| 99385 New Patient Age 18-39 |
$200 |
| 99386 New Patient Age 40-64 |
$230 |
| 99395 Established Preventative Medicine Age 18-39 |
$180 |
| 99396 Established Preventative Medicine Age -40.64 |
$210 |
| 99203 New Patient Low/Mod visit |
$160 |
| 99204 New Patient Mod/High visit |
$230 |
| 99213 Established patient OV Low/Moderate |
$125 |
| 99214 Established patient OV Mod/High |
$160 |
| 76830 Pelvic Ultrasound |
$225 + $160 OV + $385 |
| 58340 Sonohysterogram |
$300 Plus $385 (OV and US) |
| 57454 Colposcopy |
$350 + $125 OV |
| IUDs |
Cost of IUD + OV ($125) + Insertion Fee ($150) |
| Kyleena |
$900 |
| Mirena |
$900 |
| Skyla |
$750 |
| Paragard |
$750 |
| Nexplanon |
$900 + OV ($125) + Insertion ($200) |
| Pregnancy Test (urine) |
$15 |
| Urine Test |
$10 |
