Doctor's office and emergency center visits

When you select a link from the following service classifications, a pricing table will display immediately below the link you selected. By reselecting the same link, the pricing table will close, and you then can select another service classification to view more price and payment information.

Current patient: doctor's office visits

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Doctor's office visits for current Park Nicollet patients		Park Nicollet Charges			Average Insurance Payment			Average Medicare Payment
Type of service	CPT/DRG Code	MH	PNC	Total	MH	PNC	Total	MH	PNC	Total
Low-level visit**	99211	—	$46	$46	—	$45	$45	—	$18	$18
Low-to-moderate-level visit**	99212	—	$88	$88	—	$82	$82	—	$36	$36
Moderate-level visit**	99213	—	$144	$144	—	$132	$132	—	$60	$60
Moderate-to-high-level visit**	99214	—	$217	$217	—	$200	$200	—	$90	$90
High-level visit**	99215	—	$294	$294	—	$272	$272	—	$122	$122

Updated February 2009

Current patient: routine physical examinations

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Routine physical examinations for current Park Nicollet patients		Park Nicollet Charges			Average Insurance Payment			Average Medicare Payment
Type of service	CPT/DRG Code	MH	PNC	Total	MH	PNC	Total	MH	PNC	Total
Age 0-1**	99391	—	$172	$172	—	$165	$165	—	—	—
Age 1-4**	99392	—	$192	$192	—	$184	$184	—	—	—
Age 5-11**	99393	—	$190	$190	—	$182	$182	—	—	—
Age 12-17**	99394	—	$209	$209	—	$199	$199	—	—	—
Age 18-39**	99395	—	$211	$211	—	$197	$197	—	—	—
Age 40-64**	99396	—	$232	$232	—	$217	$217	—	—	—
Age 65 and older**	99397	—	$258	$258	—	$233	$233	—	—	—

Updated February 2009

New patient: doctor's office visits (anyone not seen within past three years)

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Doctors office visits for new patients		Park Nicollet Charges			Average Insurance Payment			Average Medicare Payment
Type of service	CPT/DRG Code	MH	PNC	Total	MH	PNC	Total	MH	PNC	Total
Low-level visit**	99201	—	$86	$86	—	$78	$78	—	$36	$36
Low-to-moderate-level visit**	99202	—	$149	$149	—	$138	$138	—	$62	$62
Moderate-level visit**	99203	—	$219	$219	—	$202	$202	—	$89	$89
Moderate-to-high-level visit**	99204	—	$335	$335	—	$315	$315	—	$138	$138
High-level visit**	99205	—	$423	$423	—	$393	$393	—	$174	$174

Updated February 2009

New patient: routine annual physicals (anyone not seen within past three years)

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Routine physical examinations for current Park Nicollet patients		Park Nicollet Charges			Average Insurance Payment			Average Medicare Payment
Type of service	CPT/DRG Code	MH	PNC	Total	MH	PNC	Total	MH	PNC	Total
Age 0-1**	99381	—	$214	$214	—	$210	$210	—	—	—
Age 1-4**	99382	—	$232	$232	—	$228	$228	—	—	—
Age 5-11**	99383	—	$228	$228	—	$222	$222	—	—	—
Age 12-17**	99384	—	$249	$249	—	$244	$244	—	—	—
Age 18-39**	99385	—	$249	$249	—	$237	$237	—	—	—
Age 40-64**	99386	—	$292	$292	—	$274	$274	—	—	—
Age 65 and older**	99387	—	$318	$318	—	$297	$297	—	—	—

Updated February 2009

Doctor's office visit for consultation (usually pertaining to a specialist referral)

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Doctor's Office Visit for Consultation		Park Nicollet Charges			Average Insurance Payment			Average Medicare Payment
Type of service	CPT/DRG Code	MH	PNC	Total	MH	PNC	Total	MH	PNC	Total
Low-level visit**	99241	—	$115	$115	—	$108	$108	—	$47	$47
Low-to-moderate-level visit**	99242	—	$214	$214	—	$200	$200	—	$88	$88
Moderate-level visit**	99243	—	$294	$294	—	$275	$275	—	$120	$120
Moderate-to-high-level visit**	99244	—	$434	$434	—	$403	$403	—	$179	$179
High-level visit**	99245	—	$536	$536	—	$501	$501	—	$186	$186

Updated February 2009

Park Nicollet Methodist Hospital emergency center visits

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Emergency Room Visit		Park Nicollet Charges			Average Insurance Payment			Average Medicare Payment
Type of service	CPT/DRG Code	MH	PNC	Total	MH	PNC	Total	MH	PNC	Total
Low-level visit*	99281	$93	$48	$141	$68	$45	$112	$56	$20	$76
Low-to-moderate-level visit*	99282	$154	$92	$246	$139	$85	$224	$91	$38	$129
Moderate-level visit*	99283	$243	$147	$390	$254	$139	$393	$145	$59	$204
Moderate-to-high-level visit*	99384	$390	$272	$662	$472	$254	$726	$230	$110	$340
High-level visit*	99285	$579	$405	$984	$459	$376	$835	$342	$164	$506

Updated February 2009

Pricing and payment considerations

In viewing our pricing tables, note the following.

• Services and charges may vary, depending on where the service is offered-at Methodist Hospital or a Park Nicollet Clinic location. Information provided in the table reflects pricing for the location where the service occurs most often. A single asterisk (*) notes the pricing if the service is provided at Methodist Hospital. Two asterisks (**) means that the service is provided at a clinic location.
• The total charge listed is intended to be comprehensive of all charges normally associated with the specified service or condition. If the service is done at Methodist Hospital as noted by the single asterisk (*), a facility charge for the hospital and a professional charge for the clinic will be billed to you separately. If the service is done at a clinic location (**) you will receive one bill that will include all charges.
• Some prices are classified by 'levels' of service. Levels of service are defined by the complexity of a visit, the nature of a patient's individual condition, paperwork requirements, and examination and counseling time.
• For individuals with health insurance, the average insurance payment shown on our pricing tables includes all patient expense responsibilities (co-pays, deductibles and co-insurance). The actual portion of cost for which an insured patient is responsible will depend upon each individual's insurance benefits and whether deductible or out-of-pocket maximums have been met. Your insurance company can best explain your individual health plan coverage and how much out-of-pocket expenses you may incur.
• While the date when prices were last updated is indicated on each price table above, prices are subject to change without notice. If you have questions about service prices, please refer to frequently asked questions, or call 952-993-5586.

Read more about Park Nicollet billing and insurance information. Refer to our overview of service options to better understand how Park Nicollet serves patients in Minneapolis and surrounding suburbs and greater Minnesota communities.