Pricing

Dr. Maria Isabel Esparza MD, PLLC is an out-of-network provider, including Medicare.  This means full payment is due from the patient at time of service and we do not bill your insurance company.

Per your insurance company, you will be financially responsible for our fee, but possibly reimbursed directly to you, after your applicable copayment, annual deductible, or coinsurance [all determined & calculated by your insurance plan].  You may be responsible for costs in excess of those allowed by your health benefits plan.

We strongly encourage you to obtain as much reimbursement for our services from your insurance company as possible, but it is your responsibility to submit the paperwork. You may want to know what your insurance company considers ‘ordinary and reasonable fees’ for the CPT codes below. Please call the phone number on the back of your card to find this information.

New patient consultation 99205

Telemedicine follow up 99214 with -95 modifier

Any lab work and radiology we order is billed by the respective lab and radiology organizations. Usually (but no guarantee) our lab & radiology orders will be reimbursed at your in-network rates as long as you go to those in-network labs and radiology organizations. You are responsible for obtaining this information and free to use whatever facility you choose.

For MEDICARE patients: We have opted out of Medicare, and as such, to our knowledge,  they will not reimburse you at all for our visits or related expenses. They will not pay lab work, physical therapy, or radiology connected to your visit. This includes supplemental plans or Advantage plans. Most of our Medicare patients get blood work by their usual doctor, under our recommendations. Please contact Medicare directly for details.