Physician Visits
Service | Billing (CPT) Code** | The Everett Clinic Self Pay Fee | Prompt Pay Incentive 15% |
Office Visit New Patient Level 3 - Level 4
|
99203 - 99204
|
$267.25 - $407.50
|
$227.17- $346.38 |
Office Visit Established Level 3 - Level 4
|
99213 - 99214
|
$181.25- $266.75 | $154.07- $226.74 |
Note: Complex visits may be billed at a higher level of service and cost.
Dialysis
Service | Billing (CPT) Code** | The Everett Clinic Self Pay Fee | Prompt Pay Incentive 15% |
Dialysis 1 Visit Monthly
|
90962
|
$488.75
|
$415.44 |
Dialysis 2-3 Visits Monthly
|
90961
|
$631.25 | $536.57 |
Dialysis 4+ Visits Monthly
|
90960 | $748.75 | $636.44 |
Home Dialysis Per Month
|
90966 | $630.25 | $535.75 |
Urine Analysis
Service | Billing (CPT) Code** | The Everett Clinic Self Pay Fee | Prompt Pay Incentive 15% |
UA Dipstick (No Microscope)
|
81002
|
$5.75
|
$4.89
|
Lab Urinalysis
|
81000
|
$7.25
|
$6.17
|
Treatments & Injectables - Billed per unit
Service | Billing (CPT) Code** | The Everett Clinic Self Pay Fee | Prompt Pay Incentive 15% |
**Procrit Drug
(Typically 10, 20, 30, or 40 units used)
|
J0885
|
$27.50
|
$23.38 |
Administration |
96372
|
$63.25
|
$53.77
|
*Indicates that an injectable or infusion drug price is per unit; multiple units may be administered.