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Tarifario de miembros, versión 1
416 servicios
| Servicio | Código | Precio sin membresía | Essential | Plus | Premier |
|---|---|---|---|---|---|
| Wound: Intermediate Repair, 2.6 cm or 7.5 cm Procedure | 12042 | $260.00 | $234.00 | $221.00 | $208.00 |
| Wound: Intermediate Repair, 7.6 cm or 12.5 cm Procedure | 12044 | $330.00 | $297.00 | $280.50 | $264.00 |
| Wound: Simple Repair, 2.5 cm or Less Procedure | 12001 | $80.00 | $72.00 | $68.00 | $64.00 |
| Wound: Simple Repair, 2.5 cm or Less Procedure | 12011 | $100.00 | $90.00 | $85.00 | $80.00 |
| Wound: Simple Repair, 2.6 cm to 5 cm Procedure | 12002 | $95.00 | $85.50 | $80.75 | $76.00 |
| Wound: Simple Repair, 2.6 cm to 7.5 cm Procedure | 12013 | $105.00 | $94.50 | $89.25 | $84.00 |
| Annual Acohol Misuse Screening | G0442 | $30.00 | $21.00 | $18.00 | $15.00 |
| Annual Depression Screening | G0444 | $18.00 | $12.60 | $10.80 | $9.00 |
| Behavioral Counseling for Obesity Screening | G0447 | $35.00 | $24.50 | $21.00 | $17.50 |
| Brief Emotional/Behavioral Assessment Screening | 96127 | $5.00 | $3.50 | $3.00 | $2.50 |
| Caregiver-Focused Health Risk Assessment Screening | 96161 | $5.00 | $3.50 | $3.00 | $2.50 |
| Developmental Screening | 96110 | $18.00 | $12.60 | $10.80 | $9.00 |
| Diabetes Self-Management Training, Individual per 30 Minutes Screening | G0108 | $50.00 | $35.00 | $30.00 | $25.00 |
| Ocular Instrument Screening Bilateral Screening | 99177 | $15.00 | $10.50 | $9.00 | $7.50 |
| Patient-Focused Heath Risk Assessment Screening | 96160 | $5.00 | $3.50 | $3.00 | $2.50 |
| Screening for Cervical Cancer with Human Papillomavirus (HPV) Screening | G0476 | $100.00 | $70.00 | $60.00 | $50.00 |
| Screening for Clinical Depression and Follow-Up Screening | G8431 | $15.00 | $10.50 | $9.00 | $7.50 |
| Screening for Clinical Depression, No Follow-Up Screening | G8510 | $12.00 | $8.40 | $7.20 | $6.00 |
| Visual Function Screening | 99172 | $30.00 | $21.00 | $18.00 | $15.00 |
| Bronchospasm Provocation Test | 94070 | $55.00 | $49.50 | $46.75 | $44.00 |
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