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Sliding Fee Schedule

2023 FEDERAL POVERTY GUIDELINES & SLIDING SCALE

DepartmentSlide ASlide BSlide CSlide DSlide E
Medical$20.00$25.00$30.00$35.00No Discount
Physical Therapy$10.00/visit90% OFF85% OFF80% OFFNo Discount
Audiology$20.00 (includes eval. selection and fitting)90% OFF85% OFF80% OFFNo Discount
Imaging$0.0090% OFF85% OFF80% OFFNo Discount
Laboratory (In-House)$0.00$0.00$0.00$0.00No Discount
Laboratory (Sent Out)$0.00At CostAt CostAt CostNo Discount
PharmacyAt Cost + FeesAt Cost + FeesAt Cost + FeesAt Cost + FeesAt Cost + Fees
Household income is:≤ A> B ≤ C> C ≤ D> D ≤ E> E
% of poverty guideline:≤100%101%> x ≤125%126%> x ≤150%151%> x ≤200%≥201%
HouseholdSlide ASlide BSlide CSlide DSlide E
114,580 per year
1,215 per month
281 per week
18,225 per year
1,519 per month
352 per week
21,870 per year
1,823 per month
422 per week
29,160 per year
2,430 per month
562 per week
32,805 per year
2,734 per month
633 per week
219,720 per year
1,643 per month
380 per week
24,650 per year
2,055 per month
475 per week
29,580 per year
2,465 per month
570 per week
39,440 per year
3,287 per month
760 per week
44,370 per year
3,698 per month
855 per week
324,860 per year
2,072 per month
479 per week
31,075 per year
2,590 per month
599 per week
37,290 per year
3,108 per month
719 per week
49,720 per year
4,144 per month
958 per week
55,935 per year
4,662 per month
1,078 per week
430,000 per year
2,500 per month
577 per week
37,500 per year
3,125 per month
722 per week
45,000 per year
3,750 per month
866 per week
60,000 per year
5,000 per month
1,154 per week
67,500 per year
5,625 per month
1,299 per week
535,140 per year
2,928 per month
676 per week
43,925 per year
3,661 per month
845 per week
52,710 per year
4,393 per month
1,014 per week
70,280 per year
5,857 per month
1,352 per week
79,065 per year
6,589 per month
1,521 per week
640,280 per year
3,357 per month
775 per week
50,350 per year
4,196 per month
969 per week
60,420 per year
5,035 per month
1,163 per week
80,560 per year
6,714 per month
1,550 per week
90,630 per year
7,553 per month
1,744 per week
745,420 per year
3,785 per month
874 per week
56,775 per year
4,732 per month
1,093 per week
68,130 per year
5,678 per month
1,311 per week
90,840 per year
7,570 per month
1,748 per week
102,195 per year
8,517 per month
1,967 per week
850,560 per year
4,213 per month
973 per week
63,200 per year
5,267 per month
1,217 per week
75,840 per year
6,320 per month
1,460 per week
101,120 per year
8,427 per month
1,946 per week
113,760 per year
9,480 per month
2,190 per week

For each additional person add: 5,140 per YEAR l 428 per MONTH l 99 per WEEK

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