* The following insurances are NOT accepted and will be treated as Self-Pay: NYHTC, New York Hotel and Trade Council, Employee Benefit Fund.
| Service | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| Regular Visit | $175.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Follow-Up Visit | $100.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Virtual Care (Initial Tele-Visit) | $100.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Virtual Care (Follow-Up Tele-Visit) | $50.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Suboxone Initial | $350.00 (Includes UDS) | Insurance Not Applicable |
| Suboxone Follow-Up | $200.00 (Includes UDS) | Insurance Not Applicable |
| Suboxone Bridge (7 Days Only) | $100.00 | Insurance Not Applicable |
| Mental Health Therapy (Follow-Up) | $150.00 (30-45 min) | Partially covered - Collect copay/deductible |
| Mental Health Therapy (Initial Visit) | $200.00 (30-45 min) | Partially covered - Collect copay/deductible |
| Weight Loss Consultation (Initial) | $150.00 | Partially covered - Collect copay/deductible |
| Weight Loss Follow-Up | $100.00 | Partially covered - Collect copay/deductible |
| Psychiatry Initial Visit | $250.00 | Partially covered - Collect copay/deductible |
| Psychiatry Follow-Up Visit | $150.00 | Partially covered - Collect copay/deductible |
| Nutrition Counseling | $150.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Spravato (Ketamine Treatment) | $450.00 | Partially covered - Collect copay/deductible |
| Pre-Op Clearance | $175.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Women's Health / Physical | $175.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Pre-Employment Physical | $175.00 | Insurance Not Applicable |
| Physicals | $175.00 (Excludes tests, labs, etc.) | Partially covered - Collect copay/deductible |
| Travel Visit | $100.00 (No vaccines covered) | Insurance Not Applicable |
| CDL / DOT Physical | $125.00 | Insurance Not Applicable |
| CDL Follow-Up (Within 45 Days) | $25.00 | Insurance Not Applicable |
| Vaccine Visit (For administration only) | $100.00 + cost of vaccine & admin charge | Insurance Not Applicable |
| TLC (Urinalysis & Vision Exam Only) | $100.00 | Insurance Not Applicable |
* Admin fees applied to each lab
Admin Fees: $15.00
| Service | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| ThinPrep Pap Smear (Confirm with provider) | $70.00 | Partially covered - Collect copay/deductible |
| Vaginal FB Removal | $175.00 | Partially covered - Collect copay/deductible |
| ThinPrep Pap Smear with HPV (Confirm with provider) | $200.00 | Partially covered - Collect copay/deductible |
| Vaginitis/Vaginosis Panel - BD Affirm VPIII | $145.00 | Partially covered - Collect copay/deductible |
| IUD Removal | $200.00 | Partially covered - Collect copay/deductible |
| BV, Candida, STI Panel #10700 | $450.00 | Partially covered - Collect copay/deductible |
* Vaccine visit fees apply for vaccine-only visits.
* Admin fees apply to each vaccine (Exceptions: Flu, PPD)
Vaccine Visit Fees: $100.00
Admin Fees: $15.00
| Vaccine | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| Cholera Vaccine (Pre-Order) | $330.00 | Insurance not applicable |
| COVID-19 Vaccine | $190.00 | Deductibles and Co-Pay will apply |
| Flu Vaccine | $35.00 | Deductibles and Co-Pay DO NOT apply |
|
Gardasil/HPV Injection (Insurance applicable only with PCP) |
$350.00 | Partially covered - Collect copay/deductible |
| HPV Vaccine (Pre-Order) | $250.00 | Insurance applicable only with PCP, Medicare, and Medicaid |
| IPV (Polio Vaccine) (Per Dose) | $75.00 | Insurance applicable only with PCP |
| Hep A (Per Dose) | $115.00 | Insurance not applicable |
| Hep B (Per Dose) (Insurance applicable only with PCP) |
$120.00 | Partially covered - Collect copay/deductible |
| Japanese Encephalitis Vaccine (Pre-Order) | $375.00 | Insurance not applicable |
|
MMR Vaccine (Per Dose) (Insurance applicable only with PCP) |
$175.00 | Insurance not applicable |
| Meningitis Vaccine (Pre-Order) | $250.00 | Insurance applicable only with PCP |
