Shiloh's First Board-Certified
Family Physician
Appointments (618) 277-3197
Weekday AM Appointments and Exchange (618) 277-3214
E-MAIL The Country Doctor
Please include your name, insurance plan, and telephone number.

 

 
Fee Schedule and list of common charges
Remember that your care is from a Board-Certified, Family Physician. You do not have to wait 2 hours to see a doctor. New and established patient visits are within 24-48 hours of the call for most people.
 

Outpatient Common Office Visit fees for new and established patients

Code

Charge in $

Description

Level 3 New

120

New patient with minimal medications and basic illnesses. Around half of the new patient visits.

Level 3 Est.

90

Established patient, one to three illnesses, such as the patient with hypertension and high cholesterol who is well controlled with diet, exercise, and medications. Around half of the established patient visits

These are the commonly billed fees. There are other levels of care. For patients with in network insurance, the claim will go to the insurance company. The insurance contracted fee usually is less than the charged fee, with a copay or deductible due for each visit and lab charge. These office visit, lab, procedure, and injectables fees are cash prices for self paying patients, who pay the full amount at the time of the visit. Credit and debit cards will have an additional.
 

Common Lab and procedure Fees (these may be in addition to office visit fees)

Lab

Charge in $

Description

ALT

10

Liver enzyme for medication monitoring

AST

10

Liver enzyme for medication monitoring

Blood Draw fee

10

Fee when obtaining labs by fingerstick or venipuncture

Glucose

10

Glucose/Sugar Test

Hemoglobin

10

Anemia screen

INR

10

INR for coumadin/warfarin monitoring

Urinalysis

10

Basic urine analysis, both manual and by machine

Urine Pregnancy

10

Urine pregnancy test

Urine Creatinine

10

Automated test for minute changes, which can be associated with kidney disease, diabetes, and hypertension

Urine Microalbumin

10

Automated test for minute changes, which can be associated with kidney disease, diabetes, and hypertension

CMP/Chem 14

20

Includes Sodium, Potassium, Chloride, TCO2, BUN, Creatinine, Glucose, ALT, AST, Alkaline Phosphatase, Calcium, Protein, Albumin, and Bilirubin

Rapid Strept

20

Test for streptococcal Pharyngitis

Urine Drug Screen

25

Common drugs of abuse

Lipid Panel

25

Full cholesterol panel, including total cholesterol, triglycerides, LDL (bad) cholesterol, and HDL (good) Cholesterol

Hemoglobin A1C

30

90 day sugar average for patients with impaired glucose or diabetes

 

TSH

30

For hypothyroidism screening

EKG

50

Cerumen/Wax removal

70

Impacted cerumen/wax removal

Most labs charge 1 1/2 to 10 times what our lab fees are. Not all the labs are available to all insured patients, as some insurance companies have special lab contracts at outside labs. A blood draw fee is added to the cost of some of the labs.
 
Injectables and Vaccines (the injection fee is added to the vaccine or drug charge)
Code

Charge in $

Description

B12

10

For B12 deficiency. Does not include IM Injection charge

IM/SC Injection

20

Added to the medication or drug charge. Price is per injection.

PPD Test/TB Test

20

Tuberculosis screening

Flu shot

35

Does not include IM injection charge. Preservative free.

Pneumovax

100

Pneumonia Vaccine (Merck increased our cost for 2011)

Tetanus/DTAP

65

Tetanus, Diphtheria, and Pertussis protection

Hepatitis A

90

Two dose series, price is for each dose

Hepatitis B

100

Three dose series, price is for each dose

MMR

100

Measles, Mumps, and Rubella

Varicella Booster

145

If you have not had the chicken pox or if you only had the first dose of the vaccine, you need a booster

Meningitis

160

Good for college students

Gardasil/HPV

185

HPV Cervical Cancer vaccine from Merck

Shingles/Zostavax

220

This vaccine has shipping delays

Our vaccine prices are competitive with most of the local practices. Vaccine prices do not include the injection fee. An office visit fee may be added to the cost of the vaccines.

CDC Vaccine Handouts

 
Miscellaneous Fees, which are not covered by insurance.
Code

Charge in $

Description

Paperwork completion

varies

FMLA forms, disability forms, etc. Varies, depending on complexity of the form and number of questions/pages.

Record Copying fees

varies

The amount a physician can charge for copying medical records in the state of Illinois is regulated by Illinois General Assembly Senate Bill 721. The Country Doctor, Ltd. follows the fee schedule established by state law.

Faxing fee

varies

Usually no extra charge from the paperwork fees, unless it is long distance.

Bounced check fee

$30

This is in addition to the copay or deductible

No Show Fee

$30

For patients who provide less than 24 hours of notice or do not show up to an appointment. We call our patients to remind them about their appointments.

Called in medication fee

Varies

This is mainly charged to self paying patients who cannot make it into a visit. Most medication refills or new medication prescriptions will be done at office visits.

Credit or Debit card use

The convenience fee varies

The credit card company charges between 2.5-3.5% per transaction, a 26 cents network access fee per transaction, and to verify that we are U.S. Business. Points cards cause a 1-2% deduction, and running a card over the phone adds another 1-2% deduction from the credit card company to the charged amount. Cash is the preferred method for office visit charges/fees/copays etc.

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Hours of Operation

NEW PATIENT FORMS

Accepted Insurance Plans

Physician Biography

Driving Directions/Maps

Office Pictures

Medication Questions

Links & Patient Handouts

Health Screening Recommendations

Address Directory
 The Country Doctor, Ltd.
2310 Country Road
Shiloh, IL 62221-2570
Voice (618) 277-3197
Exchange (618) 277-3214