How to Compare Las Vegas I-693 Exam Quotes

by freelancer | Oct 2, 2026 | Uncategorized | 0 comments

A practical worksheet for comparing immigration exam estimates on the same basis, so a low headline price does not turn into a surprise bill.

Updated on: 2026-10-01

Two clinics quote you different numbers for the same I-693 exam, and you have no idea which one is actually cheaper. One says "$199 and up." The other says "$260, all in." The first number looks better until you ask what "and up" covers, and the answer is tests and vaccines that may or may not apply to you.

That gap is where most people lose money. Not because a clinic lied, but because the two quotes were never describing the same thing. A useful comparison is not about who posts the lowest base fee. It is about estimating your own likely out-of-pocket total and keeping the uncertain parts visible instead of buried in a vague "starting at" line.

Here is how to do that without a medical degree.

What the I-693 exam actually is

Form I-693 is the Report of Immigration Medical Examination and Vaccination Record. It has to be completed by a USCIS-designated civil surgeon, not by any walk-in doctor and not at a visa interview. USCIS says it does not regulate what civil surgeons charge, which is exactly why quotes vary so much from one clinic to the next. You can confirm this directly in the USCIS guidance on finding a civil surgeon.

So when you collect quotes, you are comparing independent cash-pay businesses, each pricing their own exam, labs, and vaccines. There is no fixed rate. That is both the problem and the opportunity.

Why headline prices mislead

The base exam fee is only one of several line items. A full I-693 bill can include:

The exam, medical-history review, I-693 completion, signature, and the sealed packet.
The TB test and any specimen-collection or send-out lab charges.
Syphilis and gonorrhea testing, when required for your age or situation.
Each vaccine you are not already up to date on, priced per dose.
Optional immunity (titer) tests, plus whatever happens if a titer comes back negative.
Follow-up work if a screening result triggers imaging or evaluation.
Return-visit, paperwork, or pickup fees, and the turnaround time.

A clinic that quotes a low base price but charges separately for all seven can easily cost more than a clinic whose higher number already folds in your likely tests. The only way to know is to force every quote into the same categories.

A verified local example of transparent pricing

To show what a readable quote looks like, here is a real one. Partida Corona Medical Center publishes its immigration exam pricing in Las Vegas openly: $260 for an adult exam, which the page says includes initial TB and STD lab testing, and $170 for children under 14. Vaccine add-ons are listed individually, for example Tdap $60, MMR $115, varicella $200, influenza $35, hepatitis $65, polio $50, and pneumococcal $150 for age 65 and up. The page notes that vaccines not completed at the exam can be finished afterward, before you pick up your documents.

Treat those as published prices, not a guaranteed all-in bill for every patient. The page does not spell out exactly which specific labs the "STD" line covers, what testing the child fee includes, whether each vaccine price is per dose or includes administration, or what a titer or a follow-up X-ray would cost. Those are the right things to confirm before you use any clinic's figures as a full-cost comparison, including this one.

A clean sample calculation, not a prediction of what you will need: the published adult exam plus one Tdap would be $320 ($260 + $60), assuming that vaccine is actually required for you and the listed price applies. For any vaccine, ask whether the price is per dose, whether more doses are needed, and whether giving the shot is included.

The reason I use a transparent, itemized clinic as the example is simple. A quote you can break into parts is a quote you can compare. A quote that hides the parts is not really a quote, it is a teaser.

What changes the testing part of your bill

This is where a lot of outdated clinic shorthand causes confusion. "All adults need both STD tests" is not how the current CDC rules read.

Tuberculosis. CDC requires an IGRA blood test for applicants age 2 and older. A chest X-ray is required only when the IGRA is positive, or when there is known HIV, TB symptoms, or extrapulmonary TB. So ask whether the quoted TB amount covers only the initial test, and what an X-ray or referral would cost if it turns out to be needed. Do not assume everyone gets imaging. The CDC tuberculosis technical instructions spell out the triggers.

Syphilis. Required for applicants aged 18 to under 45. Outside that range, it is ordered only if there is reason to suspect infection. This is set out in the CDC syphilis technical instructions.

Gonorrhea. Required for applicants aged 18 to 24. Younger or older applicants are tested only if infection is suspected. The civil surgeon must order a NAAT at the time of the exam, and testing done elsewhere beforehand is not accepted.

This is exactly why an undifferentiated "STD lab" line deserves a question rather than a shrug. A 30-year-old and a 22-year-old do not automatically need the same tests. If a clinic charges one flat "STD" fee regardless of age, ask which tests that covers and whether you are even required to have all of them.

