| Acetaminophen (80143) |
$93 |
$93 |
5.0× |
| Afb concentration (87015) |
$113 |
$113 |
16.9× |
| Afb smear (87206) |
$75 |
$75 |
13.9× |
| Albumin serum (82040) |
$79 |
$79 |
16.0× |
| Alcohol (82077) |
$21 |
$21 |
1.2× |
| Alkaline phosphatase (84075) |
$87 |
$87 |
16.8× |
| Allergen profile perennial allergen (86003) |
$104 |
$104 |
19.9× |
| Alpha-fetoprotein serum (82105) |
$103 |
$103 |
6.1× |
| Alt (84460) |
$87 |
$87 |
16.4× |
| Ammonia (82140) |
$185 |
$185 |
12.7× |
| Amylase (82150) |
$96.50 |
$96.50 |
14.9× |
| Ana (86038) |
$176.50 |
$176.50 |
14.6× |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen (86663) |
$324 |
$324 |
24.7× |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen (86664) |
$152 |
$152 |
9.9× |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid (86665) |
$226 |
$226 |
12.5× |
| Antibody west nile virus igm (86788) |
$224 |
$224 |
13.3× |
| Antibody; Helicobacter pylori (86677) |
$215 |
$215 |
12.8× |
| Antistreptolysin o titer (86060) |
$114 |
$114 |
15.6× |
| Antithrombin iii activity (85300) |
$355 |
$355 |
30.0× |
| Ast (84450) |
$83 |
$83 |
16.0× |
| Autologous blood or component, collection processing and storage; intra- or postoperative salvage (86891) |
$6,605.50 |
$6,605.50 |
7.8× |
| Basic metabolic panel calcium ionized (80047) |
$159 |
$159 |
11.6× |
| Beta lactamase (87185) |
$82 |
$82 |
17.3× |
| Bilirubin direct (82248) |
$82 |
$82 |
16.3× |
| Bilirubin total (82247) |
$78 |
$78 |
15.5× |
| Blood count leukocyte wbc automated (85048) |
$45 |
$45 |
17.7× |
| Blood count; automated differential WBC count Other Outpatient (85004) |
$116 |
$116 |
17.9× |
| Blood gases any combination (82803) |
$286 |
$286 |
11.0× |
| Blood typing serologic abo (86900) |
$98 |
$98 |
32.8× |
| Blood typing serologic rh (d) (86901) |
$84.50 |
$84.50 |
28.3× |
| Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations… (82274) |
$56 |
$56 |
3.5× |
| Breath alcohol test (82075) |
$211.50 |
$211.50 |
7.1× |
| C diff amplified probe (87493) |
$180 |
$180 |
4.8× |
| C-reactive protein (86140) |
$98.50 |
$98.50 |
19.0× |
| C-reactive protein high sensitivity (86141) |
$146 |
$146 |
11.3× |
| Ca 125 (86304) |
$305 |
$305 |
14.7× |
| Calcium ionized (82330) |
$69 |
$69 |
5.0× |
| Calcium total (82310) |
$399.50 |
$399.50 |
77.4× |
| Cancer antigen 19-9 (86301) |
$104 |
$104 |
5.0× |
| Candida DNA amp probe (87481) |
$334 |
$334 |
9.5× |
| Carbon dioxide (82374) |
$82 |
$82 |
16.8× |
| Cardiolipin antibody ea ig class (86147) |
$140 |
$140 |
5.5× |
| Cea (82378) |
$273 |
$273 |
14.4× |
| Cell count body fluid (89050) |
$60 |
$60 |
12.7× |
| Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count… (89051) |
$70 |
$70 |
12.5× |
| Chemiluminescent assay (82397) |
$71 |
$71 |
5.0× |
| Chloride blood (82435) |
$66 |
$66 |
14.3× |
| Cholesterol total (82465) |
$53 |
$53 |
12.2× |
| Chorionic gonadotropin test (84702) |
$189 |
$189 |
12.6× |
| Ck mb fraction (82553) |
$181 |
$181 |
15.7× |
| Clostridium ag eia (87324) |
$186 |
$186 |
15.5× |
| Cortisol saliva (82533) |
$82 |
$82 |
5.0× |
| COVID-19 antibody (86769) |
$163 |
$163 |
3.9× |
