2024 Occupational Medicine Prices

	CODE	DESCRIPTION	2024 PRICE
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1	E3024	"B" BOTTLE SPLIT SPECIMEN TESTING - PER DRUG	$350.00
2	E0061	ADDITIONAL VACCINE ADMINISTRATION	$23.00
3	E0060	ADMINISTRATION IMMUNIZATION	$23.00
4	E3051	ALT	$20.00
5	E0097	ANNUAL PHYSICAL EXAM	$65.00
6	E0078	AUDIO	$35.00
7	E0083	BACK FLEX EXAM	$60.00
8	E3114	BCI ONLY	$60.00
9	E3115	BCI/FBI ONLY	$90.00
10	E3110	UDS Non dot 12 panel Fentanyl w MRO	$100.00
11	E3113	BCI/FBI UDS COMBO	$120.00
12	E0012	BLOOD ALCOHOL - LEGAL W/CONF	$75.00
13	E0001	BLOOD DRAW / VENIPUNCTURE	$30.00
14	E3125	BMP--MEDTOX TEST CODE 12009	$20.00
15	E0014	BREATH ALCOHOL - DOT (INCLUDES CONF, IF APPLICABLE)	$40.00
16	E0013	BREATH ALCOHOL NON-DOT (INCLUDES CONF, IF APPLICABLE)	$40.00
17	E3118	BSA PHYSICAL	$25.00
18	E3094	CADMIUM BLOOD TEST	$55.00
19	E3116	CARDIAC ECHO ONLY	$600.00
20	E0081	CARDIAC STRESS TEST WITH INTERPRETATION	$700.00
21	E0039	CBC WITH DIFF - TEST CODE 11704	$30.00
22	E3127	CBC W/O DIFF--TEST CODE 11726	$30.00
23	E0008	CHEMISTRY/CBC/LIPID - (COMP PANEL 2)	$40.00
24	E0003	CHEST X-RAY - 1 VIEW	$100.00
25	E0004	CHEST X-RAY-1 VIEW - "B" READ	$130.00
26	E0005	CHEST X-RAY - 2 VIEW	$105.00
27	E3041	CMP-COMPREHENSIVE METABOLIC PANEL	$40.00
28	E0085	COLLECTION ONLY - HAIR	$60.00
29	E0084	COLLECTION ONLY - URINE	$40.00
30	E0090	COMPREHENSIVE FIT FOR DUTY EXAM W/ REPORT	$145.00
31	E3075	COTININE CONFIRMATION--URINE	$45.00
32	E3095	CRUISE LINE PHYSICAL	$100.00
33	E3109	DANBURY BCI/UDS COMBO	$150.00
34	E0096	DISABILITY AND PENSION FUND EXIT EXAM (POLICE & FIRE)	$70.00
35	e3128	DOT PHYSICAL-BUNDLE	$125.00
36	E0091	DOT PRE-EMP PHYSICAL, VITALS, WHISPER HEARING	$92.00
37	E0093	DOT RE-CERT PHYSICAL, VITALS, WHISPER HEARING	$92.00
38	E0079	EKG - WITH INTERPRETATION	$85.00
39	E0080	EKG - WITHOUT INTERPRETATION	$70.00
40	E0089	EXPANDED FITNESS FOR DUTY EVAL W/ REPORT	$250.00
41	E3067	FIT TEST	$40.00
42	E0063	FLU VACCINE	$31.00
43	E3096	GC/CLAMYDIA-URINE	$70.00
44	E0018	GLUCOSE FINGERSTICK	$40.00
45	E3009	HAIR DRUG TEST - INCLUDES MRO	$175.00
46	E3008	HAIR DRUG TEST - OMEGA LABS - NO MRO	$110.00
47	E3070	HAIR DRUG TEST - OMEGA LABS - EXPANDED OPIATES	$175.00
48	E3042	HEMOGLOBEN AND HEMATOCRIT	$25.00
49	E0053	HEPATITIS A ANTIBODY	$100.00
50	E3055	CHROMIUM BLOOD	$55.00
51	E0071	HEPATITIS B SINGLE DOSE	$100.00
