(204) 231-1724

Fax: (204) 231-1829

191 Marion Street

Winnipeg, MB R2H 0T5

Uninsured Services Fee Schedule

(These are services not paid for by Manitoba Health and billed directly to you)


PHYSICAL EXAMINATIONS NOT COVERED BY MHSC

WORK PHYSICAL EXAMINATION & FORM $100.00

PRVATE COMPLETE PHYSICAL EXAM & FORM (ADOPTION/SPORT/ETC.) $100.00

PRIVATE PRE-OP EXAM (PRIVATE SURGERY) & FORM $100.00

DRIVERS PHYSICAL EXAMINATION & FORM $100.00


PATIENTS WITHOUT VALID MHSC COVERAGE

INITIAL VISIT $100.00

FOLLOW-UP VISIT $50.00


FORMS

SICK NOTE $25.00

DISABILITY INSURANCE CLAIMS FORM $80.00

MODIFIED WORK DUTIES/COMPANY FORM $80.00

PARKING PERMIT $30.00

HANDI-TRANSIT FORM $30.00

DISABILITY TAX CREDIT $100.00
DISABILITY TAX CREDIT FOLLOW-UP FORM $30.00

MPI ALCOHOL/ DRUG FORM $30.00

RCMP/WPG POLICE MEDICAL HEALTH FORM $80.00

CAMP/SCHOOL FORM $60.00

TRAVEL CANCELLATION FORM $40.00


MANTOUX 

TB One-Step (Injection Only, Form Extra) $60.00

TB One-Step (Injection Only, Form Extra) $120.00

School Immunization Form Completion $60.00


IMMUNIZATIONS NOT COVERED BY MHSC

HEPATITIS A (ADMINISTRATION ONLY) $30.00

HEPATITIS B (ADMINISTRATION ONLY) $30.00 

TWINRIX (HEPATITIS A & B) $30.00

HPV VACCINE & ADMINISTRATION (GARDASIL) $190.00

ZOSTAVAX VACCINE & ADMINISTRATION $220.00

SHINGRIX VACCINE & ADMINISTRATION $320.00

PREVNAR 13 VACCINE & ADMINISTRATION $150.00

ALL OTHER INJECTIONS NOT COVERED BY MHSC $30.00


MISCELLANEOUS

PRIVATE EKG $30.00

TRANSFER OF CHARTS $50.00