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I-693 exam cost · St. Louis
I-693 Immigration Medical Exam Cost & Timeline
The Form I-693 immigration medical exam costs $390 flat at our St. Louis office. Book Regular and pay nothing until your visit. Or book Document Verified, with $100 at booking and $290 at your visit. Lab results return in 2–5 business days. Applicants who arrive fully prepared leave with the sealed form the same day.
Every cost, published. Every turnaround time, stated. That $390 is flat. Your sealed form is issued as soon as your paperwork, testing, and immunizations are complete.
Form I-693 exam fees
| Service | What it covers | Fee |
|---|---|---|
| Initial I-693 examination — Regular | History & physical, vaccination record review, form completion and sealing per USCIS guidelines. $0 at booking; $390 at the visit. We fill out the Form I-693 paperwork with you at the clinic. | $390 |
| Initial I-693 examination — Document Verified | The same examination. $100 at booking (non-refundable, credited toward the $390); $290 at the visit. Right after booking, you complete your part of Form I-693 online. We prepare the form before you arrive, so less of your visit is spent on paperwork. | $390 |
| Follow-up visit (only if required) | Additional in-person evaluation, per visit. Charged only when a further visit is actually needed. That happens for medical reasons: lab results that arrived late, a communicable disease such as TB or syphilis needing treatment or further evaluation, or a serious condition requiring an independent consultant’s report. It also happens if you arrived without complete paperwork, testing, or immunization records. If your initial presentation is fully complete, there are no follow-up fees. Your Form I-693 is completed and sealed at whichever visit your paperwork, testing, and immunizations are all complete. For applicants who arrive fully prepared, that is the initial visit. If anything is still outstanding, it is a later visit. | $190 |
| Laboratory testing | IGRA tuberculosis blood test, syphilis blood test, gonorrhea urine test. Which tests you need depends on your age and history. So the cost differs from applicant to applicant. Self-pay, or use your own insurance at their negotiated rate. | Quoted at your visit |
| Chest X-ray (only if needed) | Required only when the initial tuberculosis blood test is positive or borderline | Quoted if required |
| Vaccinations | Only doses you’re genuinely missing; county health departments offer low-cost options | Per dose |
There is no USCIS filing fee for Form I-693 itself. Payment accepted: cash, check, or card. Specialty consultations, if medically required, are billed separately.
How long does it take to get my I-693 results?
Day 0 — Your exam visit
History & physical, vaccine review, and any lab draws happen in one appointment (plan 2–6 hours).
You can leave with your sealed envelope the same day. If you arrive with your paperwork complete, your required testing already done, and full immunization records, Dr. Padda completes and seals your Form I-693 at this visit — no return trip. Applicants who close their vaccination gaps and bring their records in order are the ones who finish in a single visit.
Days 2–5 — Laboratory results
The IGRA tuberculosis blood test and syphilis/gonorrhea screens typically result within 2–5 business days. Positive or borderline TB results may require a chest X-ray, which adds several days.
When everything is complete — If anything was still pending
If lab results, vaccine records, or other documentation were outstanding at your visit, the form is completed once everything returns. Dr. Padda reviews the results with you in person, validates your official photo ID, and directly observes your wet signature on Form I-693. He completes his own validation signature at the same time, makes two copies, and seals the original — signing across the outside of the seal. You leave with the sealed original for USCIS and an unsealed copy for your records. We are prohibited from accepting a signature completed in advance, so this step is always in person. We text you the moment your form is ready. What changed on the I-693, including the sealed envelope rule.
Understand your required lab tests
Dr. Gurpreet Singh Padda, MD, MBA, MHP explains exactly what the labs are and why USCIS requires them. He also explains what happens if a result comes back positive.
How much does the immigration medical exam cost?
The USCIS immigration medical exam (Form I-693) costs $390 at our St. Louis office. That is the complete professional fee for the exam. There is no separate facility charge and no consultation fee on top of it.
