Our Fee Structure

We believe fee transparency is an important part of the patient/practitioner relationship. To help our patients effectively plan and budget for medical expenses we provide our fee information.

Fee Schedule

Our treatment fees are based on the reimbursement structure of insurance programs like Medicare, and we offer some of the most competitive rates in the region for our services.

Clinical Visit Codes

Description

Fee

99205

Pain Crisis Consultation

$475

99203-4

New Pain Consultation (in office)

$385

99203

New Sleep Consultation

$250

99213-4

Follow up visit (in person)

$125

99203-95

New Pain Consult via telehealth

$250

99213-95

Follow-up visit via telehealth

$125

Injections

Description

Fee

20553

Trigger point injection

$175

20605

TMJ injection or aspiration

$275

64400

Trigeminal nerve block

$275

64405

Occipital never block

$300

64505

Sphenopalatine ganglion block

$250

64612

Botox injection for dystonia

$275

J0585

Botox serum for injection

$1,500

61612 + J0585

Botox dystonia treatment: Total cost

$1,775

J1885

Toradol injection

$150

J1110

Dihydroergotamine injection

$225

Oral Device

Description

Fee

E0486

Sleep apnea device (OAD)

$3,350

D7880

TMJ Orthodic (1st device)

$2,250

TMJ Orthodic (2nd device)

$700

TMJ Orthodic (3rd device)

$500

Cash Services

Description

Fee

0232T

PRF TMJ injection

$1,200

0232T-50

Bilateral PRF TMJ injections

$1,800

70486

CBCT scan

$395

95806

Home sleep apnea screening

$350

N/A

Licodaine topical treatment

$30

N/A

PBM laser treatment

$75

N/A

Nyloxin treatment

$30

N/A

Provisional OAD

$500

N/A

QuickSplint

$100
Updated September 2023

CBCT: Cone-beam computed tomography
OAD: oral airway device (for sleep apnea)
PBM: photobiomodulation
PRF: platelet-rich fibrin
TMJ: temporomandibular joint

Payment Options

We believe everyone who seeks care should be able to access affordable treatment. Many conditions we treat are covered by medical insurance. Some of our services are not covered by insurance or a specific plan — in those instances the patient is responsible for payment. We accept payment by cash, check, or credit card and offer convenient online payment options. We also offer installment plans and third-party financing through CareCredit. To learn more, please contact our office.