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Commissioner Approved Fee Schedule - FY 2025-26 54 <br /> Last <br /> Department/Program Description Current Fee Revision <br /> 88356 Morphometric Analysis Nerve(UNC Lab) $234.33 2025 <br /> 88358 Morphometric Analysis Of Tumor(UNC Lab) $62.69 2025 <br /> 88360 Morphometric Analysis,Tumor Immunohistochemistry(Eg, $96.73 2025 <br /> Her-2/Neu,Estrogen(UNC Lab) <br /> 88361 Morphometric Analysis;Tumor Immunohistochemistry(Eg, $121.49 2025 <br /> Her-2/Neu,Estrogen(UNC Lab <br /> 88362 Nerve Teasing Preparation(UNC Lab) $211.08 2025 <br /> 88364 Insitu Hybridization(Fish)(UNC Lab) $76.17 2025 <br /> 88365 Tissue In Situ Hybridization,Interpretation And Report $125.79 2025 <br /> (UNC Lab <br /> 88366 Insitu Hybridization(Fish)(UNC Lab) $117.72 2025 <br /> 88367 Morphometric Analysis,In Situ Hybridization,(Quantitative $191.73 2025 <br /> Or UNC Lab) <br /> 88368 Morphometric Analysis,In Situ Hybridization,(Quantitative $169.18 2025 <br /> Or(UNC Lab) <br /> 88369 M/Phmtrc Alysishquant/Semiq(LJNC Lab) $57.93 2025 <br /> 88371 Protein Analysis Of Tissue By Western Blot,Interp And $18.45 2025 <br /> Report(UNC Lab) <br /> 88372 Protein Analysis Of Tissue By Western Blot,Immunological $14.95 2025 <br /> Probe(UNC Lab) <br /> 88373 MJPhmtrc Alys Ishquant/Semiq(UNC Lab) $47.22 2025 <br /> 88374 M/Phmtrc Alys Ishquant/Semiq(UNC Lab) $160.19 2025 <br /> 88377 M/Phmtrc Alys Ishquant/Semiq(UNC Lab) $168.35 2025 <br /> Machroscopic Examination,Dissection,And Preparation Of <br /> Tissue For Non-Microscopic Analytical Studies(Eg,Nucleic <br /> 88387 Acid-Based Molecular Studies);Each Tissue Preparation $25.19 2025 <br /> (Eg,A Single Lymph Node)(UNC Lab) <br /> 88388 Macroscopic Examination,Dissection,And(UNC Lab) $14.75 2025 <br /> 88740 Hemoglobin,Quantitative,Transcutaneous(UNC Lab) $6.54 2025 <br /> 88741 Hemoglobin,Quantitative,Transcutaneous(UNC Lab) $6.54 2025 <br /> 89049 Caffeine Halothane Contracture Test (UNC Lab) $164.77 2025 <br /> 89310 Semen Analysis(UNC Lab) $10.66 2025 <br /> 90380 RSV,monoclonal antibody,seasonal dose,0.5 mL dosage $485.10 2024 <br /> for intramuscular-Be fortus <br /> 90381 RSV,monoclonal antibody,seasonal dose,1.0 mL dosage $485.10 2024 <br /> for intramuscular-Be fortus <br /> 90471 Admin Fee(1 vaccine) $20.45 2022 <br /> 90472 Admin Fee(2+vaccines) $20.45 2022 <br /> 90473 Immunization Adm.-Intranasal/Oral $20.45 2022 <br /> 90474 Immunization Adm.-Intranasal/Oral Additional $20.45 2022 <br /> 90480 COVID-19 Administration Fee $65.00 2024 <br /> 90619 Meningococcal conjugate vaccine,serogroups ACYW- $176.36 2025 <br /> MENQUADFI <br /> Meningococcal recombinant protein and outer membrane <br /> 90620 vesicle vaccine,serogroup B(MenB-4C),2 dose schedule- $209.12 2025 <br /> BEXSERO <br /> Meningococcal recombinant protein and outer membrane <br /> 90620SL vesicle vaccine,serogroup B(Men13 4C),2 dose schedule- $0.00 2019 <br /> Medicaid Only BEXSERO <br /> 90621 SL Meningococcal recombinant lipoprotein vaccine,serogroup $0.00 2019 <br /> Medicaid Only 113,2 or 3 dose schedule-TRUMENBA <br /> 90632 Hepatitis A vaccine,adult dose-HAVRIX $82.98 2025 <br /> Medicaid Only 90632SL He atitis A vaccine,adult dose-HAVRIX $0.00 2019 <br /> 90633SL Hepatitis A vaccine,pediatric/adolescent dose,2 dose- $0.00 2019 <br /> Medicaid Only HAVRIX <br />