You choose how to book. Regular: $0 at booking and the full $390 at your visit. We fill out your Form I-693 paperwork with you at the clinic. Document Verified: a $100 non-refundable fee at booking, credited toward the $390. The remaining $290 is due at your visit. Right after booking, you complete your part of Form I-693 online. We prepare the form before you arrive, so less of your visit is spent on paperwork. Either way, the total is $390.
Three costs sit outside that $390, because they are not ours to set:
- Laboratory testing: the IGRA tuberculosis blood test, syphilis blood test and gonorrhea urine test. Not every applicant needs the full panel. What USCIS requires depends on your age and history. So this cost differs from person to person. We quote it once we know what you need. If you would rather use your own insurance, you pay the rate your insurer has negotiated.
- Chest X-ray: needed only if your initial tuberculosis blood test comes back positive or borderline. Most applicants never need one. It is quoted at the time it is ordered. Or it is billed to your own insurance at their negotiated rate.
- Vaccinations: charged per dose, and only for doses you are truly missing. County health departments in the St. Louis area offer low-cost options. Bringing complete records is the single best way to keep this number at zero.
There is no USCIS filing fee for Form I-693 itself. Payment accepted: cash, check, or card. Specialty consultations, if medically required, are billed separately.
How much does an N-648 disability waiver evaluation cost?
The N-648 medical certification is a separate evaluation. It is far more involved than the I-693. It is a records-driven medical opinion, not a checklist exam, and it is priced to match.
| Service | What it covers | Fee |
|---|---|---|
| Records review | A structured review of your medical history. It decides whether the case can be certified at all. Non-refundable, but credited toward the evaluation if we accept the case. | $400 |
| N-648 evaluation | Full evaluation, cognitive assessment in your own language where needed, and completion of Form N-648. | from $1,400 |
| Revisions | Amendments or responses to a USCIS request, within 12 months of the evaluation. | $190 |
Frequently asked questions about I-693 exam cost
How much does the immigration medical exam cost?
$390 for the Form I-693 examination at our St. Louis office. With Regular, you pay nothing at booking and $390 at the visit. With Document Verified, you pay a $100 non-refundable fee at booking plus $290 at the visit. Laboratory testing and any vaccinations you actually need are billed separately. That is because the lab and the vaccine supplier set those prices, not us. A $190 follow-up visit applies only if another visit is needed. That can be for medical reasons, or because you arrived without complete paperwork, testing, or immunization records. If your initial presentation is fully complete, there are no follow-up fees.
The refund that backs that fee is set out in The Only 100% Money-Back Guarantee on Immigration Medical Exams in St. Louis.
Is the $390 the total cost, or are there hidden fees?
$390 is the complete professional fee for your exam. Laboratory testing is billed at lab rates and vaccinations per dose. Those apply only where USCIS requires them for your age and vaccination history.
A $190 follow-up visit fee applies only if an additional visit is actually needed. That can be for medical reasons: a finding that needs treatment or further evaluation, or a condition requiring an independent consultant’s report. Or it can be because you arrived without complete paperwork, testing, or immunization records. If your initial presentation is fully complete, there are no follow-up fees.
There is no facility fee, no separate consultation fee, and no USCIS filing fee for Form I-693.
There is more on this in The Only 100% Money-Back Guarantee on Immigration Medical Exams in St. Louis.
Are the lab tests included in the exam fee?
No, they are billed separately. And the amount truly varies. Which tests USCIS requires depends on your age and history. Some applicants need the full panel and others need less. We quote your lab cost once we know which tests apply to you. All samples are collected during your visit at our on-site draw station. So there is no separate trip.
Gonorrhea and Syphilis Testing in the I-693 Process: Who Gets Tested and Why explains what that looks like.
Can I use my own insurance for the labs and X-ray?
Yes. Some patients use their own insurance for lab testing or imaging. They pay the rate their insurer has negotiated, not our self-pay price. The $390 examination fee itself is not billed to insurance.
