(503) 419-7505 info@modernvital.com
Rates, Insurance & Fees

INSURANCE PLANS

ACCEPTED PLANS

Aetna (including Meridian), Allied Health, Blue Cross Blue Shield (including Anthem), GEHA, HMA, Providence Health Assurance, PacificSource Community Solutions, Regence, Motor Vehicle Accident insurance, most Medicaid plans (ex: OHSU Moda Medicaid) and Oregon Health Plan (OHP; including Health Share of Oregon & Care Oregon).

OUT-OF-NETWORK but accepted: Moda & United Healthcare (UHC).
.

UNACCEPTED PLANS

Medicare (We’re working on currently accepting some Medicare Advantage & Prime plans.) *We’re happy to run a benefits check for some Medicare plans.

Kaiser

Cigna

Oregon Health Plan Open Card

Trillium Community Health Plan

Trillium Oregon Health Plan

Ultimately, it is the patient’s responsibility to know what their benefits are. Please remember, “Covered” does not always mean” Pay” and copay’s may be different for an exam than a spinal manipulation. Your insurance benefits are not a guarantee of payment; they are only a quote from your insurance company. We will make every effort to follow benefit guidelines. Although, you are still responsible for making sure that all required authorizations, pre-certifications and physician’s prescriptions are in order prior to and during treatment.

Since the insurance world likes to change things for all of us (both patients & health care workers) without notice, it’s inevitable that something may fall through the cracks when it comes to insurance coverage. Here are a few examples of what may happen :

  • Prior Authorization is/was required.
  • Referral from your Primary Care Provider is/was required.
  • Underpayments leading to an Outstanding Balance can occur if your plan/coverage changed.

We want your insurance to work with you, not against you!

OUT-OF-POCKET RATES

(prices subject to change)

NEW Patient APPOINTMENTS :: $395

This visit includes 55/60minutes of time spent together either virtually or in person. This includes my out-of-state clients as well. A comprehensive history is taken and labs/imaging are ordered, if necessary or indicated. Initial treatment guidelines are initiated and goals are defined. Payment DOES NOT include potential on-site blood draw, urine dip, cost of labs, imaging, and/or supplements. I do my best to be conscious of using insurance or HSA when possible and only ordering what I deem necessary.

FOLLOW UP APPOINTMENTS :: $115-$365

These visits include 15-60 minutes of time spent together either virtually or in person. These visits further clarify your goals based on symptoms and lab/imaging results, add any recommended additional supplementation,* and have you leave with a clear idea of what to expect until the next time I see you.

LABS, SUPPLEMENTS, ETC

LABORATORY TESTING

Speciality labs are generally not covered by insurance, but as a courtesy we’ll provide you with a superbill, if you request one, that you can submit yourself to your insurance to try to get reimbursement. Fees for laboratory testing are not included in the cost of office visits. Conventional tests may be covered by your insurance provider, although cannot guarantee coverage. Lab pricing and insurance reimbursement depend on the specific test and laboratory used.

If you don’t have insurance and will be paying out-of-pocket, I contract with discount labs and can provide transparent pricing. Comprehensive blood work typically runs between $150-$250.

*Specialty labs often require a down payment or full payment prior to running your test, so I will require full payment up front. Some companies, such as Dutch/Precision, do not bill insurance, but I have heard that they will send you a super bill for insurance reimbursement if you request one. Of course, we will provide one as well, to you, as a courtesy, as described above.

FOOD INTOLERANCE EVALUATION

Dr. Ben’s Food Intolerance Evaluation is never & not covered by insurance of any kind. This is an out-of-pocket cost.

PRESCRIPTION MEDICATIONS

Private insurance benefits typically cover all or most of the cost of prescription medications. Compounded medications may not be covered. Contact your insurance carrier for details. Generally, I cannot prescribe medications for clients/patients that live out of the state of Oregon unless you can pick up the RX in Oregon.

SUPPLEMENTS & NATURAL MEDICINES

The cost of supplements vary and typically range from $40-100. Shop supplements here