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 our office 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 |
|---|---|---|
| 0502F | Subsequent Prenatal Care | - |
| 99213 | Established Patient Office Visits Level 3 | $89.05 |
| 99395 | Preventative Visit Established Age 18-39 | $124.15 |
| 76817 | OB Transvaginal Ultrasound | $202.15 |
| 99214 | Established Patient Office Visit Level 4 | $131.95 |
| 99396 | Preventative Visit Established Age 40-64 | $135.20 |
| 0503F | Postpartum Care Visit | - |
| 90471 | Immunization Administration | $44.85 |
| CXLED | Quality Code | - |
| 76813 | OB Ultrasound Measurement | $247.65 |
| 90715 | TDAP Vaccine | $80.60 |
| 99385 | Preventative Visit New Patient Age 18-39 | $142.35 |
| 76801 | OB Ultrasound Less than 14 Weeks | $254.15 |
| 76811 | OB Ultrasound Detailed | $377.00 |
| 76830 | Non OB Transvaginal Ultrasound | $244.40 |