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Insurance and Payment Policies

We accept most major insurance plans including Medicare

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SupER Urgent Care Insurance and Payment Policies

We accept most major insurance plans including Medicare.

Payment for services can be made in cash, credit card, check or SupER Urgent Care will file a claim with the participating insurance company.

Self-pay Patients are expected to pay for services before they are discharged from the Center.


Self Pay Fee For Service Schedule

CPT PROCEDURE FFS SupER Urgent Care
OFFICE VISITS
99201 Office Visit – New Level One $59.00
99202 Office Visit – New Level Two $59.00
99203 Office Visit – New Level Three $90.00
99204 Office Visit – New Level Four $110.00
99211 Office Visit – Est. Level One $59.00
99212 Office Visit – Est. Level Two $59.00
99213 Office Visit – Est. Level Three $90.00
99214 Office Visit – Est. Level Four $110.00
  OV-STD Testing $250.00
  Wellness Exam – Physical Exam – $150.00
  $150.00 $25.00
PROCEDURES
30901 Ant. Nosebleed - Simple $60.00
16020 Burn (Dressing/Debridement - 1st Degree) $50.00
16025 Burn (Dressing/Debridement - 2nd Degree) $80.00
64455 Digit Block $50.00
69000 Ear Abscess Drainage - Simple $100.00
69210 Ear Lavage (wax removal) one ear $45.00
69210 Ear lavage (wax removal) both ears $80.00
69200 Clear outer ear canal $50.00
65220 Eye Foreign Body Rem - Cornea $55.00
65205 Eye Foreign Body Rem - Conjunctiva $45.00
93000 EKG $35.00
69200 Foreign Body Removal - Ear $110.00
10120 Foreign Body Removal – Excludes Sutures $200.00
28190 Foreign Body Removal - Foot SC $200.00
30300 Foreign Body Removal - Nose $200.00
10061 I&D Abscess - Compl/Multi $125.00
10060 I&D Abscess - Simple $100.00
96360 IV Therapy $70.00
65205 Morgan Lens $67.00
94640 Nebulizer Treatment $25.00
  PFT mouth pieces $60.00
10160 Puncture Aspiration $100.00
11200 Skin Tag removal $85.00
92230 Woods Lamp procedure $77.00
17110 Wart removal (5) with Cryotherapy $80.00
PHYSICALS
97005 School Physical $20.00
97006 Sport Physical $25.00
99455 Work Physical $59.00
99455 DOT Physical $69.00
SUPPLIES
29240 Arm Sling $25.00
E0114 Crutches $30.00
29130 Finger Splint-Static/Dynamic $70.00
29131 Finger Splint-Static/Dynamic $70.00
L3260 Post Op Shoe $15.00
  Wrist Brace $15.00
  Knee Brace $35.00
IN HOUSE LABS
36415 Phlebotomy Fee $15.00
82947 Accucheck DM test strips $10.00
80048 Basic Metabolic Panel (BMP) $25.00
80053 CMP – Comprehensive metabolic panel $30.00
82272 Fecal Occult Blood $15.00
87804 FLU Testing $75.00
83036 Hemoglobin A1C $15.00
87804 Influenza A&B $30.00
87804 Rapid Influenza Test $25.00
85610 INR/PT $10.00
86308 Mono Test (rapid) $15.00
86704 Hep B Titer $20.00
81025 Pregnancy test (urine) $10.00
87880 Strep rapid $20.00
81000 Urinalysis $10.00
80061 Lipid Panel $25.00
86318 H Pylori $15.00
81003 Urinalysis Dipstick $10.00
IMMUNIZATIONS/MEDICATIONS
J3420/96372 B 12 $25.00
S0077/96372 Clindamycin 300 $25.00
S0077/96372 Clindamycin 600 $50.00
J1030/96372 Depo Medrol 40mg $25.00
J2930/96372 Depo Medrol 80mg $25.00
J2930/96372 Solumedrol $50.00
J1885/96372 Toradol 30mg $25.00
J1885/96372 Toradol 60mg $50.00
J2405/96372 Zofran $25.00
J0696 + 96372 Rocephin 1 gram $50.00
90739 Hep B (each shot) $65.00
90658 Flu Shot $15.00
86580 TB skin test (per test) $15.00
90714 Tetanus/Diptheria $50.00
20600 Joint Injections Interm/Small Joint/Major Joint $65.00
20605 Joint Injections Interm/Small Joint/Major Joint $80.00
20610 Joint Injections Interm/Small Joint/Major Joint $90.00
ORTHO
29130 Finger Splint (Stack/Tip Protector)-Static/Dynamic $10.00
29131 Finger Splint (Stack/Tip Protector)-Static/Dynamic $10.00
29105 Long Arm Splint $80.00
29126 Short Arm Splint-Static/Dynamic $54.00
29125 Short Arm Splint-Static/Dynamic $54.00
29515 Short Leg Splint $62.00
RESPIRATORY (medication only)
94644 Aerosol - 1st Dose $5.00
94645 Aerosol - 2nd Dose $10.00
J7613 Albuterol Unit Dose (1 mg) $10.00
J7620 Atrovent (0.5 mg) $3.00
94760 Pulse Ox $5.00
SUTURES
15851 Suture /staples removal (placed elsewhere) $59.00
12001 Repair Laceration <2.5 cm $108.00
12002 Repair Laceration 2.6-7.5 cm $132.00
12003 Repair Laceration 7.6-12.5 cm $155.00