Sliding Fee Scale Collection Amounts Patient Handout
The Sliding Fee Scale is a program designed to lower the cost of healthcare for individuals who meet certain income requirements, which are set annually by the federal government. If you qualify for this program, the medical services you receive at West Cecil Health Center will be offered at a discounted rate based on your eligibility. The tables below illustrate the sliding fee collection amounts, which vary according to different tiers of eligibility. This tiered payment structure adjusts the amount you owe based on your specific qualifications. The tables below represent the collection amount per visit type and/or add on service.
Visit Type
Visit Type | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
New Patient | $20.00 | $68.00 | $102.00 | $136.00 | $170.00 | $340.00 |
Est Patient | $20.00 | $43.00 | $64.50 | $86.00 | $107.50 | $215.00 |
Therapy Intake | $20.00 | $55.00 | $82.50 | $110.00 | $137.50 | $275.00 |
Therapy Follow-Up | $20.00 | $33.40 | $50.10 | $66.80 | $83.50 | $167.00 |
BH Medication Management | $20.00 | $80.00 | $120.00 | $160.00 | $200.00 | $400.00 |
BH Med Mgt Follow-Up | $20.00 | $43.00 | $64.50 | $86.00 | $107.50 | $215.00 |
Add-on Services
Add-on Service | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
A1C | - | $9.00 | $13.50 | $18.00 | $22.50 | $45.00 |
Urinalysis | - | $2.00 | $3.00 | $4.00 | $5.00 | $10.00 |
Toxicology Screen | - | $6.40 | $9.60 | $12.80 | $16.00 | $32.00 |
PPD | - | $6.00 | $9.00 | $12.00 | $15.00 | $30.00 |
Pregnancy Test | - | $6.00 | $9.00 | $12.00 | $15.00 | $30.00 |
Add-on Psychotherapy | - | $20.00 | $30.00 | $40.00 | $50.00 | $100.00 |
INR | - | $3.00 | $4.50 | $6.00 | $7.50 | $15.00 |
EKG w/Interp and Rpt | - | $12.00 | $18.00 | $24.00 | $30.00 | $60.00 |
Immunization admin | - | $9.00 | $13.50 | $18.00 | $22.50 | $45.00 |
Add-on Service | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
Therapeutic Injection | - | $9.40 | $14.10 | $18.80 | $23.50 | $47.00 |
Allergy Shot Multi | - | $6.00 | $9.00 | $12.00 | $15.00 | $30.00 |
Rapid Flu Test | - | $8.20 | $12.30 | $16.40 | $20.50 | $41.00 |
Rapid Strep Test | - | $7.40 | $11.10 | $14.80 | $18.50 | $37.00 |
Rapid Flu Covid Combo | - | $22.00 | $33.00 | $44.00 | $55.00 | $110.00 |
Hemosure | - | $11.00 | $16.50 | $22.00 | $27.50 | $55.00 |
Impacted Earwax Removal | - | $7.20 | $10.80 | $14.40 | $18.00 | $36.00 |
Lead Test | - | $5.40 | $8.10 | $10.80 | $13.50 | $27.00 |
VFC Vaccine Cost per stick | $23.28 | $23.28 | $23.28 | $23.28 | $23.28 | $23.28 |
Vaccines
Vaccine | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
Tdap | - | $14.40 | $21.60 | $28.80 | $36.00 | $72.00 |
Menactra | - | $45.20 | $67.80 | $90.40 | $113.00 | $226.00 |
Immunization Admin | - | $9.00 | $13.50 | $18.00 | $22.50 | $45.00 |
Immunization Admin >1 | - | $5.00 | $7.50 | $10.00 | $12.50 | $25.00 |
Prevnar 13 | - | $57.80 | $86.70 | $115.60 | $144.50 | $300.00 |
Hep A Ped/Adol | - | $14.00 | $21.00 | $28.00 | $35.00 | $70.00 |
Gardasil | - | $64.00 | $96.00 | $128.00 | $160.00 | $320.00 |
Kinrix DTap- IPV | - | $23.00 | $34.50 | $46.00 | $57.50 | $115.00 |
HIB | - | $12.60 | $18.90 | $25.20 | $31.50 | $63.00 |
MMR | - | $65.00 | $97.50 | $130.00 | $162.50 | $325.00 |
