Description Charge Average
Commercial P
ayment
Medicare
Reimbursement
Rate
MA
Reimbursement
Rate
Office Visit, New Patient, 20 minutes $158.00 $113.76 $104.28 $79.00
Office Visit, New Patient, 30 minutes $179.00 $128.88 $118.14 $89.50
Office Visit, Established Patient, 10 minutes $84.00 $60.48 $55.44 $42.00
Office Visit, Established Patient, 15 minutes $138.00 $99.36 $91.08 $69.00
Office Visit, Established Patient, 25 minutes $215.00 $154.80 $141.90 $107.50
Office Visit, Established Patient, 40 minutes $286.00 $205.92 $188.76 $143.00
Preventative Visit, Established Patient, < 1 year old $92.00 $66.24 $60.72 $46.00
Preventative Visit, Established Patient, Age 1-4 $104.00 $74.88 $68.64 $52.00
Preventative Visit, Established Patient, Age 5-11 $142.00 $102.24 $93.72 $71.00
Preventative Visit, Established Patient, Age 12-17 $154.00 $110.88 $101.64 $77.00
Preventative Visit, Established Patient, Age 18-39 $205.00 $147.60 $135.30 $102.50
Preventative Visit, Established Patient, Age 40-64 $228.00 $164.16 $150.48 $114.00
Injection-Immunization -X1 $38.00 $27.36 $25.08 $19.00
Joint Injection $101.00 $72.72 $66.66 $50.50
Injection-Non immunization $121.00 $87.12 $79.86 $60.50
Screening Mammogram $469.00 $337.68 $309.54 $234.50
Dexa Scan- Screen for Osteoporosis $525.00 $378.00 $346.50 $262.50
Skin Tag Removal $162.00 $116.64 $106.92 $81.00
Lipid Panel- lab test $158.00 $113.76 $104.28 $79.00
Prothrombin Time – lab test $102.00 $73.44 $67.32 $51.00
Ear Wash $43.00 $30.96 $28.38 $21.50
CBC- lab test $176.00 $126.72 $116.16 $88.00
Comprehensive Metabolic Panel- lab test $317.00 $228.24 $209.22 $158.50
TSH- lab test $164.00 $118.08 $108.24 $82.00
Venipuncture- blood draw $60.00 $43.20 $39.60 $30.00

ATTENTION: The amounts posted above DO NOT reflect the amount(s) each clinic patient will pay for services listed. Please contact your insurance carrier for specific information regarding your plan.

MN Legislature passed a law that requires certain clinics to report amounts for their top 25 most frequent services that are over $25. The list above is NOT a complete listing of all services provided at MCHC.

Charges represent the standard amount billed for clinic services. For most patients, clinics get paid a much lower amount than the listed charge.

Medicare or Medical Assistance Patients: The payment rates listed above reflect amounts set by Medicare or Medical Assistance, not by MCHC. The listed rates do not reflect the amount you may owe as a co-pay.

Commercial Insurance or Medicare Advantage Plan Patients: Your company has likely negotiated a discount/contracted rate for each service. These rates may be higher or lower than the average payment listed above.

Please contact your insurance company to learn more about the negotiated discount or how much you may owe under the terms of your policy, please contract your insurance company directly.

For more information, please request to speak with a representative from Patient Financial Services or call 507-642-5266.