How Much Does an Immigration Medical Exam Cost? What's Included (and What Isn't)
There is no single price for the immigration medical exam, sometimes called the green card medical exam. USCIS does not set civil surgeon fees, so each clinic sets its own. Advertised prices vary widely, from roughly $200 to more than $600 depending on the market and on what the price includes.
What matters is the total you pay to walk away with a complete, sealed Form I-693, and how many trips it takes.
Why advertised prices are hard to compare
Two clinics advertising the same exam can be selling very different things: one price may cover only the physical and the paperwork, another every required lab test with the form sealed in one visit. Pieces that are sometimes included and sometimes billed separately:
- Lab work. The TB blood test (IGRA), the syphilis blood test for ages 18 to 44, and the gonorrhea urine test for ages 18 to 24.
- An outside lab or a results visit. Some clinics send you elsewhere for blood work, or ask you to return to collect the form.
- Vaccines. Priced per dose, and dependent on your age and records.
- Titers. Blood tests showing immunity, as an alternative to repeat vaccines.
- Chest x-ray. Needed only after a positive TB blood test; usually billed separately.
- The form itself. Completing, sealing and handing over the I-693, plus any copies.
Unbundled, a low headline price can end up costing more than a complete one.
What usually isn’t covered by insurance
Health insurance generally does not cover the immigration medical exam, because it is required for an immigration benefit rather than for treating illness. Plan to pay the clinic directly.
Follow-up care, such as treatment for latent TB, is ordinary medical care and may be covered under your plan. Check with your insurer rather than assuming.
Questions to ask before you book
Use this checklist when you call or read a clinic’s website.
| Question | Why it matters |
|---|---|
| Is bloodwork included in the price? | Lab fees are the most common surprise bill. |
| Is blood drawn on-site or sent out? | An outside lab can mean another trip and a separate invoice. |
| Is the TB blood test (IGRA) included? | Everyone aged 2 and older needs it. |
| How are vaccines priced? | Per dose, per vaccine, or a package. Ask for likely costs at your age. |
| Do you offer titers if I don’t have records? | Can avoid paying for vaccines you don’t need. |
| If a chest x-ray is needed, where is it done and what does it cost? | Only needed after a positive TB test, but worth knowing in advance. |
| Is the completed, sealed form included? | It should be. Confirm there is no separate paperwork fee. |
| Any fee for copies or sending to my attorney? | Small fees add up across a family. |
| Do I need a second visit for results? | A second visit costs time off work and travel. |
| Is there family pricing? | Relevant if several people are applying together. |
The total-cost view
The form must be ready at filing. Since December 2, 2024, most applicants must include the sealed I-693 with their I-485, so a delay in getting it can hold up your whole filing.
The form is valid for one application only. Under the USCIS policy effective June 11, 2025, the I-693 stays with the application it was filed with. If that application is denied or withdrawn, a new exam is required and paid for again. See our guide to how long Form I-693 is valid for details.
The cost that matters:
Exam price + lab fees + vaccines + x-ray if needed + extra visits + the cost of any delay or rework
A slightly higher price that includes labs, finishes in one visit and produces a correct form is often cheaper in total than a lower one that leads to a second appointment, a separate lab bill, or a form USCIS sends back for a missing signature, an outdated edition or a blank section. Our pillar guide to the immigration medical exam lists those errors in full.
Vaccine costs deserve their own question
Vaccines are usually the most variable part of the bill: an adult with complete records may need nothing, while one with no records may need several vaccines or titers. Influenza is required only during flu season (September 1 through March 31), and the COVID-19 vaccine is no longer required, so do not pay for it as part of this exam.
Bring every record you have, in any language; our vaccinations guide explains what is required at each age and when titers make sense.
Check the credential before you compare prices
A cheaper exam from a doctor who is not a USCIS-designated civil surgeon is worthless, because the form will not be accepted. Confirm that the physician who will sign your form appears in the USCIS locator at my.uscis.gov/findadoctor. Our guide on what a civil surgeon is explains how.
How our network handles pricing
National Immigration Medical Exams is a network of independent, USCIS-designated civil surgeon practices. Each clinic in our network publishes its exam price on its clinic page, with a line-by-line list of what is included and what is not, so you can compare the total before you book rather than after. Find a clinic near you to see its price and inclusions.
Frequently asked questions
Does USCIS set the price of the medical exam, and is it part of the filing fee?
No on both counts. USCIS does not set or regulate what civil surgeons charge, and the exam fee is not included in any USCIS filing fee. You pay the civil surgeon's clinic directly, separately from what you pay USCIS for Form I-485 and any related forms. That is why prices differ so much between clinics, and why it is worth asking exactly what a quoted price covers before you book.
Can I get my vaccines somewhere else and bring the record?
Often, yes. Vaccines given by your own doctor, a pharmacy or a public health clinic can be recorded on the form if you bring clear written documentation, and records in other languages are usable. Ask the civil surgeon before you go, so you know which vaccines you actually need and what documentation they will accept. Some people also find that blood tests showing existing immunity avoid repeat doses altogether.
Will I have to pay again if USCIS asks for a corrected form?
It depends on the reason and on the clinic. A clerical error on the form, such as a missing signature or a wrong date, is something many clinics will correct, but policies differ, so ask before you book. A brand-new exam is different: if your application is denied or withdrawn, the one-application rule means a new exam, which is a new fee. Choosing a clinic that reviews the form carefully before sealing it is the best protection.
Do children cost less than adults?
Sometimes. The required tests change with age: the TB blood test starts at age 2, and syphilis and gonorrhea testing apply only to adults within set age ranges, so a child's lab work can be simpler. On the other hand, children may need more vaccines than adults. Some clinics price children differently or offer family pricing. Ask for the price of each family member's exam and the likely vaccine costs for each child's age.