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DocuSIgn Envelope ID; E03EEB4C-ODE4-4BE1-A8CMOACB3F24B10 <br />FEESCHEOULE <br />TYPE OF MEDICAL PROCEDURE COST PER TEST <br />AUDIOGRAM <br />$ <br />25,69 <br />BACK X-RAY <br />$ <br />72.00 <br />BLOOD LEAD LEVEL ZIP <br />$ <br />61.00 <br />BLOOD SCREENS- 7 panel drug screen <br />$ <br />86.00 <br />CH95TX-RAY <br />$ <br />5100 <br />COREEXAM• <br />$ <br />80.00 <br />DMV <br />$ <br />99.00 <br />HEPABLOODSCREEN <br />$ <br />50.00 <br />H EP B BLOOD SCREEN <br />$ <br />55.00 <br />HEP 8 BOOSTER <br />$ <br />100.00 <br />HEP BTITER <br />$ <br />55.00 <br />HEP B VACCINE <br />$ <br />100.00 <br />HEPAVACONE <br />$ <br />132.00 <br />HEP C BLOOD SCREEN <br />$ <br />55.00 <br />HIV BLOOD SCREEN <br />$ <br />45,00 <br />PULMONARY FUNCTION TEST <br />$ <br />70,U0 <br />RESPIRATOR FITTEST <br />$ <br />50,00 <br />RESPIRATOR PHYSICAL (requires Pulmonary Function Test) <br />$ <br />80.00 <br />RESPIRATOR QUESTIONIAREIF PX IS NOTREQUIRED W/CLEARANCE <br />$ <br />28.00 <br />TB <br />$ <br />29,00 <br />URINALYSIS <br />$ <br />15.00 <br />URINE COLLECTION FEE <br />$ <br />28.00 <br />°Core exams are basic physicals: include vital signs, vision testing, physical exam, and urinalysis <br />25F-12 <br />