Medical Fees
Other than the Aetna Student Health Plan, UHS does not bill insurance. Charges incurred at UHS will be applied to the student's Irish Pay account. Other payment options are available at time of service.
Lab tests performed by the South Bend Medical Foundation (SBMF) satellite laboratory, located in Saint Liam Hall, will be billed to the patient by SBMF. Prescriptions dispensed by the Saint Liam Hall Walgreens will be billed to the patient by Walgreens. Patients are encouraged to contact their insurance carrier to see if SBMF and Walgreens are in-network before services are rendered.
Questions about the Health Center Access Fee? Click here.
| Service Type | Service | Fee |
| Vaccine | Cholera | 265.96 |
| Vaccine | Hepatitis A | 115.34 |
| Vaccine | Hepatitis A/B Twinrix | 152.68 |
| Vaccine | Hepatitis B Energix | 103.86 |
| Vaccine | Hepatitis B Heplisav | 169.05 |
| Vaccine | HPV Gardasil 9 | 268.35 |
| Vaccine | Japanese Encephalitis | 380.91 |
| Vaccine | Meningitis ACYW Menactra | 169.77 |
| Vaccine | Meningitis B Trumenba | 172.67 |
| Vaccine | Meningitis B Bexsero | 224.76 |
| Vaccine | Measles Mumps Rubella | 119.22 |
| Vaccine | Pneumococcal | 240.70 |
| Vaccine | Rabies | 415.53 |
| Vaccine | TB Skin Test, PPD | 56.96 |
| Vaccine | Tetanus diphtheria | 76.84 |
| Vaccine | Tetanus diphtheria pertussis | 84.82 |
| Vaccine | Typhoid Injectable | 147.04 |
| Vaccine | Typhoid Oral | 119.33 |
| Vaccine | Varicella | 184.24 |
| Injection | Allergy Injection 1 unit | 36.00 |
| Injection | Allergy Injection 2+ units | 42.00 |
| Medication | Bentyl 20mg | 146.00 |
| Medication | Bicillin LA 120000 units | 222.56 |
| Medication | Bicillin LA 240000 units | 404.00 |
| Medication | Ceftriaxone 250mg | 50.00 |
| Medication | Compazine | 71.60 |
| Medication | DepoMedrol | 50.00 |
| Medication | Dexamethasone 4mg | 50.00 |
| Medication | Epinephrine | 62.00 |
| Medication | Hydroxyzine HCI 100mg/2ml | 50.00 |
| Medication | Imitrex | 86.34 |
| Medication | Kenalog 40mg | 107.60 |
| Medication | Ketorolac 60mg/2ml | 50.00 |
| Medication | Marcain | 66.42 |
| Medication | Metoclopramide | 50.00 |
| Medication | Rocephin | 50.00 |
| Medication | Phenergan | 50.00 |
| Medication | SoluMedrol 125mg, IV | 76.40 |
| Medication | Vitamin B12 | 50.00 |
| Medication | Xylocaine | 50.00 |
| Lab | Alere-i Quick Flu Test | 60.00 |
| Lab | KOH Skin Test Prep | 31.70 |
| Lab | Lab Draw Fee | 28.46 |
| Lab | Quick Strep A Test | 30.00 |
| Lab | TB Skin Test, PPD | 56.96 |
| Office Visit | No Show Fee | 10.00 |
| Procedure | Anoscopy | 355.81 |
| Procedure | Aspiration | 310.00 |
| Procedure | Audiometer | 50.00 |
| Procedure | Avulsion of Nail Plate | 284.00 |
| Procedure | Biopsy of Skin | 238.00 |
| Procedure | Cast Removal | 161.39 |
| Procedure | Casting Elbow To Fingers | 454.23 |
