providing 24-hour emergency services & more

Summary Of Pricing

EMERGENCY LEVEL I $391.00
EMERGENCY LEVEL II $611.00
EMERGENCY LEVEL III $732.00
EMERGENCY LEVEL IV $1,096.00
EMERGENCY LEVEL V $1,509.00
ER NEW/EST BRIEF $398.00
ER NEW/EST LIMITED $605.00
ER NEW/EST INTERMED $673.00
ER NEW/EST EXTENDED $818.00
LACERATION REPAIR/SIMP-UP TO 2.5 CM $485.00
LACERATION TRAY $90.00
ACCUCHECK $11.00
ACE 2 $3.30
ACE 3 $3.30
ACE 4 $3.30
Acetomenophen 500mg TABLET $3.85
ADM IMM/TOXOID SUB/IM $148.00
ADM/IV DRUG – IV PUSH $148.00
ADM/THER DRUG SUB/IM $148.00
ALBERTOL $4.80
Amoxicillian 250 mg Cap $149.00
Amoxicillian 250mg/5mL SUSP $10.62
ARM SLING UNIVERSAL $47.70
ASA 81 mg Chewable $3.85
CARDIAC MONITOR E/R $544.00
CATH IV 20GX1 $16.11
CATH IV 22GX1 $16.11
CRUTCHES REGULAR ADULT $87.73
DEXAMETHASONE (DECADRO $15.85
DRESSING TEGADERM 1624 $3.30
EMESIS BAG UM $3.30
EXTENSION SET $14.49
HYDROcodone / APAP 7.5 $5.31
HYDROcodone/APAP 5 mg $3.85
HYDROmorphone (DILAUDI $11.00
IBUPROFEN (CHILDRENS) $5.85
IPRATRO/ALBUTEROL(DUON $13.24
IV INFUSION THERAPY EACH $85.00
IV INFUSION THERAPY IN $440.00
IV PRIMARY SET $25.92
IV PUSH ADDITIONAL DOS $85.00
IV PUSH SEQUENT – EA. $120.00
KETOROLAC 30 MG / ML V $36.00
KETOROLAC 60 MG / 2 ML $45.00
KLING 2 $3.30
KLING 3 $3.30
LIDOCAINE (XYLOCAINE) $20.52
LIDOCAINE 5 ML 1% INJ $24.41
LORAZEPAM (ATIVAN) 2 M $18.30
MASK NEBULIZER ADULT $10.40
METHOCARBAMOL 500 MG T $3.85
methylPREDNISolone 125 $38.50
NALBUPHINE 10 MG AMP I $23.65
NEBUL TREATMENT EACH $73.00
NEBULIZER MTHPC W/TP $8.78
ONDANSETRON 2 MG / ML $14.40
ONDANSETRON ODT(ZOFRAN $122.61
OXYGEN ER $39.00
predniSONE 20 MG TAB $1.70
Promethazine 25 mg AMP $11.00
SENSOR O’2 PEDIATRIC $93.33
SODIUM CHL 10 ML SYR F $3.30
SOL NACL IRR 500ML , 6 $30.00
SOL NS-1000ml, 7983-09 $60.00
SPECIMEN CONT STERILE $3.30
SPECIMEN MIDSTRM KIT $3.30
SPONGES 4X4X10 STERILE $3.30
TET/DIP/TOX/ACEL/PERT $228.10
XEROFORM 1X8 $3.63