| Pneumococcal Vaccine | $350.00 | Insurance applicable only with PCP |
| TDAP Vaccine | $120.00 | Insurance not applicable |
| Tetanus (Td) | $80.00 | Insurance not applicable |
| Typhoid (Injection) | $300.00 | Insurance not applicable |
| Varicella Vaccine (Per Dose) | $210.00 | Insurance not applicable |
| Yellow Fever Vaccine | $350.00 | Insurance not applicable |
|
Zoster/Shingles Vaccine (Pre-Order) (Insurance applicable only with PCP) |
$390.00 | Insurance not applicable |
* Admin fees apply to each injection/fluids (Exceptions: PPD)
Admin Fees: $15.00
| Injection/Fluid | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| Benadryl - 50mg | $25.00 | Fully/Partially covered - Collect copay/deductible |
| Dexamethasone | $25.00 | Fully/Partially covered - Collect copay/deductible |
| Immunity Infusions | $250.00 | Insurance not applicable |
| IV Fluids | $180.00 | Fully/Partially covered - Collect copay/deductible |
| PPD |
$50.00 (Visit fee doesn’t apply if only PPD is needed) |
Insurance not applicable |
| PPD (2-Step) | $90.00 | Insurance not applicable |
| Reglan | $50.00 | Fully/Partially covered - Collect copay/deductible |
| IV Fluids 2nd Treatment | $35.00 | Fully/Partially covered - Collect copay/deductible |
| Rocephin 1GM | $75.00 | Fully/Partially covered - Collect copay/deductible |
| Rocephin 500MG | $60.00 | Fully/Partially covered - Collect copay/deductible |
| Toradol 30ML | $35.00 | Fully/Partially covered - Collect copay/deductible |
| Toradol 60ML | $50.00 | Fully/Partially covered - Collect copay/deductible |
| Zofran - 4MG | $35.00 | Insurance not applicable |
| Famotidine (Pepcid) | $35.00 | Insurance not applicable |
| Vitamin B12 | $25.00 | Insurance not applicable |
| Lab Test | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| 4 PLEX | $180.00 | Fully/Partially covered - Collect copay/deductible |
| 10 Panel Urine Drug Test | $90.00 | Fully/Partially covered - Collect copay/deductible |
| Breath Alcohol Test (BAT) |
$50.00 With Positive Confirmation: $60.00 |
Fully/Partially covered - Collect copay/deductible |
| Chain of Custody - Urine Collection | $60.00 | Insurance not applicable |
| COVID PCR |
$125.00 Expedited Fee: $150.00 |
Fully/Partially covered - Collect copay/deductible |
| COVID Rapid | $50.00 | Fully/Partially covered - Collect copay/deductible |
| COVID-19 Serum IgG | $60.00 | Fully/Partially covered - Collect copay/deductible |
| Flu Wash | $60.00 | Fully/Partially covered - Collect copay/deductible |
| RSV PCR | $125.00 | Fully/Partially covered - Collect copay/deductible |
| Glucose Finger Stick | $15.00 | Fully/Partially covered - Collect copay/deductible |
| Mono Test | $30.00 | Fully/Partially covered - Collect copay/deductible |
| Pregnancy Test | $25.00 | Fully/Partially covered - Collect copay/deductible |
| STD Package | $350.00 | Fully/Partially covered - Collect copay/deductible |
| Strep Rapid | $35.00 | Fully/Partially covered - Collect copay/deductible |
| UDS Buprenorphine | $65.00 | Fully/Partially covered - Collect copay/deductible |
| Rapid HIV | $90.00 |
Full coverage for high-risk or age patients (15-65) Partially covered for others - Collect copay/deductible |
| Urine Dip | $30.00 | Fully/Partially covered - Collect copay/deductible |
| Procedure | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| Cautery - Heat Treatment | $145.00 | Fully/Partially covered - Collect copay/deductible |
| Ear Popper (Per Ear) | $40.00 | Fully/Partially covered - Collect copay/deductible |
| Ear Wax Removal (Per Ear) | $40.00 | Fully/Partially covered - Collect copay/deductible |
| EKG Test | $60.00 | Fully/Partially covered - Collect copay/deductible |
| Epistaxis Rhino Stat | $145.00 | Fully/Partially covered - Collect copay/deductible |
| Fluorescein Eye Staining (Includes Proparacaine) | $60.00 | Fully/Partially covered - Collect copay/deductible |
| Foreign Body Removal (All Areas) | $100.00 | Fully/Partially covered - Collect copay/deductible |
| Hearing Test | $35.00 | Fully/Partially covered - Collect copay/deductible |
| Ingrown Toenail | $240.00 | Fully/Partially covered - Collect copay/deductible |
