HomeMy WebLinkAboutAgreement A-15-523-2 with Unilab Corp dba Quest Diagnostics.pdf- 1 -
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SECOND AMENDMENT TO AGREEMENT
THIS SECOND AMENDMENT TO AGREEMENT (hereinafter “Amendment”) is made and
entered into this 23rd day of June, 2020, by and between COUNTY OF FRESNO, a Political
Subdivision of the State of California, Fresno, California (hereinafter “COUNTY”), and UNILAB
CORPORATION dba QUEST DIAGNOSTICS, a California Corporation, whose address is 3714
Northgate Boulevard, Sacramento, California 95834, (hereinafter “CONTRACTOR”).
WITNESSETH:
WHEREAS, COUNTY and CONTRACTOR entered into Agreement number A-15-523, dated
October 13, 2015, and the First Amendment thereto dated April 26, 2016 (hereinafter collectively
“Agreement”), pursuant to which CONTRACTOR agreed to provide certain clinical laboratory and
toxicology testing services to COUNTY; and
WHEREAS, COUNTY and CONTRACTOR now desire to amend the Agreement in order to
extend the term for one additional year and increase maximum compensation to allow for COVID-19
testing services.
NOW, THEREFORE, for good and valuable consideration, the receipt and adequacy of which
is hereby acknowledged, COUNTY and CONTRACTOR agree as follows:
1. That all references in the existing Agreement to “Exhibit A” or “Revised Exhibit A” be
changed to read “Revised Exhibit A-1,” where appropriate, attached hereto and incorporated by this
reference.
2.That all references in the existing Agreement to “Exhibit C” or “Revised Exhibit C” be
changed to read “Revised Exhibit C-1,” where appropriate, attached hereto and incorporated by this
reference.
3.That all references in the existing Agreement to “Exhibit D” or “Revised Exhibit D” be
changed to read “Revised Exhibit D-1,” where appropriate, attached hereto and incorporated by this
reference.
4. Section 2 of the Agreement, “TERM,” located on page 3, lines 13 through 16, is deleted
in its entirety and replaced with the following:
"This agreement shall automatically be extended for three (3) additional twelve (12)
Agreement No. 15-523-2
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"This agreement shall automatically be extended for three (3) additional twelve (12)
month periods upon the same terms and conditions herein set forth, unless written notice of
non-renewal is given by CONTRACTOR or COUNTY or COUNTY’s DPH Director, or designee,
not later than ninety (90) days prior to the close of the then current Agreement term. "
5.Section 4 of the Agreement, “COMPENSATION,” located on Page 4, beginning on line
25 with the word “Three” and ending on line 26 with “($325,000.00),” is deleted in its entirety and
replaced with the following:
“One Million and no/100 Dollars ($1,000,000.00).”
6. Section 4 of the Agreement, “COMPENSATION,” located on Page 5, beginning on line
10 with the word “Forty” and ending on line 11 with “($40,000.00),” is deleted in its entirety and
replaced with the following:
“Two Hundred Forty Thousand and no/100 ($240,000.00).”
COUNTY and CONTRACTOR agree that this Amendment is sufficient to amend the
Agreement and, that upon execution of this Amendment, the Agreement and this Amendment together
shall be considered the Agreement.
The Agreement, as hereby amended, is ratified and continued. All provisions, terms,
covenants, conditions and promises contained in the Agreement and not amended herein shall remain
in full force and effect.
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DocuSign Envelope ID : DA0BC459-282C-4C59-A5A8-BF3E59013F22
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EXECUTED AND EFFECTIVE as of the date first above set forth .
