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Commissioner Approved Fee Schedule - FY 2018-19 <br />* Any fee changes will be included in this column; <br />a blank beside each fee means there is no fee change in FY 2018-19 Commissioner Approved Fee Schedule <br />Department/Program Description Current Fee <br />Commissioner Approved <br />Fee Change for <br />FY 2018-19* <br />Last <br />Revision <br />84443 TSH (UNC Lab Test)$22.00 2006 <br />84450 SGOT, AST (UNC Lab Test)$7.00 2006 <br />84460 SGPT, ALT (UNC Lab Test)$7.00 2008 <br />84466 Iron Profile/Tranferrin: % Saturation (UNC <br />Lab 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 BUN (UNC Lab Test) (11)$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) (11)$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 />58