| Creatine kinase total (82550) |
$110 |
$110 |
16.9× |
| Creatinine (82565) |
$79 |
$79 |
15.4× |
| Creatinine other source (82570) |
$159 |
$159 |
30.7× |
| Crossmatch ahg (86922) |
$57.50 |
$57.50 |
0.3× |
| Cryptosporidium ag eia (87328) |
$255 |
$255 |
18.5× |
| Crystals fluid (89060) |
$93.50 |
$93.50 |
12.8× |
| Culture anaerobic (87075) |
$129 |
$129 |
13.6× |
| Culture blood (87040) |
$270 |
$270 |
26.2× |
| Culture fungus skin hair nail (87101) |
$107 |
$107 |
13.9× |
| Culture stool (87045) |
$149 |
$149 |
15.8× |
| Culture urine (87086) |
$41 |
$41 |
5.1× |
| Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate Other… (87077) |
$176.50 |
$176.50 |
21.8× |
| Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate Other… (87076) |
$98 |
$98 |
12.1× |
| Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each… (87046) |
$143.50 |
$143.50 |
15.2× |
| Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart Other Outpatient (87084) |
$160 |
$160 |
5.9× |
| Cytopath cell enhance tech (88112) |
$312 |
$312 |
5.7× |
| Cytopath tbs c/v manual (88164) |
$160 |
$160 |
8.6× |
| Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer… (88175) |
$128.50 |
$128.50 |
4.8× |
| Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation (88106) |
$166 |
$166 |
5.4× |
| Cytp eval fine needle aspirate interp & report (88173) |
$243 |
$243 |
4.4× |
| D-dimer quantitative (85379) |
$138.50 |
$138.50 |
13.6× |
| Deoxyribonucleic acid (DNA) antibody; native or double stranded Other Outpatient (86225) |
$217 |
$217 |
15.8× |
| Digoxin (80162) |
$67 |
$67 |
5.0× |
| Direct antiglobulin test (86880) |
$285 |
$285 |
52.9× |
| DNA/RNA sequencing (87153) |
$809 |
$809 |
7.0× |
| Drug assay salicylate (80179) |
$93 |
$93 |
5.0× |
| Drug test prsmv dir opt obs (80305) |
$108 |
$108 |
8.6× |
| Ear culture (87070) |
$242.50 |
$242.50 |
28.1× |
| Electrolytes panel (80051) |
$108 |
$108 |
15.4× |
| Eosinophils urine (87205) |
$61.50 |
$61.50 |
14.4× |
| Estradiol (82670) |
$410 |
$410 |
14.7× |
| Extractable nuclear antigen antibody any method (86235) |
$239 |
$239 |
13.3× |
| F2 gene analysis (81240) |
$483 |
$483 |
7.4× |
| F5 gene (81241) |
$731 |
$731 |
10.0× |
| Factor viii activity (85240) |
$84 |
$84 |
4.7× |
| Ferritin (82728) |
$176 |
$176 |
12.9× |
| Flow cytometry first marker (88184) |
$1,034 |
$1,034 |
2.7× |
| Folate serum (82746) |
$186 |
$186 |
12.7× |
| Fructosamine (82985) |
$72 |
$72 |
4.3× |
| Gamma glutamyl transferase (82977) |
$122 |
$122 |
16.9× |
| Genet virus isolate hsv (87255) |
$341.50 |
$341.50 |
10.1× |
| Giardia antigen (87329) |
$184 |
$184 |
15.4× |
| Gluc bld gluc mntr dev cleared fda spec home use (82962) |
$24 |
$24 |
7.3× |
| Glucose Fasting (82947) |
$36 |
$36 |
9.2× |
| Glycated hemoglobin (83036) |
$169.50 |
$169.50 |
17.5× |
| Glycosylated hb home device (83037) |
$165 |
$165 |
17.0× |
| H pylori breath test (83013) |
$291.50 |
$291.50 |
4.3× |
| H pylori stool (87338) |
$150 |
$150 |
10.4× |
| Hbsag neutralization (87341) |
$144 |
$144 |
13.9× |
| Hematocrit (hct) (85014) |
$66.50 |
$66.50 |
28.1× |
| Hemoglobin (85018) |
$45.50 |
$45.50 |
19.2× |
| Hep a ab total (86708) |
