(Charges to Residents of Canada with Valid OHIP)
| Ambulance |
$45.00 |
| Accommodations |
|
| Semi-Private Room |
$235.00 daily rate |
| Private Room |
$275.00 daily rate |
(Insurance and credit card information are required when requesting a Semi or Private)
| Alternate Level of Care |
|
| Co-payment fee may apply |
$1,674.14 monthly maximum |
| Delisted Services |
|
| Circumcision |
$600.00 |
| Cosmetic |
varies |
| Cryotherapy |
$242.00 |
| Gynecomastia |
$900.00 |
| Microscopic Vasovastostomy |
$900.00 |
| Newborn Circumcision |
$242.00 |
| Scar Revision/Torn Ear Lobe |
$242.00 |
| Simple Sclerother – by injection |
$242.00 |
| Skin Lesion Excision |
$242.00 |
| Removal of Moles, Tattoo, Warts |
$242.00 |
| Tubal Reversal |
$600.00 |
| Parking Fees |
$7.50 max daily |
|
|
|
|
| Appliances |
|
| Abdominal Binder |
$20.00 |
| Abductor Pillows/Shoulder/Hip |
$100.00 |
| Aero Chamber – Adult |
$15.00 |
| Aero Chamber- Ped |
$29.00 |
| Ankle Sprain Kit (Air Cast) |
$65.00 |
| Arm Bank (Tennis Elbow) |
$25.00 |
| Bandage-Jones w/o splint |
$40.00 |
| Bandage-Jones with splint |
$50.00 |
| Cane |
$15.00 |
| Cast Boot |
$15.00 |
| Clavicle Strap |
$16.00 |
| Collar – Cervical |
$11.00 |
| Collar – Philadelphia |
$65.00 |
| Crutches Aluminum |
$28.00 |
| Custom Appliance |
varies |
| Dental Dam |
$5.00 |
| Emboli Stocking |
$24.00 |
| Fiberglass Castings |
$6.00 to $10.00 a roll |
| Fibromyalgia Exercise Book |
$7.00 |
| Fibromyalgia Tape |
$19.00 |
| Fracture Walker Boot |
$115.00 |
| Gortex Casting |
$20.00 to $42.00 a roll |
| Ice/Hot Packs (each) |
$10.00 |
| Immobilizer – Knee |
$47.00 |
| Immobilizer – Shoulder |
$14.00 |
| Knee Brace (ROM) |
$167.00 |
| Lumber Roll – Foam |
$20.00 |
| Mackenzie Educ. Book Neck/Back |
$13.50 |
| Mackenzie Roll Standard/Cervical |
$20.00 |
| Mackenzie Roll – Super |
$30.00 |
| Medications Administered in Ambulatory Care |
varies |
| Pessary |
$62.00 |
| Rib Belts |
$27.00 |
| Scrotal Support |
$17.00 |
| Sling |
$10.00 |
| Spirometer – Incentive |
$5.00 |
| Splint – Drop Foot |
$60.00 |
| Splint – finger |
$5.00 |
| Splint – Galveston |
$137.00 |
| Splint – Wrist |
$21.00 |
| Splinting – Fiberglass |
$10.00 per foot |
| Tena Pads |
$11.00 |
| Tena Pants (case) |
$75.00 |
| Tensor |
$5.00 a roll |
| Thera Band (per meter) |
$5.00 |
| Tube Grip |
$5.00 |
| Urinary Catheter Bag |
$5.00 |
| Urinary Leg Bag |
$5.00 |
| Viscopaste boot (per roll) |
$11.00 |
| Wrap – Coban 1” Roll |
$3.00 |
| Wrap – Coban 2” Roll |
$5.00 | Appliances are payable at time of service in Ambulatory Care.List and prices are effective as of July 1st, 2012 and are subject to change. |