SELF-PAY PATIENT PROGRAM

Dear Patient,

Crescent Family Medicine, committed to its mission of providing high quality, updated and cost effective care to our patients, has designed and implemented, since our establishment, a discounted rate self-pay patient program.

Our program does not have membership fees or other upfront costs. To qualify for our Self-Pay rates you must either lack health care coverage through a private or government insurance agency, or have health coverage with a high deductible and prefer to pay out pocket for medical expenses.

The Self-Pay rates are based on 20% discount of our regular fees which average the cost of processing claims through the insurance companies.

	Office Visits Rates Our fees are based on a flat rate ($) New Patient 90 Established Patient and Follow Ups 78 Complete Physicals (Male/Female) 85 Sport, Camps and School Physicals 30 Emergency Visit 95 Our Office visit rates are not based on conditions to be treated or time spent with patient. They are rather based on a flat rate, you may present with either a single or multiple acute problems or even with multiple chronic conditions.		In House Labs Influenza A & B 36 Glucose 18 Urine Pregnancy 18 Strep A 30 Urine Test 18 Lipid Profile 30 H.Pylori 25		Common Procedures Hearing Screen 22 Electrocardiogram 54 Nebulizer 26 Pulmonary Function Test 58 Skin Tag Removal (1-15) 102 Skin Tags additional 15 54 Destruction Skin Lesion (1) 108 Destruction Skin Lesion (additional 1) 60 IUD Removal 54 Remove Impacted Ear wax (1 ear) 30 Remove Impacted Ear wax (2 ears) 55 Incision and Drainage 180 Nail Removal (complete) 180 Nail Removal (partial) 132 Laceration repair (<2.5cm) 150 Laceration Repair (>2.5cm) 210		Labs done at contracted laboratory (Blood Drawing is done at our clinic) Complete Metabolic Panel 25 General Health Panel 60 Thyroid 22 Complete Blood Count 22 Urine Culture 25  Pap Smear 58 Prostate Specific Antigen (PSA) 25 Uric Acid 14 Blood Type and Rh factor 25