Do I have to pay the whole amount up front?
No. With Regular, nothing is due when you book. The full $390 is paid at the visit. With Document Verified, a $100 non-refundable fee is due when you book, credited toward the $390. The remaining $290 is due at the visit.
What to have ready before you book is covered in The I-693 Exam: What Every St. Louis Green Card Applicant Must Know Before Booking.
What if I need a second visit?
A follow-up visit is $190 per visit, and most applicants never need one. Sometimes everything is already complete at your first appointment. That means all required vaccinations documented, blood work in line with the published guidelines, no documented communicable disease exposure, and no major life-threatening illness. Then we complete the entire process on that single visit. If your initial presentation is fully complete, there are no follow-up fees.
A follow-up visit is charged only when a further visit is truly required:
- You arrived without complete records: missing paperwork, required testing not yet done, or incomplete immunization records.
- Results or records arrived late: lab results that came back after your exam, or a vaccine dose you completed afterward.
- A communicable disease finding: initial testing suggesting a condition such as tuberculosis or syphilis that needs treatment or further evaluation. These are reportable conditions. So we notify your local county health department, and the report flows on to the CDC.
- A serious underlying illness: your history and exam may suggest a major life-threatening condition. If so, we are required to engage an independent consultant. The consultant cross-validates the condition and provides a consultative report.
Your Form I-693 is completed and sealed at whichever visit your paperwork, testing, and immunizations are all complete. For applicants who arrive fully prepared, that is the initial visit. If anything is still outstanding, it is a later visit.
There is more on this in The I-693 Exam: What Every St. Louis Green Card Applicant Must Know Before Booking.
How long does the immigration medical exam take?
Plan 2 to 6 hours for the appointment itself. The history and physical, vaccine review, and any lab draws all happen in that one visit at our on-site draw station. If lab work is needed, results typically return in 2–5 business days. Some applicants arrive with paperwork, required testing, and immunization records complete. They leave with the sealed Form I-693 the same day.
Do I need a chest X-ray for the immigration medical exam?
Only if your initial tuberculosis blood test comes back positive or borderline. Most applicants never need one. When an X-ray is required, it adds several days before the form can be sealed. The cost is quoted at the time it is ordered. Or you can bill it to your own insurance and pay the rate your insurer has negotiated.
What happens if a test comes back positive at my immigration medical exam?
A positive or borderline tuberculosis result requires a chest X-ray. A communicable disease finding such as tuberculosis or syphilis needs treatment or further evaluation before the form is sealed. These are reportable conditions, so we notify your local county health department. A $190 follow-up visit applies when a further visit is needed. Your Form I-693 is sealed once the finding is resolved.
How much does the N-648 disability waiver cost?
$400 for the records review, which is non-refundable but credited toward the evaluation if the case is accepted. The evaluation itself starts at $1,400. Revisions within 12 months are $190.
How the records review and evaluation work is covered in Form N-648 Disability Waiver Evaluation.
How long until I get my sealed Form I-693?
It can be the same day. Come to your initial visit with your paperwork complete, your required testing already done, and full immunization records. Then Dr. Padda completes and seals your Form I-693 at that visit. You leave with the sealed envelope.
If anything is still outstanding, the form is sealed once it is resolved. Lab results typically return in 2–5 business days. A positive or borderline TB result requires a chest X-ray, which adds several days. A finding that needs treatment or an independent consultant’s report can take longer.
Signing and sealing is always done in person. Dr. Padda reviews your results with you and validates your official photo ID. He watches you sign in ink (your wet signature). Then he seals the original in front of you.
Know your costs. Lock in your date.
Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP — USCIS-designated civil surgeon (CSID 111051), board certified in Anesthesiology, Pain Medicine, Interventional Pain Management, Addiction Medicine, and Obesity Medicine. Last reviewed September 2026.