| Procedure | Casting Leg / Ankle | 484.20 |
| Procedure | Cryocuff Therapy | 48.69 |
| Procedure | Cryotherapy for Acne | 213.90 |
| Procedure | Debridement of Wound | 251.01 |
| Procedure | Destruction of Lesion | 352.28 |
| Procedure | Ear Lavage / Curettage | 133.00 |
| Procedure | EKG | 90.00 |
| Procedure | Evacuation of Subungual Hematoma | 161.00 |
| Procedure | Excision of Lesion | 502.84 |
| Procedure | Excision of Nail | 547.00 |
| Procedure | Eye Irrigation | 286.62 |
| Procedure | Eye Stain | 228.23 |
| Procedure | Foreign Body Removal Ear | 625.75 |
| Procedure | Foreign Body Removal Eye | 286.62 |
| Procedure | Hand Held Nebulizer Treatment | 63.00 |
| Procedure | Incision & Draining of Abcess | 270.00 |
| Procedure | Incision / Removal Foreign Body | 472.00 |
| Procedure | Incision of Soft Tissue Abcess | 310.00 |
| Procedure | Injection Therapeutic | 50.00 |
| Procedure | IV Fluid | 250.14 |
| Procedure | Lesion Shaving 0.5cm or Less | 247.71 |
| Procedure | Nasal Cautery / Packing | 588.55 |
| Procedure | Osteopathic Manipulation 1 - 10 Areas | 67.00 |
| Procedure | Pap Procedure | 203.00 |
| Procedure | Paring / Cutting of Lesion | 102.16 |
| Procedure | Platelet Rich Plasma Procedure | 300.00 |
| Procedure | Pulmonary Function Test | 96.00 |
| Procedure | Puncture Aspiration | 310.00 |
| Procedure | Removal of Foreign Body Superficial | 286.62 |
| Procedure | Removal of Skin Tags | 180.00 |
| Procedure | Splinting Short Arm (Forearm To Hand) | 320.63 |
| Procedure | Surgical Repair 12.6cm to 20cm | 965.77 |
| Procedure | Surgical Repair 2.5 or Lesson Face | 737.03 |
| Procedure | Surgical Repair 2.5cm or Less | 609.95 |
| Procedure | Surgical Repair 2.6cm to 7.5cm | 737.03 |
| Procedure | Surgical Repair 7.6cm to 12.5cm | 914.94 |
| Procedure | Suture Removal From Off Campus Provider | 96.00 |
| Procedure | Trigger Point Injection / Dry Needling | 331.70 |
| Procedure | Tympanography | 91.30 |
| Supply | Aerochamber | 74.09 |
| Supply | Air Cast Leg Brace | 166.99 |
| Supply | Aircast Ankle Brace | 42.17 |
| Supply | Ankle Brace Stabilizer | 51.84 |
| Supply | Arch Orthotics 3/4 Length | 24.73 |
| Supply | Arm Splint | 14.40 |
| Supply | Back Brace | 42.17 |
| Supply | Blood Pressure Monitoring Kit | 44.64 |
| Supply | Calf Sleeve | 11.95 |
| Supply | Cast Cover Shower Safe Arm | 13.20 |
| Supply | Clavicle Splint | 17.94 |
| Supply | Clavicle Support | 32.40 |
| Supply | Crutches | 21.25 |
| Supply | Dermabond | 56.39 |
| Supply | Dermabond Pen | 64.20 |
| Supply | Elastic Net | 10.37 |
| Supply | Ezy-Wrap Shoulder Wrap Pad | 62.00 |
| Supply | Fiberglass Splint | 14.11 |
| Supply | First Aid Kit | 27.84 |
| Supply | Foot Pads | 18.67 |
| Supply | Heel WonderZorb | 52.67 |
| Supply | Horseshoe Cushion | 21.59 |
| Supply | IROM Brace | 240.00 |
| Supply | Knee Eco Hinged Brace | 87.94 |
