| Express Medical Uninsured Services Cost List | ||||
| Category | Service Type | Billing Type | Fee | |
| No Show | Regular/Follow-up/Routine | Standard Fee | $25.00 | |
| CPX/Procedures | Premium Fee | $50.00 | ||
| Clinic Transfer | Chart Transfer | 1 year or less | $50.00 | |
| Extra pages each | $1.00 | |||
| 2 – 3 years | $75.00 | |||
| 3+ years | $100.00 | |||
| No MB Health Number (Private Billing – use code OVWMHC) | Inactive #, Non MB Resident, Tourist, International Students, IFHP etc. | Initial Consultation | $125.00 | |
| Follow up | $60.00 | |||
| Complete Physical (CPX) | $125.00 | |||
| Forms | Adoption | Physical Exam & Form | $100.00 | |
| Sports | Physical Exam & Form | $100.00 | ||
| Private Procedure | Pre-Op Exam & Form | $100.00 | ||
| Travel Cancelation | Insurance Medical Form | $50.00 | ||
| Disability Claim | Form | $50.00 | ||
| CRA Disability Tax Credit | Form | $100.00 | ||
| Work Forms | Modified Duties | $100.00 | ||
| Physical Exam & Form | $100.00 | |||
| Company Work Form | $100.00 | |||
| E.I. | Report Form | $50.00 | ||
| RCMP/Winnipeg Police | Health Form | $100.00 | ||
| Camp/School | Certificate of Fitness Form | $100.00 | ||
| Non-Insured Health Benefits (NIHB) | Form | $30.00 | ||
| Proof of Death | Form | $50.00 | ||
| Medical Clearance | Detoxification & Stabilization | $100.00 | ||
| Manitoba Public Insurance (MPI) | MPI Driver | Physical Exam & Form | $100.00 | |
| MPI Reporting | Alcohol Reporting Form | $50.00 | ||
| Drug Reporting Form | $50.00 | |||
| Doctor’s Note | Sick Note | Letter | $25.00 | |
| To Whom It May Concern | Letter | $100.00 | ||
| Referral Note | Orthotics | Letter/Rx | $20.00 | |
| Compressions | Letter/Rx | $20.00 | ||
| Physio/Massage/Chiro | Letter/Rx | $20.00 | ||
| Reports | Medical Summary (ie: injury outline, treatment, prognisis) | Provider’s Hourly Rate | ||
| Narrative Report (ie: civil litigation or competency hearing) | ||||
| Permits | Parking | Form | $50.00 | |
| Handi Transit | Form | $50.00 | ||
| Procedures (when not covered by MB Health) | Ear Flusing | Service Fee | $45.00 | |
| Cosmetic/Benign Lessions Surgical Removal | Procedure Fee – starts at | $175.00 | ||
| Joint Injection | Medication & Injection (per joint) | $150.00 | ||
| Histofreeze (each cosmetic lesion) | Warts/Skin Tags – starts at | $25.00 | ||
| Initial Visit | $60.00 | |||
| Follow up | $40.00 | |||
| Travel Health (vaccinations are extra) | Twinrix (Combined Hep A&B) 3 doses 0, 1, 6 months | Injection Only | $40.00 | |
| Hepatitis A – 2 doses at 0 & 6 months | Injection Only | $40.00 | ||
| MMR | Injection Only | $40.00 | ||
| Administration Charge | $85.00 | |||
| If no MB Health Coverage | Visit Fee | $125.00 | ||
| Shingles Vaccine (Shingrix) 2 doses at 0 & 2-6 months | Injection Only | $30.00 | ||
| TB One Step | Injection Only | $100.00 | ||
| Form | $40.00 | |||
| TB Two-Step | Injection Only | $120.00 | ||
| Form | $40.00 | |||
| Pneumonia Prevnar | Injection Only | $30.00 | ||
| Hepatitis B – 2 dose series at 0 & 6 months | Injection Only | $40.00 | ||
| Vaccinations (not including cost of rx) | HPV – Injection Only | $30.00 | ||
| HPV – Gardasil 9+ Injection (each) | $230.00 | |||
| Gardasil (born after 1997) | $40.00 | |||
| All Other Injections not covered by MB Health | Injection | $40.00 | ||