Skip to content Good Faith Estimate Notice

Fee Schedule

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

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

1) Evaluation & Management [99201, 99202, 99203, 99212]

Procedure Code – Description – Undiscounted Fee
99201 – New patient exam – 10 mins $65
99202 – New patient exam – 20 mins $164
99203 – New patient exam – 30 mins $227

Established Patient Exams
99212 – Patient exam problem focused $94

2) Medicine [98940, 98941, 98942, 98943, 97012, G0283,97035,97110,97112,97124,97140

Procedure Code – Description – Undiscounted Fee
98940 – Chiropractic Adjustment 1-2 region $60
98941 – Chiropractic Adjustment 3-4 region $75
98942 – Chiropractic Adjustment 5 regions $85
98943 – Extra Spinal Adjustment $40
97124 – Massage Therapy per unit $55
97140 – Manual Therapy per unit $70
G0283 – Electrical Stimulation per unit $55
97035 – Ultrasound Therapy per unit $55
97110 – Therapeutic Exercises per unit $67
97012 – Mechanical Traction per unit $55

3) Radiology – None

Procedure – Description – Undiscounted Fee
None – None – $0.00

4) Surgery – None

Procedure – Description – Undiscounted Fee
None – None – $0.00

5) Anesthesia – None

Procedure – Description – Undiscounted Fee
None – None – $0.00

6) Pathology & Laboratory- None

Procedure – Description – Undiscounted Fee
None – None – $0.00

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.


Ridgeview Chiropractic | (907) 458-8633