PRICING
Membership Fee.
Insurance puts significant constraints on the amount of time our team can dedicate to each patient before, during, and after each visit. Unfortunately, like much of the healthcare industry, insurance payers are behind where we need them to be. Comprehensive care for patients with complex, multisystem disorders requires care that is above and beyond what is typically covered by insurance.
What this means for you:
Our membership fee ensures every patient receives the level of coordinated, collaborative, and comprehensive care that sets Metrodora apart. It also ensures every patient has access to advanced diagnostic testing and new therapeutic interventions as they become available.
FAQ:
Why does Metrodora charge a patient membership fee?
Simply put, we are unable to provide the level of specialized, comprehensive care our patients need without it. From specialist visits that are longer than the standard, to clinical and research collaboration on care plans, our membership fee covers services that go far beyond what insurance is designed to cover.
Like traditional healthcare providers, Metrodora bills eligible insurance plans for medical visits. If your insurance plan is not one Metrodora currently accepts, we also offer discounted self-pay rates. Learn more about our self-pay rates here.
How much does a Metrodora Patient Membership cost?
Our annual membership fee is $2,200. We offer a discounted rate of $2000, which is a savings of $200, if you pay upfront. If you need flexibility, we also offer two payment plans:
1. Installments over 3 months ($566/month), with $500 down payment.
2. Installments over 6 months ($283/month), with $500 down payment.
The membership fee is not reimbursable but may be a covered expense under your FSA or HSA.
What does “unlimited messaging” mean?
As a patient member, you have access to unlimited messaging through the AthenaOne portal with your patient navigator. We strongly encourage patients to schedule an appointment if they have more complex questions for their physician.
NOTE: Unlimited messaging is not for emergency care or services. If you require urgent medical attention, please dial 911 or visit the closest emergency care center. For more complex questions, you may need to set up an appointment to speak to your doctor directly.
If medical visits are covered by my insurance, what’s included in the membership fee?
Our membership fee covers essential support services that go beyond the standard medical visit, including:
• Care coordination and a dedicated patient navigator for ongoing support throughout your health journey.
Your Patient Navigator will help schedule your new patient visit, gather and submit your medical history documentation, and help prepare you for follow-up appointments. They will also help manage referrals, coordinate diagnostic tests, review results, and facilitate follow-up communication with various physicians.
• Extended 1:1 time with your specialists and care team.
• Access to advanced diagnostic testing and deep analysis.
We recognize every patient is different, and there’s no one-size-fits-all approach to managing complex disorders. That’s why as part of your membership, your physician and care team will work with you to recommend which tests are needed based on your condition. Some blood panels do require an extra fee. We’ll let you know ahead of time if that’s the case so you can decide what works best for you. Blood work is billed through insurance, but costs vary depending on your plan. Our billing specialists are here to help you navigate these costs.
• A medical team that collaborates on your condition, care plan, and next steps.
• During regular business hours, you’ll have direct access to your patient navigator through unlimited messaging.
• Access to Metrodora’s research program and clinical trials.
• Access to Metrodora eConnect.
Insurance we Accept:
Regence Blue Cross Blue Shield
Participating
Preferred Value Care
Individual and Family
Real Value
Blue Option
BCBS Medicare Advantage
Cigna
Cigna POS Utah
OAP Plus
ChoiceFund OA Plus
ChoiceFund OA Plus with CareLink
PPO
Choice Fund PPO
Aetna
Medicare
Medicare Part B
Regence Blue Cross Blue Shield Medicare Replacement Plans
Multiplan Benefit for Out of Network Coverage
If you are unsure if you have a Multiplan Benefit, please reach out to either your plan to confirm that you do, or if your plan is through an employer reach out to your HR.
The following logo on either the front or back of your card:
If you are traveling from outside of Utah, please confirm with your plan that you have out of state benefits. Not all plans have coverage outside of the state that you reside in for “non-emergency” coverage.
| Pricing: | **Non-program | Program Pricing |
|---|---|---|
| New Patient Visit | $1,064 | $638 |
| Return Patient Visit | $866 | $520 |
| Prolonged Services | $167 per 15 min. interval | Included |
| Upper Endoscopy | $3,714 | $1,656 |
| Diagnostic Colonoscopy with Biopsy | $2,740 | $2,229 |
| New Patient Visit with Therapy | $245 | $245 |
| Return Patient Visit with Therapy | $175 | $175 |
| Dry Needling | $65 | $65 |
| New Patient Visit with Dietitian | $107 | $107 |
| Return Patient Visit with Dietitian | $93 | $93 |
| Autonomic Testing | $1,319 | $792 |
| Infusion (Hydration) | $154 | $94 |
*Cost of medication infusions will be determined based off drug.
**All prices are estimated for your convenience and are subject to change, please reference your Good Faith Estimate for a more detailed estimation of your healthcare costs.