$188 |
$188 |
15.2× |
| Hepatitis b core antibody igm (86705) |
$176 |
$176 |
15.0× |
| Hepatitis b core antibody total (86704) |
$225 |
$225 |
18.7× |
| Hepatitis b surface ab (86706) |
$144 |
$144 |
13.4× |
| Hepatitis b surface antigen (87340) |
$139 |
$139 |
13.5× |
| Hepatitis be antigen (87350) |
$65 |
$65 |
5.6× |
| Hepatitis c antibody (86803) |
$178.50 |
$178.50 |
12.5× |
| Hepatitis c RNA quantitative (87522) |
$1,154 |
$1,154 |
26.9× |
| Herpes simplex virus by PCR (87529) |
$194 |
$194 |
5.5× |
| Heterophile antibody screen (86308) |
$84.50 |
$84.50 |
16.3× |
| HIV-1 ag w/HIV-1 & HIV-2 ab (87389) |
$180.50 |
$180.50 |
7.5× |
| Hiv-1/Hiv-2, Single Assay - Rapid Hiv 1 and 2 Screen (Acc Exp/Source) (86703) |
$67 |
$67 |
4.9× |
| Hla b27 (86812) |
$229 |
$229 |
8.9× |
| Homocysteine level (83090) |
$334 |
$334 |
18.6× |
| Homogenization tissue (87176) |
$87 |
$87 |
14.8× |
| Hpv high-risk types (87624) |
$296.50 |
$296.50 |
8.4× |
| Iadna sars-cov-2 COVID-19 amplified probe tq (87635) |
$362 |
$362 |
7.1× |
| Immunoassay infectious agent antibody quan nos (86317) |
$73 |
$73 |
4.9× |
| Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure (88344) |
$686.50 |
$686.50 |
1.8× |
| Immunoperoxidase (88342) |
$319 |
$319 |
1.8× |
| In situ hybridization 1st probe stain (88365) |
$623 |
$623 |
3.5× |
| Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique Other… (87801) |
$622 |
$622 |
8.9× |
| Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique Other Outpatient (87800) |
$578 |
$578 |
13.2× |
| Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism Other… (87799) |
$407 |
$407 |
9.5× |
| Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct probe technique Other Outpatient (87480) |
$150 |
$150 |
7.5× |
| Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification Other Outpatient (87482) |
$302 |
$302 |
5.4× |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other… (87491) |
$318 |
$318 |
9.1× |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique Other Outpatient (87490) |
$307 |
$307 |
13.5× |
| Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification Other Outpatient (87497) |
$212 |
$212 |
4.9× |
| Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, quantification Other Outpatient (87512) |
$389 |
$389 |
9.3× |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse… (87521) |
$174 |
$174 |
5.0× |
| Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique Other Outpatient (87590) |
$307 |
$307 |
11.4× |
| Influenza a ag eia (87400) |
$186 |
$186 |
13.2× |
| Influenza assay w/optic (87804) |
$137 |
$137 |
8.3× |
| Insulin total (83525) |
$53.50 |
$53.50 |
4.7× |
| Iron (83540) |
$228 |
$228 |
35.2× |
| Iron binding capacity (83550) |
$39 |
$39 |
4.5× |
| Koh prep (87220) |
$45 |
$45 |
10.5× |
| Lab cytopathology, concentration techniquie, smears and interpretation (saccomanno technique) (88108) |
$237 |
$237 |
6.0× |
| Lactate (83605) |
$18.50 |
$18.50 |
1.6× |
| Lactate dehydrogenase (83615) |
$96 |
$96 |
15.9× |
| LDL direct (83721) |
$48 |
$48 |
4.6× |
| Legionella culture (87081) |
$120 |
$120 |
18.1× |
| Leukocyte assessment fecal (89055) |
