Cost of Care Estimate

Call our dedicated estimation phone line at (859) 344-5555.

To help us provide you with the most accurate price estimate, please be ready to provide as much information as possible about the specific medical services described by your physician. For surgical price estimates, you may be asked to provide us with a specific CPT Procedure code, a five-digit numerical procedure code that can be obtained from your physician. This code will help determine the procedure being performed and the estimated financial responsibility.

The estimate will be based on the information provided and the most current benefits available from the insurance company. Additional charges will apply if other services are provided that are unknown at the time of the estimate. The estimate is for physician or surgeon services only and may not include all charges for incidental supplies related to the services performed. In addition, this estimate does not include any durable medical equipment, anesthesiologist, pathologist, hospital facility charges, or radiology fees. Those fees are billed separately by their respective billing companies and are not included in this estimate.

It is important to note that the information provided is a good faith estimate. The final price may vary from the estimate based on the patient’s medical needs.

The estimate is valid for 30 days.

Indiana Urgent Care Facilities

Top 15 most common Urgent Care services:

Code for Service	Description of Service	Charge	Total Units Billed	Self Pay: No Discount	Self Pay w/30% Discount	IN Medicare and Managed Care Plans	Non-government / In-network	IN Medicaid and Managed Care Plans
99213	ESTABLISHED PATIENT OFFICE/OUTPATIENT VISIT, Level 3	$119.00	3,186	$119.00	$83.30	$71.04	$95.34	$51.99
87804	DETECT AGENT,IMMUN,DIR OBS,INFLUENZA	$26.00	2,276	$26.00	$18.20	N/A	$16.56	$16.32
99203	NEW PATIENT OFFICE/OUTPATIENT VISIT, Level 3	$173.00	1,924	$173.00	$121.10	$101.83	$141.63	$76.71
99214	ESTABLISHED PATIENT OFFICE/OUTPATIENT VISIT, Level 4	$173.00	1,857	$173.00	$121.10	$103.43	$140.23	$76.88
87880	STREP A ASSAY W/OPTIC	$26.00	1,636	$26.00	$18.20	N/A	$16.72	$16.32
99202	NEW PATIENT OFFICE/OUTPATIENT VISIT, Level 2	$120.00	896	$120.00	$84.00	$71.72	$97.70	$52.90
71046	RADIOLOGIC EXAM CHEST 2 VIEWS	$50.00	591	$50.00	$35.00	$19.86	$23.33	$13.54
96372	INJECTION,THERAP/PROPH/DIAGNOST, IM OR SUBCUT	$50.00	493	$50.00	$35.00	$13.51	$30.33	$17.61
S9088	SERVICES PROVIDED IN URGENT	$50.00	370	$50.00	$35.00	N/A	$26.23	N/A
81003	URINALYSIS, AUTO, W/O SCOPE	$6.00	353	$6.00	$4.20	N/A	$3.01	$2.49
99051	MEDICAL SERVICES, EVE/WKEND/HOLIDAY	$34.00	339	$34.00	$23.80	N/A	$24.26	N/A
81002	URINALYSIS NONAUTO W/O SCOPE	$6.00	244	$6.00	$4.20	N/A	$3.89	$3.48
73630	X-RAY FOOT 3+ VW	$46.00	223	$46.00	$32.20	$22.16	$30.33	$16.27
94640	PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT	$36.00	183	$36.00	$25.20	$16.24	$24.78	$12.80
93000	ELECTROCARDIOGRAM, COMPLETE	$40.00	161	$40.00	$28.00	$15.96	$26.00	$11.83

Special Note to Indiana Patients:

A patient treated at our Indiana locations may at any time ask a health care provider for an estimate of the price the health care providers and health facility will charge for providing a non-emergency medical service. Indiana law requires that the estimate be provided within five business days of the request.

Call our dedicated estimation phone line at (859) 344-5555.