52	E0052	HEPATITIS B SURFACE ANTIBODIES	$95.00
53	E0059	HEPATITIS B ANTIGEN 87340	$95.00
54	E0058	HEP C ANTIBODIES	$115.00
55	E0087	E99080N- MRO SERVICES- DOT	$45.00
56	E0020	HGB A1C	$40.00
57	E0051	HIV (HIV1 / HIV2 ANTIBODY SCREEN)	$65.00
58	E3099	INSTANT DRUG CONFIRMATION FEE	$35.00
59	E0098	IMMIGRATION EXAM	$185.00
60	E3083	LIPID PANEL	$20.00
61	E3064	LIMITED RETURN TO WORK W/ REPORT	$50.00
62	E3108	LITTLE TIKES UDS/BAT COMBO	$90.00
63	E0006	LUMBAR X-RAY - (2 OR 3 VIEW)	$100.00
64	E0045	MANTOUX - STEP 1 (TB)	$30.00
65	E3045	MENINGOCOCCAL VACCINE (MENACTRA)	$350.00
66	E0022	MERCURY, BLOOD	$85.00
67	E3117	MERCURY-URINE	$70.00
68	E3012	MMR TITER	$135.00
69	E0066	MMR VACCINE	$110.00
70	E3100	MMR/VARICELLA TITER COMBO	$65.00
71	E0086	MRO SERVICES - NON-DOT/POSITIVES ONLY	$40.00
72	E0054	MUMPS TEST	$60.00
73	E3071	NICOTINE TEST--INSTANT URINE	$20.00
74	E0025	NICOTINE TEST - BLOOD - MEDTOX TEST 8084	$60.00
75	E3018	ESHYLG- SHY LUNG	$50.00
76	E3034	ON SITE ADMINISTRATION IMMUNIZATION	$25.00
77	E3037	ON SITE- BREATH ALCOHOL DOT	$40.00
78	E3036	ON SITE- BREATH ALCOHOL NON DOT	$40.00
79	E3013	ON SITE TECH EXPENSE (PER HOUR)	$55.00
80	E3020	ON SITE TECH TRAVEL EXPENSE (PER HOUR)	$55.00
81	E3028	ON SITE- UDS DOT 5 PANEL SP W MRO	$85.00
82	E3029	ON SITE- UDS NONDOT 5 PANEL W MRO	$85.00
83	E3031	ON SITE UDS NONDOT 10 PANEL W MRO	$85.00
84	E3030	ON SITE- UDS NONDOT 9 PANEL SP W MRO	$85.00
85	E0073	OSHA - RESPIRATOR CLEARANCE EXAMINATION (INCLUDES QUESTIONNAIRE REVIEW)	$85.00
86	E3000	OSHA - RESPIRATORY QUESTIONNAIRE REVIEW	$40.00
87	E0021	OSHA BLOOD LEAD WITH ZPP	$80.00
88	E3002	PHYSICIAN IMMUNIZATION REVIEW AND SIGNATURE (IMMIGRATION EXAM)	$40.00
89	E3044	POLIO VACCINE	$70.00
90	E0095	PRE-PLACEMENT EXAM	$65.00
91	E0041	PSA	$50.00
92	E0044	QUANTIFERON TESTING	$130.00
93	E0049	RPR- BLOOD SEROLOGY QUALITATIVE	$40.00
94	E0050	RPR CONF TP	$100.00
95	E0082	SPIROMETRY	$55.00
96	E0094	T-8 ANNUAL EXAM (BUS DRIVER/VAN DRIVER PHYSICAL)	$92.00
97	E0092	T-8 PRE-EMP EXAM (BUS DRIVER/VAN DRIVER PHYSICAL)	$92.00
98	E3107	T-8 FORM COMPLETION	$20.00
99	E0046	TB TWO STEP - STEP ONE	$30.00
100	E0047	TB TWO STEP - STEP TWO	$30.00
101	E0069	Td VACCINE > 7 YRS AGE	$60.00
102	E0067	TDAP (ADACEL - TD /W PERTUSSIS)	$70.00
103	E0009	UA ROUTINE COMPLETE INCLUDES MICRO	$21.00
104	E0010	U-DIP (IN-HOUSE)	$18.00
105	E3021	UPPER EXTREMITY EXAM	$40.00
106	E3004	URINE COLD SPECIMEN FEE	$25.00
