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Commissioner Approved Fee Schedule - FY 2024-25 42 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> 76817-26 Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation,Transvaginal $40.00 2020 <br /> 76817-TC Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation,Transvaginal $55.00 2020 <br /> 76817 Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation,Transvaginal $95.00 2020 <br /> 76830 Ultrasound,Transvaginal $120.00 2020 <br /> 80048 Metabolic Panel,Basic(UNC Lab) $8.00 2023 <br /> 80053 Comprehensive Metabolic Panel(UNC Lab) $11.00 2023 <br /> 80061 Lipid Panel(Fasting)-(UNC Lab) $13.00 2023 <br /> 80069 Renal Function Panel(UNC Lab) $9.00 2023 <br /> 80076 Hepatic Function Panel(UNC Lab) $8.00 2023 <br /> 80178 Lithium Level(UNC Lab) $7.00 2023 <br /> 80306 Urine Toxicology Screen(UNC Lab) $17.00 2023 <br /> 80307 Drug Test(UNC Lab) $62.00 2023 <br /> 81000 U/A(W/Micro)(UNC Lab) $4.00 2023 <br /> 81002 U/A(Dipstick Only)(OCHD Lab) $18.00 2019 <br /> 81025 Pregnancy Test(OCHD Lab) $15.00 2019 <br /> 81240 F2 Fene Analysis 20210G>A Variant(UNC Lab) $66.00 2023 <br /> 81241 F5 Coagulation Factor V Anal Leiden Variant(UNC <br /> Lab) $73.37 2022 <br /> 82040 Albumin Serum(UNC Lab) $6.11 2019 <br /> 82043 Urine Microalbumin/Creatinine Ratio(UNC Lab) $6.00 2023 <br /> 82044 Urine Micro-Albumin(UNC Lab) $6.00 2023 <br /> 82105 Quad Screening(UNC Lab) $17.00 2023 <br /> 82150 Amylase(UNC Lab) $6.00 2023 <br /> 82239 Bile Acid Test(UNC Lab) $17.00 2023 <br /> 82247 Total Bilimbin(UNC Lab) $5.00 2023 <br /> 82248 Direct Bilirubin(UNC Lab) $5.00 2023 <br /> 82251 Neonatal Bilimbin(UNC Lab) $9.00 2018 <br /> 82270 Hemoccult(UNC Lab) $4.00 2023 <br /> 82274 Fecal Immunochemical Test(UNC Lab) $16.00 2023 <br /> 82306 Vitamin D 25(UNC Lab) $30.00 2023 <br /> 82310 Ca(UNC Lab) $5.00 2023 <br /> 82374 CO2(UNC Lab) $5.00 2023 <br /> 82435 CL(UNC Lab) $5.00 2023 <br /> 82465 Total Cholesterol(UNC Lab) $4.00 2023 <br /> 82550 Assay of CK(UNC Lab) $7.00 2023 <br /> 82565 CREAT(UNC Lab) $5.00 2023 <br /> 82570 24 Hour Urine Creatinine(UNC Lab) $5.00 2023 <br /> 82570 Urine creatinine ratio C lab $5.18 2023 <br /> 82607 B 12(UNC Lab) $15.00 2023 <br /> 82668 Assay of Erythropoietin $23.90 2024 <br /> 82677 Assay of Estriol(UNC Lab) $24.00 2023 <br /> 82728 Ferritin(UNC Lab) $14.00 2023 <br /> 82746 Folate(UNC Lab) $15.00 2023 <br /> 82772 Fecal occult blood,single spec.(UNC Lab) $10.00 2006 <br /> 82784 Iga(UNC Lab) $9.00 2023 <br /> 82947 GLU(UNC Lab) $4.00 2023 <br /> 82952 GTT 3 HR(OCHD Lab) $25.00 2018 <br /> 82962 Glucose Blood Test(UNC Lab) $3.00 2023 <br /> 82977 GTT(OCHD Lab) $11.00 2018 <br /> 83001 FSH(UNC Lab) $19.00 2023 <br /> 83002 Luteinizing Hormone(UNC Lab) 1$19.00 12023 <br />