Planned Parenthood of the Great
Northwest and the Hawaiian Islands © 2021
Page 1 of 3
Health Care Services Price List
Health care costs can be confusing. We’re here to help.
Understanding your health care costs and payment options is an important part of
preparing for your visit at Planned Parenthood. The price you pay for your health care
services depends on a variety of factors, including your health insurance plan, Medicaid
coverage, or if you qualify for federal, state, or local programs that help cover the cost of
your care. We can help you understand your options. Give us a call at 1-800-769-0045 to
learn more.
Price
List
This list contains the undiscounted costs for our most common health care services. The
price listed might be different than the amount you actually pay. For example, if you have
health insurance, Medicaid, or qualify for discounted care your out-of-pocket costs might be
much lower or even $0. Let us know if you’d like an estimate of your anticipated charges for
your care.
The list also includes CPT (Current Procedural Terminology) codes, which are a set of
standardized codes to describe identical medical services among different health care
providers. Because everyone uses the same codes to indicate the same services, CPT
codes make it easier for you to understand and compare costs.
Planned Parenthood is committed to quality, affordable health care. Please let us know if you
have questions or need assistance covering the cost of your visit.
Evaluation & Management
CODE
DESCRIPTION
UNDISCOUNTED
PRICE
99213
An office visit with a provider for a straightforward health concern, patient
has been seen by a Planned Parenthood provider within the last 3 years
$163
99202
An office visit with a provider for a straightforward health concern, patient
has not been seen by a Planned Parenthood provider in the last 3 years
$166
99212
An office visit with a provider for a minor health concern, patient has been
seen by a Planned Parenthood provider within the last 3 years
$98
99201
An office visit with a provider for a minor health concern, patient has not
been seen by a PPGNHI provider in the last 3 years
$99
99395
Periodic wellness visit age 18-39, established patient
$260
99385
Periodic wellness visit age 18-39, new patient
$289
Planned Parenthood of the Great
Northwest and the Hawaiian Islands © 2021
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CODE
DESCRIPTION
UNDISCOUNTED
PRICE
99214
An office visit with a provider for a moderate health concern, patient has
been seen by a Planned Parenthood provider within the last 3 years
$236
99396
Periodic wellness visit age 40-64, established patient
$277
99386
Periodic wellness visit age 40-64, new patient
$334
99203
An office visit with a provider for a moderate health concern, patient has not
been seen by a Planned Parenthood provider in the last 3 years
$237
Surgery
CODE
DESCRIPTION
UNDISCOUNTED
PRICE
36415
Venipuncture
$6
36416
Finger
Stick
$6
11983
Implant Removal/Reinsertion
$504
59840
Induced abortion by dilation and curettage
$564
58300
Insertion of intrauterine contraceptive device (IUD)
$162
11981
Insertion of contraceptive implant
$317
58301
Removal of intrauterine contraceptive device (IUD)
$210
11982
Removal of contraceptive implant
$354
59841
Induced abortion by dilation and evacuation
Up to
$1,111
57454
Cervical biopsy
$331
Radiology
CODE
DESCRIPTION
UNDISCOUNTED
PRICE
76817
OB transvaginal ultrasound
$221
76830
Non OB transvaginal ultrasound
$280
76815
OB pelvic ultrasound
$221
76857
Non OB pelvic ultrasound
$109
Planned Parenthood of the Great
Northwest and the Hawaiian Islands © 2021
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Lab / Pathology
CODE
DESCRIPTION
UNDISCOUNTED
PRICE
87491
Chlamydia
$50
87591
Gonorrhea
$50
81025
Urine pregnancy test
$20
86592
Syphilis
$9
87389
HIV 1/ HIV 2
$50
85018
Hemoglobin
$7
86901
RH (D) Blood Typing
$8
87210
Wet
Mount
$12
88142
Pap test, thin layer
$42
86703
Rapid
HIV
Test
$38
Medicine
CODE
DESCRIPTION
UNDISCOUNTED
PRICE
96372
Injection, Subcutaneous Or Intramuscular
$46
90471
Immunization
administration
$46
90651
HPV
Vaccine
(Gardasil
9)
$250
99156
Moderate sedation, different provider
$95
90632
HEP A Vaccine
$72
90746
HEP
B
Vaccine
$65
This information is posted under legal requirements outlined in AS 18.23.400 and 7 AAC 86. The undiscounted
price may be higher or lower than the amount the individual actually pays for the services on the list. You will
be provided with an estimate of the anticipated charges for your nonemergency care upon request.
Contracted health plans: Alaska Medicaid, Blue Cross and Blue Shield (Premera), MultiPlan, United Healthcare,
Aetna, First Choice, Cigna.
CPT® Copyright 2020. American Medical Association. All rights reserved. CPT is a registered trademark of the
American Medical Association. The CPT codes are provided “as is” without warranty of any kind. The AMA
specifically disclaims all liability for use or accuracy of any CPT codes.
