The following fees apply as of July 1, 2009.
CATEGORY |
FEE AMOUNT |
|
Semester Health Fee |
$60 |
|
Summer Health Fee |
$48 |
|
Summer Visit Fee |
$30 |
|
Routine Physicals |
$50 |
|
Medical Records Copying |
$10 |
|
Missed Appointment |
$10 |
LAB TEST FEES |
FEE AMOUNT |
|
CBC (complete blood count) |
NC |
|
CBC/c diff |
NC |
|
Chlamydia swab or urine (Aptima) |
$13 |
|
Chlamydia/Gonorrhea swab or urine (Aptima) |
$27 |
|
CMP (Compmetabolic) |
$18 |
General Culture |
$39 |
Glucose |
NC |
|
Gonorrhea swab or urine (Aptima) |
$14 |
|
Hepatitis BsAb (titer) |
$17 Student/$19 FS |
|
Hepatitis B/C pre-screen |
$37 |
|
Herpes Culture |
$21 |
|
HSVI & II (serum) |
$63 |
|
Hgb A1C |
$15 |
|
HIV test |
$20 |
|
HIV & Syphilis |
$25 |
|
Lipid Profile |
$16 Students/$20 FS |
|
Liver Profile |
$15 |
|
MMR Titer |
$41 |
|
Mono Test |
NC |
|
Pap Smear (Thinprep Monolayer) |
$21 |
|
Rapid Influenza |
NC |
|
Rapid Strep |
NC |
|
Sed rate |
NC |
|
Serum Pregnancy, Qual |
$14 |
|
Serum Pregnancy, Quan |
$15 |
|
Skin scrapings |
NC |
|
Stool Culture |
$17 |
|
Stool Hemocults |
NC |
|
Stool O&P |
$19 |
|
STS (Syphilis) |
$12 |
|
Thyroid Cascade |
$31 |
|
Thyroid Profile 1 |
$22 |
|
TPO Thyroid Antibody Profile |
$89 |
|
TSH |
$14 |
|
Upper Respiratory Culture |
$20 |
|
Urinalysis/routine |
NC |
Urinalysis/complete |
NC |
|
Urine Pregnancy (HCG) |
NC |
|
Urine culture |
$31 |
|
Vaginal wet preps (KOH & saline) |
NC |
|
Varicella Titer |
$24 |
MEDICATIONS/IMMUNIZATIONS |
FEE AMOUNT |
|
Albuterol/Nebulizer treatments |
$5 |
|
Allergy injections (per injection) |
$7 |
|
Azithromycin (generic for Zithromax) (1gm) |
$5 |
|
Ceftriaxone injection 125/250mgIM |
$9 |
|
Ceftriaxone injection (500mgIM & 1gm IM/IV) |
$10 |
|
Cefixime (Suprax) (400mg tab) |
$12 |
|
Cipro 500mg |
N/C |
|
Injection Fee (per injection) |
$7 |
|
Gardasil vaccine(HPV) (per dose) |
$133 |
|
Hepatitis B Vaccine (per dose) |
$31 Student |
Influenza vaccine |
$15 Student/FS $20 |
Menactra (meningitis) Vaccine |
$103 |
MMR Vaccine (measles/mumps/rubella) |
$52 |
|
PPD (TB skin test) |
$6 |
Tetanus-Diphtheria Vaccine (Decavac) |
$24 |
Tdap (Tetanus, diphtheria, acellular pertussis) |
$37 |
Toradol injection (Ketorolac) (30mg IM/60mg IM) |
$8/$16 |
CONTRACEPTIVES |
FEE AMOUNT |
|
Apri (generic for Desogen) |
3/$29 6/$51 10/$81 13/$103 |
|
Aviane-28 (generic for Alesse) |
3/$45 6/$84 10/$135 13/$174 |
|
Condoms (Regular/Magnums) |
12/$1-$3 |
|
Nortrel (generic for Modicon) |
3/$42 6/$78 10/$125 13/$160 |
|
Medroxprogesterone acetate Injection
(generic DepoProvera) |
$31 |
|
Plan B (Levonorgestrel) |
$12 |
|
Tri-Sprintec (generic for Ortho Tri-Cyclen)
|
3/$37 6/$68 10/$108 13/$138 |
Velivet (generic for Cyclessa) |
3/$42 6/$78 10/$125 13/$160 |
MISCELLANEOUS |
FEE AMOUNT |
|
Cryotherapy (1-6 warts & 7 or more warts) |
$10/$15 |
|
Dental Dams |
3/$2 |
|
Ear-wax Removal Kit |
$6.50 |
|
Electrocardiogram |
$20 |
|
IV Fluid |
$20 first liter/$15 addl liter |
|
Minor surgical procedures |
$25 |
|
Peak Flow Meters |
$16 |
ORTHOPEDIC DEVICES |
FEE AMOUNT |
|
Crutch rental* |
$20 |
|
Lace-Up Ankle Brace |
N/C |
|
Slings |
N/C |
|
Aluminum Wrist/Forearm Splint/ Thumb Splint |
N/C |
