CVMC - Fountain Green Clinic

Cash prices

1. Joint injection (large joint, e.g. knee)

   CPT 20610

   Facility fee only
   $98
   US typical $392

   Doctor fees are billed separately.
2. Medium joint aspiration or injection, without ultrasound

   CPT 20605

   Scan only
   $83
   US typical $327

   The radiologist read is billed separately.
3. Small joint drain or injection (e.g. finger, toe), without ultrasound

   CPT 20600

   Scan only
   $80
   US typical $323

   The radiologist read is billed separately.
4. Established patient office visit (minimal)

   CPT 99211

   Facility fee only
   $30
   US typical $63.96

   Doctor fees are billed separately.
5. Established patient office visit (straightforward, ~10-19 min)

   CPT 99212

   Facility fee only
   $70
   US typical $88.23

   Doctor fees are billed separately.
6. Injection into one tendon sheath or ligament

   CPT 20550

   Facility fee only
   $86
   US typical $322

   Doctor fees are billed separately.
7. Established patient office visit (low complexity, ~20-29 min)

   CPT 99213

   Facility fee only
   $110
   US typical $116

   Doctor fees are billed separately.
8. Established patient office visit (moderate complexity, ~30-39 min)

   CPT 99214

   Facility fee only
   $160
   US typical $155

   Doctor fees are billed separately.
9. Established patient office visit (high complexity, 40+ min)

   CPT 99215

   Facility fee only
   $220
   US typical $203

   Doctor fees are billed separately.
10. New patient office visit (low complexity, ~30-44 min)

    CPT 99203

    Facility fee only
    $150
    US typical $148

    Doctor fees are billed separately.
11. New patient office visit (moderate complexity, ~45-59 min)

    CPT 99204

    Facility fee only
    $225
    US typical $202

    Doctor fees are billed separately.
12. New patient office visit (basic, ~15-29 min)

    CPT 99202

    Facility fee only
    $100
    US typical $109

    Doctor fees are billed separately.
13. IUD removal

    CPT 58301

    Facility fee only
    $167
    US typical $300

    Doctor fees are billed separately.
14. New patient office visit (high complexity, 60+ min)

    CPT 99205

    Facility fee only
    $300
    US typical $255

    Doctor fees are billed separately.
15. Removal of non-dissolving drug implant

    CPT 11982

    Facility fee only
    $180
    US typical $364

    Doctor fees are billed separately.
16. Circumcision using clamp or device, with nerve block

    CPT 54150

    Facility fee only
    $267
    US typical $660

    Doctor fees are billed separately.
17. IUD insertion

    CPT 58300

    Facility fee only
    $160
    US typical $262

    Doctor fees are billed separately.
18. Mirena hormonal IUD (levonorgestrel 52 mg)

    HCPCS J7298

    Facility fee only
    $1,150
    US typical $1,822

    Doctor fees are billed separately. As listed: LEVONORGESTREL-RELEASING INTRAUTERINE CONTRACEPTIVE SYSTEM
19. Insertion of drug delivery implant

    CPT 11981

    Facility fee only
    $160
    US typical $243

    Doctor fees are billed separately.
20. Finger tendon sheath release (trigger finger surgery)

    CPT 26055

    Facility fee only
    $915
    US typical $1,885

    Doctor fees are billed separately.
21. Dilation and curettage (D&C), not pregnancy-related

    CPT 58120

    Facility fee only
    $455
    US typical $2,875

    Doctor fees are billed separately.
22. Etonogestrel birth control arm implant (Nexplanon), 68 mg

    HCPCS J7307

    Facility fee only
    $1,100
    US typical $1,530

    Doctor fees are billed separately. As listed: ETONOGESTREL IMPLANT SYSTEM NEXPLANON
23. Vasectomy, one or both sides, with follow-up semen tests

    CPT 55250

    Facility fee only
    $582
    US typical $1,586

    Doctor fees are billed separately.
24. Wrist ganglion cyst removal, first time

    CPT 25111

    Facility fee only
    $501
    US typical $1,643

    Doctor fees are billed separately.
25. Preventive checkup, new patient, age 18-39

