|
| |
Fees for IUI with Clomiphene Citrate
| Office Visit |
$65.00 |
| Ultrasound Examination (Usually one ultrasound examination is
sufficient, depending on an individual patient’s response to medications. If
additional ultrasound examinations are needed, there is an additional fee of $65.00 for
each visit. |
$220.00 |
|
ESTIMATED TOTAL (1)
|
$285.00 |
|
WITH ARTIFICIAL INSEMINATION, ADD
|
|
| Sperm Washing for Intrauterine
Insemination Laboratory Fee |
$165.00 |
|
Intrauterine Insemination
Procedure Fee
|
$195.00 |
|
TOTAL (2)
|
$360.00 |
These fees DO NOT
INCLUDE MEDICATIONS, or:
-
Laboratory
tests ordered during treatment or to monitor a patient's response to
medication
-
Follow-up
pregnancy tests, office visits, ultrasound
examinations, or laboratory testing to monitor a resulting pregnancy or
procedures related to pregnancy, or management of ovarian hyperstimulation.
-
NON-REFUNDABLE
Administrative Surcharge due prior to each treatment cycle:
|
Local Florida Patients |
$100.00 |
(Broward, Miami-Dade,
and Palm Beach Counties only) |
|
Domestic Long-Distance Patients |
$200.00 |
|
|
International Patients |
$300.00 |
|
If using a gestational carrier, the following additional
management fees apply each cycle:
|
Local Florida
Traditional Surrogates |
$500.00 |
(Broward, Miami-Dade, and Palm Beach
Counties only) |
|
Domestic Long-Distance
Traditional Surrogates |
$750.00 |
|
|
International
Traditional Surrogates |
$1,000.00 |
|
Unless F.I.R.S.T. is contracted
with your insurance, fees are due at the
time service is rendered. Please arrive prepared to pay at the time of each visit. There are
no refunds if the procedure does not result in pregnancy or a live birth. If a
repeat procedure is necessary, there are no discounts for a repeat cycle. F.I.R.S.T.
accepts cash, local checks, and credit cards. As a courtesy, F.I.R.S.T.
may help you bill and collect from your insurance company by preparing your claim
form from your carrier. |
