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DocuSign Envelope ID: 5D3BFA70-490C-4COC-A2FC-B15EBFBB678D <br />Exhibit A <br />Services and PrIcin <br />.eryf` Os <br />PE — BASIC VITALS SNELLEN, UA, EXAM <br />$80 00 <br />PE — DOT <br />$99.00 <br />PR— RESPIRATOR CLEARANCE EXAM ONLY) <br />$80.00 <br />AUDIOGRAM <br />$30,00 <br />REVIEW -• QUESTIONNAIRE — GENERAL <br />$30,00 <br />REVIEW — QUESTIONNAIRE — RESPIRATOR <br />$30.00 <br />RESPIRATOR FIT TEST — QUALITATIVE <br />$50.00 <br />*HEPATITUS A TITER (ANTIBODY) —BLOOD <br />$50.00 <br />*HEPATITUS ABC PANEL (ACTIVE INFECTION/IMMUNUITY TEST) — <br />BLOOD <br />$275.00 <br />*HEPATITIS B —TITER SURFACT ANTIBODY QUANTITATIVE — BLOOD <br />$60.00 <br />*HEPATITIS C — ANTIBODY -- BLOOD <br />$55.00 <br />*HIV <br />$94.00 <br />*VACCINE -- HEPATITIS A (2-DOSE SERIES <br />$138,00 per dose <br />*VACCINE — HEPATITIS B SHOW AS DOSE 1, DOSE 2, DOSE 3 <br />$100.00 er dose <br />*LEAD WITH ZPP — BLOOD <br />$61.00 — <br />CHEM20/CHD/CBD/UA <br />$55.00 <br />w <br />*CBC W/DIFF <br />$25.00 <br />VENIPUNCTURE FEE_ <br />$0.00 <br />COLLECTION <br />— <br />$22.00 <br />*BLOOD CHESMISTERY PROFILE 24_ <br />$80.00 <br />DS — URINE 7 PANEL NON DOT <br />$60.00 <br />DS — URINE 5 PANEL NON DOT <br />$55.00 <br />UA WITH MICRO — URINE <br />$28.00 <br />UA DIP STICK <br />Included in <br />physical <br />CHEST X-RAY 1 VIEW <br />$70.00 <br />VISION — ISHIHARA <br />$22.00 <br />EKG — WITH INTERPRETATION <br />$65,00 <br />PFT SPIROMETRY <br />_ <br />$44,00 <br />CARDIAC STRESS TEST <br />$325,00 <br />*TB SKIN TEST (1 STEP <br />$37, 00 <br />Expert Testimony <br />$254,00 per hour <br />After the Tirst twelve months or MIS Agreement, if the current market price for the above <br />Services change due to market conditions, demand(s) and/or shortage(s), the City will be <br />billed the then current market rate. <br />Agreement between City of Sdnta Ana and Concentra ` 12 <br />