Fee Schedule

Effective January 31, 2021 and until further notice, the Arctic Chiropractic Juneau LLC’s charges the following undiscounted fees for the listed health care services.

This notice is being posted in accordance with AS 18.23.400 - disclosure and reporting of health care services, prices, and fee information.

You will be provided an estimate of the anticipated charges for your non-emergency care upon request, within 10 business days. Please do not hesitate to ask for information.

The undiscounted prices listed below may be higher than the amount an individual actually pays for the health care services described.

Arctic Chiropractic Juneau LLC is contracted to provide health care services as an in-network preferred provider with Premera Blue Cross Blue Shield, TRICARE, Medicare, and Medicaid. We are also a Choice provider for VA.

1) Evaluation/Management [99201, 99202, 99203, 99212, 97161, 97162, 97163, 97164.]

Procedure Code - Description - Undiscounted Fee

99201 - New patient exam - 10 minutes - $195

99202 - New patient exam - 20 minutes - $250

99203 - New patient exam - 30 minutes - $300

99212 - Established patient exam problem focused - $125

97164 - Physical therapy re-evaluation - $225

97161 - New patient physical therapy evaluation low complexity - $225

97162 - New patient physical therapy evaluation moderate complexity - $235

97163 - New patient physical therapy evaluation high complexity - $255

2) Medicine [98940, 97941, 98942, 98943, 97124, 97140, 97032, 97035, 97110, 97012]

Procedure Code - Description - Undiscounted Fee

98940 - Chiropractic Adjustment 1- 2 regions - $75

98941 - Chiropractic Adjustment 3-4 regions - $95

98942 - Chiropractic Adjustment 5 regions - $115

98943 - Extremity Adjustment – i.e. shoulder, wrist, ankle - $65

97124 - Massage Therapy per unit - $60

97140 - Manual Therapy per unit - $75

97032 - Electrical muscle stimulation per unit - $55

97035 - Ultrasound therapy per unit - $55

97110 - Therapeutic exercises per unit - $95

97012 - Mechanical Traction per unit - $55

3) Radiology [72040, 72050, 72070, 72100, 72110, 73030, 73560, 73600]

Procedure Code - Description - Undiscounted Fee

72040 - X-ray – neck – 2/3 views - $285

72050 - X-ray – neck – 4/5 views - $375

72070 - X-ray – thoracic spine - 2 views - $270

72100 - X-ray – lumbosacral – 2/3 views - $275

72110 - X-ray - lumbosacral – 2/3 views and oblique - $350

73030 - X-ray – shoulder 2 views - $150

73560 - X-ray – knee 2 views - $150

73600 - X-ray – ankle 2 views - $125

4) Surgery - NONE

Procedure Code - Description - Undiscounted Fee

NONE - None - $0.00

5) Anesthesia - NONE

Procedure Code - Description - Undiscounted Fee

NONE - None - $0.00

6) Pathology & Laboratory - NONE

Procedure Code - Description - Undiscounted Fee

NONE - None - $0.00

The State of Alaska Department of Health and Social Services website address is http://dhss.alaska.gov/Pages/default.aspx

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