| BRYN MAWR COLLEGE HEALTH CENTER | |
| Fee Schedule 2012-13 | |
| IMMUNIZATIONS: | |
| Allergy | $30.00 |
| PPD | $20.00 |
| Flu | $25.00 |
| MMR* | $60.00 |
| Tdap* | $45.00 |
| Hepatitis B* | $75.00 |
| HPV* | $135.00 |
| Meningitis* | $100.00 |
| (*add $10 RN Injection Fee) | |
| LABORATORY(internal): | |
| Phlebotomy | $5.00 |
| Urine Dip | $10.00 |
| Quick Strep | $25.00 |
| HCG | $20.00 |
| Glucose | $10.00 |
| Hemoccult 3 | $15.00 |
| EKG | $30.00 |
| LABORATORY(external): | |
| PHLEBOTOMY | $5.00 |
| COMP METABOLIC PANEL | $10.00 |
| LIPID PANEL | $20.00 |
| HEMOGLOBIN | $10.00 |
| CBC W/ DIFF | $10.00 |
| GLUCOSE, SERUM | $10.00 |
| HCG, SERUM QUANT | $55.00 |
| HEALTH SCREEN | $20.00 |
| IRON, TOTAL | $15.00 |
| RPR | $15.00 |
| RUBELLA IGG AB | $30.00 |
| TSH | $15.00 |
| T4, free | $10.00 |
| URINE CULTURE, ROUTINE | $30.00 |
| UA COMPLETE | $10.00 |
| CULTURE(2 TUBES) | $30.00 |
| CULTURE, GROUP A STREP | $15.00 |
| CHLAMYDIA & GC | $25.00 |
| CULTURE, CAMPYLOBACTER | $20.00 |
| CULTURE, SALMONELLA/SHIGELLA | |
| STAPH SCREEN | |
| O & P | $30.00 |
| HETEROPHILE, MONO | $15.00 |
| HERPES CULTURE | $30.00 |
| HSV I/II HERPES SELECT | $20.00 |
| WOUND CULTURE | $65.00 |
| C-DIFFICILE | $40.00 |
| LITHIUM | $20.00 |
| LABORATORY(gyn): | |
| CT/GC | $25.00 |
| HCG | $20.00 |
| HEALTH SCREEN | $20.00 |
| HERPESELECT | $20.00 |
| HERPES CULTURE | $30.00 |
| PAP-LIQUID BASED | $80.00 |
| PAP-SLIDE | $25.00 |
| PHLEBOTOMY | $5.00 |
| RPR | $15.00 |
| URINE DIP | $5.00 |
| URINE CULTURE | $20.00 |
| WET MOUNT | $10.00 |
| SERVICES | |
| COUNSELING VISIT (BEYOND FIRST 6) | $75.00 |
| PHYSICAL EXAM | $75.00 |
| 6 MONTH ATHLETIC CLEARANCE | $50.00 |
| PE FOR DRIVERS LICENSE | $40.00 |
| MISSED APPOINTMENT -MEDICAL | $10.00 |
| MISSED APPOINTMENT -COUNSELING | $20.00 |
| MEDICATIONS (OTC): | |
| ANTIBIOTIC OINTMENT | $5.00 |
| HYRDOCORTISONE CREAM | $5.00 |
| PLAN B | $40.00 |
| VAGINAL YEAST CREAM | $15.00 |
| Medications(Prescription) | |
| ORAL CONTRACEPTIVES | $15.00 |
| ALBUTEROL INHALER | $50.00 |
| IMITREX- ORAL | $20.00 |
| IMITREX- IM | $100.00 |
| TAMIFLU | $120.00 |
| CIPRO EYE DROPS | $25.00 |
| PRESCRIPTION RX | $15.00 |
| DIFLUCAN | $20.00 |
| Z-PACK | $20.00 |
| SERVICES AND SUPPLIES: | |
| ACE WRAP | $5.00 |
| ANKLE BRACE | $30.00 |
| COLD PACK | $5.00 |
| MININEB X __ | $30.00 |
| RN INJECTION | $10.00 |
| SHORT STAY | $0.00 |
| SLING | $10.00 |
| SOFT CERVICAL COLLAR | $15.00 |
| SPLINT- ARM | $15.00 |
| THERMOMETER | $10.00 |