Pricing for Common Services at Medical Park
Below are the prices for the top 10 most common services at Medical Park. Please note these are the “list price,” the amount all patients are charged. Your individual insurance plan, including Medicare and Medicaid reimburse Medical Park at different rates and they determine how much you, the patient, will be responsible for.
Medical Park may charge and collect at the time of service, a co-pay or an estimated amount of your bill. We will adjust the final amount accordingly once your insurance has paid their portion.
Medical Visit (E&M – Evaluation & Management Services)
|
CPT Code |
Description |
Price |
| 99203 | Level 3 Low Level Exam, New Patient | $369.00 |
| 99204 | Level 4 Moderate Level Exam; New Patient | $553.00 |
| 99212 | Level 2 Straightforward Exam; Established Patient | $187.00 |
| 99213 | Level 3 Low Level Exam, Established Patient | $299.00 |
| 99214 | Level 4 Moderate Level Exam, Established Patient | $424.00 |
| 99215 | Level 5 High Level Exam, Established Patient | $585.00 |
| 99385 | Annual Preventative Exam 18-39; New Patient | $426.00 |
| 99395 | Annual Preventative Exam 18-39; Established Patient | $384.00 |
| 99396 | Annual Preventative Exam 40-64; Established Patient | $409.00 |
| 99397 | Annual Preventative Exam 65 and over; Established Patient | $439.00 |
Procedures
|
CPT Code |
Description |
Price |
| 11104 | Punch Biopsy of Skin; Single Lesion | $605.00 |
| 11200 | Removal of skin tags; 1 – 15 lesions | $430.00 |
| 17000 | Destruction of Premalignant Lesion, any method | $318.00 |
| 17110 | Destruction of Benign Lesions; up to 14 lesions | $525.00 |
| 20552 | Injection Trigger Points, 1 or 2 Muscles | $275.00 |
| 20605 | Arthrocentesis Aspiration/Inj Intermediate Joint | $274.00 |
| 20610 | Injection/Aspiration/Arthrocentesis, Major Joint or Bursa | $330.00 |
| 36415 | Collection of Venous Blood, Venipuncture | $20.00 |
| 36416 | Collection of Capillary Blood, Finger Stick | $12.00 |
| 69209 | Ear Irrigation | $72.00 |
Imaging / Radiology
|
CPT Code |
Description |
Price |
| 71046 | X-Ray Exam, Chest; 2 views | $139.00 |
| 73030 | X-Ray Exam of Shoulder, Minimum 2 views | $121.00 |
| 73502 | X-Ray Exam of Hip, Unilateral | $165.00 |
| 73562 | X-Ray Exam, Knee, Minimum 3 views | $142.00 |
| 76536 | Ultrasound, Head and Neck | $422.00 |
| 76705 | Ultrasound, Abdominal, Limited; single organ | $338.00 |
| 76830 | Ultrasound, Transvaginal | $447.00 |
| 76856 | Ultrasound, Pelvic, Non Obstetric | $406.00 |
| 76882 | Ultrasound, Extremity, Non-Vascular, Limited | $219.00 |
| 77080 | Dexascan Bone Density Study, 1 or more sites; axial skeleton | $415.00 |
Lab
|
CPT Code |
Description |
Price |
| 80050 | General Health Screen Panel | $185.00 |
| 80053 | Comprehensive Metabolic Panel (CMP) | $67.00 |
| 80061 | Lipid Profile | $84.00 |
| 81001 | Urinalysis, Automated with Microscopy | $20.00 |
| 82043 | Microalbumin; Urine, Quantitative | $37.00 |
| 82570 | Creatinine, Any Source | $33.00 |
| 83036 | Glycohemoglobin (HGB A1C) | $61.00 |
| 84153 | PSA; Total | $116.00 |
| 84443 | TSH Assay | $106.00 |
| 85025 | CBC Hemogram and Platelet Count WBC | $49.00 |
Other/Medicine
|
CPT Code |
Description |
Price |
| 90471 | Immunization Administration, One Vaccine | $69.00 |
| 90472 | Immunization Administration, Each Additional Vaccine | $50.00 |
| 90480 | Immunization Administration, SARS-CoV-2 (Covid) Vaccine | $75.00 |
| 90662 | Influenza Virus Vaccine, Split virus, enhanced immunogenicity | $110.00 |
| 90686 | Influenza Virus Vaccine, Quadrivalent | $30.00 |
| 90715 | Tetanus, Diphtheria, Pertussis Vaccine (Tdap); > age 7 |
$60.00 |
| 91320/91322 | SARS-CoV-2 (Covid 19) Vaccine | $160.00 |
| 93000 | Electrocardiogram, Complete | $50.00 |
| 95251 | Continuous Glucose Monitoring, Analysis & Interpretation | $118.00 |
| 96127 | Brief Emotional/Behavioral Assessment | $17.00 |
Prices are subject to change at any time. This list was last updated January 30, 2024.
