• $1

  $1 PAYMENT - Add to CART for odd amounts

  Price$1.00
• $10

  $10 INSURANCE COPAYMENT

  Price$10.00
• $15

  $15 INSURANCE COPAYMENT

  Price$15.00
• $20

  $20 INSURANCE COPAYMENT

  Price$20.00
• $25

  $25 INSURANCE COPAYMENT

  Price$25.00
• $100

  $100 PAYMENT

  Price$100.00
• $145

  SELF-PAY or "Missed Appointment" or WRITTEN REPORT PAYMENT

  Price$145.00