Visits & Screenings

Physician Visits

ServiceCPT
Code
HIMG
Charge
Cash
Price
Office Visit New Level 199201$87.00 $52.20
Office Visit New Level 299202$150.00 $90.00
Office Vist New Level 399203$220.00 $131.97
Office Visit New Level 499204$338.00 $202.77
Office Visit New Level 599205$420.00 $252.00
Office Visit Established Level 199211$40.00 $24.05
Office Visit Established Level 299212$87.00 $52.19
Office Visit Established Level 399213$147.00 $88.20
Office Visit Established Level 499214$217.00 $130.20
Office Visit Established Level 599215$292.00 $175.20

Preventive Visits

ServiceCPT
Code
HIMG
Charge
Cash
Price
Preventive Visit New 12-17 years99384$306.00 $111.60
Preventive Visit New 18-39 years99385$297.00 $111.66
Preventive Visit New 40-64 years99386$344.00 $131.40
Preventive Visit New 65+ years99387$374.00 $142.80
Preventive Visit Established 5-11 years99393$229.00 $82.20
Preventive Visit Established 12-17 years99394$252.00 $91.20
Preventive Visit Established 18-39 years99395$253.00 $92.40
Preventive Visit Established 40-64 years99396$278.00 $102.00
Preventive Visit Established 65+ years99397$311.00 $112.20
Annual Wellness Exam Initial Medicare/MedAdvG0438$355.00 Paid in full by Medicare
Annual Wellness Exam Subsequent Medicare/MedAdvG0439$238.00 Paid in full by Medicare

Preventive Screenings

ServiceCPT
Code
HIMG
Charge
Cash
Price
Colonoscopy Diagnostic Screening/Surveillance45378ASC$484.00 $290.40
Colonoscopy Facility Fee45378SG $1,339.00 $803.40
Screening MammogramG0202$300.00 $163.80