Price Transparency List

PROBLEM OR SICK CHILD VISIT
these prices are for the exam charge only,additional charges may be necessary

New Patient - Minimal severity

990201

$ 100.00

New Patient - Minor severity

990202

$ 106.00

New Patient - Moderate to low severity

990203

$ 153.00

New Patient - Moderate to high severity

990204

$ 237.00

New Patient - High severity

990205

$ 298.00

Established Patient - Minimal severity

990211

$ 36.00

Established Patient - Minor severity

990212

$ 68.00

Established Patient - Moderate to low severity

990213

$ 110.00

Established Patient - Moderate to high severity

990214

$ 155.00

Established Patient - High severity

990215

$ 210.00

WELL CHILD PHYSICAL EXAM
- these prices are for the exam charge only, additional charges may be necessary

New Patient under the age of 1 year

99381

$ 150.00

New Patient ages 1 - 4 years

99382

$ 165.00

New Patient ages 5 - 11 year

99383

$ 160.00

New Patient ages 12 - 17 years

99384

$ 180.00

Established Patient under the age of 1 year

99391

$ 150.00

Established Patient ages 1 - 4 years

99392

$ 160.00

Established Patient ages 5 - 11 year

99393

$ 155.00

Established Patient ages 12 - 17 years

99394

$ 180.00

Established Patient ages 18 years and older

99395

$ 160.00

SCREENINGS

Vision screen

99173

$ 10.00

Hearing screen

92551

$ 20.00

Developmental screen

96110

$ 25.00

Depression screen

96127

$ 20.00

IN OFFICE LABORATORY

Rapid Strep test

87880

$ 30.00

Throat Culture

87081

$ 20.00

Urinalysis

81002

$ 10.00

Urine Culture

87086

$ 20.00

Influenza A & B

87804

$ 60.00

Cholesterol (Lipid)

Lead

Hemoglobin

80061

83655

85018

$30.00

$20.00

$ 8.00

Tuberculosis test

86580

$ 15.00

PRICES LISTED FOR ANY GIVEN SERVICE IS AN ESTIMATE. 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 BY A HEALTH CARE PROVIDER AT THIS OFFICE. IF YOU ARE NOT COVERED BY HEALTH INSURANCE, YOU ARE STRONGLY ENCOURAGED TO CONTACT OUR BUSINESS OFFICE AT 303-545-5679 TO DISCUSS PAYMENT OPTIONS PRIOR TO RECEIVING A HEALTH CARE SERVICE FROM A HEALTH CARE PROVIDER AT THIS OFFICE SINCE POSTED HEALTH CARE PRICES MAY NOT REFLECT THE ACTUAL AMOUNT OF YOUR FINANCIAL RESPONSIBILITY.