Fees and Charges

We at the Tepeyac Family Center are committed to you and your unborn child. The following is an outline of the fees and maternity services provided by the Tepeyac Family Center. Please note that some of these sevices listed may not apply to you.

Office Charges
  • Excessive Maternity Visit (Within the Global Fee)
    $150.00
  • Single Maternity Visit (Outside of Global Fee)
    $150.00
  • Non-Stress Test
    $150.00
  • Pap Smear
    $67.73
  • Pregnancy Confirmation Visit
    $150.00
  • Pregnancy Test/Urine
    $30.00
  • Sonogram
    $235.00
  • STD Cultures
    $17.60 - $26.40 ea.
  • Vaginal Cultures
    $5.50ea.
  • Wet Prep Vaginal Culture
    $20.00
  • Infertility Consultation
    Call Office

Inpatient Hospital Charge/Infant Male

  • Circumcision
    $225.00
Inpatient/Outpatient Services
  • Cerclage of Cervix
    $1,000.00
  • Cord Blood Retrieval
    $500.00
  • Global Fee/Cesarean Delivery
    $3,500.00
  • Global Fee/Cesarean/Twins
    $5,500.00
  • Global Fee/Vaginal/Twins
    $5,100.00
  • Global/Vaginal & Cesarean/Twins
    $5,300.00
  • Global/Vaginal Birth after a Cesarean
    $3,300.00
  • Global/Vaginal
    $3,100.00
  • Inpatient Observation
    $250.00
  • Prolonged Physician Services (1st hour)
    $200.00
  • Prolonged Physician Services (each additional hour)
    $95.00

The charges that are shown are the fees of the Tepeyac Family Center only, and not that of the hospital or laboratory. Please contact them for pricing information. (Please note that although laboratory services are accessible through Clinical Pathology Laboratories (CPL) at our office location only.  We do not bill for these services. Please contact them for any billing inquiries)

Fee Descriptions

Global Maternity Care:

This applies to patients that, from the start of their pregnancy, are insured by the same insurance company that they are insured by when they deliver. The services that are not included in the Global Fee are as follows:

  • Cerclage of Cervix
  • Cultures of any kind
  • Circumcision of male infant
  • Induction
  • Inpatient Observation
    		•
    • Pregnancy Test
    • Pregnancy Confirmation Visit
    • Prolonged Physician Services
    • Sick Visits (Only routine visits are covered in the global maternity package. Primary Care type visits are not included in this package and patients seeking this type of care are generally referred to their primary care physician.)

    Policies and Procedures for Antepartum Care

    Per AMA's Physicians' Current Procedural Terminology (CPT) guidelines routine antepartum care for a normal, uncomplicated pregnancy consist of typically 13 visits. If increased monitoring for high-risk conditions in excess of the CPT guidelines for normal antepartum visits is needed, a patient may be charged for the visit outside the normal global fee. The most common illness are and may be billed a copay if not covered by your insurance company.

    All illness oriented visits (i.e. UTI, Bronchitis, pharyngitis) and hospitalizations due to complications are outside the global and are billed separately and patient may be required to pay co-pay at time of visit.

     Itemized Services:

    This applies to the following patients: For those that are uninsured at the start of the pregnancy and later become insured; or who are insured by one insurance carrier at the start of the pregnancy, and then deliver while insured by a different insurance company than they originally started with; or who miscarry or transfer to another facility for the duration of care. The birth will be billed as a delivery only charge, in addition to any other hospital services that are provided. It is important that the patient notify us immediately once they become effective with a new insurance carrier. Prior-Authorization must be obtained before you are admitted to the hospital for the birth of your child.

    Self-Pay Patients:

    Patients who have no insurance coverage, we expect that you will pay in monthly increments so that when you deliver the charges will be paid in full. We are happy to set up a payment plan that suits both yours and our needs. If you need to set up a payment plan with Fair Oaks Hospital, please call (703) 645-2864 once you start to go into labor.

    Circumcision Of Male Infants:

    Please note that this is a separate charge from the delivery and is charged under your infant's name, with exception to a few insurance companies. For this reason, we will need you to supply us with the child's full name and insurance information. Please let us know if the child is insured through the father under a separate policy from the mother

    Finally, we want to encourage you to familiarize yourself with your insurance benefits so that there are no surprises when you receive a billing statement. Please note, most hospital admissions require prior-authorization. Because this is ultimately your responsibility, we ask that you please contact your insurance prior to your delivery to inform them of the future admission. For your convenience, we accept both Visa and MasterCard, as well as offer payment plans. If you have any questions about your benefits, please call us at (703) 273-9440, extension 109. For billing inquiries, please call Capture Billing and Consulting at 703-327-1800. Thank you!

    Should you have any questions, please feel free to ask us at any time.