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.
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 |
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 |
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 |
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 |
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 |
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.