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Page 3 of 6 <br />CPT Code Description Current Fee <br />Requested Fee <br />Change for FY <br />2015-16 <br />Last <br />Revision <br />ORANGE COUNTY HEALTH DEPARTMENT FEE SCHEDULE <br />PERSONAL HEALTH SERVICES + NUTRITION <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 BUN (UNC Lab Test)$5.01 2014 <br />84550 Uric Acid (UNC Lab Test)$6.00 2006 <br />84702 QUANT HCG/Serum (UNC Lab Test)$12.00 2006 <br />85025 CBC with Diff (UNC Lab Test)$10.00 2006 <br />85027 CBC w/o Diff (UNC Lab Test)$9.00 2006 <br />85611 Prothrombin Time (UNC Lab)$5.00 2006 <br />85651 SED Rate (UNC Lab Test)$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 MONO Spot (UNC Lab Test)$7.00 2006 <br />86430 RA Factors - Qual (UNC Lab Test)$7.00 2006 <br />86431 RA Factors - Quan (UNC Lab Test)$7.00 2006 <br />86580 PPD $17.00 2012 <br />86677 H. Pyloric (UNC Lab Test)$20.00 2011 <br />86706 Hepatitis B Surface Antibody (UNC Lab)$15.38 2011 <br />86757 RMSF (Convalescent) (UNC Rate)$27.00 2009 <br />86762 Rubella (UNC Lab Test)$20.00 2009 <br />86787 Varicella Immune Status Test *UNC 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 Group (UNC Lab Test)$4.00 2009 <br />86901 RH Type (UNC Lab Test)$7.00 2009 <br />87070 Other Bacterial Culture (UNC Lab Test)$12.00 2008 <br />87081 Throat Culture (UNC Lab Test)$8.00 2008 <br />87086 Urine Culture (UNC Lab Test)$11.00 2006 <br />87101 Culture, Fungal Dermatology Screen (UNC Lab)$10.00 2008 <br />87184 ID & Sensitivity (UNC Lab Test)$9.00 2008 <br />87205 STAT Male Smear $22.00 2008 <br />87206 Fungal Direct Test (FDIR) (UNC 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 (UNC Lab)$16.00 2009 <br />87340 HBsAG (UNC Lab Test)$13.00 2009 <br />87420 RSV (Respiratory Syncytial Virus) Antigen Screen (UNC <br />Lab)$16.00 2008 <br />87880 Streptococcus Group A Assay W/Optic (UNC Lab)$20.00 2009 <br />88175 Cytopath C/V Auto Fluid Redo $35.00 2012 <br />90460 Admin Fee (1 vaccine) to children by RN or higher $15.70 2012 <br />90461 Admin Fee (2 vaccines) to children by RN or higher $8.84 2012 <br />90470 Administration of H1N1 Vaccine $18.00 2010 <br />90471 Admin Fee (1 vaccine)$18.00 2012 <br />90472 Admin Fee (2+ vaccines)$18.00 2012