Patient Information
Prices of Common Services
Pricing Details
The listed price reflects the undiscounted rate. The price you pay for a service or procedure may differ from the amount stated on this list, depending on your sliding fee discount and insurance plan benefits.
Request a price estimate: Please email billing@anhc.org to request an estimate. Within 3 to 10 business days after you request an estimate, you will be provided with an estimate of the anticipated charges for your non-emergency care.
Procedure codes: Procedure codes are numbers used to report the health care services provided to a patient. They are used for billing purposes.
Evaluation and Management
Procedure: Brief virtual check-in with an established patient (5–10 minutes)
Procedure code: 98016
Price: $164.00
Procedure: New patient office visit (level III)
Procedure code: 99203
Price: $483.00
Procedure: New patient office visit (level IV)
Procedure code: 99204
Price: $869.00
Procedure: Established patient office visit (level II)
Procedure code: 99212
Price: $245.00
Procedure: Established patient office visit (level III)
Procedure code: 99213
Price: $394.00
Procedure: Established patient office visit (level IV)
Procedure code: 99214
Price: $555.00
Procedure: Established patient office visit (level V)
Procedure code: 99215
Price: $781.00
Procedure: Established patient (under age 1) preventive visit
Procedure code: 99391
Price: $424.00
Procedure: Established patient (age 1–4) preventive visit
Procedure code: 99392
Price: $340.00
Procedure: Initial hospital care for a normal newborn
Procedure code: 99462
Price: $336.00
Medicine and Behavioral Health
Procedure: Vaccine administration fee (children, first vaccine)
Procedure code: 90460
Price: $105.00
Procedure: Vaccine administration fee (children, each additional vaccine)
Procedure code: 90461
Price: $69.00
Procedure: Vaccine administration fee (adults, first vaccine)
Procedure code: 90471
Price: $61.00
Procedure: Vaccine administration fee (adults, each additional vaccine)
Procedure code: 90472
Price: $54.00
Procedure: TDAP (vaccine to prevent diphtheria, pertussis, and tetanus)
Procedure code: 90715
Price: $83.00
Procedure: Shingrix (vaccine to prevent shingles)
Procedure code: 90750
Price: $250.00
Procedure: Behavioral health appointment (30 minutes)
Procedure code: 90832
Price: $203.00
Procedure: Behavioral health appointment (45 minutes)
Procedure code: 90834
Price: $260.00
Procedure: Behavioral health appointment (60 minutes)
Procedure code: 90837
Price: $280.00
Procedure: Therapeutic, prophylactic, or diagnostic substance injection via intramuscular or subcutaneous route
Procedure code: 96372
Price: $190.00
Pathology/Lab
Procedure: Complete metabolic panel (glucose level, electrolyte and fluid balance, kidney and liver function)
Procedure code: 80053
Price: $110.00
Procedure: Lipid panel (measurement of fats and fatty substances in blood)
Procedure code: 80061
Price: $138.00
Procedure: Urinalysis, by dip stick or tablet reagent (detects substances in urine associated with different metabolic and kidney disorders)
Procedure code: 81001
Price: $48.00
Procedure: Blood sugar measurement
Procedure code: 83036
Price: $95.00
Procedure: Thyroid stimulating hormone (measurement of thyroid gland function)
Procedure code: 84443
Price: $138.00
Procedure: Complete blood count (measurement of red blood cells, white blood cells, and platelets)
Procedure code: 85025
Price: $80.00
Procedure: Complete blood count (measurement of red blood cells, white blood cells, platelets, hemoglobin, hematocrit)
Procedure code: 85027
Price: $47.00
Procedure: Evaluation of patient’s serum for antibodies to hepatitis C virus
Procedure code: 86803
Price: $145.00
Procedure: Test for chlamydia trachomatis using amplified nucleic acid probe technique
Procedure code: 87491
Price: $220.00
Procedure: Test for Neisseria gonorrhoeae using amplified nucleic acid probe technique
Procedure code: 87591
Price: $220.00
Radiology
Procedure: X-ray of chest (single view)
Procedure code: 71045
Price: $69.00
Procedure: X-ray of chest (2 views)
Procedure code: 71046
Price: $236.00
Procedure: X-ray of spine (2 views)
Procedure code: 72100
