You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

• Make sure to save a copy or picture of your Good Faith Estimate.

 

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises..

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Self Pay Fee Sheet (Fee schedule)        
       
Service:
New Patient Exam                                     99202    $75.00
New Patient Exam                                     99203    $125.00
New Patient Exam                                     99204    $200.00
Established Patient Exam (Re-Exam)      99212    $50.00
Established Patient Exam (Re-Exam)      99213    $80.00
Established Patient Exam (Re-Exam)      99214    $100.00
Chiropractic Adjustment (1-2 regions)    98940    $40.00
Chiropractic Adjustment (3-4 regions)    98941    $50.00
Chiropractic Adjustment (5 regions)        98942    $60.00
Chiropractic Adjustment (Extraspinal)     98943    $30.00
Modality: Electric Muscle Stimulation      97032    $20.00
Modality: Manual Therapy                         97140    $40.00
Modality: Mechanical Traction                  97012    $15.00
Modality: Therapeutic Exercise                 97110    $25.00
Motion Mechanical Therapy                          N/A    $10
Vibe Therapy 1 session (<10 minutes)         N/A    $10
Vibe Therapy 2 session (11<20 minutes)     N/A    $20
Zyto Scan                                                          N/A    $50 for scan only
ProBalance single session                             N/A    $50
Longevity Program                                          N/A    $259 per month
*Prices are subject to change. We do our best to keep our fees listed up to date.