CONTRACTOR
,,.--Oo cuSigned by:
4 P o.lvick. Plw!~i,.,t,\,
5
'(7\Clttt~tf'.z~~ignature)
Patrick Plewman, VP & GM
Print Name & Title
COUNTY OF FRESNO
s:~~~
Ernest B~Chairman of the
Board of Supervisors of the County of
Fresno 6
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8401 Fallbrook Avenue, West Hills , CA 91304
Mailing Address ATTEST:
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FOR ACCOUNTING USE ONLY:
18 Fund : 0001
19 Subclass : 10000
20 ORG: 5620 ($1 ,000 ,000)
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24 Account: 72 95
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Bernice E . Seidel
Clerk of the Board of Supervisors
County of Fresno , State of California
By : --~--•-~-etif+--+-y ----
5630 ($240,000)
1019 ($200 ,000)
2092 ($15,000)
2099 ($20,000)
4610 ($5 ,000)
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SCOPE OF WORK
GROUPS I AND II
DEPARTMENTS OF PUBLIC HEALTH
AND BEHAVIORAL HEALTH SERVICE REQUIREMENTS
The Contractor will be responsible for providing all needed supplies for specimen
collection, collecting and picking up from the various sites.
Services include, but are not limited to, supplies for specimen collections, phlebotomy
services, specimen pick-up and delivery, laboratory testing, critical value reporting and
timely response for STAT and routine laboratory orders. These services will be required
for the operation of County of Fresno and metropolitan Fresno-Clovis sites as outlined
below.
Contractor will provide all laboratory services and necessary supplies. Contractor must
be CLIA (Clinical Laboratory Improvement Amendments) certified. Laboratory services
will be provided in response to telephone or fax requests from authorized nursing or
clerical staff acting as agents of assigned licensed physicians or from requests ordered
through the computer system.
1.All Services will be provided in accordance with Fresno County, State and
Federal client/consumer confidentiality requirements.
2.Blood draws/specimen collection will be performed by the Contractor.
Occasionally, County staff will do the collection, as deemed necessary, by
County staff ordering the testing. Contractor will provide a lab book to DBH
outlining specific procedures for specimen collection that are necessary for
processing/testing, such as collection requirements, storage requirements,
minimum volumes, etc.
3.The Contractor will provide blood draw services up to 3 days each week for a
period of up to 3.5 hours at the DBH Metro Outpatient site located at 4441 E.
Kings Canyon Road, Fresno, CA 93702. The specific days and time period of
services needed currently and for future needs will be determined by the DBH
Medical Director, or designee.
4.A list of available testing/collection sites and hours of operation within Fresno
County shall be submitted by Contractor.
5.All STAT services will be provided 7 days per week, 24 hours per day at
designated DBH facilities. All specimen pick-ups, where necessary, will be
performed by the Contractor. STAT response time will be within one hour of
receipt of request. DBH have approximately 10 STAT requests per year.
Revised Exhibit A-1
Page 1 of 8
6.Reporting of Critical Test Values shall be completed within 30 minutes after
verification and ordering physician will be called with name, date and time of
specimen collection, along with test results, as well as patient’s/client’s DOB
(Date of Birth) when necessary. Reporting of Critical Test Values ordered during
regular business hours (Monday through Friday 8:00 am – 5:00 pm) for DBH
shall be provided to the Metro Outpatient nurses with name, date and time of
specimen collection, and test results, as well as patient’s/client’s DOB (Date of
Birth) when necessary. Reporting for Critical Test Values ordered outside
regular business hours for DBH shall be provided directly to the DBH Medical
Director with name, date and time of specimen collection, and test results, as
well as patient’s/client’s DOB (Date of Birth) when necessary. Critical Test Value
reporting is rare for DBH and DPH. Critical Test Values also known as “critical
values” and “critical results” are test results that fall significantly outside the
normal range and may represent life-threatening values even if from routine
tests.
7.Billings for services will be submitted on a monthly invoice statement and are to
be listed by Department and cost center, listing the full name of the patient/client,
date of birth, Fresno County Medical Record Number, date of service and name
of laboratory test. Payments may be delayed if invoices are incomplete or
incorrect.
Invoices are to be sent to:
Department of Public Health (DPH) P.O. Box 11867
Fresno, CA 93775
Department of Behavioral Health (DBH) P.O. Box 45003,
Fresno, CA 93718
8.Billing Discrepancies: The County prefers the Contractor provide one contact
person to address billing questions and discrepancies for DPH and DBH. The
Contractor is to respond to inquiries in a timely manner –within 7 business days.