MMR II | - | $27.00 | $40.50 | $54.00 | $67.50 | $135.00 |
Vaccine | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
Shingrix | - | $62.40 | $93.60 | $124.80 | $156.00 | $312.00 |
Pediarix | - | $30.00 | $45.00 | $60.00 | $75.00 | $150.00 |
Rotavirus | - | $26.00 | $39.00 | $52.00 | $65.00 | $130.00 |
IPV | - | $10.20 | $15.30 | $20.40 | $25.50 | $51.00 |
Hep B Adult | - | $24.20 | $36.30 | $48.40 | $60.50 | $121.00 |
Varicella | - | $38.00 | $57.00 | $76.00 | $95.00 | $190.00 |
Pneumovax 23 | - | $35.00 | $52.50 | $70.00 | $87.50 | $175.00 |
Infanrix Dtap | - | $12.00 | $18.00 | $24.00 | $30.00 | $60.00 |
FLUCELVAX 2024/2025 | - | $9.40 | $14.10 | $18.80 | $23.50 | $47.00 |
FLUAD 65+ 2024/2025 | - | $17.20 | $25.80 | $34.40 | $43.00 | $86.00 |
Prevnar 20 | - | $60.00 | $90.00 | $120.00 | $150.00 | $300.00 |
Vaxelis | - | $48.00 | $72.00 | $96.00 | $120.00 | $240.00 |
Physicals
Physical | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
NP age <1 yr | $20.00 | $40.00 | $60.00 | $80.00 | $100.00 | $200.00 |
NP age 1-4 yrs | $20.00 | $43.00 | $64.50 | $86.00 | $107.50 | $215.00 |
NP age 5-11 yrs | $20.00 | $43.20 | $64.80 | $86.40 | $108.00 | $216.00 |
NP age 12-17 yrs | $20.00 | $50.00 | $75.00 | $100.00 | $125.00 | $250.00 |
NP age 18-39 yrs | $20.00 | $55.00 | $82.50 | $110.00 | $137.50 | $275.00 |
NP age 40-64 yrs | $20.00 | $66.00 | $99.00 | $132.00 | $165.00 | $330.00 |
Est Pt age <1 yr | $20.00 | $34.40 | $51.60 | $68.80 | $86.00 | $172.00 |
NP age 65 yrs & older | $20.00 | $72.00 | $108.00 | $144.00 | $180.00 | $360.00 |
Est Pt age 1-4 yrs | $20.00 | $36.00 | $54.00 | $72.00 | $90.00 | $180.00 |
Physical | Slide 1 Nominal | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6/7 Self Pay 100% |
Est Pt age  5-11yrs | $20.00 | $38.40 | $57.60 | $76.80 | $96.00 | $192.00 |
Est Pt age 12-17yrs | $20.00 | $40.80 | $61.20 | $81.60 | $102.00 | $204.00 |
Est Pt age 18-39 yrs | $20.00 | $48.00 | $72.00 | $96.00 | $120.00 | $240.00 |
Est Pt age 40-64 yrs | $20.00 | $50.00 | $75.00 | $100.00 | $125.00 | $250.00 |
Est Pt age 65 yrs & older | $20.00 | $59.20 | $88.80 | $118.40 | $148.00 | $296.00 |
NP = New Patient
Est Pt = Established Patient
Family Planning
Visit Type/ Procedure | Slide 1 Nominal/No Fee | Slide 2 20% | Slide 3 30% | Slide 4 40% | Slide 5 50% | Slide 6 60% | Slide 7/Self Pay 100% |
FPL | up to 100% | 100.01-125% | 125.1-150% | 150.1-175% | 175.1-200% | 200.1-250% | 250.1 + % |
New Patient | - | $68.00 | $102.00 | $136.00 | $170.00 | $204.00 | $340.00 |
Est Patient | - | $43.00 | $64.50 | $86.00 | $107.50 | $129.00 | $215.00 |
Nexplanon | - | $321.80 | $482.70 | $643.60 | $804.50 | $965.40 | $1609.00 |
Remove/Insert Nexplanon | - | $374.40 | $561.60 | $748.80 | $936.00 | $1123.20 | $1872.00 |
Remove Nexplanon | - | $76.40 | $114.60 | $152.80 | $191.00 | $229.20 | $382.00 |
Paragard | - | $264.00 | $396.00 | $528.00 | $660.00 | $792.00 | $1320.00 |
Liletta | - | $204.00 | $306.00 | $408.00 | $510.00 | $612.00 | $1020.00 |
Mirena | - | $304.00 | $456.00 | $608.00 | $760.00 | $912.00 | $1520.00 |
Depo | - | $33.40 | $50.10 | $66.80 | $83.50 | $100.20 | $167.00 |
Remove IUD | - | $33.00 | $49.50 | $66.00 | $82.50 | $99.00 | $165.00 |
Pregnancy Test | - | $6.00 | $9.00 | $12.00 | $15.00 | $18.00 | $30.00 |
Updated 7/2025Â Â Â Â Â Â Â Â