What changes the vaccine part of your bill

Do not assume you need every vaccine on a clinic's price list. The civil surgeon looks at your age, your written vaccine records, documented immunity, and the CDC age table, then recommends only what is required and missing.

A few things worth knowing before you pay:

The CDC-required categories include diphtheria, tetanus, pertussis, polio, MMR, rotavirus, Hib, hepatitis A, hepatitis B, meningococcal, varicella, pneumococcal, and influenza. Many of these are age-specific. Meningococcal applies to ages 11 to 18. Influenza is required when available for anyone older than six months. The CDC vaccination technical instructions list the full age table.
Acceptable dated vaccine records can save you from paying for doses you already have.
CDC accepts lab evidence of immunity (a titer) for measles, mumps, rubella, hepatitis A and B, polio, and varicella. A positive titer can remove a vaccine charge. Ask what the clinic charges for the titer itself, and whether it will review your records before recommending anything paid.
If it is not flu season and influenza vaccine is unavailable, the civil surgeon documents a "Not flu season" waiver. You do not get charged for a shot that is not available.

A first dose may not finish a multi-dose series, so the "complete" vaccine total on your I-693 might span more than one visit. Ask about that too.

The comparison worksheet

Use this for every clinic, and give each one the same information: your age and whatever vaccine records you already have. Ask each to label every line as included, additional if needed, or not included / not priced.

Line item	What to ask	Clinic A	Clinic B
Exam + I-693 completion	Does the base fee include form completion, signature, and the sealed packet?
TB test (IGRA)	Is it included? What does a chest X-ray or referral cost if required?
Syphilis test	Required for my age? Included or extra? Any collection fee?
Gonorrhea test	Required for my age? Included or extra?
Vaccines	Which do you expect after reviewing my records? Price per dose? Administration included?
Titers / immunity tests	Can a titer avoid a vaccine charge? What does the titer cost?
Follow-up / imaging	If a result requires more work, what are the charges and who arranges them?
Return visit / pickup	Any fee to come back for vaccines, sign, or pick up the packet?
Turnaround	How long to completion? Does it depend on labs or finishing vaccines?
Payment terms	Is the quote cash-pay? Any other conditions?

Fill in the same rows for each clinic and the real comparison appears. Often the clinic with the higher base fee ends up cheaper once the "extras" at the low-price clinic are added back in.

What I would do first

Call two or three clinics with your age and your vaccine card in hand. Read them the same list of rows above. If a front desk cannot tell you what the base fee covers or whether a test applies to your age, that tells you something about how the final bill will feel.

Then do the arithmetic on your own likely total, not the advertised number. A clinic like Partida Corona Medical Center that posts itemized prices and includes the initial TB and STD labs in the adult fee makes that math easy to do, which is the whole point. A clinic that answers "it depends" to every line, then quotes a low base, is asking you to trust a number that has not been defined.

Pay attention to the sealed packet, too. USCIS requires the completed I-693 to be handed to you in a sealed envelope that you must not open or alter. Factor the pickup step into both cost and timing.

FAQ

How do I compare two I-693 quotes when they include different things?

Normalize both into the same line items: exam and form, TB test, syphilis and gonorrhea tests if required for your age, each vaccine you actually need, titers, possible follow-up, and return or pickup fees. Then compare your estimated total, not the base price. A low base fee with many extras often beats nothing.

Does every adult need both STD tests for the exam?

No. Syphilis testing is required for ages 18 to under 45, and gonorrhea testing for ages 18 to 24. Outside those ranges, testing happens only if there is clinical reason. If a clinic bills one flat "STD" fee for everyone, ask which tests apply to your age.

Can I avoid paying for vaccines I might already have?

Often, yes. Bring dated vaccine records. CDC also accepts lab evidence of immunity for several vaccines, so a titer can sometimes replace a dose. Ask the clinic to review your records before recommending anything you pay for, and ask what the titer itself costs.

How long is a completed I-693 good for?

Under current USCIS policy, an I-693 signed on or after November 1, 2023 generally serves as evidence while the application it was filed with stays pending. If that application is denied or withdrawn, a later one needs a new I-693. Do not rely on older claims about a fixed multi-year validity.

Is the cheapest clinic always the best choice?

Not necessarily. The clinic that gives you a complete, itemized, like-for-like estimate and a predictable packet turnaround is usually worth more than one that advertises a rock-bottom base fee and leaves the rest undefined. Transparency is part of the price.