Clinical Services Fee Schedule  Effective July 21, 2020

Fee schedule is NOT an all inclusive list of services provided.
Non-TB Contact Tuberculins
$25.00
Pregnancy Test
$35.00
Blood Glucose Testing (By physician request)
$10.00
Well-Water Fluoride Testing
$5.00

Immunization Administration per vaccine

(plus the cost for vaccine noted below)

$25.00
     Hepatitis A Vaccine (19+ yrs. old & meeting criteria)
$109.18
     Hepatitis B Vaccine (19+ yrs. old & meeting criteria)
$98.18
     Varicella Vaccine (non-VFC eligible patients)
$199.63
     Tdap Vaccine (11 yrs of age & above meeting criteria)
$65.00
     HPV Vaccine (Gardasil)
$332.59
     Prevnar Vaccine
$281.25
     Meningitis Vaccine (Serogroups A, C, Y, & W-135)
$196.09
     Trumenda Vaccine (Meningitis – Serogroup B)
$218.75
     Flu Vaccine
$30.00
     Flu Vaccine ~ High Dose (65 yrs of age and older)
$75.00
     Pneumococcal Vaccine (Pneumonia)
$156.25
     Shringrix Vaccine (Shingles)
$225.00
Family Planning Services
Based on sliding fee scale
Maternal Health Services
Based on sliding fee scale
Child Health Services (for those under age 21)
Based on sliding fee scale

No patient will be denied services based solely on their ability to pay. Service restrictions may apply.

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