For patients without insurance, or with insurance that Dr. Siegrist does not participate with:

  • Our fees are based on the rates from Excellus and MVP.
  • The patient is responsible paying the entire fee, regardless of what the insurance company may or may not reimburse. Contact your insurance company and ask if you can submit the receipt to be reimbursed by your HSA, FSA or the plan.
  • These costs may or may not apply to your deductible. Ask your insurance company about their rules

Dr. Siegrist’s 2017 Fees for Common Services: Self-Pay and Out-of-Network

CPT Office  
99203 Office Visit, New Patient, Straightforward $130
99204 Office Visit, New Patient, Complex $190
99212 Office Visit, Follow-up, Minor $50
99213 Office Visit, Follow-up, Straightforward $85
99214 Office Visit, Follow-up, Complex or New Problem $125
7XXXX XRay, any body part $45
20XXX Steroid Injection, any area, Including drug $90
J7325 Synvisc-One, includes 20610 $650 (or $100 + Mail Order)
J7323 Euflexxa Injection Series, includes 20610 x 3 $750 (or $250 + Mail Order)
 
Ex. New Patient, 1 body part, XR, Injection

New Patient, 2 body parts, 2 XRs, 2 Inj’s

Follow-Up, 1 body part, XR, Injection

Follow-Up, 2 body parts, 2 XRs, 2 Inj’s

$265

$415

$220

$350

  Surgery*  
64721 Carpal Tunnel Release $500
26055 Trigger Finger Release $350 ( + $175 each additional finger)
25000 DeQuervain’s Release $375
24359 Medial/Lateral Elbow Tenotomy (“Tennis Elbow”) $750
298XX Shoulder Arthroscopy, Standard w/23120 $1,410
23420 Rotator Cuff Repair w/23120 $1,450
23120 Partial Claviculectomy $670
298XX Knee arthroscopy, standard $650
2829X Bunion Surgery $750 – $1000
2829X Bunion Surgery $750 – $1000

*Surgery will also incur charges from the anesthesiologist and the surgery center. Patients can contact those providers for terms:  Westfall Surgery Center or Rochester Ambulatory Surgery Center.