Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696592768297.pdf (United States)
Fee Explanation for Reproductive Health Services 2022 At Riley County Health Department, we offer some services on a sliding scale fee scale for uninsured and underinsured clients who are seeking reproductive health services.
Fees are based on annual gross income (wages, commission, tips, allowances/stipends, alimony/child support, Disability Income, Temporary Assistance Needy Families(TANF), student grants, scholarships, and financial aid used for living expenses) and family size (Yourself plus # of persons being supported in the home by this income.)
Income will be verified by 30 days of pay stubs for the current year, employer letter stating pay, self- employed income tax returns for 2019 and financial aid, scholarship, grant, loans, fellowships, and assistantships.

$0 is not an income.

If you are unable to produce proof of income or decline, charges will be accessed at Full Fee*.

(This does not apply to anyone 17 years of age, confidential minors.)

Insurances are charged Full Fee.


After insurance pays, the remaining balance may be discounted depending on your policy and income.

Please note, Riley County is NOT a Tricare Health Insurance or Cigna provider.

The following table shows our sliding scale categories by household size and monthly income: Household income is anyone that is working in the household and the number of people living in the household that is being supported by this income.

Not just the client income.
Sliding Fee Scale Categories for 2022 No Charge Income up to Pay 25% B Income between Pay 50% C Income Between Pay 75% D Income Between Pay 100% 1 $12,880 12,881 19,320 19,321 25,760 25,761 32,200 32,201 Gross household ANNUAL Income 2 $17,420 17,241 26,130 26,131 34,840 34,481 43,550 43,551 3 $21,960 21,961 32,940 32,941 43,920 43,921 54,900 54,901 4 $26,500 26,501 39,750 39,751 53,000 53,001 66,250 66,251 5 $31,040 31,041 46,560 46,561 62,080 62,081 77,600 77,601 6 $35,580 35,581 53,370 53,371 71,160 71,161 88,950 88,951 7 $40,120 40,121 60,180 60,181 80,240 80,241 100,300 100,301 8 $44,660 44,661 66,990 66,991 89,320 89,321 111,650 111,651 Each additional household member over 8, add $4,540 for each person.
Health Department Clinics 2030 Tecumseh Road Manhattan, Kansas 66502 P: 785-776-4779 F: 785-565-6565 Family & Child Resource Center 2101 Claflin Road Manhattan, Kansas 66502 P: 785-776-4779 F: 785-587-2879 You can opt to not use the discount and pay full price.

Full Fees for services listed below.

For additional questions about the sliding fee scale, please ask the medical clerk.

Payment is expected and encouraged at the time of service.
A visit with Advanced Practice Nursing Practitioner (APRN) is required once per year.

• Not all charges are known on the date of service and could be applied later to your account such as HPV lab testing on cervical pap smear.

• Clients with income at or below 100% (Category A) Federal Poverty Level will not be charged for basic Reproductive Health Services that are covered by grant funding.

(Doesn’t apply to all services and doesn’t apply to abnormal treatments.)
• Donations are accepted and appreciated for all services, even ones with a charge.

Here is an example of estimated fees for selected clinic services based on your sliding scale category.
Category A B C D Service/Procedure Initial Exam Annual Exam Interim APRN –New Client Registered Nurse Visit Pharmaceuticals/Contraceptives $0 $0 $0 $0 $21.25 $20 $17.50 $7.50 $42.50 $40 $35 $15 $63.75 $60 $52.50 $22.50 $ $$ $$ $$$ $ $$$ Oral Contraceptives $0 Hormonal Injections (3months) $0 $0 Nuva Ring $0 Condoms $0 Nexplanon Insertion/Removal $0 Nexplanon $0 IUD Insertion/Removal $0 Liletta (Hormonal IUD) $0 Paragaurd (Non-hormonal IUD) Treatment Meds for some infections $5 Laboratory $5 $22.50 $10.50 $0 $50 $7.50 $33.75 $15.75 $0 $75 $2.50 $11.25 $5.25 $0 $25 $118.75 $237.50 $356.25 $25 $31.25 $81.25 $50 $62.50 $162.50 $243.75 $75 $93.75 $5 $5 $5 Cervical (Pap) smear HPV Testing on Pap Smear Pregnancy Test Urinalysis Syphilis/HIV – lab blood test Quick HIV Test 15 minute results Chlamydia/Gonorrhea Urine/Swab $5 $0 $45 $45 $0 $0 $0 $0 $2.50 $1.25 $0 $4 $10 $45 $5 $2.50 $0 $8 $15 $45 $7.50 $3.75 $0 $12 $0 $0 $0 $0 1-$ is the least expensive to 3-$$$ the most expensive.
*Full Fee $85 $80 $70 $30 $10 $45 $21 $0 $100 $475 $100 $125 $325 $5 $20 $45 $10 $5 $0 $16 $0 Health Department Clinics 2030 Tecumseh Road Manhattan, Kansas 66502 P: 785-776-4779 F: 785-565-6565 Family & Child Resource Center 2101 Claflin Road Manhattan, Kansas 66502 P: 785-776-4779 F: 785-587-2879