My old pdoc was wonderful. She took insurance, but if you were at an appointment, and you needed 30 minutes of her time or even more, she would let the staff in front know and give it to you without extra cost. She billed the insurance $90 a session, but at times I had no insurance, she charged my $50 for out-of-pocket. My new pdoc is good, he will give you the extra time, but you can't tell he really wants to be efficient and stick to his 15 minute appts. I doubt he will charge less for out-of-pocket payments the way my old pdoc did. The downside with my old pdoc was sometimes you had to wait a long time past your appointment time to see her. The new doctor runs right on schedule unless he's had an emergency case. I still wish my old pdoc were not retiring, but she's also a wonderful person and has worked hard and deserves to enjoy this stage of her life.