| Joint Injections | $100.00 | Fully/Partially covered - Collect copay/deductible |
| Morgan Lens | $100.00 | Fully/Partially covered - Collect copay/deductible |
| Nebulizer Treatment | $35.00 | Fully/Partially covered - Collect copay/deductible |
| Nebulizer Treatment - Each Additional Nebule Used | $15.00 | Fully/Partially covered - Collect copay/deductible |
| Vision (DMV Vision Only Check - No Visit Fee) | $30.00 | Fully/Partially covered - Collect copay/deductible |
| X-Ray Type | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| 1-2 Views | $105.00 | Fully/Partially covered - Collect copay/deductible |
| 3 or More Views | $115.00 | Fully/Partially covered - Collect copay/deductible |
| X-Ray CD | $20.00 | Insurance not applicable to this service |
| Service | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| Immigration Physical with RPR | $175.00 | Insurance not applicable |
| Expedited Service (Additional Fee) | $150.00 (in addition to $175.00) | Insurance not applicable |
| Urine Gonorrhea | $100.00 | Insurance not applicable |
| TPPA - Confirmation Test for Syphilis (For Positive RPR) | $55.00 | Insurance not applicable |
| Syphilis Treatment Per Visit (Patient to Bring Medicine) | $60.00 | Fully/Partially covered - Collect copay/deductible |
| RPR | $25.00 | Insurance not applicable |
| Sputum Culture and Gram Stain | $45.00 | Insurance not applicable |
| Quantiferon-TB Gold (Venipuncture) | $120.00 | Insurance not applicable |
| IPV (Polio Vaccine) + Admin | $75.00 per dose | Insurance not applicable |
| Service | No Insurance (Self Pay) | With Insurance |
|---|---|---|
| ACE Wrap | $25.00 | Partially covered - Collect copay/deductible |
| Finger Splint | $30.00 | Partially covered - Collect copay/deductible |
| Upper Extremities | $240.00 | Partially covered - Collect copay/deductible |
| Lower Extremities | $280.00 | Partially covered - Collect copay/deductible |
| Hudson Medical Supplies | Sling, Crutches, Knee Immobilizer, Post-Op Shoe, Hand Splint | |
| Service | Cost |
|---|---|
| Medical Records Request | $0.75 per page |
| Forms to be Completed (any forms that patient brings to be filled out) | $12 per page |
| Service | No Insurance | With Insurance |
|---|---|---|
| Laceration Repair Initial Less than 2CM | $300.00 | Partially covered - collect copay or deductible |
| Laceration Repair Initial 2CM-5CM | $360.00 | Partially covered - collect copay or deductible |
| Laceration Repair Initial Greater than 5CM | $420.00 | Partially covered - collect copay or deductible |
| Laceration Repair Initial for 2nd Layer Repair | $60.00 (in addition to laceration repair) | Partially covered - collect copay or deductible |
| I & D Simple | $215.00 | Partially covered - collect copay or deductible |
| I & D Complicated | $240.00 | Partially covered - collect copay or deductible |
| Suture/Staple Removal | $60.00 | Partially covered - collect copay or deductible |
| Silver Nitrate | $70.00 | Partially covered - collect copay or deductible |
| Burn Dressing | $100.00 | Partially covered - collect copay or deductible |
| Steri-Strips | $100.00 | Partially covered - collect copay or deductible |
| Wound Care | $60.00 | Partially covered - collect copay or deductible |
| Ring Cutter | $100.00 | Partially covered - collect copay or deductible |
| Dermabond/Skin Glue | $250.00 (first vial), $85.00 (additional vial) | Partially covered - collect copay or deductible |
| Wound, Superficial | $30.00 | Partially covered - collect copay or deductible |
| Deep Wound with Anaerobes Culture | $60.00 | Partially covered - collect copay or deductible |
| Service | No Insurance | Follow-up Visits |
|---|---|---|
| Weight Loss Semaglutide .25mg | $99.00 per month | $0.00 (within the month) |
| Weight Loss Semaglutide .5mg | $199.00 per month | $0.00 (within the month) |
| Weight Loss Semaglutide 1mg | $299.00 per month | $0.00 (within the month) |
| Weight Loss Semaglutide 2mg | $399.00 per month | $0.00 (within the month) |
Note: Labs go to Sunrise, Quest, or any lab where there is no insurance or employer.
