Fee Schedule:

*Cash paying patients receive a 30% discount from listed price except for aesthetic treatments,    medications, IV treatments, or procedures.

*If you are experiencing financial hardship, alternative payment options are available.

*The prices on this list are subject to change and will be updated regularly.

Description	Code	Fee
Wellness visit age 4 years, new patient	99382	$175
Wellness visit ages 5-11 years, new patient	99383	$250
Wellness visit ages 12-17 years, new patient	99384	$250
Wellness visit ages 18-39 years, new patient	99385	$250
Wellness visit ages 40-64 years, new patient	99386	$275
Wellness visit ages 65 years and up, new patient	99387	$325
Wellness visit age 4 years, established patient	99392	$150
Wellness visit ages 5-11 years, established patient	99393	$200
Wellness visit ages 12-17 years, established patient	99394	$200
Wellness visit ages 18-39 years, established patient	99395	$200
Wellness visit ages 40-64 years, established patient	99396	$225
Wellness visit ages 65 years and up, established patient	99397	$250
Office visit, established patient level 2	99212	$115
Office visit, established patient level 3	99213	$150
Office visit, established patient level 4	99214	$200
Office visit, established patient level 5	99215	$300
Office visit, new patient level 2	99202	$135
Office visit, new patient level 3	99203	$175
Office visit, new patient level 4	99204	$250
Office visit, new patient level 5	99205	$325
Blood Draw	36415	$35
Specimen collection and processing	99000	$5
Urinalysis	81000	$25
Influenza swab	87804	$40
Covid swab	87426	$40
Urine pregnancy test	81025	$25
Strep A swab	87880	$40
Airway Inhalation Treatment	94640	$75
Epinephrine (medication)	J0171	$300
Emergency Intervention	99058	$350
Vision screening	99173	$45
Brief emotional/ mental exam	96127	$40
Intramuscular Injection (does not include medication)	96372	$25
Suture Placement	12001-12005	$150-$300
Suture Removal	15851-15853	$50-$120
Benign Lesion Cryotherapy	17110/17111	$150-$300
Skin Tag Removal	11200/11201	$250-$450
Vitamin B12 for Injection IM	J3420	$20
Vitamin B1 -Thiamine for injection IM	J3411	$20
Jeuveau	J05851	$10
Botox	J0585	$12
Filler Injection per syringe	11950	$750
Hyaluronidase up to 150 units	J3470	$300
Disability Paperwork/ Evaluation	99455-99456	$150
Additional time in office	99417	$50
Nexplanon insertion	11981	$200
Nexplanon removal	11982	$250
Nexplanon removal and reinsertion	11983	$425
Medroxyprogesterone 150mg IM	J1050	$150
Trigger point injections up to 2	20552	$150
Trigger point injections 3 to 4	20553	$250
Vitamin D3 for Injection IM	J0636	$30
IV push (does not include medication)	96374	$50
IV push additional drug (does not include medication)	96375	$25
IV Infusion: Mitochondrial Optimization	MITOPT	$200
IV Infusion: Emergency Plan Immunity	EMRPLN	$150
IV Infusion: Youth and Vitality	YOUVIT	$175
IV Infusion: Meta Energy	METENER	$150
IV Infusion: Refresh and Hydrate	REFHYDR	$175
IV Infusion: Brain Health	BRAHLTH	$175
IV Infusion: Athletic Recovery	ATHREC	$175
IV Infusion: Detox	DETOX	$150
IV Infusion: Beauty Replenishing	BEAUREP	$150
IV Infusion: Iron Sucrose	J1756	$150
IV Infusion: Normal Saline 1,000ml	J7030	$100
IV Infusion: Normal Saline 500ml	J7040	$125
IV Infusion: Normal Saline 250ml	J7050	$125
Therapeutic Infusion up to 1 hour	96365	$150
Therapeutic Infusion ea. additional hour	96366	$100
Hydration Infusion Initial 31-90 min	96360	$150
Hydration Infusion ea. additional 30 min	96361	$100
IV ADD-ON: Glutathione per 200mg	GLUTA	$10
IV ADD-ON: Myer’s Cocktail Plus/Enhanced/Complete	MYERS	$85
IV ADD-ON: Vitamin B1 (Thiamine) per 100mg	J3411	$20