Direct-Pay / Self-Pay Fee Schedule
Effective 2025
2265 W. Fair Ave. | Lancaster, OH 43130
Phone: (740) 494-1470 | Fax: (740) 494-1472
www.peakperformss.com
⚖️ Legal & Industry Notice
This fee schedule reflects Direct-Pay / Self-Pay pricing and is not billable to insurance. These rates are discounted in accordance with:
1. Usual, Customary, and Reasonable (UCR) -based pricing relative to other local providers for Direct/Self-Pay services.
2. Time-of-Service (TOS) or Pre-Payment Discounts, based on reduced administrative costs and prompt payment.
3. Lower overhead due to reduced billing, coding, and collection tasks.
These fees comply with federal and state guidelines for self-pay pricing transparency. Discounts are applied legally in accordance with OIG guidance and are not intended for patients submitting claims to insurance.
| Service |
Standard Fee |
VA/Military/First Responder/Senior (65%) |
Friends & Family / BU Student |
| Exam (Standard) |
$85 |
$76 |
$72 |
| Exam + X-rays |
$112 |
$100 |
$95 |
| Sports Physical |
$50 |
$45 |
$42 |
| X-rays (per series) |
$40 |
$36 |
$34 |
| Adjustment |
$50 |
$45 |
$42 |
| Youth Adjustment (4-17) |
$30 |
$27 |
$25 |
| Massage (30 min / 60 min) |
$45 / $90 |
$40 / $81 |
$38 / $76 |
| Massage + Adjustment (30 / 60) |
$85 / $126 |
$76 / $113 |
$72 / $107 |
| PT Session |
$60 |
$54 |
$51 |
| PT + Adjustment |
$99 |
$89 |
$84 |
| Shockwave |
$99 |
$89 |
$84 |
| Cupping / IASTM |
$40 |
$36 |
$34 |
| Infrared Session (30 min) |
$45 |
$40 |
$38 |
| Recovery Boots (20-30 min) |
$25 |
$22 |
$21 |
| Traction / Decompression |
$40 |
$36 |
$34 |
| Ultrasound |
$20 |
$18 |
$17 |
| E-Stim |
$15 |
$13 |
$12 |
| KT Taping (1st / Add’l Region) |
$15 / $10 |
$13 / $9 |
$12 / $8 |
| TENS Unit |
$75 |
$67 |
$63 |
| Posture Pump |
$100 |
$90 |
$85 |
| Back Brace |
$125 |
$112 |
$106 |
| Knee Brace |
$150 |
$135 |
$127 |
| Foot Orthotics (pair) |
$200 |
$180 |
$170 |
| Ankle/Wrist/Elbow Brace |
$30 |
$27 |
$25 |
