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Orange County Commissioner Approved Fee Schedule - FY 2013 -14 44 <br />Department/Program <br />Description <br />Current Fee <br />\` \ <br />Last <br />Revision <br />Fecal occult blood, single spec. <br />$10.00 <br />2007 <br />Remove foreign body intranasal <br />$244.00 <br />2009 <br />Dsg and/or debridement, small <br />$97.00 <br />2009 <br />Insertion of non - dwelling bladder cath <br />$94.00 <br />2009 <br />Paring of corn/callus (1 lesion) <br />$46.00 <br />2008 <br />Chem. Cant of granulation tissue <br />$79.00 <br />2009 <br />Luteinizing Hormone *UNC rate <br />$25.00 <br />2007 <br />Varicella Immune Status Test *UNC rate <br />$17.00 <br />2007 <br />Paragard IUD <br />$390.00 <br />2012 <br />Nuvaring <br />$57.00 <br />2009 <br />Irnplanon <br />$580.00 <br />2012 <br />Oral Contraceptive Pills <br />$5.00 <br />2012 <br />Immunization Adm. - huranasal/Oral <br />$18.00 <br />2011 <br />Immunization Adm. - huranasal/Oral Additional <br />$18.00 <br />2011 <br />PSA Screen (UNC Lab) <br />$25.00 <br />2008 <br />PSA Diagnostic (UNC Lab) <br />$25.00 <br />2008 <br />Lab) <br />$10.00 <br />2008 <br />Screen (UNC Lab) <br />$16.00 <br />2008 <br />Inactived Polio Vaccine (IPV) <br />$31.00 <br />2008 <br />Prolactin (UNC Lab) <br />$27.00 <br />2009 <br />Prothrombin Time (UNC Lab) <br />$5.00 <br />2009 <br />Hep C Antibody (UNC Lab) <br />$20.00 <br />2009 <br />Prevnar (PCV7 - Pneumococcal Vaccine <br />$116.00 <br />2009 <br />Rotateq (Rotavirus Vaccine) <br />$99.00 <br />2009 <br />OAE (Limited) <br />$100.00 <br />2012 <br />TD Vaccine (90714) (10) <br />Tdap Vaccine <br />N/A <br />$35.00 <br />New <br />2012 <br />Urine Micro - Albumin (UNC Lab) <br />$4.18 <br />2010 <br />Free T3 (UNC Lab) <br />$42.00 <br />2010 <br />Iga (UNC Lab) <br />$13.58 <br />2010 <br />Ttg (UNC Lab) <br />$16.85 <br />2010 <br />Urine Toxicology Screen (UNC Lab) <br />$160.88 <br />2010 <br />DSME/DSMT Individual Assessment <br />$22.00 <br />2010 <br />DSME/DSMT Group Class <br />$12.00 <br />2010 <br />Lithium Level (UNC Lab) <br />$9.46 <br />2010 <br />Medical Nutrition Therapy - Group (2 or more) <br />$15.00 <br />2010 <br />Medical Nutrition Therapy Minimum Fee <br />$20.00 <br />2012 <br />Diabetic management program, dietitian visit <br />$35.00 <br />2010 <br />Nutritional counseling, dietian visit <br />$35.00 <br />2010 <br />Additional MD req. MNT indiv- Medicare <br />$25.00 <br />2010 <br />Additional MD req. MNT group- Medicare <br />$13.00 <br />2010 <br />DT Pediatric Vaccine <br />$38.00 <br />2010 <br />DTaP <br />$31.00 <br />2010 <br />*Any fee changes wi I I be included in this column; <br />a bl ank besi de each f ee means there i s no f ee change i n FY 2013 -14 Comm i ssi oner Approved Fee Schedule <br />