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INDIAN RIVER COUNTY HEALTH DEPARTMENT <br /> FEE SCHEDULE <br /> 1" rriunir tioa�e 50-,` . .. , , r?, ' - 11';B 3396 <br /> Influenza $0.00 $3.23 $6.27 $9. 50 $ 12 . 73 $15. 77 $19.00 19.00 <br /> Pneumococcal Pneumonia $0. 00 $11 . 05 $21 .45 $32. 50 $43. 55 $53. 95 $65.00 65. 00 <br /> Measles/Mumps/Rubella $0.00 $11 .05 $21 .44 $32.49 $43.54 $53.93 $64.98 64.98 <br /> Tetanus $0. 00 $6.64 $12 . 89 $ 19.53 $26. 16 $32.41 $39. 05 39.05 <br /> Tdap $0.00 $8.84 $17. 16 $26. 01 $34.85 $43. 17 $52 . 01 52 . 01 <br /> Injected Polio Vaccine $0.00 $7.51 $ 14. 57 $22 .08 $29.58 $36.64 $44. 15 44. 15 <br /> Varivax (Chicken Pox) $0,001 $20.64 $40.07 $60. 71 $81 .35 $ 100.78 $ 121 .42 121 .42 <br /> Meningococcal $0.00 $20. 92 $40.60 $61 .52 $82.44 $ 102. 12 $ 123. 04 123.04 <br /> Rabies Vaccine (per injection) $0.00 $30.60 $59.40 $90.00 $ 120.60 $ 149.40 $180.00 180. 00 <br /> RIG - Per 2cc Vial $0. 00 $37.40 $72 .60 $110.00 $147.40 $ 182.60 $220.00 220.00 <br /> Hepatitis A Vaccine (per injection) $0.00 $7.22 $14. 01 $21 .23 $28.45 $35.24 $42.46 $42.46 <br /> Hepatitis B Vaccine (per injection) $0. 00 $8.43 $16. 35 $24.78 $33. 21 $41 . 13 $49.56 $49. 56 <br /> Twinrix -Hep A & B (per injection) $0.00 $ 11 .24 $214811 $33.05 $44.29 $54e861 $66. 10 $66. 10 <br /> Shingles Vaccines ` . S 1 G $170.32 170.32 <br /> Cervical Cancer Vaccine $0.00 $24.23 $47.03 $71 .27 $954501 $118. 30 $ 142. 53 142. 53 <br /> Per CDC guidelines, vaccine for childhood immunizations are covered under the Vaccine for Children Program and are provided at no cost to <br /> children <br /> age 0-18. Charges for communicable disease control issues will be waived with authorization . <br /> CY 12-13 <br /> m . n o tl n F S led _ , a Per to ori <br /> Travel Immunization Consult Visit $35.00 <br /> Administration Fee - 90471 $5.00 <br /> Administration Fee, additional shot - 90472 $5.00 <br /> Hepatitis B Vaccine $49.56 <br /> Hepatitis B Vaccine - Children $40.86 *All vaccines will be chargeable at cost <br /> Hep B Immune Globulin* per ml $ 130.00 <br /> plus $20.00 on the last received invoice <br /> Hepatitis A Vaccine $42.46 by Indian River County Health Department <br /> Hepatitis A Vaccine - Children $48.09 <br /> Hep A Immune Globulin* $60.00 Per 2 ml dose <br /> Twinrix (Hep A & B) $66. 10 <br /> Meningococcal ! 123.04 <br /> Tetanus _ $39. 0 <br /> Tdap* $52. 0 <br /> Typhoid $69. 75 <br /> Yellow Fever $101 .05 <br /> *As available <br /> Page 4 of 9 <br />