9.The Contractor will be required to assume full responsibility for all services and
activities offered in the quotation and resulting Agreement, with the exception of
services and activities provided by the County of Fresno whether or not they are
provided directly. The County of Fresno will consider the Contractor to be the
sole point of contact with regard to contractual matters, including payment of any
and all charges resulting from the contract. The contractor may not subcontract
or transfer the contract, or any right or obligation arising out of the contract,
without first having obtained the express written consent of the County.
10.Public Health requires a daily 4:30 pm specimen pick-up. All DPH specimens
are to be picked up in the TB Clinic. Located at 1221 Fulton Mall, First Floor,
Fresno, CA 93775.
11.Specimen pick-up for DBH facilities shall be no later than 4:00 pm
12.The Contractor shall be responsible for billing Medi-Cal for Medi-Cal eligible
clients as well as other applicable third party insurances. The Contractor shall
Revised Exhibit A-1
Page 2 of 8
collect necessary information pertinent to billing Medi-Cal and third party
insurances from clients. DBH reports that currently approximately 45% of their
outpatient billings are Medi-Cal. These Medi-Cal percentages could change if
the department can see only Medi-Cal recipients. Approximately 46% of the
clients DPH treats are Medi-Cal or Medi-Cal eligible, or have other third party
insurance.
13.The Contractor shall provide online access to printable test results, requests and
lab results twenty four hours (24) per day 365 days per year.
14.The Contractor shall provide online access of lab results to medical staff and
these results must be printable. Common tests, such as CBCs, will be available
online within 24 hours of collection. Specialty tests such as Medication level and
Hep-C tests will be available online within 5 days.
15.The County requires at least 60 days’ prior notice, or reasonable notice, of any
and all system changes that impact portal access, invoicing and requisition
forms. The notice should include what change is taking place, when it is
happening, what is causing the change, what will be impacted (i.e., internet
access, account numbers, test codes, etc.) and how it will be implemented. If the
changes will impact existing account numbers, the Contractor will provide
detailed steps that will be taken to avoid duplicate billing.
Revised Exhibit A-1
Page 3 of 8
Revis ed Exhibit A -1
Page 4 of 8
SCOPE OF WORK
GROUP I
DEPARTMENT OF PUBLIC HEALTH
TYPES OF REQUIRED CLINICAL LABORATORY TESTS
The average volume of clinical laboratory tests that the Public Health Department conducted in
the past year is provided in the Quotation Schedule. While every effort was made to get the most
current information on the types of tests needed by each program, the types of tests listed below
are best estimates only. The County does not guarantee any minimums for any of the tests
listed below.
Program Types of Te sts
County Laboratory Majority of tests are T-Lymphocyte Helper CD
Panels and miscellaneous other tests
Chest Clinic Tests include Coccidiodal Serology Panels, liver
function panels, TSH and miscellaneous other tests
HIV Prevention Testing HIV Screening, HIV -1/2 Antigens and Antibodies
(CPT Code 91431), HIV -1/2 Antibody - HIV -
Differentiation (CPT Code 91432), and HIV -1 RNA
comprise the bulk of testing in this area.
Court Ordered HIV Testing Approximately 20 individuals undergo HIV Screening
tests annually
COVID-19 Approximately 600 RNA diagnostic tests per month,
or 7,200 tests annually
Revis ed Exhibit A -1
Page 5 of 8
SCOPE OF WORK
GROUP II
DEPARTMENT OF BEHAVIORAL HEALTH
TYPES OF REQUIRED CLINICAL LABORATORY TESTS
The average volume of clinical laboratory tests the Behavioral Health Department conducted in
the past year are provided for the programs with the highest utilization. While every effort was
made to get the most current information on the types of tests needed by each program, the
types of tests listed below are best estimates only. The County does not guarantee any
minimums for any of the tests listed below.
