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4 <br /> ORANGE COUNTY HEALTH DEPARTMENT FEE SCHEDULE <br /> PERSONAL HEALTH SERVICES+NUTRITION <br /> Requested Fee <br /> CPT Code Change for FY Last <br /> Description Current Fee 2015-16 Revision <br /> 59430 Postpartum care only $175.00 2012 <br /> 64435 Paracervical Block $176.00 2008 <br /> 65205 IRemove Foreign Body from External Eye $67.00 2007 <br /> 69200 Remove Foreign Body from Outer Ear Canal $140.00 2006 <br /> 69210 Remove Ear Wax $67.00 2006 <br /> 80061 Lipid Panel(Fasting)-UNC Lab $18.00 2006 <br /> 80101 Urine Toxicology Screen(UNC Lab) $160.88 2010 <br /> 80178 Lithium Level(UNC Lab) $9.46 2011 <br /> 81000 U/A(W/Micro) $28.00 2006 <br /> 81002 U/A(Dipstick Only) $18.00 2006 <br /> 81025 Pregnancy Test $15.00 2012 <br /> 82040 Albumin Serum(UNC Lab Test) $6.00 2006 <br /> 82044 Urine Micro-Albumin(UNC Lab) $4.18 2010 <br /> 82150 Amylase(UNC Rate) $9.00 2006 <br /> 82239 Bile Acid Test $93.00 2006 <br /> 82247 Total Bilirubin(UNC Lab Test) $7.00 2006 <br /> 82248 Direct Bilirubin(UNC Lab Test) $7.00 2006 <br /> 82251 Neonatal Bilirubin(UNC Lab Test) $9.00 2006 <br /> 82270 Hemoccult $11.00 2008 <br /> 82306 Vitamin D 25(UNC Lab) $71.00 2011 <br /> 82310 Ca(UNC Lab Test) $7.00 2008 <br /> 82374 CO2(UNC Lab Test) $6.22 2014 <br /> 82435 CL(UNC Lab Test) $6.00 2007 <br /> 82465 Total Cholesterol(UNC Lab Test) $6.00 2006 <br /> 82565 CREAT(UNC Lab Test) $7.00 2007 <br /> 82607 B 12(UNC Lab Test) $21.00 2006 <br /> 82728 Ferritin(UNC Lab Test) $19.00 2006 <br /> 82746 Folate(UNC Lab Test) $20.00 2006 <br /> 82772 Fecal occult blood,single spec. $10.00 2006 <br /> 82784 Iga(UNC Lab) $13.58 2010 <br /> 82947 GLU(UNC Lab Test) $5.00 2006 <br /> 82952 GGT 3 HR $25.00 2012 <br /> 82977 GGT(UNC Lab Test) $11.00 2006 <br /> 83001 FSH(UNC Lab Test) $25.00 2006 <br /> 83002 Luteinizing Hormone*UNC rate $25.00 2006 <br /> 83516 Ttg(UNC Lab $16.85 2010 <br /> 83540 Iron Profile(FE):IBC(UNC Lab Test) $9.00 2006 <br /> 83615 LDH(UNC Lab Test) $8.00 2006 <br /> 83690 Lipase(UNC Rate) $9.00 2006 <br /> 83718 Lipid Panel(Non-Fasting)HDL(UNC Lab Test) $11.00 2006 <br /> 83721 LDL(UNC Lab Test) $13.00 2006 <br /> 84075 ALK PROS(UNC Lab Test) $7.00 2006 <br /> 84132 K(UNC Lab Test) $6.00 2006 <br /> 84146 Prolactin(UNC Lab) $27.00 2006 <br /> 84153 PSA Screen(UNC Lab) $25.00 2006 <br /> 84153 PSA Diagnostic(UNC Lab) $25.00 2006 <br /> 84155 'IT-Serum(UNC Lab Test) $5.00 2007 <br /> 84156 'IT-Urine(UNC Lab Test) $5.00 2006 <br /> 84295 NA(UNC Lab Test) $6.12 2014 <br /> 84436 Thyroxine(T4)-(UNC Lab Test) $8.00 2006 <br /> 84439 Free T4(UNC Lab Test) $12.00 2006 <br /> 84443 TSH(UNC Lab Test) $22.00 2006 <br /> 84450 SGOT,AST(UNC Lab Test) 1 $7.00 2006 <br /> 84460 SGPT,ALT(UNC Lab Test) $7.00 2008 <br /> 84466 11ron Profile/Tranferrin:%Saturation(UNC Lab Test) $17.00 2006 <br /> Page 2 of 6 <br />