If you are covered by health insurance you are strongly encouraged to consult with your health insurer to determine accurate information about your financial responsibility for a particular health care service provided at this health care facility. If you are not covered by health insurance, you are strongly encouraged to contact HealthOne Physician Group at $host.phoneNumber to discuss payment options prior to receiving a health care service from this health care facility since posted health care prices may not reflect the actual amount of your financial responsibility. The health care price for any given health care service is an estimate and the actual charges for the health care service are dependent on the circumstances at the time the service is rendered.
| Procedure Code | Description | Self-Pay Price |
|---|---|---|
| J1050 | Medroxyprogesterone Acetate | $0.65 |
| 0502F | Subsequent Prenatal Care | - |
| 99213 | Established Patient Office Visits Level 3 | $89.05 |
| 76830 | Non OB Transvaginal Ultrasound | $244.40 |
| 99396 | Preventative Visit Established Age 40-64 | $135.20 |
| 99395 | Preventative Visit Established Age 18-39 | $124.15 |
| 99024 | Postop Follow Up Visit | - |
| 59025 | Fetal Non-Stress Test | $90.35 |
| 76817 | OB Transvaginal Ultrasound | $202.15 |
| 76816 | OB Ultrasound Follow Up | $228.15 |
| 90471 | Immunization Administration | $44.85 |
| 36415 | Blood Draw | $5.85 |
| 0503F | Postpartum Care Visit | - |
| 99385 | Preventative Visit New Patient Age 18-39 | $142.35 |
| 99203 | New Patient Office Visit Level 3 | $132.60 |