HTML Preview Feelistcurrent page number 1.


Student Health Price List
Covered by the Comprehensive Fee
Student Health professional services are covered by your comprehensive fee, pre-paid when you pay tuion and fees. This
means there is no charge for your visit with a care provider (e.g. physician, nurse praconer, mental health clinician, or
health educator. The list below shows prices of most immunizaons, injecons, laboratory tests, medical supplies and services.
Student Responsibility
As a paent, it is your responsibility to know and understand your insurance plan benets and your responsibility for any pre-
authorizaon, deducbles, co-insurance, or co-payment amounts prior to any visit. Not all services are covered in all insurance
contracts. If your insurance plan does not cover a service or procedure, you are responsible for payment of these charges.
Student Health does not accept nor le Medicaid claims.
Billing
Student Health will place the following charges on your UVA SIS account unless you have the school’s sponsored Aetna
Student Health Insurance. If you have the school’s sponsored Aetna Student Health insurance, Student Health will bill directly
on your behalf. Student Health does not bill to any other insurance companies or Medicaid.
The Laboratory and Pharmacy located in Student Health are satellites of the UVA Medical Center and will le prescripon and
lab charges to most insurance companies including Medicaid. The UVA Center Medical Center will bill separate from Student
Health for services rendered.
Before you have any procedures or labs test performed check with your insurance company to see what coverage
your insurance plan provides to you.
Prices are subject to change
CBC ....................................................$102.00
CBC + Di ........................................$132.00
Drug Screening .............................$446.00
Glucose by Meter ............................ $46.00
Pap Smear........................................$189.00
HCG-Qualitative ............................$123.00
HCG-Quantitative ......................... $211.00
Hep A Antibody ............................$155.00
Hep B Core Antibody-Total .......$170.00
Hep B Surface Antigen ...............$163.00
Hep B Titer .......................................$167.00
Hep C Antibody .............................$225.00
Hep C Viral Load ............................ $555.00
Herpes Antibody 1&2 – blood .$362.00
Herpes Simplex V Culture .......... $231.00
Herpes Simplex V typing ...........$462.00
HPVGEN ...........................................$313.00
Inuenza Screen A&B ..................$460.00
Measles Titer ...................................$162.00
Monospot ........................................$107.00
Mumps Titer ...................................$162.00
Polio Titer (price for 2 tests) ......$844.00
Rapid Strep .....................................$140.00
Rubella Titer ....................................$184.00
Stool-Micro-White Blood Cell ..... $78.00
Stool – Occult Blood ...................... $82.00
Tenanus Titer .................................. $192.00
Throat Culture ................................$120.00
Urinalysis Protocol ......................... $50.00
Urinalysis Micro ............................... $91.00
Urine Culture .................................. $108.00
Urine HCG Pregnancy Test .......... $97.00
Varicella Titer .................................. $193.00
Venipuncture ................................... $34.00
White Blood Cell-Urethral............ $78.00
Immunizations:
Flu ........................................................ $30.00
Gardasil (Series of 3)...each .......$207.00
HBIG (1ml dose) .......................... $166.00
Hepatitis A (Series of 2)…each .. $75.00
Hepatitis B (Series of 3)…each .. $65.00
Japanese Encephalitis (Series of 2)….
each ................................................... $301.00
Measles/Mumps/Rubella ............. $78.00
Meningitis .......................................$125.00
Meningitis B ....................................$157.00
Polio..................................................... $45.00
Pneumococcal ................................ $77.00
PPD….................................................. $20.00
Rabies Immune Globulin (per 2ml vial)
estimate ...........................................$475.00
Rabies IM (Series of 4-5).each ..$285.00
Twinrix (Series of 3)…each ......$102.00
Typhoid ............................................ $102.00
Td (Tetanus/Diphtheria) ............... $31.00
Tdap ..................................................... $46.00
Varicella (Series of 2)…each .....$117.00
Yellow Fever ...................................$156.00
Injectable Medications:
Benadryl 50 mg .............................. $16.00
Bicillin L-A 1.2mu ..........................$145.00
Ceftriaxone 250 mg ...................... $17.00
Demerol (50 mg) ............................. $16.00
Depo ................................................... $98.00
Gentamicin ....................................... $16.00
Imitrex ................................................ $69.00
Ketorlac (30 mg) .............................. $17.00
Phenergan......................................... $16.00
Reglan ................................................. $16.00
Solu-Medrol (125mg) .................... $20.00
Services:
Allergy Injections ...... $15.00 (1) $25(2+)
EKG....................................................... $45.00
Employment Physical................…$75.00
Inhalation Therapy ......................... $45.00
IV Fluids .............................................. $30.00
Other Injections .............................. $15.00
Summer Fee ...... $10 per visit per clinic
Copy of Medical Records ...... $.50/page
up to 50 pages then $.25/page
Labs
Chlamydia LCx ................................. $18.00
GC LC ................................................... $18.00
GC/Chlamydia .................................. $20.00
HIV1/HIV2 Antibody Screen........ $22.00
Quantiferon Gold ........................... $68.00
Syphilis IGG ....................................... $17.00
Supplies:
Ankle Brace ....................................... $48.00
Ankle Splint-Flex Fit ....................... $39.00
Crutches ............................................ $20.00
C-Spine Collar .................................. $15.00
Finger Splint ........................................$8.00
Derma Bond ..................................... $52.00
Knee Immobilizer ........................... $32.00
Shoecast ............................................ $18.00
Shoulder Immobilizer ................... $17.00
Suture Tray ........................................ $24.00
Wrist Splint ........................................ $28.00
Wrist Thumb ..................................... $43.00
No Show Charge ............................. $25.00
A “walk out statement” of your encounter may be obtained through your Healthy Hoos account at
hps://www.healthyhoos.virginia.edu.
Updated 9/15/2017
Billed by Medical Center - for more informaon go to hp://www.upg.virginia.edu/PaentBillingCenter
Lab Prices:
Billed by Student Health:
Student Health will place the following charges on your UVA SIS account unless you have the school’s sponsored Aetna Student Health
Insurance. If you have the school’s sponsored Aetna Student Health insurance, Student Health will bill directly on your behalf.
DOWNLOAD HERE


You are not your resume, you are your work. | Seth Godin