Privacy Notice
This notice is being posted in accordance with AS 18.23.400. Disclosure and reporting of health care services, prices, and fee information.
Effective January 1, 2019 and until further notice, the Back & Neck Center charges the following undiscounted fees for the listed health care services:
You will be provided an estimate of the anticipated charges for your non-emergency care upon request. Please do not hesitate to ask for information.
The undiscounted prices listed below may be higher or lower than the amount an individual actually pays for the health care services described.
Back & Neck Center is contracted to provide health care services as an in-network preferred provider with Premera Blue Cross Blue Shield of Alaska and Aetna.
Evaluation/Management
|
Procedure Code |
Description |
Undiscounted Fee |
|
99201 |
New patient exam 10 minutes |
$165.00 |
|
99202 |
New patient exam 20 minutes |
$205.00 |
|
99203 |
New patient exam 30 minutes |
$265.00 |
|
99204 |
New patient exam 45 minutes |
$305.00 |
|
99212 |
Established patient exam 10 minutes |
$130.00 |
|
99213 |
Established patient exam 15 minutes |
$170.00 |
|
99214 |
Established patient exam 25 minutes |
$245.00 |
Medicine
|
Procedure Code |
Description |
Undiscounted Fee |
|
98940 |
Chiropractic Adjustment 1- 2 regions |
$70.00 |
|
98941 |
Chiropractic Adjustment 3-4 regions |
$85.00 |
|
98942 |
Chiropractic Adjustment 5 regions |
$88.00 |
|
98943 |
Extremity Adjustment – i.e. shoulder, wrist, ankle, |
$50.00 |
|
97124 |
Massage Therapy per unit |
$60.00 |
|
97140 |
Manual Therapy per unit |
$60.00 |
|
97032 |
Electrical muscle stimulation per unit |
$55.00 |
|
97035 |
Ultrasound therapy per unit |
$55.00 |
|
97110 |
Therapeutic exercises per unit |
$55.00 |
|
97012 |
Mechanical Traction per unit |
$55.00 |
Radiology
|
Procedure Code |
Description |
Undiscounted Fee |
|
72040 |
X-ray – neck – 2/3 views |
$250.00 |
|
72050 |
X-ray – neck – 4/5 views |
$320.00 |
|
72052 |
X-ray – neck – 7 views |
$380.00 |
|
72070 |
X-ray – thoracic spine - 2 views |
$250.00 |
|
72100 |
X-ray – lumbosacral – 2/3 views |
$250.00 |
|
72120 |
X-ray – lumbar – Flexion/Extension |
$160.00 |
|
73030 |
X-ray – shoulder – 2 views |
$110.00 |
|
73501 |
X-ray – hip – 1 view |
$75.00 |
|
73510 |
X-ray – hip – 2 views |
$150.00 |
|
73600 |
X-ray – ankle – 2 views |
$150.00 |
Surgery - NONE
|
Procedure Code |
Description |
Undiscounted Fee |
|
NONE |
None |
$0.00 |
Anesthesia - NONE
|
Procedure Code |
Description |
Undiscounted Fee |
|
NONE |
None |
$0.00 |
Pathology + Laboratory - NONE
|
Procedure Code |
Description |
Undiscounted Fee |
|
NONE |
None |
$0.00 |
You may also find a copy of this fee schedule on our website at www.wasillabackandneck.com
The State of Alaska Department of Health and Social Services website address is http://dhss.alaska.gov/Pages/default.aspx
The State of Alaska Department of Health and Social Services physical address is 3601 C St. #902, Anchorage, Alaska 99503
