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 177.36
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 August 10, 2018