Self-Pay Fee Schedule

Professional Fees

Plus Lab Test charges, if applicable

For Common Illness, Allergies, Minor Injuries and Disease  
Management Visits

Annual Physical

Plus charges for screening tests

• Up to 17 Years of Age

  $100

• 18 to 39 Years Old

  $125

• 40 to 64 Years Old

  $135

• 65 Years and Above

  $150

Lab Tests

Plus Professional Fees

• Flu Test

  $20

• Mono Spot

  $10

• PPD (TB Skin)

  $13

• Strep Test

  $20

• Urinalysis

  $10

• Wet Prep/KOH

  $10

Preventive Screening Tests

• Blood Glucose

  $8

• Lipid Panel (Cholesterol Screening)

  $20

• CMP (Comp Metabolic Panel)

  $12

• Liver Panel

  $12

• CBC (Complete Blood Count)

  $10

• Prostate Cancer Screening (PSA)

  $25

• FSH

  $25

• Pap Smear

  $40

• Pap Smear with HPV

  $80

• Hemoglobin A1C

  $12

• Thyroid Panel (TSH)

  $20

Physical Evaluations

Plus Lab, Vaccination charges, if applicable

• School/Sports/Camp Physical

  $45

• College Physical

  $55

• Work Physical

  $60

• Extensive Work Physical

  $90

• Teacher Physical

  $55

Travel Vaccines*

Plus Vaccine Consultation Fees

• Hepatitis A

  $85

• Hepatitis B

  $78

• Hepatitis A&B

  $100

• Meningitis

  $125

• Tetanus

  $40

• Typhoid

  $75

• Yellow Fever

  $125

*Travel Vaccines not normally covered by Insurance Plans.

Vaccination

Plus Vaccine Consultation Fees

• Hepatitis A

  $85

• Hepatitis B

  $78

• Hepatitis A&B

  $100

• Meningitis

  $125

• Gardasil

  $150

• Flu

  $25

• MMR

  $65

• Pneumonia

  $50

• Polio

  $38

• Tetanus

  $40

Vaccine Consultation

• Up to two Vaccines

  $50

• Three or more vaccines

  $125