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ORANGE FAMILY MEDICAL CENTER <br />FEE SCHEDULE <br />REFERENCE LABORATORY PROCEDURES <br />PROCEDURE <br />LIVER PANEL <br />PRENATAL PROFILE <br />ELECTROLYTE PANEL <br />ANEMIA PROFILE II <br />LIPID PANEL B <br />CBC & DIFFERENTIAL <br />THYROID PANEL <br />CHOLESTEROL <br />TRIGLYCERIDES <br />SEROLOGY (APR) <br />PROTHROMBIN (PT) <br />PART. THROMBOPLASTIN <br />TIME (PTT) <br />LITHIUM <br />THEOPHYLLINE <br />PLATELET COUNT <br />PHENOBARBITAL <br />EXC D PANEL <br />MULTI CHEM PANEL <br />CHLAMYDIA /GC BY ONA PROB <br />GC BY DNA PROBE <br />TOTAL <br />TOTAL <br />COST <br />PROCEDURE <br />COST <br />22.18 <br />DIGOXIN <br />50.00 <br />32.75 <br />DILANTIN <br />55.25 <br />23.05 <br />GLUCOSE TOLERANCE <br />36.75 <br />29.80 <br />FSH SERUM <br />71.75 <br />30.61 <br />FOLIC ACID <br />75.25 <br />21.40 <br />HEPATITIS PANEL <br />97.00 <br />39.68 <br />IRON BINDING CAP <br />43.50 <br />26.00 <br />PINWORM PREP <br />12.00 <br />29.75 <br />OVA & PARASITES <br />59.75 <br />29.00 <br />ANTIBODY TITER <br />30.00 <br />27.00 <br />URIC ACID <br />25.00 <br />VITAMIN B -12 <br />62.75 <br />32.00 <br />ALPHA FETOPROTEIN <br />40.00 <br />43.25 <br />STREP TEST <br />14.00 <br />57.50 <br />BLOOD GROUP & RH <br />31.25 <br />25.00 <br />CULTURE & SENSATIV. <br />33.00 <br />56.00 <br />FUNGUS CULTURE <br />52.50 <br />53.00 <br />HERPES CULTURE <br />37.79 <br />27.80 <br />CHLAMYDIA BY ONA PROBE <br />34.00 <br />37.45 <br />STOOL CULTURE <br />55.00 <br />23.55 <br />SPUTUM CULTURTE <br />40.75 <br />3 <br />