Our Fee for Service Patient Price. Self Pay Price Elsewhere

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1 DPC Services & Savings - February 2019 Mind & Body Christian Health Group, LLC Appointment Types Reason for the Appointment Service Patient s Out of Network General Adult Annual Physical (60 minute face to face time) $0 $100 $ % $ % $218 Well Child Appointment $0 $100 $ % $ % $194 Sports Physical $0 $40 $ % $ % $98 Gynecological Appointment $0 $100 $ % $ % $400 Lab Draw Only Appointment $0 $10 $ % $ % $19 Follow Up Appointment (within 14 calendar days from previous appointment) Minor Illness: Allergies (Seasonal) Bronchitis Cold, Cough & Flu Diarrhea, Nausea & Vomiting Earache & Ear Infections Female Bladder & Urinary Tract Infections Fever Headaches & Migraines Joint Pain Laryngitis Lyme Disease (Early) Minor Back Pain Mono (Infectious Mononucleosis) Pink Eye & Styes Sinus Infections Sore Throat & Strep Throat Swimmer s Ear Upper Respiratory Infections $0 $70 $ % $ % $340 Minor Injury: Burns (Minor) Corneal & Eye Abrasions Foreign Body Removal from Eyes or Ears (Limited) Laceration Repair (Minor) Splinter Removal Sprains & Strains Staple & Suture Removal s Subject to Change 1

2 DPC Services & Savings - February 2019 Mind & Body Christian Health Group, LLC Appointment Types Skin Conditions: Acne Athlete s Foot Chickenpox Eczema Head Lice & Scabies Hives Impetigo Oral, Mouth & Cold Sores Poison Ivy, Poison Oak & Poison Sumac Ringworm Shingles (Herpes Zoster) Skin Infections, Irritations & Rashes Sunburn Swimmer s Itch Tick/Insect Bites & Stings Smoking Cessation Medical Counseling $0 $100 $ % $ % $98 s Subject to Change 2

3 DPC Services & Savings - February 2019 Mind & Body Christian Health Group, LLC Labs Labs (Sent out of the office) Service Patient Savings to Savings to s Out of Network B12 $4 $8 $ % $ % $98 Folate $4 $8 $ % $ % $88 Magnesium $2 $5 $ % $ % $66 Iron $3 $5 $ % $ % $34 Iron Binding $3 $5 $ % $ % $46 TSH $4 $8 $ % $ % $88 Vitamin D $14 $27 $ % $ % $232 CBC $4 $7 $ % $ % $40 Uric Acid $2 $5 $ % $ % $30 CMP $3 $7 $ % $ % $60 C-Reactive Protein $4 $9 $ % $ % $68 Ferritin $3 $7 $ % $ % $85 Free T3 $3 $7 $ % $ % $189 Thyroxine T4 $4 $8 $ % $ % $80 A1C $5 $11 $ % $ % $53 Lipid Panel $3 $6 $ % $ % $82 Annual Labs Total: $64 $128 $ % $ % $1,339 The 4 Basics $14 $27 $ % $ % $270 Basic Metabolic $2 $5 $ % $ % $50 Testosterone Free/Total $15 $30 $ % $ % $228 Hepatitis Panel $23 $46 $ % $ % $363 Lipase $6 $11 $ % $ % $78 s Subject to Change 3

4 DPC Services & Savings - February 2019 Mind & Body Christian Health Group, LLC POC Labs Point of Care Labs (Done in the office) Service Patient s Out of Network In Hourse Qual. Drug Screen $10 $20 $ % $ % $106 Dipstick Urinalysis (in house) $3 $6 $ % $ % $35 Flu Test $14 $28 $ % $ % $71 Rapid Strep Test $4 $8 $ % $ % $58 Blood Sugar Test $3 $6 $ % $ % $84 Mono Test $9 $18 $ % $ % $64 Cholesterol Screen $4 $8 $ % $ % $37 Pregnancy Test $5 $9 $ % $ % $37 PPD Test for TB $10 $20 $ % $ % $19 s Subject to Change 4

5 DPC Services & Savings - February 2019 Mind & Body Christian Health Group, LLC Procedures Procedure s (on top of the appointment fee) Service Patient s Out of Network Toe Nail Removal (1 or 2) $20 $40 $ % $ % $300 1 Skin Biopsy $35 (lab included) $70 (lab included) $90 (lab not included) 61.11% $110 (lab not included) 68.18% $243 (lab not included) Skin Tag Removal $0 $10 $ % $ % $166 Minor Laceration Repair $25 $50 $ % $ % $407 Wound Care (Simple) Supply cost 20 + supply cost $ % $ % $224 Joint Injections $15 $30 $ % $ % $627 IV Fluid Resuscitation $20 $45 $ % $ % $301 EKG Machine $0 $20 $ % $ % $102 Spirometry $0 $20 $ % $ % $276 Ear Wax Removal $0 $35 $ % $ % $307 Fair Health Consumer Everrett Clinic Minute Clinic s s Subject to Change 5

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