ACCUCHECK $11.00
ACETAMINOPHEN (TYLENOL $3.85
ACETAMINOPHEN(TYLENOL $3.85
ALBUTEROL (VENTOLIN)2. $4.80
AMLODIPINE (NORVASC) 5 $3.85
ASPIRIN 81 MG CHEWABLE $3.85
ASPIRIN 81 MG EC TAB $3.85
ATORVASTATIN (LIPITOR) $3.00
CARVEDILOL(COREG) 3.12 $12.60
CLOPIDOGREL(PLAVIX) 75 $26.17
DIAPER, XL 59X66 $3.30
DIAPERS PULL UP X. LAR $3.30
DILTIAZEM CD (CARDIZEM $8.98
DOCUSATE(COLACE) 100 M $3.85
DONEPEZIL(ARICEPT) 5 M $46.73
FUROSEMIDE (LASIX) 20 $3.85
GABAPENTIN (NEURONTIN) $9.96
HEPARIN SODIUM 5,000 U $14.80
HYDRALAZINE (APRESOLIN $3.85
INSULIN LANTUS 100 U/M $3.30
INSULIN novoLOG ASPAR $3.30
IPRATRO/ALBUTEROL(DUON $13.24
IPRATROPIUM (ATROVENT) $7.92
ISOSORBIDE DINIT 5 MG $5.91
IV INFUSION THER EACH $85.00
LACTOBACILLUS GG(CULTU $3.30
LACTULOSE(CEPHULACE ) $5.85
LEVOFLOXACIN 250 MG TA $90.71
LEVOTHYROXINE 50 MCG T $7.92
LIPITOR $3.00
MED PASS 4 OZ ORIGINAL $3.30
METFORMIN 500 MG TAB $3.85
METHOCARBAMOL 500 MG T $3.85
METOPROLOL 25 MG TAB $3.85
METOPROLOL (TOPROL XL) $8.58
MULTIVITAMIN TABLET $3.85
NEBUL TREATMENT EACH $73.00
OMEPRAZOLE 20 MG CAP $6.68
OXYCODONE IR 5 MG TAB $3.85
OXYGEN PER 24HR $513.00
PANTOPRAZOLE SOD DR 40 $2.06
POTASSIUM CHLOR ER 20 $5.58
PRAVASTATIN 20 MG TABL $19.60
PREDNISONE 20 MG TAB $1.70
RANITIDINE 150 MG TAB $3.85
SODIUM CHL 10 ML SYR F $3.30
TAMSULOSIN(FLOMAX) 0.4 $2.84
TRAMADol (ULTRAM) 50 M $3.85
WARFARIN(COUMADIN) 2.5 $3.85

ARTERIAL BLOOD GAS $273.00
BIPAP SETUP $410.00
CARDIAC MONITOR E/R $544.00
CPAP SETUP $385.00
EKG $341.00
INCENTIVE SPIROMETER TRTMT $101.00
MDI TREATMENT EACH $89.00
NEB SUBSEQUENT EACH AD $70.15
NEB, MDI, IPPB EDUCATI $99.00
NEBULIZER TREATMENT EACH $73.00
OXYGEN PER 24HR $513.00
OXYGEN PRN (PER 24HR) $408.00
PULMONARY FUNCTION TEST $447.00
PULMONARY STRESS TEST $132.00
PULSE OXIMETER MULTIPL $139.00
PULSE OXIMETRY SINGLE $519.00
SIMPLE SPIROMETRY TEST $132.00
TELEMETRY DAILY $380.50
TELEMETRY SET UP $184.45

ADL Self Care 15 mins $66.00
Balance $99.00
Dressing Change $55.00
E Stim $83.00
Electrode $30.00
Gait Training $121.00
Hot-Cold Packs $44.00
Initial Evaluation $186.00
Manual Therapy/Back $15.00
Manual Therapy Tech $89.00
Neuromuscular Re-Ed $99.00
Orthotic/Prost Use per 15 mins $140.00
Re-Eval $125.00
TENS $57.00
Ther Act $103.00
Ther Ex $76.00
Traction $48.00
Ultrasound per 15 mins $61.00
Whirlpool $105.00

ADL Self-Care $103.00
Contrast Bath $54.00
Dressing Change $44.00
Heat/Cold Packs $33.00
Initial Evaluation $253.00
Iontophoresis $192.00
Manual Therapy Tech $89.00
Neuromuscular Re-ed $198.00
Orthotic/Prosthetic Use (Initial) $113.00
Orthotic/Prosthetic Use (Established) $140.00
Re-eval $99.00
Ther Act $103.00
Ther Ex $288.00
Ultrasound $50.00
C-Splint/Hand-Based $210.00
IP Gutter Splint $85.00
Thumb Spica Splint $285.00
WHFO Wrist Support Splint $420.00

