Green Card Medical Exam Cost in 2026: What You Will Pay

What the Total Price Covers

The cost of the green card medical exam is not one flat number. It is a few charges added together. Some civil surgeons quote one price that covers everything. Others charge for each part as they go. Knowing the parts helps you compare quotes and spot a low price that will grow later.

If you file Form I-485 inside the United States, you need this exam. A USCIS-designated civil surgeon does the exam and fills out Form I-693, Report of Immigration Medical Examination and Vaccination Record. USCIS does not set the price. Each civil surgeon sets their own fee.

In most cities, the total commonly lands between about $200 and $500 or more. The range is wide because the parts are not the same for every applicant. Your age, your vaccine records and your test results all change the bill.

• The four parts of the bill: the exam fee, lab tests, vaccines, and a chest X-ray only if needed.

The Exam Fee

The exam fee is the base charge. It covers the civil surgeon's time. That includes reviewing your medical and vaccine history, the physical exam, and the mental health and substance use screening. It also covers the paperwork: filling out Form I-693, signing it and sealing it in an envelope for USCIS.

This fee is the part you can compare most easily. Ask each office what their exam fee includes. One office may fold the lab work into the quote. Another may list it as a separate line.

Keep the timing in mind too. Since December 2, 2024, USCIS generally requires Form I-693 to be filed together with Form I-485. The civil surgeon must sign the form no more than 60 days before you file. If you wait too long, you may need to pay for parts of the exam again. Confirm current filing rules on uscis.gov before you book.

Lab Tests Are Often Billed Separately

The lab work is usually the second charge. What you need depends on your age.

Some offices send these tests to an outside lab and pass along the lab bill. Others run them in house. That is one reason two offices in the same city can quote different totals.

Results usually take a few days to two weeks. The civil surgeon cannot finish Form I-693 until the results are back, so plan for that wait.

Ask a simple question when you call: does your quote include all the lab tests I need for my age? Get the answer before you book.

• A tuberculosis blood test (IGRA) is required for applicants age 2 and older.
• A blood test for syphilis is required for applicants age 18 to 44.
• A urine test for gonorrhea is required for applicants age 18 to 24.

Vaccines Can Be the Biggest Extra

Vaccines are the part most likely to change your total. The civil surgeon checks your records against the vaccines required for your age and history. If you are missing some, you either get them at the visit or show proof you already had them.

Required vaccines can include MMR, Tdap or Td, polio, hepatitis A and B, varicella, influenza in flu season, pneumococcal, Hib, meningococcal, rotavirus and others. The exact list depends on your age and your records.

One change to know: COVID-19 vaccination is no longer required for Form I-693 as of January 22, 2025. If a clinic still lists a COVID-19 charge, ask why.

Bring your vaccination records to the visit. Old records, school forms, or a note from a prior doctor can save you money. Every vaccine you can document is one you may not have to pay for.

Chest X-ray and Other Possible Charges

A chest X-ray is not routine. It is only needed if a test points to a possible problem, such as a positive tuberculosis test. Many applicants never need one.

If you do need it, expect an extra charge for the X-ray and for reading it. Ask whether the office arranges it or sends you to an imaging center. The price can differ between the two.

If you had a chest X-ray in the past, bring the results. They may help, but the civil surgeon decides what is needed for your case.

Why Prices Differ by City

USCIS does not set the price, so the local market does. A few things push the total up or down from one city to the next.

Rent and staff pay differ. A clinic in a large, expensive city often charges more than one in a smaller town. The number of civil surgeons nearby matters too. More choices usually means more competition on price.

Lab costs vary by area and by lab. Some offices use a lab that charges more but returns results faster. Vaccine prices vary as well, and so does what each office stocks.

Finally, some offices quote one price for everything and some quote the exam only. A low quote may not include labs or vaccines. Compare the full picture, not just the first number.

You can compare civil surgeons by city on our site to see who serves your area.

How to Avoid Surprise Charges

Ask for the total before you book. Say your age and what vaccines you have records for. Ask what the quote covers and what it does not.

Bring the right items so the visit does not need a second trip: a government photo ID such as your passport, your vaccination records, a list of current medicines, past chest X-ray results if you have them, and payment.

Health insurance often does not cover this exam, so plan to pay out of pocket.

Remember the sealed envelope. The civil surgeon gives you the completed I-693 sealed. Do not open it. If it is opened, USCIS may not accept it, and you could pay for a replacement.

Rules and forms can change. Confirm the current requirements on uscis.gov before you file.

• Does the quote include the exam, all lab tests for my age, and the I-693 paperwork?
• Are vaccines included, or billed one by one?
• Is a chest X-ray included if I need one?
• What happens if my labs come back and I need a repeat test?