Fees and Payments

Fee Schedule Effective 6-19-2012

Abortion Services  – Surgical

 Local Anesthesia Valium; Vicodin Demoral Injection  Nitrous Oxide I.V. Sedation Ultram (take home) Valium (take home) 
Up to 11 weeks 6 days $400.00 No Charge
  $25 $50

$100

(Free for Minors)

 $5 $10 
12 weeks to 12 weeks 6 days $500.00 No Charge $25  $50

$100

(Free for Minors)

 $5 $10 
13 weeks to 13 weeks 6 days $550.00 No Charge $25  $50

$100

(Free for Minors)

 $5  $10
 14 weeks to 14 weeks 6 days  $600.00 No Charge   $25  $50

$100

(Free for Minors)

  $5  $10
15 weeks to 15 weeks 6 days $650.00 No Charge $25  $50

$100

(Free for Minors)

 $5 $10 
16 weeks to 16 weeks 6 days $750.00 price includes patients choice of anesthesia. $5 $10 
17 weeks to 17 weeks 6 days $850.00 price includes patients choice of anesthesia. $5  $10
18 weeks to 18 weeks 6 days $1,150.00 price includes patients choice of anesthesia.  $5   $10
19 weeks to 19 weeks 6 days $1,250.00 price includes patients choice of anesthesia. $5   $10
 20 weeks       We provide an out of state referal
Medical Abortion – Mifeprex
up to 6 weeks 6 days		 $750.00 N/A  N/A N/A N/A    
 I.V. sedation free to any minor under 18  
♦ For all abortion services the patient pays $100.00 on the first day and the balance on the date of procedure.
♦ An adult driver is required for I.V. sedation, Demoral and Valium & Vicodin patients. No taxis are allowed.
♦ We do not accept insurance however, upon request, we will provide a receipt for you to submit to your health insurance company.
 
Additional Services and Fees:
  • Patients with a Body Mass Index (BMI) of 35+ add $100.00
  • Nitrous Oxide can be administered with I.V. sedation for an additional $25
  • Rhogam for Rh Negative Patients:
- Less than 12 weeks 6 days — $ 60.00
- 13 weeks and above — $120.00
  • Antibiotic Coverage (as needed for an implanted medical device.) — $ 5.00
  • Urine Pregnancy Tests Are Provided Free Of Charge No additional charge
  • Emergency Contraceptive Pill Visit (Morning After Pills) $ 50.00
  • Gonorrhea/Chlamydia Testing $ 50.00
Annual Exams and Checkups:
Annual Exam and birth control prescription (samples if available) $ 75.00 — Note: You will be billed an additional  $45.00 fee from the laboratory.
6 month checkup includes birth control prescription (samples if available) $ 50.00
Depo-Provera (3 month birth control injection) $ 60.00 ( If patient gets Depo-Provera at a drug store on prescription plan, the injection fee is  $10.00)
Diaphragm Fitting at time of regular visit $15.00
Payment Options:
We accept Visa, MasterCard, Discover, American Express, Money Orders, and Cash.  No checks.
Financial Need:
Most of the time we have access to funds from organizations that feel a civic and moral responsibility to help women in extreme need.
To qualify for this assistance, please make an appointment to come in and discuss your situation.