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Cost Estimator
ESTIMATE FOR
M ACTIVITY PRESCRIPTION FORM APF
CPT: 1073M 
at Monson Test
using Cash - No Insurance
7/18/2026 12:45 AM
Monson Test Estimate
Patient portion estimate
$57.00*
Facility fee
$57.00
3rd party fees
Billed separately
*You may receive bills from any 3rd party providers involved with this procedure.
Pay in Full
$51.30
10% OFF for 30 days
Pay in Full 15
$48.45
15% OFF for 3000 days
2 Month Plan
$28.50
This estimate covers only the fees from Monson Test and may not include any 3rd party fees you may incur.
To schedule or ask a question
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Cost Detail
Total starting charges
$57.00
Cash Discount
$0.00
Total Estimated Patient Portion
$57.00

Cost data updated 6/23/2026 8:45 PM