| Supply | Knee Immobilizers | 44.04 |
| Supply | Knee Sleeve Closed | 12.52 |
| Supply | Knee Sleeve Open | 12.79 |
| Supply | Lumbar Roll | 15.95 |
| Supply | Monsel Ferric Substrate Solution | 28.94 |
| Supply | Nasal Packing | 25.80 |
| Supply | Oval Finger Splint | 30.53 |
| Supply | Oxygen Mask with Oxygen use | 43.20 |
| Supply | Peak Flow Meter | 10.80 |
| Supply | Rib Belt | 10.19 |
| Supply | Shin Sleeve | 20.39 |
| Supply | Shoulder Immobilizer | 16.80 |
| Supply | Spenco Full Arch | 22.19 |
| Supply | Taxi Ride - One Way | 15.98 |
| Supply | Thumbkeeper | 75.60 |
| Supply | Thumbspica Splint | 44.10 |
| Supply | Walker Air Brace | 141.60 |
| Supply | Walker Short Foot | 32.94 |
| Supply | Walker Tall Foot | 32.94 |
| Supply | Wrist Sleeve | 13.20 |
| Supply | Wrist Support Proflex | 15.16 |
| Supply | Wrist Wrap | 24.06 |
| X-Ray | Abdomen | 134.00 |
| X-Ray | AC Shoulder Joint | 120.00 |
| X-Ray | Ankle - 2 Views | 140.00 |
| X-Ray | Ankle - 3 Views | 200.00 |
| X-Ray | Cervical Spine - 2 3r 3 View | 157.00 |
| X-Ray | Chest - Single View | 165.60 |
| X-Ray | Chest Posterior Anterior Lateral | 112.00 |
| X-Ray | Clavicle | 173.00 |
| X-Ray | C-Spine - Minimum 4 Views | 210.00 |
| X-Ray | C-Spine Flexion And Extension | 277.00 |
| X-Ray | Elbow | 150.00 |
| X-Ray | Facial Bones | 171.85 |
| X-Ray | Facial Bones Complete | 207.04 |
| X-Ray | Feet Both - Single View | 183.00 |
| X-Ray | Feet Both - Single View | 183.00 |
| X-Ray | Femur Anterior Lateral | 212.82 |
| X-Ray | Fingers | 112.20 |
| X-Ray | Foot - 2 Views | 65.00 |
| X-Ray | Foot - 3 Views | 188.00 |
| X-Ray | Forearm | 167.00 |
| X-Ray | Hand - 3 Views | 194.00 |
| X-Ray | Heel / Calcaneus | 124.00 |
| X-Ray | Hip - 2 Views | 227.49 |
| X-Ray | Humerus | 173.00 |
| X-Ray | Knee | 262.00 |
| X-Ray | Knee Complete | 262.00 |
| X-Ray | Lumbar Spine w/Oblique Views | 255.00 |
| X-Ray | Lumbosacral Spine - 2 or 3 Views | 178.00 |
| X-Ray | Mandible Complete - 3 Views | 169.77 |
| X-Ray | Nasal Bones | 153.00 |
| X-Ray | Neck | 125.00 |
| X-Ray | Orbits - 4 Views | 200.83 |
| X-Ray | Pelvis | 171.00 |
| X-Ray | Pelvis Bilateral - 2 Views | 275.19 |
| X-Ray | Ribs - 3 Views | 193.00 |
| X-Ray | Sacroliac Joints | 144.93 |
| X-Ray | Sacrum Coccyx - 2 Views | 178.00 |
| X-Ray | Scapula Complete | 164.00 |
| X-Ray | Scoliosis Study | 364.81 |
| X-Ray | Shoulder - 1 View | 128.00 |
| X-Ray | Shoulder - 2 Views Or Complete | 183.00 |
| X-Ray | Sinus - 4 Views | 171.85 |
| X-Ray | Skull - 4 Views | 225.68 |
| X-Ray | Skull - Less Than 4 Views | 163.56 |
| X-Ray | Spine Thoracic - 2 View | 113.00 |
| X-Ray | Spine Thoracic - 3 View | 124.00 |
| X-Ray | Sternum - 2 Views | 149.07 |
| X-Ray | Tibia / Fibula | 165.00 |
| X-Ray | Toes - Minimum 2 Views | 116.00 |
| X-Ray | Wrist - 2 View | 129.00 |
| X-Ray | Wrist - 3 Views | 226.00 |
Updated 10/18/2018