Pennsylvania Self-Pay Program


Simplified Pricing for Patients without Insurance

  • Visit charge for routine problem $145
  • Lab, x-ray, and other add-on services discounted and priced separately
  • Visit charge plus add-ons capped at $314 1


Pricing for Patients without Insurance

A) Office Visit Charges  
Routine Visit $145
Follow-up Visit $69
Telehealth – Routine Visit $90
Telehealth – Follow-up Visit $50
Visit for Diabetes, Cholesterol, or Prostate Cancer Screening $59
Visit for DOT Physical (price includes urinalysis) $135
Visit for 10 Panel Drug Screen (with collection) $115
Visit for Drug Screen – collection only 2 $41
Visit for Standard-Dose Flu Shot (Ages 3+) 3 $45
Visit for High-Dose Flu Shot (Ages 65+) 3 $80
Visit for Pregnancy Testing $55
Visit for Removal of Sutures Placed Elsewhere $49
Visit for TB Risk Assessment $35
Visit for TB Test $55
Visit for a School, Sports or Camp Physical 4 $55
B) Add-On Services  
Lab Test (on-site), each $45
X-ray Exam, each $99
EKG $99
Burn Care (2nd and 3rd degree) $99
Fracture/Dislocation Initial Office Care $99
IV Fluids $99
Nebulizer Treatment $99
Stitches/Laceration Repair $99
Supplies & Durable Medical Equipment (crutches, etc.) Discounted 20%
A) Office Visit Charge
+
B) Add-On Services
=
Total Visit Cost (capped at $314)
Charges Not Included in the $314 Cap  
Prescriptions 1 Discounted 20%
Vaccines Discounted 20%
Outside Lab Billed separately by the outside reference lab 5

This program is offered only to patients not covered by a government health insurance plan and not covered by any private insurance plan with which we participate. Terms and conditions apply.

1 Prescriptions, vaccines, and outside labs not included in cap.
2 'Drug Screen – collection only' services available only to patients who present with a completed Custody and Control Form (CCF).
3 Flu vaccine is not subject to the additional 20% discount. Flu vaccine is included in the charge for a 'Visit for Standard-Dose Flu Shot' and a 'Visit for High-Dose Flu Shot' as listed above under Office Visit Charges.
4 Price applies to patients age 3 and up presenting for a sports or camp physical. Price includes physical exam, dipstick urinalysis, if required, and completion of form(s). Price does not include: other types of physicals; additional services such as additional labs (including titers), x-rays, medications (including vaccines and immunizations), dispensed prescriptions, supplies, and procedures; and follow-up visits. If additional services are required, additional charges will apply
5 Except in Virginia. See Virginia Self-Pay Program pricing materials for outside lab pricing in Virginia.