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1-25 pages 26-100 pages 101+ pages
$0.75/page $0.50/page $0.25/page
1-30 pages 31-388 pages 389+ pages Supplies & postage
$0.65/page $0.50/page $0.00/page $1.61*
1- 50 pages 51+ pages Supplies & postage
$0.50/page $0.25/page $1.61*/page
Minimum Fee - NC Fetal monitoring strips Thumb Drive Video*** Email Third party portal NH Link Fax CD/DVD Contractual - Flat Fee
$10.00* $30.00* $30.00* $30.00* $20.00* $20.00* $15.00* $15.00* $30.00* Manually Calculate
Pre-payment is requested prior to the release of records.
*Rates represent flat rates. Additional charges may apply for rush shipping.
**Option only available for records created in a video format such as procedures utilizing a scope/camera.
Billing Certification Billing Affidavit Claim Form Coding Summary Expedite Service Stat Service Imaging Study Itemized Bill Record Certification Record Affidavit
$25.00/per signature or form $5.00/per signature or form $2.00/each $2.00/each $7.50 $10.00 $25.00/per study +$10 Search & Retrieval fee +postage $2.00/each $25.00/per signature or form $5.00/per signature of form