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Disclaimer: All price estimates are estimations only and should not be considered a price quote. Actual charges may vary based on on insurance coverage (see below), medical condition, unknown circumstances, final diagnosis, and treatment recommended by your provider. All requests for an estimate will receive a response within 10 business days.
Prices for Common Services and Procedures
In-Network Preferred Providers
What is the difference between in-network and out-of-network? If a health care provider has reached an agreement with a health insurance company to provide services at a discounted rate, the health care provider is in-network. If a health care provider and a health insurance company have not reached such an agreement, the health care provider is out-of-network. Visiting a health care provider that is out-of-network with your health insurance company may result in higher prices for you.
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ANHC is an in-network preferred provider with the following health insurance companies:
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Medical
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Aetna
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Medicaid
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Medicare
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Moda
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Premera Blue Cross Blue Shield
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TriWest
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Dental
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Cigna Dental
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Delta Dental
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Medicaid
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Premera Blue Cross Blue Shield Dental
Price List
Note: The listed prices reflects the undiscounted rate. The price you pay for a particular service or procedure may differ from the amount stated on this list depending on your insurance coverage and sliding fee discount.
Procedure codes: Procedure codes are numbers used to report the health care services provided to a patient. They are used for health care billing.
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Evaluation and Management
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Procedure Code: 99204
Procedure: New Patient Office Visit Level IV
Price: $457.00
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Procedure Code: 99203
Procedure: New Patient Office Visit Level III
Price: $320.00
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Procedure Code: 99202
Procedure: New Patient Office Visit Level II
Price: $245.00
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Procedure Code: 99214
Procedure: Established Patient Office Visit Level IV
Price: $299.00
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Procedure Code: 99213
Procedure: Established Patient Office Visit Level III
Price: $207.00
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Procedure Code: 99212
Procedure: Established Patient Office Visit Level II
Price: $162.00
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Procedure Code: 99211
Procedure: Established Patient Office Visit Level I
Price: $114.00
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Procedure Code: 99396
Procedure: Established Patient (40–64 Years) Preventive Visit
Price: $450.00
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Procedure Code: 99392
Procedure: Established Patient (1–4 Years) Preventive Visit
Price: $260.00
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Procedure Code: 99391
Procedure: Established Patient (Under 1 Year) Preventive Visit
Price: $244.00
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Surgery
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Procedure Code: 11981
Procedure: Insertion of Implanon birth control device under the skin
Price: $825.00
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Procedure Code: 20610
Procedure: Removal of fluid or injection for diagnosis and/or to relieve pain and swelling in the joint (one side or both sides)
Price: $450.00–$900.00
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Procedure Code: 20551
Procedure: Injection where tendon connects with muscle to relieve pain and reduce inflammation
Price: $367.00
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Procedure Code: 17110
Procedure: Removal of common or plantar warts
Price: $357.00
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Procedure Code: 11200
Procedure: Removal of skin tags (1–15 tags)
Price: $477.00
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Procedure Code: 11421
Procedure: Removal of smaller skin growths from scalp, neck, hands, feet, or genitals
Price: $606.00
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Procedure Code: 11422
Procedure: Removal of larger skin growths from scalp, neck, hands, feet, or genitals
Price: $764.00
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Procedure Code: 17000
Procedure: Removal of growths (mole, lesion, tumor) from skin without biopsy
Price: $317.00
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Procedure Code: 11301
Procedure: Removal of smaller skin growths from torso, arms, legs
Price: $421.00
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Procedure Code: 11403
Procedure: Removal of larger skin growths from torso, arms, legs
Price: $921.00
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Radiology
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Procedure Code: 77063
Procedure: 3D x-ray to check for breast cancer
Price: $84.73
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Procedure Code: 77067
Procedure: X-ray to screen for breast cancer
Price: $397.00
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Procedure Code: 71046
Procedure: X-ray of chest (2 views)
Price: $239.00
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Procedure Code: 72100