Venipuncture Fee: $25.00 (applies to all blood draws)
| Lab Test | No Insurance | With Insurance |
|---|---|---|
| CBC/PLT/DIFF (019) | $25.00 | Full/Partially covered - collect copay or deductible |
| MMR PANEL (084) | $120.00 | Full/Partially covered - collect copay or deductible |
| Hemoglobin A1C (053) | $40.00 | Full/Partially covered - collect copay or deductible |
| Lipid Panel (075) | $40.00 | Full/Partially covered - collect copay or deductible |
| Varicella IgG (115) | $75.00 | Full/Partially covered - collect copay or deductible |
| RPR (094) | $25.00 | Full/Partially covered - collect copay or deductible |
| Quantiferon-TB Gold (INC) (119) | $120.00 | Insurance not applicable |
| Comprehensive Metabolic Panel with GFR (023) | $30.00 | Full/Partially covered - collect copay or deductible |
| Vitamin B12 (838) | $40.00 | Full/Partially covered - collect copay or deductible |
| Vitamin D (494) | $25.00 | Full/Partially covered - collect copay or deductible |
| Lead (802) | $35.00 | Full/Partially covered - collect copay or deductible |
| ZPP (20605) | $85.00 | Full/Partially covered - collect copay or deductible |
| TP-PA (121) | $55.00 | Full/Partially covered - collect copay or deductible |
| N. Gonorrhoeae Urine (122) | $100.00 | Full/Partially covered - collect copay or deductible |
| COVID-19 Serum IgG (VDAB) | $60.00 | Full/Partially covered - collect copay or deductible |
| Strep Throat Culture (098) | $30.00 | Full/Partially covered - collect copay or deductible |
| TSH (38) | $35.00 | Full/Partially covered - collect copay or deductible |
| Free T4 (847) | $30.00 | Full/Partially covered - collect copay or deductible |
| T4 (35) | $25.00 | Full/Partially covered - collect copay or deductible |
| T3 Total (34) | $50.00 | Full/Partially covered - collect copay or deductible |
| Free T3 (276) | $60.00 | Full/Partially covered - collect copay or deductible |
| T3 Uptake (37) | $25.00 | Full/Partially covered - collect copay or deductible |
| Rabies Titer | $120.00 | Full/Partially covered - collect copay or deductible |
| Hep A Titer | $75.00 | Full/Partially covered - collect copay or deductible |
| Hep B Titer | $75.00 | Full/Partially covered - collect copay or deductible |
| PTT/INR | $35.00 | Full/Partially covered - collect copay or deductible |
| Urine Culture (112) | $35.00 | Full/Partially covered - collect copay or deductible |
| Urinalysis (111) | $30.00 | Full/Partially covered - collect copay or deductible |
| HIV 1/2 AG/AB, 4th generation | $35.00 | Full/Partially covered - collect copay or deductible |
| Thyroid Profile | $100.00 | Full/Partially covered - collect copay or deductible |
| Activated Partial Thromboplastin Time (APTT) | $15.00 | Full/Partially covered - collect copay or deductible |
| HIV 1/ HIV 2 Antibody & Antigen Screen | $35.00 | Full/Partially covered - collect copay or deductible |
| HCG (Quant) | $25.00 | Full/Partially covered - collect copay or deductible |
| Hepatic Function Panel (AMA) | $10.00 | Full/Partially covered - collect copay or deductible |
| Chlamydia Trachomatis, Urine (81471) | $100.00 | Full/Partially covered - collect copay or deductible |
| Trichomonas Vaginalis (3814) | $110.00 | Full/Partially covered - collect copay or deductible |