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 Arctic Chiropractic Anchorage Dimond 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.

Arctic Chiropractic Anchorage Dimond is contracted to provide health care services as an in-network preferred provider with Premera Blue Cross Blue Shield of Alaska.

Billing Code	Description	Fee
Evaluation/Management
99202	New Patient Exam, Focused Exam	$213
99203	New Patient Exam, Expanded Exam	$277
99212	Established Patient, Focused Exam	$142
99213	Established Patient Exam, Expanded Exam	$181
72040	Cervical AP/Lat	$329
72070	Thoracic AP/Lat	$241
Medicine
Billing Code	Description	Fee
98940	Chiropractic Adjustment 1-2 Regions	$67
98941	Chiropractic Adjustment 3-4 Regions	$111
97140	Manual Therapy Per Unit	$51
97012	Mechanical Traction Per Unit	$59

You may also find a copy of this fee schedule on our website at https://arcticchiropractic.com/.

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