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

99202

Level 2 Expanded Exam; New Patient

$236.00

99203

Level 3 Detailed Exam; New Patient

$362.00

99204

Level 4 Comprehensive Exam; New Patient

$539.00

99211

Level 1 Minimal Exam; Established Patient

$75.00

99213

Level 3 Expanded Exam, Established Patient

$293.00

99214

Level 4 Detailed Exam, Established Patient

$413.00

99215

Level 5 Comprehensive Exam, Established Patient

$582.00

99385

Annual Preventative Exam 18-39; New Patient

$430.00

99395

Annual Preventative Exam 18-39; Established Pt

$378.00

99396

Annual Preventative Exam 40-64; Established Pt

$406.00

Procedures

CPT Code

Description

Price

36415

Collection of Venous Blood, Venipuncture

$25.00

36416

Collection of Venous Blood, Finger Stick

$11.00

20610

Arthrocentesis Aspiration/Injection Major Joint/Bursa

$307.00

20600

Arthrocentesis Aspiration/Injection Small Joint/Bursa

$248.00

17110

Destruction of Benign Lesions; up to 14 lesions

$528.00

11104

Punch biopsy of skin; single lesion

$588.00

10060

Incision & Drainage of abscess; simple or single

$585.00

10061

Incision & Drainage of abscess; complicated or multiple

$1,030.00

11200

Removal of skin tags; 1 - 15 lesions

$308.00

58300

Insertion of Intrauterine Device

$377.00

58301

Removal of Intrauterine Device

$487.00

Radiology

CPT Code

Description

Price

71046

X-ray exam, Chest; 2 views

$115.00

72100

X-ray exam, Spine; 2-3 views

$137.00

73030

X-ray exam of shoulder; minimum 2 views

$166.00

76536

Ultrasound, Head and Neck

$422.00

76700

Ultrasound, Abdominal; Complete

$453.00

76705

Ultrasound, Limited; single organ

$338.00

76770

Ultrasound , Retroperitoneal; Complete

$419.00

76830

Ultrasound, Transvaginal

$515.00

76856

Ultrasound, Pelvic (nonobstetric); complete

$406.00

76882

Ultrasound, Limited joint; Non-vascular

$217.00

77080

Dexascan

$426.00

Lab

CPT Code

Description

Price

83036

Glycohemoglobin (HGB A1C)

$61.00

80061

Lipid Profile

$84.00

80053

Comprehensive Metabolic Panel

$67.00

85025

CBC Hemogram and Platelet Count WBC

$49.00

80050

General Health Screen Panel

$160.00

81003

Urinalysis, Automated without Microscopy

$15.00

84443

TSH Assay

$106.00

87635

COVID-19 Infectious Agent Detection

$70.00

81001

Urinalysis, Automated with Microscopy

$20.00

82570

Creatinine, any source

$33.00

36415

Collection of Venous Blood, Venipuncture

$25.00

Other/Medicine

CPT Code

Description

Price

90471

Immunization Administration; 1 vaccine

$43.00

96372

Therapeutic,prophylactic or diagnostic injection

$66.00

90715

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

$64.00

90472

Immunization Administration; each additional vaccine

$43.00

95251

Continuous Glucose Monitoring Analysis & interpretation

$118.00

90750

Shingric Vaccine, each dose

$225.00

93000

Electrogardiogram, complete

$50.00

99173

Visual Acuity Screening Test

$11.00

90651

HPV Vaccine (Gardasil)

$275.00

90670

Pneumococcal Vaccine (PCV13), intramuscular

$225.00

Physical Therapy / Massage Therapy

CPT Code

Description

Price

97110

Therapeutic Exercise, each 15 minutes

$105.00

97140

Manual Therapy techniques, each 15 minutes

$92.00

97112

Neuromuscular Re-education, each 15 minutes

$117.00

97161

Physical Therapy Evaluation; Low Complexity

$255.00

97162

Physical Therapy Evaluation; Moderate Complexity

$255.00

97530

Therapeutic Activities

$127.00

97535

Self-Care Management Training

$112.00

97014

Electrical Stimulation, unattended

$45.00

20560

Needle Insertion w/o Injections; 1-2 muscles

$100.00

97164

Physical Therapy Re-Evaluation

$235.00

Prices are subject to change at any time.  This list was last updated June 30, 2022.  Prices

linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram