{"id":1496,"date":"2020-11-19T16:48:40","date_gmt":"2020-11-19T22:48:40","guid":{"rendered":"https:\/\/healthwellnessok.com\/?page_id=1496"},"modified":"2025-01-06T13:49:55","modified_gmt":"2025-01-06T19:49:55","slug":"fee-schedule","status":"publish","type":"page","link":"https:\/\/healthwellnessok.com\/fee-schedule","title":{"rendered":"Fee Schedule"},"content":{"rendered":"\t\t
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Health & Wellness Center
Costs of Most Common Services<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Transparency in Health Care Prices Act<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\tCommunity health centers offer service to all individuals regardless of insurance status or ability to pay. Qualified patients in households with incomes below 200% of the Federal Poverty Level (FPL) receive discounts on a sliding fee scale. Qualified patients with incomes less than 100% FPL pay a nominal fee. If a patient has insurance, the carrier will be billed. Copays and denied services will be transferred to the guarantor. All patients may apply for the Sliding Fee scale.\n\nBelow are some of the most common services provided. The costs below represent the cost of services for self-pay patients and do not take into account any coverage from Medicaid, Medicare, or private health insurance. Contact us if you would like help enrolling in health insurance coverage.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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(Information Publishing Date: 1\/6\/25)<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tBehavioral Health\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>

90834<\/p><\/td>

PSYCHOTHERAPY 45 MINUTES<\/p><\/td>

$201.29<\/p><\/td><\/tr>

90834,N<\/p><\/td>

Psychotherapy 45 Minutes - New Patient<\/p><\/td>

$318.57<\/p><\/td><\/tr>

90832<\/p><\/td>

psychotherapy, 30 minutes with patient\/family member<\/p><\/td>

$239.76<\/p><\/td><\/tr>

90837<\/p><\/td>

psychotherapy, 60 minutes with patient and or family<\/td>

$469.53<\/p><\/td><\/tr>

H0004<\/p><\/td>

Behavioral Health Counseling & Therapy 15Min<\/td>$55.68<\/td><\/tr>

G0470<\/p><\/td>

FQHC Behavioral Health Established Patient<\/td>

$178.15<\/p><\/td><\/tr>

9100T<\/p><\/td>

Integrated BH phone visit<\/p><\/td>

$0.00<\/td><\/tr>

9200T<\/p><\/td>

PRSS non-billable phone charges<\/p><\/td>

$0.00<\/p><\/td><\/tr>

920FT<\/p><\/td>

PRSS charges Family Tree<\/p><\/td>

$0.00<\/p><\/td><\/tr>

90791<\/p><\/td>

initial evaluation intake - Established<\/td>$314.00<\/td><\/tr>

G2025<\/p><\/td>

FQHC telehealth services<\/td>

$168.72<\/p><\/td><\/tr>

9100R<\/p><\/td>

INH Referral<\/td>$0.00<\/td><\/tr>

NC<\/p><\/td>

no charge encounter<\/td>$0.00<\/td><\/tr>

NCBH<\/p><\/td>

Behavioral Health No Charge services<\/p><\/td>

$0.00<\/p><\/td><\/tr>

PCC01<\/p><\/td>

PCC visit<\/p><\/td>

$0.00<\/p><\/td><\/tr>

EAPCH<\/p><\/td>

EAP patient charge<\/p><\/td>

$0.00<\/p><\/td><\/tr>

99443<\/p><\/td>

telephonic visit 21-30 minutes<\/td>$40.00<\/td><\/tr>

910FT<\/p><\/td>

Family Tree Grant<\/td>$0.00<\/td><\/tr>

H0003<\/p><\/td>

Alcohol and\/or drug screening; laboratory analysis of spec<\/p><\/td>

$0.00<\/p><\/td><\/tr>

H0031<\/p><\/td>

Mental Health Assessment<\/td>$103.33<\/td><\/tr>

H0032<\/p><\/td>

Activity Therapy 15 minutes<\/p><\/td>

$135.08<\/p><\/td><\/tr>

98968<\/p><\/td>

telephonic mental health 30 minutes<\/td>$132.35<\/td><\/tr>

910ME<\/p><\/td>

Medicaid expansion code<\/td>$0.00<\/td><\/tr>

90853<\/p><\/td>

GROUP COUNSELING 1 HOUR<\/td>$84.00<\/td><\/tr>

91CDP<\/p><\/td>

mental health court diversion<\/td>$0.00<\/td><\/tr>

G0071<\/p><\/td>

communication technology-based services FQHC<\/td>$30.00<\/td><\/tr>

91SUP<\/p><\/td>

mental health step up<\/td>$0.00<\/td><\/tr>

G0511<\/p><\/td>

CHRONIC CARE MANAGEMENT<\/p><\/td>

$195.36<\/p><\/td><\/tr>

91000<\/p><\/td>

Integrated BH visit<\/p><\/td>

$0.00<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>

D0001<\/p><\/td>

Dental Treatment Plan Completed<\/p><\/td>

$0.00<\/p><\/td><\/tr>

D0220<\/td>INTRA ORAL PERI 1ST<\/td>

$37.81<\/p><\/td><\/tr>

D0140<\/td>

ORAL EXAM(EMERGENCY\/LIMITED)<\/p><\/td>

$112.38<\/p><\/td><\/tr>

D7210<\/td>FLAP-DONE OR SECTION<\/td> $260.92 <\/td><\/tr>
D0330<\/td>PANORAMIC FILM<\/td>

$145.86<\/p><\/td><\/tr>

D0150<\/td>ORAL EXAM (COMPLETE)<\/td>

$118.30<\/p><\/td><\/tr>

D0120<\/td>Periodic Oral Exam<\/td>

$67.03<\/p><\/td><\/tr>

D1110<\/td>PROPHYLAXIS ADULT 13-20<\/td>

$116.30<\/p><\/td><\/tr>

D0274<\/td>XRAY BITEWINGS 4 FILMS<\/td>

$82.30<\/p><\/td><\/tr>

D1208<\/td>

topical application of fluoride<\/p><\/td>

$43.39<\/p><\/td><\/tr>

D1120<\/td>PROPHYLAXIS 01-12<\/td>

$80.26<\/p><\/td><\/tr>

D1206<\/td>

topical application of fluoride varnish<\/p><\/td>

$65.09<\/p><\/td><\/tr>

D0230<\/td>INTRA ORAL PERI EA ADD<\/td>

$34.03<\/p><\/td><\/tr>

D0272<\/td>BITEWINGS2 FILMS<\/td>

$58.52<\/p><\/td><\/tr>

D2392<\/td>RESIN 2 SURFACE POST<\/td>

$296.57<\/p><\/td><\/tr>

D1351<\/td>SEALANTS PER TOOTH<\/td>

$75.56<\/p><\/td><\/tr>

D7140<\/td>EXT TOOTH OR ROOT<\/td>

$223.17<\/p><\/td><\/tr>

D2150<\/td>AMAL 2 SURFACE<\/td> $179.41 <\/td><\/tr>
D2391<\/td>RESIN 1 SURFACE POST<\/td> $184.81 <\/td><\/tr>
D4341<\/td>P SCAL RP\/QUAD<\/td>

$329.59<\/p><\/td><\/tr>

D2393<\/td>RESIN 3 SURFACE POST<\/td> $300.50<\/td><\/tr>

D0603<\/p><\/td>

Dental caries assessment high risk<\/p><\/td>

$90.42<\/p><\/td><\/tr>

D0601<\/p><\/td>

Dental caries assessment low<\/p><\/td>

$90.42<\/p><\/td><\/tr>

D0180<\/p><\/td>

PERIO CHART<\/p><\/td>

$128.15<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tMedical\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>
99213<\/td>OFFICE VISIT EXPANDED<\/td>

$275.28<\/p><\/td><\/tr>

99214<\/td>OFFICE VISIT DETAILED<\/td>

$391.83<\/p><\/td><\/tr>

G0467<\/td>FQHC Visit Established Patient<\/td>

$178.15<\/p><\/td><\/tr>

99212<\/td>OFFICE VISIT FOCUSED<\/td>

$167.61<\/p><\/td><\/tr>

83036<\/td>HGB A1C<\/td>$82.00<\/td><\/tr>
91000<\/td>Integrated BH visit<\/td>$0.00<\/td><\/tr>
99211,X0<\/td>Nurse visit only (no chg)<\/td>$0.00<\/td><\/tr>
0241U<\/td>SARS-Cov-2\/ Flu\/ RSV<\/td>$142.63<\/td><\/tr>
81002<\/td>URINALYSYS NON-AUTOMATED W\/O MICROSCOPY<\/td>$18.00<\/td><\/tr>
G0511<\/td>CHRONIC CARE MANAGEMENT<\/td>

$195.36<\/p><\/td><\/tr>

96160<\/td>behavior health screening<\/td>$25.00<\/td><\/tr>
MAT01<\/td>Medical assisted treatment (MAT)<\/td>$0.00<\/td><\/tr>
90471<\/td>IMMUNIZATION<\/td>$51.00<\/td><\/tr>
99203<\/td>OFFICE\/OUTPATIENT VISIT, NEW, DETAILED<\/td>

$338.55<\/p><\/td><\/tr>

NC<\/td>no charge encounter<\/td>$0.00<\/td><\/tr>
J1100<\/td>DECADRON 4 MG\/per 1ml<\/td>$15.00<\/td><\/tr>

J3301<\/p><\/td>

KENALOG 40 MG\/ML<\/p><\/td>

$15.00<\/p><\/td><\/tr>

J0696<\/p><\/td>

ROCEPHIN 500 mg per mil<\/p><\/td>

$15.00<\/p><\/td><\/tr>

99202<\/td>OFFICE\/OUTPATIENT VISIT, NEW, EXPANDED PROBLEM<\/td>$175.00<\/td><\/tr>
80305<\/td>urine drug screen<\/td>$60.66<\/td><\/tr>
9100T<\/td>Intergrated BH phone visit<\/td>$0.00<\/td><\/tr>
0013A<\/td>Moderna Covid-19 vaccine third dose- Booster<\/td>$40.00<\/td><\/tr>

36415<\/p><\/td>

venipuncture blood draw<\/p><\/td>

$17.03<\/p><\/td><\/tr>

87880<\/p><\/td>

STREP SCREEN<\/p><\/td>

$40.96<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tOptical\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>
99213<\/td>OFFICE VISIT EXPANDED<\/td>

$275.28<\/p><\/td><\/tr>

V2100<\/td>SPHERE, SINGLE VISION, PLANO TO +\/- 4.00 PER LENS<\/td>

$56.35<\/p><\/td><\/tr>

V2020<\/td>Frames Slideable<\/td>

$70.76<\/p><\/td><\/tr>

92015<\/td>refraction<\/td>

$61.05<\/p><\/td><\/tr>

G0467<\/td>FQHC Visit Established Patient<\/td>

$178.15<\/p><\/td><\/tr>

V2784<\/td>POLYCARB<\/td>

$65.00<\/p><\/td><\/tr>

99214<\/td>OFFICE VISIT DETAILED<\/td>

$391.83<\/p><\/td><\/tr>

1036F<\/td>pt screened for tobacco use & identified as tobacco non-user<\/td> $0.01 <\/td><\/tr>
V2300<\/td>SPHERE, TRIFOCAL, PLANO TO +\/- 4.00D, PER LENS<\/td>

$90.63<\/p><\/td><\/tr>

92014<\/td>exam comp., established<\/td>

$378.51<\/p><\/td><\/tr>

92310<\/td>contact lens service<\/td>

$308.58<\/p><\/td><\/tr>

G9903<\/td>pt screened for tobacco use\/ tobacco non-user<\/td> $0.01 <\/td><\/tr>
92340<\/td>Fitting of Spectacles<\/td>

$104.34<\/p><\/td><\/tr>

V2760<\/td>SCRATCH 1 YR WARRANTY<\/td> $17.69 <\/td><\/tr>
V2744<\/td>Transitions\/TINT GRADE<\/td>

$39.00<\/p><\/td><\/tr>

99212<\/td>OFFICE VISIT FOCUSED<\/td>

$167.61<\/p><\/td><\/tr>

V2200<\/td>SPHERE, BIFOCAL PLANO TO +\/- 4.00D, PER LENS<\/td> $59.09 <\/td><\/tr>
99203<\/td>OFFICE\/OUTPATIENT VISIT, NEW, DETAILED<\/td> $224.00 <\/td><\/tr>
92004<\/td>exam comp, new<\/td> $304.50 <\/td><\/tr>
V2750<\/td>Anti Reflective High<\/td> $25.40<\/td><\/tr>

BSV01<\/p><\/td>

Bundle single vision with frame and lens<\/p><\/td>

$40.00<\/p><\/td><\/tr>

PREV<\/p><\/td>

Prepayment for Vision Services<\/p><\/td>

$0.00<\/p><\/td><\/tr>

92134<\/p><\/td>

scanning imaging retina<\/p><\/td>

$122.10<\/p><\/td><\/tr>

V2520<\/p><\/td>

CONTACT LENS, HYDROPHILIC SPHERICAL, PER LENS<\/p><\/td>

$147.98<\/p><\/td><\/tr>

92250<\/p><\/td>

photography, fundus w\/ interpretation<\/p><\/td>

$143.88<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n

CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>
COPAY<\/td>COPAY FOR THE OAKS<\/td> $4.00 <\/td><\/tr>

NCOI<\/p><\/td>

NO CHARGE OAKS INTAKE<\/p><\/td>

$0.00<\/p><\/td><\/tr>

92000<\/p><\/td>

PRSS non-billable charges<\/p><\/td>

$0.00<\/p><\/td><\/tr>

9200T<\/p><\/td>

PRSS non-billable phone charges<\/p><\/td>

$0.00<\/p><\/td><\/tr>

H2017<\/td>psychosocial rehab services per 15 minutes<\/td> $24.48 <\/td><\/tr>

H0003<\/p><\/td>

Alcohol and\/or drug screening; laboratory analysis of spec<\/p><\/td>

$0.00<\/p><\/td><\/tr>

H0004<\/td>Behavioral Health Counseling & Therapy 15Min<\/td> $55.68 <\/td><\/tr>
H2015<\/td>Comprehensive Community Support Services 15min<\/td> $9.75 <\/td><\/tr>
H0002<\/td>BH Screen \/ Eligibility for Admission<\/td> $25.00 <\/td><\/tr>
OFCRAS<\/td>OFFENDER SCREENING ASSESSMENT<\/td> $117.21 <\/td><\/tr>
H0001<\/td>Alcohol and \\ drug assessment<\/td> $5.00 <\/td><\/tr>
T1012<\/td>alcohol \/ substance abuse services skills development<\/td> $4.50 <\/td><\/tr>
OFSCRC<\/td>OFFENDER SCREENING RECORDS CLOSED<\/td> $13.75 <\/td><\/tr>
H0031<\/td>Mental Health Assessment<\/td> $103.33 <\/td><\/tr>
H0032<\/td>Activity Therapy 15min<\/td> $135.08 <\/td><\/tr>
OUTRE<\/td>Community Outreach thru Oaks<\/td> $20.00 <\/td><\/tr>
90834<\/td>PSYCHOTHERAPY 45 MINUTES<\/td> $184.37 <\/td><\/tr>
90832<\/td>psycotherapy, 30 minutes with patient\/family member<\/td> $160.33 <\/td><\/tr>
90791<\/td>initial evaluation intake - Established<\/td> $314.00 <\/td><\/tr>
90837<\/td>psychotherapy, 60 minutes with patient and or family<\/td>

$469.53<\/p><\/td><\/tr>

H2011<\/td>Crisis intervention<\/td> $50.00 <\/td><\/tr>
81001<\/td>URINALYSIS AUTOMATED WITH MICROSCOPY<\/td> $29.00 <\/td><\/tr>
87480<\/td>CANDIDA SPECIES DIRECT PROBE TECHNIQUE<\/td> $92.00 <\/td><\/tr>
87491<\/td>CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH<\/td> $162.00<\/td><\/tr>

1010<\/p><\/td>

UA COLLECTING<\/p><\/td>

$22.00<\/p><\/td><\/tr>

H0019<\/p><\/td>

BH Long-Term Residential w\/o R&B Per Diem<\/p><\/td>

$95.00<\/p><\/td><\/tr>

2010<\/p><\/td>

SA INDIVIDUAL COUNSELING<\/p><\/td>

$40.00<\/p><\/td><\/tr>

2011<\/p><\/td>

SUBSTANCE ABUSE ASSESSMENT<\/p><\/td>

$232.00<\/p><\/td><\/tr>

NCADI<\/p><\/td>

NO CHARGE 6MO ASI UPDATE<\/p><\/td>

$0.00<\/p><\/td><\/tr>

NC<\/p><\/td>

no charge encounter<\/p><\/td>

$0.00<\/p><\/td><\/tr>

REENT<\/p><\/td>

Re-Entry Code<\/p><\/td>

$0.00<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tPsychiatry\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>
99213<\/td>OFFICE VISIT EXPANDED<\/td>

$275.28<\/p><\/td><\/tr>

99214<\/td>OFFICE VISIT DETAILED<\/td>

$391.83<\/p><\/td><\/tr>

99212<\/td>OFFICE VISIT FOCUSED<\/td>

$167.61<\/p><\/td><\/tr>

G0467<\/td>FQHC Visit Established Patient<\/td>

$178.15<\/p><\/td><\/tr>

G2025<\/td>FQHC telehealth services<\/td>

$168.72<\/p><\/td><\/tr>

80305<\/td>urine drug screen<\/td> $60.66 <\/td><\/tr>
99203<\/td>OFFICE\/OUTPATIENT VISIT, NEW, DETAILED<\/td>

$338.55<\/p><\/td><\/tr>

91000<\/p><\/td>

Integrated BH visit<\/p><\/td>

$0.00<\/p><\/td><\/tr>

83036<\/td>HGB A1C<\/td> $82.00 <\/td><\/tr>
99441<\/td>telephonic visit 5-10 minutes<\/td> $15.00 <\/td><\/tr>
G0071<\/td>communication technology-based services FQHC<\/td> $30.00 <\/td><\/tr>
99215<\/td>OFFICE VISIT COMPREHENSIVE<\/td> $376.80 <\/td><\/tr>
99204<\/td>OFFICE\/OUTPATIENT VISIT, NEW, MOD COMPLEX<\/td>

$508.38<\/p><\/td><\/tr>

G0466<\/td>FQHC Visit New Patient<\/td>

$239.01<\/p><\/td><\/tr>

99202<\/td>OFFICE\/OUTPATIENT VISIT, NEW, EXPANDED PROBLEM<\/td>

$218.67<\/p><\/td><\/tr>

G0511<\/td>CHRONIC CARE MANAGEMENT<\/td>

$195.36<\/p><\/td><\/tr>

84146<\/td>PROLACTIN LEVEL<\/td> $167.00 <\/td><\/tr>
99442<\/td>telephonic visit 11-20 minutes<\/td> $30.00 <\/td><\/tr>
81025<\/td>URINE PREGNANCY TEST<\/td> $56.00 <\/td><\/tr>
80061-90<\/td>LIPID PANEL<\/td> $91.00 <\/td><\/tr>
84443-90<\/td>TSH<\/td> $110.00<\/td><\/tr>

96372<\/p><\/td>

Injection Administration<\/p><\/td>

$49.31<\/p><\/td><\/tr>

36415<\/p><\/td>

venipuncture blood draw<\/p><\/td>

$17.03<\/p><\/td><\/tr>

85025<\/p><\/td>

CBC<\/p><\/td>

$46.02<\/p><\/td><\/tr>

MAT01<\/p><\/td>

Medical assisted treatment (MAT)<\/p><\/td>

$0.00<\/p><\/td><\/tr>

99211<\/p><\/td>

OFFICE\/OUTPATIENT VISIT, EST, MIN<\/p><\/td>

$0.00<\/p><\/td><\/tr>

NC<\/p><\/td>

no charge encounter<\/p><\/td>

$0.00<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tRecovery Housing\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>

RHDAY<\/p><\/td>

Recovery Housing Daily Rate<\/p><\/td>

$28.57<\/p><\/td><\/tr>

RHMEA<\/p><\/td>

Recovery Housing Meal<\/p><\/td>

$3.00<\/p><\/td><\/tr>

H0019<\/td>BH Long-Term Residential w\/o R&B Per Diem<\/td>$95.00<\/td><\/tr>
H0003<\/td>Alcohol and\/or drug screening;laboratory analysis of spec<\/td>$0.00<\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tResidential Services\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/p><\/th>

Description<\/th> Cost <\/th><\/tr><\/thead>
H0019<\/td>BH Long-Term Residential w\/o R&B Per Diem<\/td>$95.00<\/td><\/tr>
COPAY<\/td>COPAY FOR THE OAKS<\/td>$4.00<\/td><\/tr>
H0018<\/td>BH short-term residential services<\/td>$400.00<\/td><\/tr>
H2034<\/td>Alcohol\/Drug Use Half-Way House Per Diem<\/td>$63.00<\/td><\/tr>
HANDB<\/td>OAKS HANDBOOK<\/td>$5.00<\/td><\/tr>
H0003<\/td>Alcohol and\/or drug screening;laboratory analysis of spec<\/td>$0.00<\/td><\/tr>
NCOI<\/td>NO CHARGE OAKS INTAKE<\/td>$0.00<\/td><\/tr>
NC<\/td>no charge encounter<\/td>$0.00<\/td><\/tr>

80305<\/p><\/td>

urine drug screen<\/p><\/td>

$60.66<\/p><\/td><\/tr>

RHDAY<\/p><\/td>

Recovery Housing Daily Rate<\/p><\/td>

$28.57<\/p><\/td><\/tr>

99211<\/p><\/td>

OFFICE\/OUTPATIENT VISIT, EST, MIN<\/p><\/td>

$66.60<\/p><\/td><\/tr>

87798<\/p><\/td>

infectious agent detection, each organism amplified probe<\/p><\/td>

$650.00<\/p><\/td><\/tr>

87661<\/p><\/td>

trichomonas RNA qualitative<\/p><\/td>

$173.69<\/p><\/td><\/tr>

87591<\/p><\/td>

neisseria gonorrhoeae, amplified probe<\/p><\/td>

$162.00<\/p><\/td><\/tr>

87563<\/p><\/td>

Genitalium SureSwab<\/p><\/td>

$190.00<\/p><\/td><\/tr>

87529<\/p><\/td>

herpes simplex virus, amplified probe<\/p><\/td>

$500.00<\/p><\/td><\/tr>

87511<\/p><\/td>

gardnerella vaginalis, amplified<\/p><\/td>

$130.00<\/p><\/td><\/tr>

87491<\/p><\/td>

CHLAMYDIA TRACHOMATIS, AMPLIFIED PROBE TECH<\/p><\/td>

$162.00<\/p><\/td><\/tr>

91000<\/p><\/td>

Integrated BH visit<\/p><\/td>

$0.00<\/p><\/td><\/tr>

99211<\/p><\/td>

OFFICE\/OUTPATIENT VISIT, EST, MIN<\/p><\/td>

$0.00<\/p><\/td><\/tr>

PRESR<\/p><\/td>

Prepayment for Residential Services<\/p><\/td>

$0.00<\/p><\/td><\/tr>

REENT<\/p><\/td>

Re-Entry Code<\/p><\/td>

$0.00<\/p><\/td><\/tr><\/tbody><\/table>\n <\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t

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\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\tCOVID Specific\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t<\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t
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CPT<\/th>Description<\/th> Cost <\/th><\/tr><\/thead>
99201<\/td>OFFICE\/OUTPATIENT VISIT, NEW, PROBLEM FOCUSED<\/td>$88.00 <\/td><\/tr>
99202<\/td>OFFICE\/OUTPATIENT VISIT, NEW, EXPANDED PROBLEM<\/td>$163.00 <\/td><\/tr>
99203<\/td>OFFICE\/OUTPATIENT VISIT, NEW, DETAILED<\/td>$224.00 <\/td><\/tr>
99204<\/td>OFFICE\/OUTPATIENT VISIT, NEW, MOD COMPLEX<\/td>$334.50 <\/td><\/tr>
99205<\/td>OFFICE\/OUTPATIENT VISIT, NEW, HIGH COMPLEX<\/td>$433.00 <\/td><\/tr>
99211<\/td>OFFICE\/OUTPATIENT VISIT, EST, MIN<\/td>$50.00 <\/td><\/tr>
99212<\/td>OFFICE\/OUTPATIENT VISIT, EST, FOCUSED<\/td>$89.00 <\/td><\/tr>
99213<\/td>OFFICE\/OUTPATIENT VISIT, EST, EXPANDED<\/td>$150.00 <\/td><\/tr>
99214<\/td>OFFICE\/OUTPATIENT VISIT, EST, DETAILED<\/td>$248.00 <\/td><\/tr>
99215<\/td>OFFICE VISIT COMPREHENSIVE<\/td>$376.80 <\/td><\/tr>
87635<\/td>SARS COV W\/COV 2 RNA (COVID19 Test)<\/td>$100.00 <\/td><\/tr>
0241U<\/td>SARS-Cov-2\/ Flu\/ RSV (COVID19 Rapid Test)<\/td>$142.63 <\/td><\/tr>
86769<\/td>SARS-CoV2-Antibody IGG Immunology<\/td> $100.00 <\/td><\/tr>
0011A<\/td>Adm. Sarscov2 100mcg\/0.5ml 1st dose<\/td> $40.00 <\/td><\/tr>
0012A<\/td>Adm Sarscov2 100mcg\/0.5ml 2nd dose<\/td> $40.00 <\/td><\/tr>
0031A<\/td>Adm J&J SARSCOV2 Single Dose<\/td> $28.39<\/td><\/tr><\/tbody><\/table>\n <\/div>
<\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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We can help you determine whether you qualify for sliding fee scale discounts or if you are eligible for health care coverage to help cover the cost of care.<\/p>

This document will be updated annually by Stephanie Long and will be displayed on the Health & Wellness Center website.<\/p>

Please contact 1 (800) 640-9741 or questions@healthwellnessok.com with any questions.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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The Health & Center offers a sliding fee program for qualified patients. This program is based on a combination of the patients documented income and the federal poverty guidelines.<\/p>

If a patient has insurance, the carrier will be billed. Copays and denied services will be transferred to the guarantor.<\/p>

Many insurance plans are waiving copays on COVID19 related visits. Please check with your plan for specifics.
Prices valid as of 4\/20\/2020.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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\n\t\t\t\n\t\t\t \n\t\t\t \n\t\t\t\t\t\t\t\t\t \n\t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\tCPT Code<\/span><\/th>\n\t\t\t \t\t\t\t \n\t\t\t\t\t\t\t\t\t\t\t\t\t\tDescription<\/span><\/th>\n\t\t\t \t\t\t\t \n\t\t\t\t\t\t\t\t\t\t\t\t\t\tCost<\/span><\/th>\n\t\t\t \t\t\t\t <\/tr>\n\t\t\t <\/thead>\n\t\t\t \t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t99201\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, NEW, PROBLEM FOCUSED\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$88.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99202\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, NEW, EXPANDED PROBLEM\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$163.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99203\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, NEW, DETAILED\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$224.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99204\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, NEW, MOD COMPLEX\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$334.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99205\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, NEW, HIGH COMPLEX\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$443.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99211\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, EST, MIN\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$50.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99212\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, EST, FOCUSED\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$89.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99213\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, EST, EXPANDED\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$150.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99214\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE\/OUTPATIENT VISIT, EST, DETAILED\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$248.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t99215\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tOFFICE VISIT COMPREHENSIVE\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$376.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t87635\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tSARS COV W\/COV 2 RNA (COVID19 Test)\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$100.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t0241U\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\tSARS-Cov-2\/ Flu\/ RSV (COVID 19 Rapid Test)\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t \t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t
\n\t\t\t\t\t\t\t\t\t\t\t\t\t$142.00\n\t\t\t\t\t\t\t\t\t\t\t\t<\/div><\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/td>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/tr>\n\t\t\t \t\t\t <\/tbody>\n\t\t\t<\/table>\n\t\t<\/div>\n\t \t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
\n\t\t\t\t
\n\t\t\t\t\t
<\/div>
\n
CPT<\/th>Description<\/th> Cost <\/th><\/tr><\/thead>
99201<\/td>OFFICE\/OUTPATIENT VISIT, NEW, PROBLEM FOCUSED<\/td>$88.00 <\/td><\/tr>
99202<\/td>OFFICE\/OUTPATIENT VISIT, NEW, EXPANDED PROBLEM<\/td>$163.00 <\/td><\/tr>
99203<\/td>OFFICE\/OUTPATIENT VISIT, NEW, DETAILED<\/td>$224.00 <\/td><\/tr>
99204<\/td>OFFICE\/OUTPATIENT VISIT, NEW, MOD COMPLEX<\/td>$334.50 <\/td><\/tr>
99205<\/td>OFFICE\/OUTPATIENT VISIT, NEW, HIGH COMPLEX<\/td>$433.00 <\/td><\/tr>
99211<\/td>OFFICE\/OUTPATIENT VISIT, EST, MIN<\/td>$50.00 <\/td><\/tr>
99212<\/td>OFFICE\/OUTPATIENT VISIT, EST, FOCUSED<\/td>$89.00 <\/td><\/tr>
99213<\/td>OFFICE\/OUTPATIENT VISIT, EST, EXPANDED<\/td>$150.00 <\/td><\/tr>
99214<\/td>OFFICE\/OUTPATIENT VISIT, EST, DETAILED<\/td>$248.00 <\/td><\/tr>
99215<\/td>OFFICE VISIT COMPREHENSIVE<\/td>$376.80 <\/td><\/tr>
87635<\/td>SARS COV W\/COV 2 RNA (COVID19 Test)<\/td>$100.00 <\/td><\/tr>
0241U<\/td>SARS-Cov-2\/ Flu\/ RSV (COVID19 Rapid Test)<\/td>$142.63 <\/td><\/tr>
86769<\/td>SARS-CoV2-Antibody IGG Immunology<\/td> $100.00 <\/td><\/tr>
0011A<\/td>Adm. Sarscov2 100mcg\/0.5ml 1st dose<\/td> $40.00 <\/td><\/tr>
0012A<\/td>Adm Sarscov2 100mcg\/0.5ml 2nd dose<\/td> $40.00 <\/td><\/tr>
0031A<\/td>Adm J&J SARSCOV2 Single Dose<\/td> $28.39<\/td><\/tr><\/tbody><\/table>\n <\/div>
<\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

Health & Wellness CenterCosts of Most Common Services Transparency in Health Care Prices Act Community health centers offer service to all individuals regardless of insurance status or ability to pay. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-1496","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/pages\/1496","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/comments?post=1496"}],"version-history":[{"count":67,"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/pages\/1496\/revisions"}],"predecessor-version":[{"id":7898,"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/pages\/1496\/revisions\/7898"}],"wp:attachment":[{"href":"https:\/\/healthwellnessok.com\/wp-json\/wp\/v2\/media?parent=1496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}