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Fee Schedule

UHS Pricing as of 8/23/19

Description Charge Transaction Category
Established Patient; Brief $51.00 Office Visit
Established Patient; Comprehensive $150.00 Office Visit
Established Patient; Detailed $113.00 Office Visit
Established Patient; Expanded Problem Focused $83.00 Office Visit
Established Patient; Problem Focused $68.00 Office Visit
Nurse Procedure Only Visit $0.00 Office Visit
Office Visit – did not keep appointment $25.00 Office Visit
Office Visit – no charge $0.00 Office Visit
Preventive Medicine Est. Pt. 12-17 $96.00 Office Visit
Preventive Medicine Est. Pt. 65 or Over $0.00 Office Visit
Preventive Medicine New Pt. 12-17 $116.00 Office Visit
Preventive Medicine New Pt. 65 or Over $0.00 Office Visit
Preventive/Annual Gyn Est. 18-39 $126.00 Office Visit
Preventive/Annual Gyn Est. 40-64 $106.00 Office Visit
Preventive/Annual Gyn New 18-39 $146.00 Office Visit
Preventive/Annual Gyn New 40-64 $137.00 Office Visit
Acupuncture Consultation $30.00 Acupuncture
Acupuncture, without Elec Stim, 1st 15 min $15.00 Acupuncture
Acupuncture, without Elec Stim; each add’l 15 min $15.00 Acupuncture
Massage Therapy; each 15 min $15.00 Massage
Medical Record Copies $10.00 Administrative
Medical Record Retrieval $50.00 Administrative
Venipuncture, Routine $10.00 Office Procedures
Alcohol Edu $100.00 Office Procedures
Allergy Injection; multiple $33.00 Office Procedures
Allergy Injection; single $31.00 Office Procedures
Colposcopy with Biopsy and ECC $175.00 Office Procedures
IUD Insertion $100.00 Office Procedures
Flu Vaccine $20.00 Immunizations
Hepatitis A Vaccine

Hepatitis B Vaccine (Adult)

$130.00

$106.00

Immunizations

Immunizations

Human Papilloma Vaccine, 3 Dose IM $325.00 per dose Immunizations
Meningococcal Vaccine (Quadrivalent) $193.00 Immunizations
Mumps-Measles-Rubella Vaccine $109.00 Immunizations
Tdap (Adacel) Tetanus $67.00 Immunizations
Drug Screen IH A $60.00 Laboratory IH
Pregnancy Test (urine) IH $8.00 Laboratory IH