Program Types of Tests
Metro Outpatient Services Majority of tests are CBC differential, mostly for Clozaril monitoring
(30%) and Blood Drawing (15%). Other tests include TSH,
Comprehensive Metabolic Panel, Valproic Acid, Lipid Profile,
Lithium, Hepatic Function Panel, Glucose Plasma, Triglycerides,
AST, Glucose Random, Prolactin, Urine Toxicology, Hemoglobin
A1C Immunoassay, EtOH serum, Drug Abuse Panel 9 Serum, and
miscellaneous other tests.
Pathways to Recovery Tests include, but are not limited to, Urine Toxicology and
miscellaneous other tests.
Older Adult Mental Health
Clinic
Tests include, but are not limited to, Comprehensive Metabolic
Panel, CBC differential, Lipid Panel, Hemoglobin A1C
Immunoassay, TSH, Urinalysis Reflex, Valporic Acid, etc.
COVID-19 Approximately 166 RNA diagnostic tests per month, or 2,000 tests
annually at the facilities below:
Cent ral Star Behavioral Health, Inc.
Yout h Psychiatric Health Facility
4411 E Kings Canyon Rd Building 319
Fresno, CA 93702
Cent ral Star Behavioral Health, Inc.
Crisis Residential Treatment Facility
496 S Barton Ave
Fresno, CA 93702
Ex odus Crisis Stabilization Center
4411 E Kings Canyon Rd Building 319
Fresno, CA 93702
Ex odus Adult Psychiatric Health Facility
4411 E Kings Canyon Rd Building 319
Fresno, CA 93702
Revis ed Exhibit A -1
Page 6 of 8
SCOPE OF WORK
GROUP I
DEPARTMENT OF PUBLIC HEALTH
LABORATORY SERVICES FOR FACILITIES THAT OPERATE
MONDAY THROUGH FRIDAY, 8:00 A.M. TO 5:00 P.M.
Please note that Billing/Cost Center numbers listed at the end of each program below are for
internal use only. DP H facilities and programs that require Contractor’s services include, but are
not limited, to the following:
1.Chest Clinic, 1221 Fulton Street, Fresno, CA 93721, phone: (559) 600-3413.
(BILLING/COST CENTER #56201650)
The Chest Clinic provides services for the detection, prevention and treatment of TB,
specifically, skin testing, chest X-rays, prevention treatment, and diagnosis of an active
disease. The clinic also operates a Directly Observed Therapy outreach unit which
monitors and ensures patient compliance with the prescribed treatment plan. The state
and federal government have established priorities and objectives which are designed to
address the highest priorities in TB control: (1) The first priority is to identify persons who
have active TB cases and ensure that they complete appropriate therapy, including using
confinement measures in exceptional cases . (2) The second priority is to find and screen
persons who have been in contact with TB clients to determine whether they have TB
infection or disease and provide them with appropriate treatment . (3) The third is to
screen high-risk populations to detect persons who are identified with Multiple Drug
Resistant TB.
2.Drug Alcohol Testing, 1221 Fulton Street, Fresno, CA 93721, phone: (559) 600-3434.
(BILLING/COST CENTER # 56201639)
HIV counseling and screening services are provided to individuals who are currently
participating in drug/alcohol treatment programs, both residential as well as outpatient
programs. The program is supported through an interagency agreement with the
Substance Abuse Division. In addition to counseling and testing services, group
education is provided to clients as well as regular program updates with the staff of
participating programs.
3.HIV Prevention Testing, 1221 Fulton Street, Fresno, CA 93721, phone: (559) 600-3434
(BILLING/COST CENTER #56201645)
HIV counseling and screening services are provided to individuals who demonstrate an
increased risk for HIV transmission. This program is supported through a grant from the
California Department of Public Health.
4.Court Ordered HIV Testing, 1221 Fulton Street, Fresno, CA 93721, phone: (559) 600-
3434, (BILLING/COST CENTER #56201648)
Court ordered HIV counseling and screening is provided to individuals who have been
ordered by the court to complete HIV education and testing, under Penal Code 1202.1.
