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Commissioner Approved Fee Schedule- FY 2016-17 ATTACHMENT 45 <br /> Approved Fee Change for Last <br /> De artment/Pro ram Description Current Fee FY2016-17 Revision <br /> 84443 TSH(UNC Lab Test $22.00 2006 <br /> 84450 SLOT,AST U-NC Lab Test $7.00 2006 <br /> 84460 SGPT,ALT U-NC Lab Test $7.00 2008 <br /> 84466 Iron Profile/Tranferrin:%Saturation(U-NC Lab <br /> Test) $17.00 2006 <br /> 84478 TRIG(UNC Lab Test $8.00 2006 <br /> 84479 T3U(UNC Lab Test $8.00 2006 <br /> 84481 Free T3(UNC Lab $42.00 2010 <br /> 84520 BU-.N(UNC Lab Test I I 1 $5.01 2014 <br /> 84550 Uric Acid(UNC Lab Test $6.00 2006 <br /> 84702 1 QUANT HCG/Serum(UNC Lab Test $12.00 2006 <br /> 85025 CBC with Ditf(UNC Lab Test $10.00 2006 <br /> 85027 CBC w/o Ditf U-NC Lab Test $9.00 2006 <br /> 85611 Prothrombin Time(UNC Lab) $5.00 2006 <br /> 85651 SED Rate(UNC Lab Test I I $4.51 2014 <br /> 86038 ANA anti-nuclear antibody titer(UNC Rate $16.00 2006 <br /> 86039 Confirmation,if ANA+(UNC Rate $15.00 2008 <br /> 86308 YIO'VO S of C Lab Test $7.00 2006 <br /> 86430 RA Factors- ual U-.'V'C Lab Test $7.00 2006 <br /> 86431 RA Factors-Qu..(UNC Lab Test $7.00 2006 <br /> 86580 PPD $17.00 2012 <br /> 86677 H.Pvloric(UNC Lab Test $20.00 2011 <br /> 86706 Hepatitis B Surface Antibodv U-.'V'C Lab $15.38 2011 <br /> 86757 RVISF Convalescent U-.'V'C Rate $27.00 2009 <br /> 86762 Rubella UNC Lab Test $20.00 2009 <br /> 86787 Varicella Immune Status Test'U-NC rate $17.00 2008 <br /> 86803 Hep C Antibody(UNC Lab) $20.00 2007 <br /> 86804 Hepatitis C RIBA(UNC Lab Test $16.00 2009 <br /> 86870 Antibody Identification(UNC Lab Test $21.00 2010 <br /> 86900 ABO Grou NC Lab Test $4.00 2009 <br /> 86901 RH Type U-.'V'C Lab Test $7.00 2009 <br /> 87070 Other Bacterial Culture U-NC Lab Test $12.00 2008 <br /> 87081 Throat Culture U-.'V'C Lab Test $8.00 2008 <br /> 87086 Urine Culture o est $11.00 2006 <br /> 87101 Culture,Fun U molT y S N <br /> $10.00 2008 <br /> 87184 1D&Sensitivmear ity U-NC Lab Test $9.00 2008 <br /> 87205 STAT Male S $22.00 2008 <br /> 87206 Fun al Direct Test FDIR)(U-NC Lab Test $7.00 2008 <br /> 87210 Wet Mount $18.00 2009 <br /> 87269 Parasitology Test#9807-Giardia(UNC Lab Test)$16.00 2009 <br /> 87272 Parasitology Test#9807-Cryptosporidium(U-NC <br /> Lab) $16.00 2009 <br /> 87340 HBSAG(UNC Lab Test $13.00 1 1 2009 <br /> * Any fee changes wi I I be i nd uded i n thi s col umn; <br /> a bl ank besi de each fee means there i s no fee change i n FY 2016-17 Manager Recommended Fee Schedule <br />