Evaluate Swallowing per hour $286.00
Cognitive Skills Dev each 15 mins $110.00
Eval/Re-eval per hour $173.00
Treatment per hour $237.00
Swallowing/Feed Treatment per hour $256.00

AC Joints $304.00
Abd 1 view $326.00
Abd 2 view $244.00
Abd Series $506.00
Ankle $309.00
C Spine $347.00
C Spine Complete $386.00
Chest 2v $311.00
Chest 1v $266.00
Clavicle $365.00
Elbow $271.00
Facial Bones $365.00
Femur $365.00
Fingers $264.00
Foot $304.00
Forearm $347.00
Hand $304.00
Hip $413.00
Humerus $334.00
Knee $413.00
L Spine $405.00
Mandible $405.00
Mastoids $448.00
Neck Soft Tissue $235.00
Orbit $341.00
Pelvis $295.00
Ribs Bilat $537.00
Ribs Unilat $365.00
Sacrum & Coccyx $386.00
SI Joints $326.00
Scapula $304.00
Shoulder $339.00
Sinuses $457.00
Skull $365.00
Scoliosis Series $271.00
Sternum $285.00
TMJ $330.00
T Spine $426.00
Tib Fib $365.00
Toe $264.00
Wrist $347.00

Abdomen $847.00
Aorta $810.00
Arterial Extremity $880.00
Arterial Extremity- Bilat $1,075.00
Breast $494.00
Carotid $833.00
Echo $1,212.00
Pelvic $659.00
Renal $254.00
Thyroid $601.00
Venous Bilat $1,205.00
Venous Unilat $800.00
Transvaginal $659.00

Establish Patient Preventative Visit <1 yr of age $167.00
Establish Patient Preventative Visit 1 – 4 yrs of age $182.00
Establish Patient Preventative Visit 5 – 11 yrs of age $182.00
Establish Patient Preventative Visit 12 -17 yrs of age $196.00
Establish Patient Preventative Visit 18 – 39 yrs of age $196.00
Establish Patient Preventative Visit 40 – 64 yrs of age $196.00
Establish Patient Preventative Visit >65 yrs of age $196.00
Establish Patient Visit Brief $42.00
Establish Patient Visit Minimal $70.00
Establish Patient Visit Moderate $98.00
Establish Patient Visit Complex $142.00
New Patient Preventative Visit <1 yr of age $175.00
New Patient Preventative Visit 1 – 4 yrs of age $188.00
New Patient Preventative Visit 5 -11 yrs of age $188.00
New Patient Preventative Visit 12 – 17 yrs of age $196.00
New Patient Preventative Visit 18 – 39 yrs of age $202.00
New Patient Preventative Visit 40 – 64 yrs of age $209.00
New Patient Preventative Visit >65 yrs of age $196.00
New Patient Visit Minimal Visit $133.00
New Patient Visit Moderate Visit $196.00
Pap Smear $70.00
Rapid Strep Test $20.00
Urine Dipstick Test $11.00
Accucheck $12.00
Pregnancy Test $11.00
Immunization – DTAP $188.00
Immunization – Hep A Peds $253.00
Immunization – Hep B up to age 11 $194.00
Immunization – HIB $198.00
Immunization – HPV $760.00
Immunization – Influenza $98.00
Immunization – Influenza 6 -35 months $86.00
Immunization – IPV (Polio) $198.00
Immunization – Kentrix (DTAP/Polio) $308.00
Immunization – MMR $303.00
Immunization – PCV 0-5 $29.00
Immunization – Pentacel (DTAP, Polio, HIB) $473.00
Immunization – Rotovirus $506.00
Immunization – TDAP $293.00
Immunization – VZV (Varicella) $84.00
Injection fee for Immunizations $105.00
Injection fee for therapeutics $66.00
Injection – B12 $18.00
Injection – Decadron $22.88
Injection – Depo Provera $362.52
Injection – Phenergan $15.00
Injection – Rocephin $112.00
Injection – Solumedrol $28.00
Injection – Toradol $65.00
Psychotherapy Services $196.00