Direct Patient & Third Party Costs

Your guide to fees not coverd by OHIP

  1. Home
  2. Locations
  3. Carleton Place
  4. Uninsured and Direct Patient Costs

Please note our prices have changed as of October 14, 2025

Are you aware that not all of the services that your physician provides to you are insured through the Ontario Health Insurance Plan, (OHIP)?

Payments for services not covered by OHIP will be charged directly to the patient. Some services may be requested by other third parties, such as insurance companies, lawyers etc. These will be charged to the requesting organization. Please note, no forms will be completed without a signed release from the patients.

Charging for non-OHIP services is Clinic Policy however, your primary care clinician may use their discretion in some circumstances.

Listed below are the most common uninsured medical services, including the associated costs, which are not covered by OHIP.

Visits and Procedures:

General Assessment (expired OHIP)

$251

Intermediate Assessment (expired OHIP)

$109

Skin Tag Removal (1)

$50.00

Skin Tag Removal (2)

$75.00

Skin Tag Removal (3+)

$100.00

Liquid Nitrogen for wart removal per treatment (1-5)

$50.00

Liquid Nitrogen for wart removal per treatment (5+)

$100.00

Shave Excision (1)

$85.00

Shave Excision (2)

$120.00

Shave Excision (3+)

$150.00

Excision and Sutures (1)

$150.00

Cortisone Injection (1 vial - purchased in clinic)

$40.00

Cortisone Injection (2 vials - purchased in clinic)

$60.00

TB Test - one step

$75.00

TB Test - two step

$150.00

Ear Syringe

$40.00

Pregnancy Test

$20.00

Other Services:

Photocopying

$30.00

First 20 pages

Additional pages – $ 0.25

Chart Transfers

$50.00

Missed Appointments

$40.00

Failure to attend appointment or cancel less that 24 hours notice

Government Forms:

CPP Disability Medical Report

$150.00

Federal Disability Tax Credit

$120.00

Insurance Forms:

Attending Physician's Statement

$200.00

Insurance Medical

$300.00+

Disability Certificate

$256.00

Life Insurance Death Certificate

$200.00

EI Compassionate Care Benefits

$72.00

Veteran Affairs

$150.00

Other forms and notes:

Misc Form (per page)

$20.00

MTO Driver's Medical Exam (form + physical)

$150.00

MTO - other conditions form

$50.00

CAS Application Foster Parent

$246.00

Catastrophic Impairment

$151.00

Drug Prior Authorization Form

$40.00

Treatment Confirmation

$256.00

Treatment Plan

$272.00

Travel Cancellation Form

$160.00

Return to work/daycare

$25.00

Sick Note

$25.00

School/Camp/fitness clubs

$40.00

Pre-Employment/Employment

$40.00