Revis ed Exhibit A -1
Page 7 of 8
5.COVID-19 Testing. 1221 Fulton Street, Fresno, CA 97321, phone (559) 600-3200,
(BILLING/COST CENTER #56201019)
As part of DPH’s ongoing emergency response to the COVID-19 pandemic, DPH staff
will collect approximately 7,200 SARS-CoV -2 viral RNA tests from July 1, 2020 through
June 30, 2021.
Revised Exhibit A-1
Page 8 of 8
SCOPE OF WORK
GROUP II
DEPARTMENT OF BEHAVIORAL HEALTH
LABORATORY SERVICES FOR FACILITIES THAT OPERATE
MONDAY THROUGH FRIDAY, 8:00 A.M. TO 5:00 P.M.
Please note that Billing/Cost Center numbers listed at the end of each program below are for
internal use only. DBH facilities and programs that require Contractor’s services include, but are
not limited, to the following:
1.Metro Outpatient Services, 4441 E. Kings Canyon Road, Fresno, CA 93702, phone (559)
600-4099, fax (559) 600-9135. (BILLING/COST CENTER # 56302920)
Metro Services provides culturally appropriate therapeutic outpatient and rehabilitative
group services to seriously and persistently mentally ill and homeless mentally ill
consumers. Staff provides medication administration and education, monitor medication
levels for consumers and perform physical and mental health assessments.
2.Older Adult Mental Health Clinic, 2025 E. Dakota Ave., Fresno, CA 93726, phone (559)
600-5755, fax (559) 229-2982. (BILLING/COST CENTER # 56304610)
3.Pathways to Recovery, Building 320, 515 S. Cedar Avenue, Fresno, CA 93702, phone
(559)600-6068, fax (559) 600-6090. (BILLING/COST CENTER # 56302093 and
56302096)
Pathways to Recovery offers a three-track program that provides outpatient substance
abuse treatment services for pregnant and parenting women, mental health services for
CalWORKs clients and co-occurring services for clients with co-existing mental health
and substance abuse challenges.
4.COVID-19 Testing, locations listed on Page 5, phone (559) 600-9180. (BILLING/COST
CENTER #56301019)
As part of DBH’s ongoing emergency response to the COVID-19 pandemic, DBH
contracted health and treatment facility staff will collect approximately 2,000 SARS-CoV-2
viral RNA tests from July 1, 2020 through June 30, 2021.
Revised Exhibit C
Page 1 of 2
SCHEDULE OF FEES
DEPARTMENT OF PUBLIC HEALTH
TEST TEST UNIT
CODE NAME PRICE
1. 14742 Amphetamine conf (GC/MS) $ 26.00
2. 4846 Cannabinoid conf (GC/MS) $127.55
3. 11328 Cocaine conf (GC/MS) $ 17.75
4. 15860 Opiates conf (GC/MS) $ 24.50
5. 6251
6.N/A
7.799
Phencyclidine (PCP) conf (GC/MS)
Ethanol conf (GC/MS)
RPR (screening)
$ 38.10
N/A
$ 4.56
8. 285 Direct Bilirubin (CPT Code = 82248) $ 3.25
9. 287 Total Bilirubin (CPT Code = 82247) $ 3.25
10.5463 Complete Urinalysis (CPT Code = 81000) $ 4.00
11.4550 General Bacterial Culture $ 10.00
12. 484 Glucose $ 5.00
