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+) 10%	Friends & Family / BU Student 15%
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	$80	$72	$68
Posture Pump	$125	$112	$106
Back Brace	$175	$157	$148
Knee Brace	$200	$180	$170
Foot Orthotics (pair)	$250	$225	$212
Ankle/Wrist/Elbow Brace	$45	$40	$38

Multi-Service Discount: Patients receiving 3 or more services on one visit (not pre-bundled) may receive an additional 10% discount on the subtotal.
Note: Durable Medical Equipment (DME) cannot be further discounted.