Clinic Prices – Hilltop Medical Clinic

A new patient is defined as someone who has not been treated at our clinic in the last three years.

NEW PATIENT: The clinic cash visit charge is 130 dollars.

ESTABLISHED PATIENT: The clinic cash visit charge is 120 dollars.

Additional charges may apply if you need labs, sutures, casting, equipment such as crutches, slings, walking boots, etc.

X-RAYS: Cost depends on the number of views and location and ranges between 50 – 120 dollars.

Insurance contracts may affect costs and payments. Please check to see if we have a contract with your insurance company. We are renegotiating contracts and coverage may be interrupted or discontinued, in which case, our cash prices apply.

Services not covered by insurance:

DMV Physicals – $125.00

Sports Physicals – $45

Flu Shot – $ 30 for 2021-2022 flu season

PPD – $45.00

Tetanus Vaccine – $80.00

TdaP Vaccine (Tetanus with Pertussis) – $82.00

Urine Drug Screen – $45.00 – $75.00

These listed prices are not a guarantee. This is an approximate amount that you may be charged when seen at the clinic. Billing insurance may mean that you will be asked to pay either your copay or the allowable deductible amounts depending on your insurance company. Please note this example is for your office visit only. Depending on your insurance you may owe additional deductible amounts and co-insurance on other services.

The cost of a medical visit is based on the procedure codes that represent the intensity of the visit and the allowed prices for those procedure codes. The amounts for each procedure code are set by federal and state laws or our contracts with insurance companies. Patients without insurance are charged over the allowed Medicare procedure code charge, because of Federal Law.

Medical billing or coding is complex and is now a separate industry created by the insurance companies to help them understand and control costs. Each code has specific criteria to justify its use. For urgent care and primary care offices, the most commonly used codes for visits with a single complaint or problem are: 99203 for a new patient-focused history and exam, or 99213 for an established patient expanded history and exam. Patients with multiple complaints or complex problems requiring additional services, such as an x-ray or specialty referral are coded at a higher level. Additional codes are added for necessary testing and procedures, for example, strep screens, x-rays, or antibiotic injections.

The patient’s final, out-of-pocket cost, is based on the patient’s insurance contract: the allowed amounts, deductibles, and co-pay amounts. Every plan is different, even within a single insurance group or category.

EXAMPLES BELOW-THESE PRICES ARE NOT A GUARANTEE (BLUE CROSS Insurance EXAMPLE)

New Patients

To be seen as a new patient at the clinic for medical issues such as Asthma, Eye Injury or Wrist strain – Total Amount owing for the office visit portion only, if you are paying your deductible would be $99.15

	Code	Cash	Discount	Amount
Visit	99203	135.00	35.85	99.15

Depending on your insurance contract, a co-pay may cover the visit charge. Co-pays for visit charges sometimes are fixed amounts like 15 or 25 dollars, or they are a percentage of the visit charge, i.e., 20 percent. Please note this example is for your office visit only. Depending on your insurance you may owe additional deductible amounts, and co-insurance on other services such as labs, X-rays or injections.

Established Patients

To be seen as an established patient at the clinic for medical issues such as Poison Oak, Urinary Tract Infection, Ear Ache – Total Amount owing for the office visit portion only, if you are paying your deductible would be $70.56.

	Code	Cash	Discount	Amount
Visit	99213	90.00	19.44	70.56