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QuantiFERON TB Gold
$120.00

Processing Fee $4.20

Total Payable Amount $124.20

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Testing/Reads 3 (Instant Drug Screen, Fit Test, TB/PPD Place/Read)
$150.00

Processing Fee $5.25

Total Payable Amount $155.25

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Hepatitis C titer
$150.00

Processing Fee $5.25

Total Payable Amount $155.25

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MMR Vaccination
$155.00

Processing Fee $5.43

Total Payable Amount $160.43

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Heplisav B 1 Vaccine (Series of 2)
$175.00

Processing Fee $6.13

Total Payable Amount $181.13

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Titers 3 (Hep B, MMR, Varicella)
$206.50

Processing Fee $7.23

Total Payable Amount $213.73

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Titers 3/Testing 1 (Hep B, MMR, Varicella, Physical (Provider RN))
$246.50

Processing Fee $8.63

Total Payable Amount $255.13

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Varicella Vaccination
$265.00

Processing Fee $9.28

Total Payable Amount $274.28

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Titers 4 (Hep B, MMR, Varicella, QuantiFERON TB Gold )
$326.50

Processing Fee $11.43

Total Payable Amount $337.93

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Titers 4/Testing 1 (Hep B, MMR, Varicella, QuantiFERON TB Gold, Physical (Provider RN))
$366.50

Processing Fee $12.83

Total Payable Amount $379.33

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Page 2 of 212

QuantiFERON TB Gold

Testing/Reads 3 (Instant Drug Screen, Fit Test, TB/PPD Place/Read)

Hepatitis C titer

MMR Vaccination

Heplisav B 1 Vaccine (Series of 2)

Titers 3 (Hep B, MMR, Varicella)

Titers 3/Testing 1 (Hep B, MMR, Varicella, Physical (Provider RN))

Varicella Vaccination

Titers 4 (Hep B, MMR, Varicella, QuantiFERON TB Gold )

Titers 4/Testing 1 (Hep B, MMR, Varicella, QuantiFERON TB Gold, Physical (Provider RN))

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