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 Kotzebue 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 Kotzebue 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
99201	New Patient Exam Minimal Exam	$175
99202	New Patient Exam Focused exam	$225
99212	Established Patient Focused Exam	$142
99213	Established Patient Expanded Exam	$180
Medicine
Billing Code	Description	Fee
98940	Chiropractic Adjustment 1- 2 regions	$75
98941	Chiropractic Adjustment 3-4 regions	$110
97110	Therapeutic Exercise per unit	$99.00/per unit
97014	Muscle Stimulation	$65
97140	Manual Therapy per unit	$80
97035	Ultrasound	$70