Depo

Established Patient
Visit 99213: $146.00
Depo J1050: $73.50
Administration 96372: $51.00
Pregnancy Test 81025: $32.50

*TOTAL= $303.00

New Patient
Visit 99203: $218.00
Depo J1050: $73.50
Administration 96372: $51.00
Pregnancy Test 81025: $32.50

*TOTAL= $375.00

*Total varies. Contact Billing Department for detailed estimate.


The Good Faith Estimate (GFE) shows the costs of items/services that are reasonably expected for your health care needs. The GFE does not include any unknown or unexpected costs that may arise during treatment. Charges could be added if complications or special circumstances occur. Regulations establish the billed charges for any GFE to be within $400.00 of actual charges. Please contact the Billing Department for a more detailed estimate.

Our practice offers discounted cash-pay rates for patients who choose to pay out of pocket for their medical services. Please note the following:

1. Rate Variance: Cash-pay rates are typically lower than the rates billed to insurance companies. These discounted rates are designed to accommodate patients without insurance or those who opt not to use their coverage.
2. Insurance Billing: The rates billed to insurance companies may be higher due to contractual agreements, administrative costs, and reimbursement structures.
3. Non-Applicability of Discounts: Cash-pay discounts do not apply to services billed to insurance companies. If you elect to submit a claim to your insurer, the cash-pay discount will not be honored retroactively.
4. Patient Responsibility: It is your responsibility to understand the terms of your insurance plan, including out-of-pocket expenses and coverage limitations.

By choosing the cash-pay option, you acknowledge and agree to these terms. If you have questions or need clarification, our staff will be happy to assist.