107	E3016	URINE DRUG SCREEN - INSTANT - 5 PANEL	$60.00
108	E3082	URINE DRUG SCREEN - INSTANT - 10 PANEL	$60.00
109	E3003	URINE DRUG SCREEN - NONDOT 9 PANEL W/ NICOTINE - SPLIT - /W MRO	$70.00
110	E0032	URINE DRUG SCREEN DOT 5 PANEL SPLIT W/MRO	$85.00
111	E0023	URINE DRUG SCREEN NICOTINE TEST	$60.00
112	E0031	URINE DRUG SCREEN NONDOT 10 PANEL SINGLE NO MRO	$60.00
113	E0035	URINE DRUG SCREEN NONDOT 10 PANEL SPLIT W/ MRO, EXPANDED OPIATES--88904	$85.00
114	E3123	URINE DRUG SCREEN NON DOT 12 PANEL NO MRO TEST CODE 87509	$80.00
115	E3023	URINE DRUG SCREEN NONDOT 12 PANEL SPLIT W/MRO--TEST CODE 87509	$100.00
116	E0030	URINE DRUG SCREEN NONDOT 5 PANEL SPLIT NO MRO	$65.00
117	E0033	URINE DRUG SCREEN NONDOT 5 PANEL SPLIT W/MRO	$85.00
118	E0034	URINE DRUG SCREEN NONDOT 9 PANEL SPLIT W/MRO	$85.00
119	E0036	URINE DRUG SCREEN NONDOT 9 PANEL SPLIT NO MRO	$65.00
120	E0029	URINE DRUG SCREEN NONDOT 9 PANEL SPLIT W/ ALCOHOL W/MRO	$85.00
121	E3043	URINE DRUG SCREEN NONDOT 9 PANEL SPLIT W/ ALCOHOL NO MRO	$65.00
122	E3006	URINE EXTENDED UDS COLLECTION	$25.00
123	E3017	URINE SHY BLADDER EXAM	$75.00
124	E0057	VARICELLA TITER	$80.00
125	E0068	VARICELLA VACCINE	$170.00
126	E0099	VISION - SNELLEN	$0.00
127	E0077	VISION - TITMUS	$24.00
128	E3069	DRUGS OF ABUSE SCREEN 5 PANEL BLOOD	$250.00
129	E3086	HEALTH PROVIDER SUMMARIES	$650.00
130	E3090	METAL PANEL, BLOOD	$135.00
131	FORMS	FORM COMPLETION	$25.00
132	E3146	ORBITAL X-RAY 4+ VIEW	$300.00
133	STAFF	ON-SITE STAFF FEE	$55.00
134	E0088	LIMITED FITNESS FOR DUTY EXAM W/ REPORT	$90.00
135	E3001	REPEAT COMPLETION OF IMMUNIZATION FORMS	$45.00
136	E3035	ON-SITE FLU ADMIN	$28.00
137	E3039	DOT UDS W/O MRO SERVICE	$70.00
138	E3092	LAUREL LAKE FMLA REVIEW	$35.00
139	E3111	CITY OF CUY FALLS WELLNESS EXAM	$85.00
140	E3131	ON-SITE PSA	$25.00
141	E3132	ON-SITE BIOMETRIC SCREEN	$25.00
142	E3151	9 PANEL INSTANT W/O THC	$60.00
143	E3152	LEAD, BLOOD	$45.00
144	E3136	LYME DISEASE AB	$90.00
145	E3137	LYME DISEASE AB/AG	$130.00
146	E3143	DOT/DIVE EXAM	$120.00
147	E0070	PNEUMONIA VACCINE	$150.00
148	E3084	E8249U- CHROMIUM URINE	$50.00
149	E3102	Zinc Total	$35.00
150	E3103	Synthetic Cannabinoids - K2	$80.00
151	E3104	Synthetic Bath Salts	$80.00
152	E3105	Synthetic Bath Salts	$50.00
153	E3112	Yearly Consortium Fee	$50.00
154	E3141	Ear Irrigation, Occ Med	$75.00
155	E3142	12 Panel W/Exp Amp and OPI	$90.00