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Cash Pay Rates

Cash-Pay (Non-Insurance) Prices

Transparent pricing for patients without insurance coverage. Prices are subject to change without notice.

💳 Self-Pay Pricing
These prices apply to patients paying at the time of service and may change without prior notice.
🩺 New Patient Office Visits
Code Description Cash Price
99202 New Patient Evaluation – Level 2 (15–29 min) $110.00
99203 New Patient Evaluation – Level 3 (30–44 min) $165.00
99204 New Patient Evaluation – Level 4 (45–59 min) $250.00
99205 New Patient Evaluation – Level 5 (60–74 min) $300.00
👨‍⚕️ Established Patient Follow-Up Visits
Code Description Cash Price
99212 Follow-Up Visit – Level 2 (10–19 min) $65.00
99213 Follow-Up Visit – Level 3 (20–29 min) $110.00
99214 Follow-Up Visit – Level 4 (30–39 min) $165.00
99215 Follow-Up Visit – Level 5 (40–54 min) $220.00
⏱️ Prolonged Services
Code Description Cash Price
99417 Prolonged Visit (Each Additional 15 Minutes) $50.00
99358 Non Face-to-Face Prolonged Service (First Hour) $170.00
99359 Each Additional 30-Minute Increment $85.00
👶 Well Child Visits
Code Description Cash Price
99391 Established Patient Well Child Visit (Under 1 Year) $165.00
99392 Established Patient Well Child Visit (1–4 Years) $165.00
99393 Established Patient Well Child Visit (5–11 Years) $165.00
99394 Established Patient Well Child Visit (12–17 Years) $165.00
99395 Established Patient Well Child Visit (18+ Years) $165.00
99381 New Patient Well Child Visit (Under 1 Year) $200.00
👶 New Patient Well Child Visits
Code Description Cash Price
99382 New Patient Well Child Visit (1–4 Years) $200.00
99383 New Patient Well Child Visit (5–11 Years) $200.00
99384 New Patient Well Check Visit (12–17 Years) $200.00
99385 New Patient Well Check Visit (18–39 Years, 45 Minutes) $200.00
🌙 Extended Hours & Special Office Services
Code Description Cash Price
99050 Services Provided Outside Regular Office Hours $125.00
99051 Services During Scheduled Evening, Weekend, or Holiday Hours $85.00
99056 Office Service Provided Outside Office at Patient Request $100.00
99058 Emergency Services Provided in Office $290.00
🔬 Screenings & Assessments
Code Description Cash Price
92551 Hearing Screening Test (Pure Tone, Air Only) $20.00
92650 Newborn Hearing Screening N/A
94760 Pulse Oximetry (Single Reading) $4.00
94761 Pulse Oximetry (Multiple Readings) $6.00
96110 ASQ / MCHAT Developmental Screening $10.00
96127 Teen Depression Screening / PHQ-9 $10.00
96160 Asthma Screening, HEEADSSS, CRAFFT $5.00
96161 EPDS (Postpartum Depression Screening) $5.00
99173 Vision Screening $5.00
💬 Counseling Services
Code Description Cash Price
99401 Counseling Visit – 15 Minutes $60.00
99402 Counseling Visit – 30 Minutes $100.00
99403 Counseling Visit – 45 Minutes $135.00
99404 Counseling Visit – 60 Minutes $170.00
🏥 Office Procedures
Code Description Cash Price
11200 Accessory Digit Ligation $145.00
17250 Chemical Cauterization of Granulation Tissue $100.00
41010 Frenulotomy $200.00
54150 Circumcision with Block $350.00
10060 Incision & Drainage of Simple Abscess $185.00
69210 Removal of Impacted Ear Wax $70.00
S0630 Suture Removal $75.00
💉 Vaccine Administration
Code Description Cash Price
90460 Vaccine Administration – First/Only Component (0–18 Years) $35.00
90461 Each Additional Vaccine Component (0–18 Years) $20.00
90471 IM/SubQ Immunization Administration (No Documentation or Age 18+) $35.00
💉 Additional Vaccines, Respiratory Treatments & Injection Services
Code Description Cash Price
90472 Immunization Administration – Each Additional Component (No Documentation or Age 18+) $20.00
90473 Oral/Nasal Vaccine Administration $35.00
90474 Additional Oral/Nasal Vaccine Administration $20.00
94640 Nebulizer Inhalation Treatment $20.00
💧 Hydration & Infusion Services
Code Description Cash Price
96360 Initial Hydration Infusion (Up to 1 Hour) $50.00
96361 Each Additional Hour of Hydration $20.00
96365 Initial Infusion (Up to 1 Hour) $105.00
96366 Each Additional Hour of Infusion $30.00
96367 Sequential Infusion (Up to 1 Hour) $45.00
96368 Concurrent Infusion $30.00
💉 Injection & Medication Administration Services
Code Description Cash Price
96372 Intramuscular / Subcutaneous Injection $20.00
96374 Initial IV Push or Infusion (Less Than 16 Minutes) $60.00
96375 IV Push – Each Push of a Different Medication $25.00
96376 Additional IV Push of Same Medication (Intervals Greater Than 30 Minutes) $25.00
🌿 Thank You for Choosing Pimri Pediatrics

We believe in transparent healthcare pricing and providing families with clear information about expected costs. If you have questions regarding services, pricing, or payment options, please contact our office.
👶

Every Child Deserves Access to Quality Care

Let us help you care for your child in the most natural and least toxic way possible. Our compassionate team is ready to support your family's wellness journey.

📞 (480) 485-5166 Call today to schedule your child's appointment.