New Jersey Insurance Participation & Self-Pay Pricing
Patient First participates with most major health insurance plans. The following list should be used only as a guide as the status of the plans is subject to change. Please note the exceptions. If you have an employer-sponsored health plan and Patient First is not in-network, you may still be seen as a self-pay patient. If you have a Medicaid or Medicare Advantage plan where Patient First is not in-network, you are not eligible to be seen as self-pay. If you are uncertain as to whether your individual health benefits plan includes receiving in-network services from Patient First, please call your insurance company using the number on the back of your insurance card.
New Jersey Insurance Participation
| PLAN NAME | PLAN TYPE | PRIMARY CARE | URGENT CARE | TELEHEALTH |
|---|---|---|---|---|
| AETNA | Individual & Employer Sponsored | |||
| Medicaid | ||||
| Medicare | ||||
| AETNA SIGNATURE ADMINISTRATORS | Individual & Employer Sponsored | |||
| AMERIHEALTH (PA/NJ) | Individual & Employer Sponsored | |||
| Medicare | ||||
| AMERIHEALTH ADMINISTRATORS | Individual & Employer Sponsored | |||
| CIGNA/GREAT WEST | Individual & Employer Sponsored | |||
| Medicare | ||||
| FIRST HEALTH | Individual & Employer Sponsored | |||
| HORIZON BLUE CROSS BLUE SHIELD | Individual & Employer Sponsored | |||
| Medicaid | ||||
| Medicare | ||||
| HUMANA | Medicare | |||
| INDEPENDENCE BLUE CROSS | Individual & Employer Sponsored | |||
| Medicaid | ||||
| Medicare | ||||
| JEFFERSON HEALTH PLANS | Medicare | |||
| MEDICARE | Individual | |||
| MEDI-SHARE HEALTHCARE | Individual | |||
| MULTIPLAN | Individual & Employer Sponsored | |||
| TRICARE | Employer Sponsored | |||
| UNITED HEALTHCARE | Individual & Employer Sponsored | |||
| Medicaid | ||||
| Medicare | ||||
| Velocity National Provider Network | Individual | |||
| Medicare | ||||
| VETERANS CCN | Employer Sponsored |
Insurance Participation
- Visit charge for routine problem $145
- Lab, x-ray, and other add-on services discounted and priced separately
- Visit charge plus add-ons capped at $317 1
Pricing for Patients without Insurance
| A) Office Visit Charges | PLAN TYPE |
|---|---|
| Routine visit fee | $125 |
| Follow-up visit | $50 |
| Telehealth – routine visit | $90 |
| Telehealth – follow-up visit | $50 |
| Visit for diabetes, cholesterol, or prostate cancer screening | $59 |
| Visit for DOT physical (price includes urinalysis) | $135 |
| Visit for 10-panel medication screen (with collection) | $115 |
| Visit for medication screen (collection only 2 ) | $41 |
| Visit for Standard-Dose Flu Shot (Ages 3+) 3 | $45 |
| Visit for High-Dose Flu Shot (Ages 65+) 3 | $80 |
| Visit for pregnancy testing | $55 |
| Visit for removal of sutures placed elsewhere | $49 |
| Visit for TB risk assessment | $35 |
| Visit for TB test | $55 |
| Visit for a school, sports, or camp physical 4 | $55 |
| B) Add-On Services | PLAN TYPE |
|---|---|
| Lab test on-site (each) | $62 |
| X-ray exam (each) | $120 |
| EKG | $120 |
| Burn care (2nd or 3rd degree) | $120 |
| Fracture/dislocation (initial office care) | $120 |
| IV fluids | $120 |
| Nebulizer treatment | $120 |
| Stitches or laceration repair | $120 |
| Supplies and durable medical equipment (e.g., crutches) | Discounted 20% |
A) Office Visit Charge + B) Add-On Services = Total Visit Cost (capped at $317)
| Charges Not Included in the $317 Cap | PLAN TYPE |
|---|---|
| Prescriptions 1 | Discounted 20% |
| Vaccines | Discounted 20% |
| Outside Lab | Billed separately by the outside reference lab 5 |
This program is offered only to patients not covered by a government health insurance plan and not covered by any private insurance plan with which we participate. Terms and conditions apply.
1 Prescriptions, vaccines, and outside labs not included in cap.
2 ‘Drug Screen – collection only’ services available only to patients who present with a completed Custody and Control Form (CCF).
3 Flu vaccine is not subject to the additional 20% discount. Flu vaccine is included in the charge for a ‘Visit for Standard-Dose Flu Shot’ and a ‘Visit for High-Dose Flu Shot’ as listed above under Office Visit Charges.
4 Price applies to patients age 3 and up presenting for a sports or camp physical. Price includes physical exam, dipstick urinalysis, if required, and completion of form(s). Price does not include: other types of physicals; additional services such as additional labs (including titers), x-rays, medications (including vaccines and immunizations), dispensed prescriptions, supplies, and procedures; and follow-up visits. If additional services are required, additional charges will apply.
5 Except in Virginia. See Virginia Self-Pay Program pricing materials for outside lab pricing in Virginia.