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Kittitas County Sheriff's Office <br />307 W. Umptanum Rd <br />Ellensburg, WA 98926 <br />Services Provided: Pre -Employment Physical <br />KIrT�TgS CO <br />U/yl, 1pp <br />Description <br />Code <br />Price <br />Physical Exam (including visual field test) <br />99203 <br />$ <br />115.00 <br />Range of Motion (no charge) <br />97750 <br />$ <br />- <br />XR Chest, 1 View <br />71045 <br />$ <br />30.00 <br />XR Spine Thoracolumbar 2+ Views <br />72080 <br />$ <br />35.00 <br />Urinalysis w/Micro <br />81001 <br />$ <br />10.00 <br />Vision Screen (Snellen) <br />99173 <br />$ <br />5.00 <br />Ishihara Test (no charge) <br />$ <br />- <br />Venipuncture (no charge) <br />36415 <br />$ <br />- <br />Lab - CBC <br />005009 <br />$ <br />5.00 <br />Lab - LP <br />303756 <br />$ <br />5.00 <br />Lab - CMP <br />303756 <br />$ <br />5.00 <br />Lab - TSH w/Reflex <br />004259, 349829 <br />$ <br />10.00 <br />Lab - QuantiFERON-TB Gold Plus <br />182879 <br />$ <br />70.00 <br />Breathing Capacity Test <br />94010 <br />$ <br />25.00 <br />EKG <br />930001 <br />$ <br />25.00 <br />Pure Tone Audiometry (Hearing Test) <br />92552 <br />$ <br />10.00 <br />Urine Drug Test w/DNA Authentication <br />0007U <br />$ <br />100.00 <br />TOTAL S 450.00 <br />