PLEASE READ: The discounted “out-of-network” rates listed below are available for families who alert Hirsch Pediatrics of their insurance status BEFORE the appointment. Families who present insurance at the appointment that is later found to be terminated on the date of appointment are not eligible for a retroactive discount. Therefore, to receive the discounted fee schedule if you are out-of-network, you must notify us BEFORE the appointment.
** Note: Children who are uninsured may be eligible to receive all vaccines at no charge through the Montgomery County Health Department. Please call our office for more details.
** Discounted rates below will be adjusted periodically to reflect current pricing (last updated 10/2022).
To help families anticipate out-of-pocket expenses, Hirsch Pediatrics includes ALL additional labs tests, procedures, and screening tests in the sick and well child visit fees. Note: The ONLY additional cost is for the vaccines. Please see below for vaccine expenses.
| Fee Schedule | |||
| Sick Visit | $125 | ||
| Well Child Exam | $250 |
Individual Vaccine Costs
| Vaccine | Self-pay/Out-of-network insurance | ||
| Pentacel (DTaP/Hib/Polio) | $165 | ||
| Hepatitis B | $40 | ||
| Pneumococcal | $354 | ||
| Rotateq | $140 | ||
| MMR | $135 | ||
| Hepatitis A | $56 | ||
| DTaP | $42 | ||
| Hib | $18 | ||
| Varivax | $235 | ||
| Polio | $44 | ||
| Proquad (MMR/Varivax) | $389 | ||
| Quadracel (DTaP/Polio) | $86 | ||
| Tdap | $66 | ||
| Meningitis ACWY | $187 | ||
| Gardasil | $337 | ||
| Flu | $55 | ||
| COVID-19 | $125 |
Well Child Exam Total Fee Including Vaccines
| Age | Additional vaccines usually done at appointment | Self-pay/Out-of-network insurance total cost | |
| Newborn first check-up | None | $250 | |
| 2 Week | None | $250 | |
| 1 Month | None | $250 | |
| 2 Month | Pentacel (DTaP/Polio/Hib), Hepatitis B, Pneumococcal, Rotateq | $949 | |
| 4 Month | Pentacel (DTaP/Polio/Hib), Pneumococcal, Rotateq | $909 | |
| 6 Month | Pentacel (DTaP/Polio/Hib), Hepatitis B, Pneumococcal, Rotateq | $894 | |
| 9 Month | None | $250 | |
| 12 Month | MMR, Prevnar, Hepatitis A | $795 | |
| 15 Month | DTaP, Hib, Varivax | $545 | |
| 18 Month | Hepatitis A | $306 | |
| 24 Month | None | $250 | |
| 3 Year | None | $250 | |
| 4 Year | Quadracel (DTaP/Polio), Proquad (MMR/Varivax) | $725 | |
| 5-10 Year | None | $250 | |
| 11 Year | Tdap, Meningitis ACWY, Gardasil* | $840 | |
| 12-15 Year | None | $250 | |
| 16 Year | Meningitis ACWY | $437 | |
| 17-21 Year | None | $250 |
* Note: Gardasil vaccine given at age 11 requires one additional dose.
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