    CPT 99385

    Facility fee only
    $175
    US typical $144

    Doctor fees are billed separately.
26. Preventive checkup, established patient, age 18-39

    CPT 99395

    Facility fee only
    $155
    US typical $127

    Doctor fees are billed separately.
27. Preventive checkup, established patient, age 40-64

    CPT 99396

    Facility fee only
    $165
    US typical $134

    Doctor fees are billed separately.
28. Preventive checkup, new patient, age 40-64

    CPT 99386

    Facility fee only
    $200
    US typical $164

    Doctor fees are billed separately.
29. Preventive checkup, established patient, age 65 or older

    CPT 99397

    Facility fee only
    $180
    US typical $149

    Doctor fees are billed separately.
30. Preventive checkup, established patient, age 12-17

    CPT 99394

    Facility fee only
    $150
    US typical $123

    Doctor fees are billed separately.
31. Preventive checkup, new patient, age 12-17

    CPT 99384

    Facility fee only
    $180
    US typical $144

    Doctor fees are billed separately.
32. Knee arthroscopy with meniscus repair/removal

    CPT 29881

    Facility fee only
    $857
    US typical $3,614

    Doctor fees are billed separately.
33. Preventive checkup, established patient, age 5-11

    CPT 99393

    Facility fee only
    $145
    US typical $117

    Doctor fees are billed separately.
34. Preventive checkup, new patient, age 5-11

    CPT 99383

    Facility fee only
    $170
    US typical $134

    Doctor fees are billed separately.
35. Preventive checkup, new patient, age 65 and older

    CPT 99387

    Facility fee only
    $215
    US typical $179

    Doctor fees are billed separately.
36. Well-child checkup, established patient, age 1-4

    CPT 99392

    Facility fee only
    $140
    US typical $118

    Doctor fees are billed separately.
37. Preventive checkup, established patient, infant under 1 year

    CPT 99391

    Facility fee only
    $130
    US typical $112

    Doctor fees are billed separately.
38. Preventive checkup, new patient, age 1-4

    CPT 99382

    Facility fee only
    $160
    US typical $133

    Doctor fees are billed separately.
39. Preventive checkup, new patient, infant under 1 year

    CPT 99381

    Facility fee only
    $145
    US typical $131

    Doctor fees are billed separately.
40. Total knee replacement

    CPT 27447

    Facility fee only
    $2,200
    US typical $9,715

    Doctor fees are billed separately.
41. Total shoulder replacement

    CPT 23472

    Facility fee only
    $2,233
    US typical $11,030

    Doctor fees are billed separately.
42. Total abdominal hysterectomy, with or without tube/ovary removal

    CPT 58150

    Facility fee only
    $1,608
    US typical $3,002

    Doctor fees are billed separately.
43. Endoscopic carpal tunnel release

    CPT 29848

    Facility fee only
    $850
    US typical $2,339

    Doctor fees are billed separately.
44. Vaginal hysterectomy, uterus 250 g or less

    CPT 58260

    Facility fee only
    $1,302
    US typical $4,480

    Doctor fees are billed separately.
45. Prenatal care only, 4 to 6 visits

    CPT 59425

    Facility fee only
    $860
    US typical $653

    Doctor fees are billed separately.
46. Vaginal delivery (routine care incl. prenatal/postpartum)

    CPT 59400

    Facility fee only
    $3,700
    US typical $3,700

    Doctor fees are billed separately.
47. C-section delivery (routine care incl. prenatal/postpartum)

    CPT 59510

    Facility fee only
    $4,060
    US typical $4,156

    Doctor fees are billed separately.
48. Total hip replacement after previous hip surgery (conversion)

    CPT 27132

    Facility fee only
    $2,700
    US typical $6,986

    Doctor fees are billed separately.

Prices are published cash prices with their source and the date we last checked. Confirm with the provider before you book. Hospital prices for a billing code are often the facility charge only.