$22 |
$22 |
5.2× |
| Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization… (88302) |
$364 |
$364 |
9.2× |
| Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm -… (88304) |
$316 |
$316 |
5.7× |
| Level IV - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone… (88305) |
$319 |
$319 |
5.8× |
| Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone… (88307) |
$485 |
$485 |
1.3× |
| Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional… (88309) |
$578 |
$578 |
0.7× |
| Lidocaine (80176) |
$217 |
$217 |
14.8× |
| Lipase (83690) |
$107 |
$107 |
15.5× |
| Lipoprotein (a) (83695) |
$187 |
$187 |
13.1× |
| Lyme disease antibody (86618) |
$269 |
$269 |
15.8× |
| Magnesium (83735) |
$114 |
$114 |
17.0× |
| Malaria smear (87207) |
$94 |
$94 |
15.7× |
| Methemoglobin quant (83050) |
$39 |
$39 |
4.8× |
| Microalbumin urine (82043) |
$94 |
$94 |
16.3× |
| Mold id (87107) |
$163 |
$163 |
15.8× |
| Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen receptor/progesterone receptor),… (88360) |
$530 |
$530 |
2.9× |
| Mrsa PCR (87641) |
$117 |
$117 |
3.3× |
| Mumps antibody (86735) |
$212 |
$212 |
16.2× |
| Mycoplasma pneumoniae by PCR (87581) |
$533 |
$533 |
15.2× |
| Myelin associated glycoprotein (mag) antibody (83516) |
$59 |
$59 |
5.1× |
| N.gonorrhoeae DNA amp prob (87591) |
$318 |
$318 |
9.1× |
| Natriuretic peptide (83880) |
$399 |
$399 |
10.2× |
| Occult blood other sources (82271) |
$33.50 |
$33.50 |
6.3× |
| Occult blood screening (82270) |
$54 |
$54 |
12.3× |
| Osmolality serum (83930) |
$35 |
$35 |
5.3× |
| Osmolality urine (83935) |
$36 |
$36 |
5.3× |
| Ova and parasite exam (87177) |
$115.50 |
$115.50 |
13.0× |
| Parathyroid hormone (83970) |
$626 |
$626 |
15.2× |
| Pathology consultation during surgery; first tissue block, with frozen section(s), single specimen (88331) |
$616 |
$616 |
3.4× |
| Pathology examination of specimen during surgery (88329) |
$263 |
$263 |
4.2× |
| Pertussis by PCR (87798) |
$194 |
$194 |
5.5× |
| Ph body fluid (83986) |
$25 |
$25 |
7.0× |
| Phosphorus urine (84105) |
$27 |
$27 |
4.7× |
| Potassium (84132) |
$72 |
$72 |
15.1× |
| Potassium urine (84133) |
$78 |
$78 |
16.5× |
| Prealbumin (84134) |
$65 |
$65 |
4.5× |
| Prolactin (84146) |
$89 |
$89 |
4.6× |
| Prostate specific antigen (PSA); complexed (direct measurement) Other Outpatient (84152) |
$89.50 |
$89.50 |
4.9× |
| Protein c activity (85303) |
$298 |
$298 |
21.5× |
| Protein s antigen, free (85306) |
$295.50 |
$295.50 |
19.3× |
| Protein total urine (84156) |
$17 |
$17 |
4.6× |
| PSA free (84154) |
$236 |
$236 |
12.8× |
| Rbc antibody identification (86870) |
$263 |
$263 |
0.7× |
| Rbc antibody screen (86850) |
$117 |
$117 |
12.0× |
| Reagent strip/blood glucose (82948) |
$57 |
$57 |
11.3× |
| Reflex herpes simplex virus type 1 glycoprotein g-specific antibody, igg by elisa (herpeselect(r) (86695) |
$206 |
$206 |
15.6× |
| Reflex herpes simplex virus type 2 glycoprotein g-specific antibody, igg by elisa, csf arup 00503 (86696) |
$300 |
$300 |
15.5× |
| Rheumatoid factor quant (86431) |
$89.50 |
$89.50 |
15.8× |
| Rl immediate spin crossmatch (86920) |
$195 |
$195 |
1.1× |
