255

99381 – Preventive Checkup, new, infant – $160

57455 – Colposcopy w/ biopsy of cervix – $240

58563 – Hysteroscopy w/ endometrial ablation – $3,695

58565 – Hysteroscopy/sterilization – $3,400

57288 – Repair bladder defect – $1,276

57260 – Repair of vagina – $1,460

58150 – Total hysterectomy – $2,050

58152 – Total hysterectomy with suspension – $2,114

58260 – Vaginal hysterectomy – $1,796

76801 – U/S OB < 14 weeks single fetus – $258

76805 – U/S OB complete, routine 20 weeks – $280

76770 – U/S abdomen (Renal U/S) – $215

76700 – U/S abdomen, complete – $281

76856 – U/S pelvic B scan complete – $247

76870 – U/S testicle/scrotal – $206

74018 – Abdomen, single AP View – $61

73610 – Ankle, complete minimum 3 views – $70

71045 – Chest 1 view AP – $60

71046 – Chest AP and Lateral – $71

77080 – Dexa Bone Density, Axial (hips, pelvis, spine) – $190

73620 – Foot AP and Lateral views – $68

73630 – Foot, complete minimum 3 views – $70

73120 – Hand, 2 views – $54

73130 – Hand, minimum of 3 views – $66

73562 – Knee, complete 3 views – $88

72100 – Spine lumbosacral AP and Lateral – $79

73590 – Tibia and Fibula AP and Lateral – $72

73110 – Wrist complete, minimum 3 views – $76