Procedure: X-ray of spine (2 views)
Price: $285.00
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Procedure Code: 73030
Procedure: X-ray of shoulder (2 views)
Price: $301.00
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Procedure Code: 73502
Procedure: X-ray of hip (2–3 views)
Price: $284.00
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Procedure Code: 73560
Procedure: X-ray of knee (2 views)
Price: $242.00
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Procedure Code: 73562
Procedure: X-ray of knee (3 views)
Price: $270.00
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Procedure Code: 73610
Procedure: X-ray of ankle (3 views)
Price: $253.00
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Procedure Code: 73630
Procedure: X-ray of foot (3 views)
Price: $248.00
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Pathology/Lab
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Procedure Code: 36415
Procedure: Blood sample for lab testing
Price: $46.00
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Procedure Code: 83036
Procedure: Blood sugar measurement
Price: $95.00
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Procedure Code: 80053
Procedure: Complete metabolic panel (sugar [glucose] level, electrolyte and fluid balance, and kidney and liver function)
Price: $131.00
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Procedure Code: 85025
Procedure: Complete blood count (measurement of red blood cells, white blood cells, and platelets)
Price: $75.00
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Procedure Code: 84443
Procedure: Thyroid stimulating hormone (measurement of thyroid gland function)
Price: $161.00
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Procedure Code: 80061
Procedure: Lipid panel (measurement of fats and fatty substances in blood)
Price: $150.00
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Procedure Code: 81001
Procedure: Urinalysis (test for diseases or drugs present in urine)
Price: $47.00
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Procedure Code: 82044
Procedure: Microal-Creat Ratio Dipstick (measurement of a protein in urine to check for kidney disease)
Price: $74.00
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Procedure Code: 80050
Procedure: General health panel (includes complete metabolic panel, complete blood count, and thyroid hormone test)
Price: $256.00
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Procedure Code: 82306
Procedure: Measurement of vitamin D levels
Price: $323.00
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Medicine
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Procedure Code: 90471
Procedure: Vaccine administration fee (adults, first vaccine)
Price: $35.00–$62.00
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Procedure Code: 90460
Procedure: Vaccine administration fee (children, first vaccine)
Price: $35.00–$62.00
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Procedure Code: 90472
Procedure: Charge for each additional vaccine (adults)
Price: $37.00
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Procedure Code: 90461
Procedure: Charge for each additional vaccine (children)
Price: $37.00
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Procedure Code: 90715
Procedure: TDAP (vaccine to prevent diphtheria, pertussis, and tetanus)
Price: $75.00
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Procedure Code: 90750
Procedure: Shingrix (vaccine to prevent shingles)
Price: $571.00
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Procedure Code: 90732
Procedure: PPSV Pneumococcal (vaccine to prevent pneumonia)
Price: $107.00
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Procedure Code: 90832
Procedure: Behavioral health appointment (30 minutes)
Price: $178.00
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Procedure Code: 90834
Procedure: Behavioral health appointment (45 minutes)
Price: $228.00
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Procedure Code: 90837
Procedure: Behavioral health appointment (60 minutes)
Price: $320.00
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Dental
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Procedure Code: D0150
Procedure: Dental exam (new patients)
Price: $169.00
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Procedure Code: D0120
Procedure: Dental exam (established patients)
Price: $98.00
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Procedure Code: D1110
Procedure: Cleaning (to prevent gum disease)
Price: $170.00
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Procedure Code: D1206
Procedure: Fluoride application (to prevent tooth decay)
Price: $35.00
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Procedure Code: D0220
Procedure: Dental x-ray showing tooth and surrounding tissue (first x-ray)
Price: $45.00
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Procedure Code: D0230
Procedure: Dental x-ray showing tooth and surrounding tissue (additional x-rays)
Price: $40.00
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Procedure Code: D0274
Procedure: Dental x-ray (upper and lower teeth)
Price: $108.00
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Procedure Code: D0330
Procedure: Dental x-ray (entire mouth)
Price: $183.00
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Procedure Code: D7140
Procedure: Removal of a tooth
Price: $309.00
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Procedure Code: D2392
Procedure: Fillings (back teeth)
Price: $412.00
CPT Copyright 2020, American Medical Association (AMA). All rights reserved. CPT is a registered trademark of the American Medical Association. The CPT codes are provided "as is" without warranty of any kind. The AMA specifically discalims all liability for use or accuracy of any CPT codes. The undiscounted price may differ from what the patient actually pays. You will be provided an estimate of services upon written request.