| Rotavirus ag eia (87425) |
$186 |
$186 |
15.5× |
| Rpr qual (86592) |
$68 |
$68 |
15.9× |
| Rsv DNA/RNA amp probe (87634) |
$362 |
$362 |
5.2× |
| Rubella antibody (86762) |
$115 |
$115 |
8.0× |
| Rubeola antibody (86765) |
$167 |
$167 |
13.0× |
| Russell viper venom diluted (85613) |
$145 |
$145 |
15.1× |
| Sedimentation rate rbc automated (85652) |
$15.50 |
$15.50 |
5.7× |
| Skin test tuberculosis intradermal (86580) |
$32 |
$32 |
1.0× |
| Sodium (84295) |
$77 |
$77 |
16.0× |
| Sodium urine (84300) |
$29 |
$29 |
5.7× |
| Special stains group i (88312) |
$158 |
$158 |
2.9× |
| Special stains group ii (88313) |
$158 |
$158 |
1.1× |
| Staph a DNA amp probe (87640) |
$114 |
$114 |
3.2× |
| Stone analysis (82365) |
$206.50 |
$206.50 |
16.0× |
| Strep a assay w/optic (87880) |
$177 |
$177 |
10.7× |
| Surg path level 1 (88300) |
$306 |
$306 |
10.0× |
| Surgical pathology consultation and report on referred slides prepared elsewhere (88321) |
$175 |
$175 |
4.4× |
| Susceptibility mic per plate (87186) |
$126 |
$126 |
14.6× |
| Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, antibiotic gradient strip) Other… (87181) |
$57 |
$57 |
12.0× |
| T3 free (84481) |
$224 |
$224 |
13.2× |
| T3 reverse (84482) |
$80 |
$80 |
5.1× |
| T3 uptake (84479) |
$30 |
$30 |
4.6× |
| T4 (thyroxine) total (84436) |
$120 |
$120 |
17.5× |
| Tb test cell immun measure (86480) |
$42 |
$42 |
0.7× |
| Testosterone free (84402) |
$601 |
$601 |
23.6× |
| Testosterone total (84403) |
$400 |
$400 |
15.5× |
| Thyroglobulin antibody (86800) |
$80 |
$80 |
5.0× |
| Thyroid peroxidase antibody (86376) |
$113 |
$113 |
7.8× |
| Thyroxine free (ft4) (84439) |
$264.50 |
$264.50 |
29.3× |
| Trichomonas vagin dir probe (87660) |
$195 |
$195 |
9.7× |
| Trichomonas vaginalis amplif (87661) |
$690 |
$690 |
19.7× |
| Trichrome stain (87209) |
$172.50 |
$172.50 |
9.6× |
| Triglycerides (84478) |
$81 |
$81 |
14.1× |
| Triiodothyronine total assay, tt-3 - t3 (thyroid hormone) (84480) |
$129 |
$129 |
9.1× |
| Troponin t (84484) |
$158 |
$158 |
12.7× |
| Urea nitrogen quantitative (84520) |
$66 |
$66 |
16.7× |
| Uric acid blood (84550) |
$60.50 |
$60.50 |
13.4× |
| Urinalysis auto w/micro (81001) |
$43.50 |
$43.50 |
13.7× |
| Urinalysis microscopic only (81015) |
$53 |
$53 |
17.4× |
| Urinalysis; qualitative or semiquantitative, except immunoassays Other Outpatient (81005) |
$37 |
$37 |
17.1× |
| Urine bacteria culture (87088) |
$38 |
$38 |
4.7× |
| Urine Pregnancy Test POC (81025) |
$96.50 |
$96.50 |
11.2× |
| Urnls dip stick/tablet rgnt auto w/o microscopy (81003) |
$54 |
$54 |
24.0× |
| Vancomycin (80202) |
$73 |
$73 |
5.4× |
| Varicella zoster antibody igg (86787) |
$130.50 |
$130.50 |
10.1× |
| Vitamin b-12 (82607) |
$288 |
$288 |
19.1× |
| Vitamin b1 whole blood (84425) |
$167 |
$167 |
7.9× |
| Vitamin b6 (84207) |
$198 |
$198 |
7.0× |
| Vitamin d 25 hydroxy (82306) |
$362 |
$362 |
12.2× |
| Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Other Outpatient (82652) |
$362 |
$362 |
9.4× |
| West nile virus antibody (86789) |
$236 |
$236 |
16.4× |
| Yeast id (87106) |
$109 |
$109 |
10.6× |
| Zinc (84630) |
$65 |
$65 |
5.7× |