13. 480 Gonorrhea Culture $ 21.15
14. 497 Gram Stain $ 16.00
15.7600 Lipid Panel $ 9.00
16.10256 Liver Function Panel (CPT Code = 80061) $ 4.27
17. 622 Magnesium $ 10.00
18.10165 Metabolic Panel (CPT Code = 80048) $ 4.46
19.4503 Mycobacterial Acid Fast Smear $ 21.55
20.4554 Mycobacterial Culture $ 97.40
21. 718 Phosphorus $ 3.25
22.17304 SDA for Gonorrhea $ 25.00
23.17303 SDA for Chlamydia $ 25.00
24. 809 Sed Rate (ESR) Westergren $ 11.15
25.10108 Stool Culture $ 169.46
26.859 T-3, Total (CPT Code = 84480)$ 28.40
27.867 T-4, (Thyroxine), Total $ 16.30
28.653 TPPA (confirmation)$ 86.00
29.899 TSH $ 8.00
30.905 Uric Acid $ 14.35
31. 8563 Urinalysis (Micro only)(CPT Code = 81002) $ 2.16
32. 6448 Urinalysis (w/o Micro)(CPT Code = 81015) $ 1.84
33. 395 Urine Culture $ 11.20
34. 4128 VDRL (CSF only) $ 26.35
35. 6399 CBC with Differential $ 5.00
36. 90858 Coccidioidal Serology Panel $ 153.92
37. 10231 Comprehensive Metabolic Panel* (CPT
Code = 80053; *different from Metabolic Panel
$ 5.57
Revised Exhibit C
Page 2 of 2
SCHEDULE OF FEES
DEPARTMENT OF PUBLIC HEALTH
TEST TEST UNIT
CODE NAME PRICE
(4th Generation, with Reflexes, CPT 91431)
*Price increases (notifed by S. Butler on 11/4/15 that Herpes Simples Virus
testing involved two separate tests and revised prices).
38.496 Hemoglobin A1C Immunoassay $ 47.00
39.1759 Hemogram (BC w/ platelet count) $ 4.95
40.512 Hepatitis A Antibody, IgM $ 11.00
41.501 Hepatitis B Core Antibody $ 11.00
42.8475 Hepatitis B Surface Antibody $ 11.00
43.498 Hepatitis B Surface Antigen $ 11.00
44.8472 Hepatitis C (Anti-HCV) $ 11.00
45.6447 Herpes Simplex Virus, Type I and II, IgG $ 172.00*
46.90849 Herpes Simplex Virus, Type I and II, IgM $ 101.00*
47.10110 HIV 1 and HIV 2 Antibody (HIV Serology) $ 25.00
48.5233 HIV 1 Western Blot $ 25.00
49.40085 HIV-1 RNA, QUAL, Real Time PCR (Viral Load Tests) $ 291.00
50.91431 HIV Screen Only $ 22.50
51.7195 Lymphocyte Subset Panel $ 50.00
52.FPNR1 PAP, SurePath Focal Point $ 23.75
53.CYTP1 PAP, Thin Layer Prep $ 22.50
54.5363 Prostate-specific Antigen $ 109.00
55.8847 Prothrombin Time $ 13.70
56.10314 Renal Function Panel (CPT Code = 80069) $ 4.83
57.799 STS (Rapid Plasma Reagin) Qual $ 4.56
58.899 Thyroid Stimulating Hormone
(3rd Generation)
$ 8.00
59.7195 T-Lymphocyte Helper/CD $ 50.00
60.3679 Toxoplasma Gondii Antibody IgG $ 59.50
61.91431 HIV-1/2 Antigens and Antibodies, $ 22.50
62.91432 HIV-1/2 Antibody Differentiation, CPT 91432 $ 25.00
63.39448 SARS-CoV-2 RNA (COVID-19) Qualitative $ 100.00
Revised Exhibit D
Page 1 of 2
SCHEDULE OF FEES
DEPARTMENT OF BEHAVIORAL HEALTH
TEST TEST UNIT
CODE NAME PRICE
1. 10306 Acute Hepatitis Panel $ 44.00
2. 2128 Alcohol (Ethanol) Urine $ 75.00
3. 443 Alcohol, Ethyl (B) $ 50.00
4. 423 Amytriptyline $ 45.00
