Self - Pay Guide

Payment Process

We generate a bill equal to what we would bill any insurance company and discount that by 25% for patients who pay on the day of service.  

Please note: the 25% discount applies only to day of service payments.  It does not apply to patient responsibilities after that day that arise from insurance billing problems, deductibles, etc. 

Payment with credit card (preferred), cash or check (established patients only) results in a 25% discount off the billable rate.

Costs of Care

Fees vary depending on the complexity of the visit.

We cannot always answer the most common question of “what will my visit cost” as that depends on the complexity of the visit.  We generate the same billing codes for self-pay patients as we would submit for an insurance claim, but payment with credit card (preferred), cash or check (established patients only) results in a 25% discount off the billable rate. 

Please note – the 25% discount is offered for same day payment only.  We offer the discount because we do not have to go through the process and payment delay inherent in billing insurance.  Once a patient has taken advantage of this discount, we cannot submit a claim for the same visit later and reimburse the amount paid to us at the time of the visit. 

Examples of Costs

The following three examples provide some idea of the cost of self-pay visits with us.  Again, every visit is unique so charges will vary:

1. An established patient comes in for an upper respiratory infection present for the past week.  They require a strep test, a brief focused history and a physical.  Time with the provider may be less than 15 minutes total.  This would be billed as a 99213 insurance code.  self-pay price: $101.25

2.  Patient presents with a few complaints.    They have a chronic condition (e.g. diabetes) which is not well-controlled and requires medication adjustments.  They also have a sore ankle that requires an exam and a referral for physical therapy.  In order to take good care of them, the provider obtains a complete past medical history, family history, and social history while also performing a physical exam involving multiple body sections.  This would be billed as a 99214 office visit:  self-pay price: $146.25

3. A 45 year-old established patient requests a prevention-focused complete physical.  The provider obtains a complete medical history including family, social, past medical, medication, immunization, surgery etc.  Discussion includes reviewing all indicated screening tests given the patient’s age and medical history specifics.  A couple of medication refills are needed.  A complete physical exam is performed and prevention advice is provided on diet, exercise, medication compliance and testing that would be appropriate.  This would be billed using a 99396 prevention-focused visit code:  Self pay price: $168.75