Price: $295.00
Procedure: X-ray of shoulder (2 views)
Procedure code: 73030
Price: $280.00
Procedure: X-ray of hand (3+ views)
Procedure code: 73130
Price: $227.00
Procedure: X-ray of hip (2–3 views)
Procedure code: 73502
Price: $280.00
Procedure: X-ray of knee (1 or 2 views)
Procedure code: 73560
Price: $275.00
Procedure: X-ray of foot (1 view)
Procedure code: 73620
Price: $200.00
Procedure: 3D X-ray to screen for breast cancer
Procedure code: 77063
Price: $364.00
Procedure: X-ray to screen for breast cancer
Procedure code: 77063
Price: $1,072.00
Surgery
Procedure: Removal of skin tags (1–15 tags)
Procedure code: 11200
Price: $525.00
Procedure: Insertion of Implanon birth control device under the skin
Procedure code: 11981
Price: $800.00
Procedure: Removal of a contraceptive implant from the arm
Procedure code: 11982
Price: $968.00
Procedure: Destruction of benign lesions using techniques such as cryosurgery
Procedure code: 17110
Price: $639.00
Procedure: Removal of fluid or injection for diagnosis and/or to relieve pain and swelling in the join (one or both sides)
Procedure code: 20610
Price: $485.00
Procedure: Placement of contraceptive intrauterine device (IUD) in uterine cavity
Procedure code: 58300
Price: $785.00
Procedure: Removal of contraceptive intrauterine device (IUD) in uterine cavity
Procedure code: 58301
Price: $600.00
Procedure: Measurement of the fetal heart rate of a fetus in response to its own movements
Procedure code: 59025
Price: $389.00
Procedure: Admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery of the fetus and placenta on the same date of service.
Procedure code: 59409
Price: $5,134.00
Procedure: Cesarean delivery only
Procedure code: 59514
Price: $6,100.00
Procedure: Flush or wash out entrapped wax from a patient’s external ear canal with a stream of water to correct hearing loss or discomfort
Procedure code: 69209
Price: $90.00
Dental
Procedure: Dental exam (established patients)
Procedure code: D0120
Price: $99.00
Procedure: Dental exam (specific problem)
Procedure code: D0140
Price: $166.00
Procedure: Comprehensive oral evaluation
Procedure code: D0150
Price: $175.00
Procedure: Periapical X-ray (first x-ray)
A periapical X-ray captures the whole tooth, showing everything from the chewing surface of the tooth to the tip of the root.
Procedure code: D0220
Price: $50.00
Procedure: Periapical X-ray (each additional X-ray)
Procedure code: D0230
Price: $45.00
Procedure: Bitewing x-rays (set of 4)
A bitewing X-ray consists of four films (two on each side) which are necessary to capture all the crowns of the back teeth.
Procedure code: D0274
Price: $111.00
Procedure: Panoramic X-ray
A panoramic X-ray is a two-dimensional X-ray that captures a picture of the entire mouth in just one image.
Procedure code: D0330
2025 price: $188.00
Procedure: Cleaning (to prevent gum disease)
Procedure code: D1110
Price: $165.00
Procedure: Fluoride application (to prevent tooth decay)
Procedure code: D1206
Price: $35.00
Procedure: Periodontal maintenance
Periodontal maintenance includes removal of hard and soft deposits from above and below the gum.
Procedure code: D4910
Price: $251.00
Procedure: Simple extraction of erupted tooth or exposed root
Procedure code: D7140
Price: $316.00
CPT Copyright 2025, 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 disclaims 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.
ANHC’s In-Network Preferred Providers
What does "in-network" mean? It means that a health care provider has made 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 made 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.
Out-of-pocket charges: Even if your ANHC provider is in-network with your insurance company, there may be services or procedures that your insurance company does not cover or only partially covers. You may still be responsible for out-of-pocket charges, depending on your insurance plan benefits.
ANHC providers are in-network with the following health insurance companies:
Medical
Aetna
Medicaid
Medicare
Moda
Premera Blue Cross Blue Shield
TriWest
Dental
Cigna Dental
Delta Dental
Medicaid
Premera Blue Cross Blue Shield Dental
Metlife Dental
United Concordia