5. 14742 Amphetamine Conf by GC/MS, Urine $ 26.00
6. 10165 Basic Metabolic Panel $ 4.46
7. 8416 Barbiturates by CG/MS Urine $ 75.00
8. 8417 Benzodiazepines Conf (GC/MS) Urine $ 25.00
9. 3259 Blood drawing $ 8.00
10.329 Carbamazinepine (Tegretol) $ 8.00
11.6399 CBC (Includes Diff/Plt) $ 5.00
12.1759 CBC (RBC, H/H, Indices, WBC, Plt) $ 4.95
13. 334 Cholesterol Direct LDL $ 2.00
14.1769 Clozapine $ 18.75
15.10231 Comprehensive Metabolic Panel $ 5.57
16. 395 Culture, Urine, Routine $ 11.20
17.19733 Drug Abuse Panel 9, Serum $ 366.55
18.2180 Drug Screen with Alcohol $ 25.00
19.136140 Drug Test, General Toxicology, (B) $ 64.75
20.136140 Drug Test, General Toxicology, (SP) $ 64.75
21.29424 EIA 10 $ 50.00
22.701089 EIA 10 + Alcohol $ 50.00
23.701033 EIA7 + Alcohol w/ GC/MS $ 50.00
24.701011 EIA 7 + Alcohol w/o Rflx $ 50.00
25. 457 Ferritin $ 25.00
26. 482 GGT $ 15.00
27. 483 Glucose $ 3.50
28. 484 Glucose, plasma $ 5.00
29. 396 HCG, Total QL $ 4.50
30.8396 HCG, Total QL $ 14.00
31. 496 Hemoglobin A1C Immunoassay $ 10.00
32. 498 Hep B Surface Ag w/ Reflex Confirm $ 11.00
33. 10306 Hepatic Panel Acute w/ Ref $ 63.00
34. 10256 Hepatic Function Panel $ 4.27
35. 499 Hepatitis B Surface AB, Qual $ 25.00
36. 8472 Hepatitis C $ 11.00
37. 91431 HIV AB, HIV ½, EIA with Reflex $ 22.50
Revised Exhibit D
Page 2 of 2
SCHEDULE OF FEES
DEPARTMENT OF BEHAVIORAL HEALTH
TEST TEST UNIT
CODE NAME PRICE
38.7573 Iron and IBC w/o Reflex $ 30.00
39.14852 Lipid Panel with Reflex to Direct LDL $ 9.00*
40.7600 Lipid Profile $ 9.00
41.613 Lithium $ 6.00
42.622 Magnesium, Serum $ 10.00
43.4846 Marijuana Metabolite, Quant, Urine $ 127.55
44.272 Nortriptyline $ 20.00
45.70073 Olanzapine $ 160.00
46.15860 Opiates, Confirmation by GC/MS, UR $ 24.50
47.713 Phenytoin (Dilantin) $ 10.00
48.733 Potassium, Serum $ 3.50*
49.396 Pregnancy Test, Urine $ 4.50
50.746 Prolactin $ 30.00
51.5363 Prostate Specific Antigen (PSA) $ 109.00
52.10314 Renal Function Panel $ 4.83
53.2339 Risperidone $ 92.00
54.701030 RPR/Reflex TPPA $ 70.00
55.39448 SARS-CoV-2 RNA (COVID-19) Qualitative $100.00
56.3820 STAT Charge $ 30.00
57.701030 STS Titer + T. Pallidum-PA Reflex $ 70.00
58.859 T3 Total (Triiodothyronine) $ 28.40
59.861 T3 Uptake $ 10.00
60.34429 T3, Free $ 50.00
61.867 T4 (Thyroxine) $ 16.30
62.866 T4, Free $ 10.00
63.896 Triglycerides $ 25.00
64.899 TSH $ 8.00
65.36127 TSH Reflex to Free T4 $ 8.00*
66.3020 Urinalysis C + S, If IND $ 4.00
67.6448 Urinalysis Macroscopic $ 1.84
68.8563 Urinalysis Microscopic $ 2.16
69.5463 Urinalysis, Complete $ 4.00
70.7909 Urinalysis, Macro w/Reflex to Micro $ 1.84*
71.916 Valproic Acid $ 15.00
72.7065 Vitamin B-12 and Folate $ 50.00
73.17306 Vitamin D, 25-hydroxy, LC/MS/MS $ 75.00
*Prices reduced (notified of the price changes on 11/3/15).