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Commissioner Approved Fee Schedule - FY 2025-26 41 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> 76801 Ultrasound,Pregnant Uterus,Real Time with Image <br /> Documentation $120.00 2020 <br /> 76805-TC Ultrasound,Pregnant Uterus,B-Scan and/or Real Time with <br /> Image Documentation $90.00 2020 <br /> 76805 Ultrasound,Pregnant Uterus,B-Scan and/or Real Time with <br /> Image Documentation $135.00 2020 <br /> 76817-26 Ultrasound,Pregnant Uterus,Real Time with Image Documei$40.00 2020 <br /> 76817-TC Ultrasound,Pregnant Uterus,Real Time with Image Documei$55.00 2020 <br /> 76817 jUltrasound,Pregnant Uterus,Real Time with Image Documej$95.00 2020 <br /> 76830 Ultrasound,Transvaginal $120.00 2020 <br /> 80048 Metabolic Panel,Basic(UNC Lab) $10.19 2025 <br /> 80047 Basic Metabolic Panel(Calcium,Ionized)(UNC Lab) $9.93 2025 <br /> 80053 Comprehensive Metabolic Panel(UNC Lab) $10.74 2025 <br /> 80061 Lipid Panel(Fasting)-(UNC Lab) $17.04 2025 <br /> 80069 Renal Function Panel(UNC Lab) $10.19 2025 <br /> 80076 Hepatic Function Panel(UNC Lab) $10.19 2025 <br /> 80151 Measurement of Amiodarone(UNC Lab) $16.96 2025 <br /> 80163 Assay of Digoxin Free(UNC Lab) $16.44 2025 <br /> 80167 Measurement of Felbamate(UNC Lab) $16.96 2025 <br /> 80178 Lithium Level(UNC Lab) $8.41 2025 <br /> 80181 Measurement of Flecainide C Lab $16.96 2025 <br /> 80195 Sirolimus(UNC Lab) $17.09 2025 <br /> 80204 Measurement of Methotrexate(UNC Lab) $18.30 2025 <br /> 80306 Urine Toxicology Screen(UNC Lab) $18.51 2025 <br /> 80307 Drug Test(UNC Lab) $72.63 2025 <br /> 81000 Urinalysis,By Dip Stick or Tablet Reagent for Bilirubin, $4.03 <br /> Glucose,Hemoglobin 2025 <br /> 81002 Urinalysis Routine Without Microscopy(UNC Lab) $3.25 2025 <br /> 81003 Ua,By Dip Stick or Tablet,Automated,Wo Micro $2.86 2025 <br /> 81005 Urine Tests(UNC Lab) $2.76 2025 <br /> 81007 Urinalysis;Bacteriuria Screen,Except By Culture Or <br /> Dipstick(UNC Lab) $3.27 2025 <br /> 81015 Microscopic Urine Exam(UNC Lab) $3.86 2025 <br /> 81025 Pregnancy Test(OCHD Lab) $15.00 2019 <br /> 81025 Ua Preg Test-Color Comparison Method $8.04 2025 <br /> 81105 HPA-1 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81106 HPA-2 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81107 HPA-3 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81108 HPA-4 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81109 HPA-5 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81110 11PA-6 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81111 HPA-9 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81112 HPA-15 GENOTYPING(UNC LAB) $111.22 2025 <br /> 81120 IDH1 COMMON VARIANTS(UNC LAB) $175.86 2025 <br /> 81121 IDH2 COMMON VARIANTS(UNC LAB) $269.17 2025 <br /> 81161 Dmd(Dystrophy)(UNG LAB) $253.89 2025 <br /> 81163 BRCA 1&2 GENE FULL SEQ ALYS(UNC LAB) $425.88 2025 <br /> 81164 BRCA 1&2 GEN FUL DUP/DEL ALYS(UNC LAB) $531.65 2025 <br /> 81165 JBRCA 1 GENE FULL SEQ ALYS(UNC LAB) $257.42 2025 <br /> 81166 BRCA 1 GENE FULL DUP/DEL ALYS(UNC LAB) $274.23 2025 <br /> 81167 BRCA 2 GEND FULL DUP/DEL ALYS(UNC LAB) $257.42 2025 <br /> 81171 AFF2 GEN ALY DETC ABNL ALLEL(UNC LAB) $124.67 2025 <br /> 81172 AFF2 GEN ALYS CHARAC ALLELES(UNC LAB) $250.10 2025 <br /> 81173 AR GENE FULL GENE SEQUENCE(UNC LAB) $274.23 2025 <br /> 81174 AR GENE KNOWN FAMIL VARIANT(UNC LAB) $168.53 2025 <br /> 81175 EE$NTRK <br /> SXL 1 FULL GENE SEQUENCE(UNC LAB) $615.62 2025 <br /> 81176 SXL 1 GENE TARGET SEQ ALYS(UNC LAB) $220.13 2025 <br /> 81191 TRK 1 TRANSLOCATION ANALYSIS(UNC LAB) $188.65 2025 <br /> 81192 2 TRANSLOCATION ANALYSIS(UNC LAB) 1$188.65 2025 <br />