Transparent pricing.
No surprise bills.
We believe everyone deserves excellent care—without surprises or confusion. At Form and Function Healthcare, we do everything we can to keep care affordable, while making sure we can stay open and keep serving our community. That’s why we offer flexible options to fit your needs and budget—including insurance billing, fair cash prices, and affordable membership plans.
1) Use health insurance.
We accept many insurances and will bill them for your visit. However, insurance reimbursement rates have dropped significantly as well a patient deductibles increasing. In order to continue providing care, we require a minimum payment of $100 per visit. If your insurance pays less, we’ll notify you and ask you to cover the difference.
2) Monthly subscription.
With your 12-month subscription, you will receive unlimited office visits and portal access and messaging.
Individual: $75/month
Couple: $135/month
Family (up to 4): $200/month
Labs: You choose whether labs are to be billed to your insurance or directly to you. Lab pricing is available here.
3) Cash pay.
For patients without insurance or choosing not to use it:
New Patient Visit with Examination: $150
Your first visit includes a full 60-minute appointment where we’ll take time to get to know you—your health history, current concerns, and your goals. We’ll do a focused physical exam and talk through labs, medications, supplements, and lifestyle habits that may be affecting your health. If you have labs done, we’ll include a follow-up phone call to go over the results together.
Follow Up Visit $100
For one year post initial evaluation, any follow up visits needed to further discuss ongoing management of known issues, your health plan, complete further tests or assessments, please schedule 40-minute follow up visit.
Sick Visit $90
For new or acute issues like sore throat, UTI, rash, or other workups, schedule a 20-minute visit. Some testing is included like point-of-care strep testing, urine dip, etc.
Brief Visit $60
Prescription refills, quick questions, simple paperwork can be completed in a brief visit.
We believe that cost should never be a barrier to getting the care you need. If you’re experiencing financial hardship or living on a limited income, we offer a sliding fee scale to help make our services more accessible. Just let us know. We’re here to help.
In order to qualify for the sliding fee scale, please provide two months of pay stubs.
Sliding Fee Scale
| Household Size | 100% | 150% | 175% | 200% |
|---|---|---|---|---|
| 1 person | $15,650.00 | $23,475.00 | $27,387.50 | $31,300.00 |
| 2 people | $21,150.00 | $31,725.00 | $37,012.50 | $42,300.00 |
| 3 people | $26,650.00 | $39,975.00 | $46,637.50 | $53,300.00 |
| 4 people | $32,150.00 | $48,225.00 | $56,262.50 | $64,300.00 |
| 5 people | $37,650.00 | $56,475.00 | $65,887.50 | $75,300.00 |
| 6 people | $43,150.00 | $64,725.00 | $75,512.50 | $86,300.00 |
| 7 people | $48,650.00 | $72,975.00 | $85,137.50 | $97,300.00 |
| 8 people | $54,150.00 | $81,225.00 | $94,762.50 | $108,300.00 |
| Household Size | 100% | 150% | 175% | 200% |
|---|---|---|---|---|
| 1 person | $1,304.17 | $1,956.25 | $2,282.29 | $2,608.33 |
| 2 people | $1,762.50 | $2,643.75 | $3,084.28 | $3,525.00 |
| 3 people | $2,220.83 | $3,331.25 | $3,886.46 | $4,441.67 |
| 4 people | $2,679.17 | $4,018.75 | $4,688.54 | $5,358.33 |
| 5 people | $3,137.50 | $4,706.25 | $5,490.63 | $6,275.00 |
| 6 people | $3,595.83 | $5,393.75 | $6,292.71 | $7,191.67 |
| 7 people | $4,054.17 | $6,081.25 | $7,094.79 | $8,108.33 |
| 8 people | $4,512.50 | $6,768.75 | $7,896.88 | $9,025.00 |
| Tier | Payment per Visit | Discount on Procedures |
|---|---|---|
| 100% FPL | $25.00 | 50% |
| 150% FPL | $40.00 | 50% |
| 175% FPL | $50.00 | 50% |
| 200% FPL | $60.00 | 50% |