Medical Records Fee Schedule

Records delivered via MyChart are provided at no cost. Records provided in all other formats may be subject to a fee in accordance to State and Federal regulations. Our fee schedule is listed below.

Requests Made by the Patient, Parent or Legal Guardian

Electronic Delivery of Medical Records

(including itemized statements and visit listings)

  • MyChart: FREE
  • Fax & Email: $6.50

Paper-Based Delivery

  • Cost per page: $0.0129 per page
  • Shipping: $9.85–$10.60
  • Staffing time: $22.00/hour
  • Flash Drive: $2.42
  • Affidavit Fee: $5.00
  • Disclosure Listing: $6.50
  • Miscellaneous letter: $6.50
  • Expedited Shipping: Fees by carrier

Requests Made by All Other Third-Party Requestors

  • Retrieval Fee: $23.25
  • Pages 1–10: $1.53/page
  • Pages 11–50: $0.79/page
  • Pages 51+: $0.31/page
  • Flash Drive: $2.42
  • Affidavit Fee:  $5.00
  • Itemized Statement: $6.50
  • Visit Listing: $6.50
  • Disclosure Listing: $6.50
  • Miscellaneous Letter: $6.50
  • Shipping: $9.85–10.60
  • Expedited Shipping: Fees by carrier