Medical Park Family Care
Open Mon-Fri 7:30am-6pm • Saturday 9am-2pm
907-279-8486
Medical Park Family Care
Mountains

Top 10 Procedure Codes & Pricing

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 Detailed Exam, New Patient

$367.00
99204

Level 4 Comprehensive Exam; New Patient

$544.00
99213

Level 3 Expanded Exam, Established Patient

$295.00
99214

Level 4 Detailed Exam, Established Patient

$415.00
99215

Level 5 Expanded Exam, Established Patient

$585.00
99385

Annual Preventative Exam 18-39; New Patient

$425.00
99386

Annual Preventative Exam 40-64; New Patient

$486.00
99395

Annual Preventative Exam 18-39; Established Pt

$380.00
99396

Annual Preventative Exam 40-64; Established Pt

$403.00
99397

Annual Preventative Exam 65+; New Patient

$435.00

Procedures

CPT Code

Description

Price

10060

Incision & Drainage of abscess; simple or single

$589.00
11104

Punch biopsy of skin; single lesion

$602.00
11200

Removal of skin tags; 1 - 15 lesions

$425.00
17110

Destruction of Benign Lesions; up to 14 lesions

$431.00
20610

Arthrocentesis Aspiration/Injection Major Joint/Bursa

$318.00
36415

Collection of Venous Blood, Venipuncture

$20.00
36416

Collection of Venous Blood, Finger Stick

$11.00
58300

Insertion of Intrauterine Device

$482.00
58301

Removal of Intrauterine Device

$508.00
69209

Ear Irrigation

$65.00

Radiology

CPT Code

Description

Price

71046

X-Ray Exam, Chest; 2 views

$135.00
73130

X-Ray Exam, Hand; minimum 3 views

$128.00
73562

X-Ray Exam, Knee; minimum 3 views

$141.00
73630

X-Ray Exam, Foot, complete; minimum 3 views

$119.00
76536

Ultrasound, Head and Neck

$422.00
76705

Ultrasound, Abdominal, Limited; single organ

$338.00
76770

Ultrasound, retroperitoneal (renal, aorta, nodes)

$419.00
76830

Ultrasound, Transvaginal

$447.00
76882

Ultrasound, Limited joint; Non-vascular

$217.00
77080

Dexascan

$405.00

Lab

CPT Code

Description

Price

80053

Comprehensive Metabolic Panel

$67.00
83036

Glycohemoglobin (HGB A1C)

$61.00
80061

Lipid Profile

$84.00
85025

CBC Hemogram and Platelet Count WBC

$49.00
84443

TSH Assay

$106.00
81001

Urinalysis, Automated with Microscopy

$20.00
80050

General Health Screen Panel

$185.00
87635

Covid -19 Infectious Agent Detection

$70.00
84153

PSA; Total

$116.00
81003

Urinalysis, by Dip Stick, Automated without Microscopy

$15.00

Other/Medicine

CPT Code

Description

Price

90471

Immunization Administration; 1 vaccine

$69.00
90472

Immunization Administration; each additional vaccine

$50.00
90662

Influenza Virus Vaccine, split virus

$110.00
90670

Pneumococcal Vaccine

$235.00
90686

Influenza Virus Vaccine, quadrivalent

$30.00
90715

Tetanus, Diphtheria, Pertusis Vaccine (Tdap); > age 7

$60.00
90750

Shingrix Vaccine, each dose

$275.00
93000

Electrocardiogram, complete

$50.00
95251

Continuous Glucose Monitoring Analysis & interpretation

$118.00
96372

Therapeutic,prophylactic or diagnostic injection

$66.00

Physical Therapy / Massage Therapy

CPT Code

Description

Price

97014

Electrical Stimulation

$45.00
97010

Hot/Cold Packs

$22.00
97110

Therapeutic Exercise, each 15 minutes

$102.00
97112

Neuromuscular Re-education, each 15 minutes

$117.00
97116

Gait Training Therapy

$102.00
97140

Manual Therapy techniques, each 15 minutes

$94.00
97161

Physical Therapy Evaluation; Low Complexity

$345.00
97164

Physical Therapy Re-Evaluation

$240.00
97530

Therapeutic Activities

$128.00
97535

Self-Care Management Training

$113.00

Prices are subject to change at any time.  This list was last updated February 1, 2023.

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