Self-Pay Rates and Insurance Billing

Patients who choose not to use insurance benefits or who are uninsured may receive services at our established self-pay rates. Current self-pay rates are subject to change and may vary based on the type and length of service provided.

• Initial Assessment: $200  (A $100 scheduling deposit is required to reserve your appointment. This deposit will be credited toward your first visit.
• Follow-Up Visits & Medication Management $120
• Blood Draw / Venipuncture $15
• FMLA forms: $50–$75 (based on complexity)
• Provider letters: $25–$50
• Nexus letters: $30
• Therapy referrals are available at no cost upon request and when clinically appropriate, as determined by your provider.

A Good Faith Estimate will be provided upon request or as required by law for uninsured and self-pay patients.

For patients utilizing insurance benefits, actual out-of-pocket costs are determined by the patient's insurance plan and may include:

• Deductibles
• Copayments
• Coinsurance
• Non-covered services

Because these amounts are determined by your insurance carrier, Good Faith Estimates and self-pay rates do not reflect or guarantee the amount you may owe when insurance is billed.

Patients are responsible for understanding their insurance benefits and verifying coverage with their insurance company. We encourage patients to contact their insurance carrier directly regarding deductibles, copays, coinsurance, prior authorization requirements, and coverage limitations.

The Good Faith Estimate is not a bill and does not guarantee coverage by any insurance plan. It applies only to uninsured patients or patients who choose not to submit claims to their insurance provider. Actual charges may vary based on services provided and insurance processing.

Please Note: Self-pay rates apply only to patients who are not using insurance benefits. Patients using insurance may have financial responsibility for deductibles, copayments, coinsurance, or non-covered services as determined by their health plan. Self-pay rates and Good Faith Estimates do not represent or predict insurance-related patient responsibility.