Price Transparency
Minnesota Statute 62J.812 Primary Care Price Transparency
In 2018, the Minnesota legislature passed a new policy (Minnesota Statute 62J.812) which requires the prices for certain health care procedures be made available to patients. If any provider in your clinic specializes in family medicine, general internal medicine, gynecology, or general pediatrics you must comply with this statute. Beginning July 1, 2019, the state of Minnesota is requiring providers to maintain the list on their website.
Please note: Patients covered by commercial insurance companies or Medicare Advantage plans have rates specific to their particular company and policy. The amounts posted on our list do not necessarily reflect the amount individual patients or their health insurance plan will owe for the services listed. For specific information about the amount you will owe for the services you receive, please contact your insurer.
| 99202 | New Patient Eval & Mgmt - Level 2 | $226.00 | $188.00 | $73.00 | $59.00 |
| 99203 | New Patient Eval & Mgmt - Level 3 | $344.00 | $270.00 | $111.00 | $83.00 |
| 99204 | New Patient Eval & Mgmt - Level 4 | $514.00 | $410.00 | $165.00 | $126.00 |
| 99205 | New Patient Eval & Mgmt - Level 5 | $679.00 | $523.00 | $218.00 | $158.00 |
| 99211 | Established Patient Eval & Mgmt - Level 1 | $70.00 | $58.00 | $24.00 | $18.00 |
| 99212 | Established Patient Eval & Mgmt - Level 2 | $172.00 | $119.00 | $56.00 | $35.00 |
| 99213 | Established Patient Eval & Mgmt - Level 3 | $280.00 | $196.00 | $90.00 | $57.00 |
| 99214 | Established Patient Eval & Mgmt - Level 4 | $397.00 | $282.00 | $128.00 | $84.00 |
| 99215 | Established Patient Eval & Mgmt - Level 5 | $554.00 | $382.00 | $179.00 | $112.00 |
| 99384 | Age 12 - 17 Years | $414.00 | $341.00 | $134.00 | $106.00 |
| 99385 | Age 18 - 39 Years | $402.00 | $331.00 | $130.00 | $102.00 |
| 99386 | Age 40-64 Years | $466.00 | $383.00 | $150.00 | $119.00 |
| 99394 | Age 12 - 17 Years | $356.00 | $291.00 | $114.00 | $90.00 |
| 99395 | Age 18 - 39 Years | $363.00 | $298.00 | $117.00 | $92.00 |
| 99396 | Age 40-64 years | $387.00 | $317.00 | $125.00 | $98.00 |
| 99397 | Age 65+ Years | $389.00 | $341.00 | $134.00 | $106.00 |
| G0101 | Pelvic & Clinical Breast Examination | $115.00 | $88.00 | $39.00 | $27.00 |
| 76817 | OB Ultrasound, Transvaginal | $353.00 | $224.00 | $96.00 | $76.00 |
| 76816 | Ultra Sound - OB | $417.00 | $265.00 | $114.00 | $89.00 |
| 76830 | Ultrasound Transvaginal | $455.00 | $286.00 | $125.00 | $88.00 |
| 76857 | Follicular and/or GYN Ultrasound | $175.00 | $114.00 | $49.00 | $35.00 |
| 76819 | Ultrasound, Fetal Biophysical W/O Nst | $317.00 | $204.00 | $86.00 | $69.00 |
| 76856 | Ultrasound, Gyn Transabdominal | $403.00 | $255.00 | $110.00 | $79.00 |
| 76805 | Ultrasound-Ob Fetal and Maternal Eval | $513.00 | $327.00 | $140.00 | $110.00 |