Laserfiche WebLink
INDIAN RIVER COUNTY HEALTH DEPARTMENT <br /> FEE SCHEDULE -- Effective Oct 1 , 2003 <br /> Topical Application of Fluoride $ 10 . 00 Addt'I Tooth Extraction (Adult) $25 . 00 <br /> Sealant - Per Tooth $ 10.00 Crown Build-Up $70.00 <br /> Amalgam - One Surface $31 . 00 Root Removal (Exposed Roots - Child ) $28 . 00 <br /> Amalgam - Two Surface $41 . 00 Root Removal (Exposed Roots - Adult) $40 .00 <br /> Amalgam - Three Surface $51 .00 Removal of Impacted Tooth (Soft Tissue ) $55. 00 <br /> Amalgam - Four or more $61 . 00 Removal of Impacted Tooth ( Partially Bony) $67 . 00 <br /> Resin - One Surface $31 .00 Removal of Impacted Tooth (Completely Bony) $67.00 <br /> Resin - Two Surface $41 . 00 Surgical Removal of Tooth $55 . 00 <br /> Resin - Three Surface $51 .00 Root Canal (Anterior) $ 148.00 <br /> Resin - Four or more $72 . 00 Root Canal (Bicuspid ) $ 190 . 00 <br /> Resin Elected - One Surface** $45 . 00 Root Canal ( Molar) $235 . 00 <br /> Resin Elected - Two Surface** $55.00 Permanent Crown* $225 . 00 <br /> Resin Elected - Three Surface** $70 . 00 Gold Crown ( Posterior)* $250 .00 <br /> Resin Elected - Four or more** $85. 00 Gold Tooth for Denture* $ 150 . 00 <br /> Anterior Composite Resin Crown $50 . 00 Upper Denture ( Full )* $310 .00 <br /> Recement Crown $ 15 . 00 Lower Denture ( Full )* $310 . 00 <br /> Prefabricated Steel Crown $56 . 00 Cast Metal Partial (Upper/Lower)* $350 .00 <br /> Adult Cleaning/Scaling $32 . 00 Acrylic Partial ( Upper/Lower)* $ 166 . 00 <br /> Root Planning per Quadrant $40 . 00 Acrylic Flipper* $ 125 . 00 <br /> *All lab fees must be collected before work can begin . <br /> **If client requests Resin fillings . <br /> Laboratory Services 0% - A 17% - B 33% - C 50% - D 67% - E 83% - F 100% - G COST <br /> IN -HOUSE LAB <br /> EKG $0 . 00 $4 . 25 $8 . 25 $ 12 . 50 $ 16 . 75 $20 . 75 $25 . 00 $25 . 00 <br /> FBS ( Fasting Blood Sugar) $0 . 00 $0 . 85 $ 1 . 65 $2 . 50 $3 . 35 $4 . 15 $5 . 00 $5 . 00 <br /> Hematocrit $0 . 00 $2 . 38 $4 . 62 $7. 00 $9 . 38 $ 11 .62 $ 14 . 00 $ 14 . 00 <br /> KOH Slide $0 .00 $ 1 . 11 $2 . 15 $3. 25 $4 . 36 $5 .40 $6 . 50 $6 . 50 <br /> Pregnancy Test - Urine $0 . 00 $ 1 . 36 $2 .64 $4 . 00 $5 . 36 $6 . 64 $8 . 00 $8 . 00 <br /> Rapid Strep $0 . 00 $0 . 51 $0 . 99 $ 1 . 50 $2 . 01 $2 .49 $3 . 00 $3 . 00 <br /> Urine Dip Sticks $0 . 00 $0 . 51 $0 .99 $ 1 . 50 $2 . 01 $2 .49 $3 . 00 $3 . 00 <br /> Wet Mount $0 . 00 $ 1 . 02 $ 1 . 98 $3 . 00 $4 . 02 $4 .98 $6 . 00 $6 . 00 <br /> 9/9/2003CLFEE2003-04 Page 4 of 7 <br />