Lab & pathology prices at Antelope Memorial Hospital

Neligh, NE · every code in this section with a posted price and a Medicare benchmark.

529 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
1 25 Dihydroxy includes fractions if performed (82652) $416
5 Hiaa (83497) $163
Acetaminophen level (80143) $342
Actinomyces antibody (86602) $131
Activated protein c resistance (85307) $221
Acute hepatitis panel (80074) $480
Acylcarnitine Plasma (82017) $208
Albumin Fluid (82042) $98
Albumin serum (82040) $85
Aldolase (82085) $119
Aldosterone urine (82088) $307
Alkaline phosphatase isoenzymes (84080) $181
Allerg sp igg quan or semiquan (86001) $62
Allergen specific ige (86003) $24
Allergen specific ige; qualitative, multiallergen screen (86005) $14
Allg Spec Ige Recomb Ea (86008) $24
Alpha-1-antitrypsin phenotype (82104) $58
Alpha-1-antitrypsin, total (82103) $80
Alpha-fetoprotein amniotic (82106) $437
Alpha-fetoprotein, serum (82105) $162
Alt (sgpt) (84460) $117
Aluminum (82108) $63
Amikacin trough (80150) $248
Amino acids 6/> amino acids quantitative ea spe (82139) $391
Ammonia (82140) $200
Amniotic fluid enzyme test (84081) $348
Amylase urine (82150) $132
Ana Titer (86039) $57
Angiotensin i enzyme test (82164) $150
Antibody Absorption (86978) $671
Antibody aspergillus (86606) $27
Antibody coxiella burnetii q fever (86638) $60
Antibody cytomegalovirus cmv (86644) $118
Antibody cytomegalovirus cmv igm (86645) $171
Antibody epstein-barr eb virus early antigen ea (86663) $222
Antibody haemophilus influenza (86684) $211
Antibody helicobacter pylori (86677) $180
Antibody herpes smplx type 1 (86695) $238
Antibody HIV-2 (86702) $44
Antibody identification (86870) $329
Antibody influenza virus (86710) $152
Antibody mumps (86735) $125
Antibody Protozoa Nes (86753) $59
Antibody rubeola (86765) $118
Antibody screen (86850) $182
Antibody treponema pallidum (86780) $107
Antibody; Coccidioides (86635) $58
Antigen typing (86905) $238
Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) $174
Antinuclear antibodies (86038) $134
Antistreptolysin o titer (86060) $118
Antithrombin iii activity (85300) $147
Antithrombin iii antigen (85301) $270
Apolipoprotein b (82172) $293
Arsenic Urine (82175) $113
Aspergillus ag eia (87305) $175
Assay Lipoprotein Pla2 (83698) $418
Assay of acth (82024) $339
Assay of androstenedione (82157) $277
Assay of blood chloride (82435) $21
Assay of c-peptide (84681) $151
Assay of calcitonin (82308) $83
Assay of ceruloplasmin (82390) $245
Assay of cyclosporine (80158) $272
Assay of erythropoietin (82668) $226
Assay of ethosuximide (80168) $286
Assay of ferritin (82728) $188
Assay of g6pd enzyme (82955) $189
Assay of gammaglobulin igm (82784) $154
Assay of gastrin (82941) $207
Assay of gentamicin (80170) $295
Assay of homocystine (83090) $323
Assay of lipoprotein(a) (83695) $152
Assay of metanephrines (83835) $425
Assay of parathormone (83970) $449
Assay of phenobarbital (80184) $204
Assay of prealbumin (84134) $169
Assay of proinsulin (84206) $357
Assay of pyruvate (84210) $125
Assay of serotonin (84260) $350
Assay of somatomedin (84305) $418
Assay of tacrolimus (80197) $271
Assay of urine vma (84585) $244
Assay Ph Body Fluid Nos (83986) $91.50
Ast (sgot) (84450) $147
B cells total count (86355) $92
Bartonella antibody (86611) $110
Bcr/abl1 gene major bp (81206) $479
Bcr/abl1 gene minor bp (81207) $233
Beta 2 Glycoprotein I Antibody,Ea (86146) $132.50
Beta hydroxybutyrate (82010) $183.50
Beta-2 microglobulin (82232) $45
Bile acids, total (82239) $144
Bilirubin direct (82248) $69
Bilirubin total (82247) $87
Biotinidase ea specimen (82261) $39.50
Bl Smear W/Diff Wbc Count (85007) $100
Bl Smear W/O Diff Wbc Count (85008) $18
Blastomyces antibody (86612) $57
Blood gases (82803) $421
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $18
Blood Ph - Ph Venous (82800) $145
Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen (86902) $198
Blood typing abo (86900) $97
Blood typing serologic rh (d) (86901) $91
Body fluid cell count (89051) $181
Bordetella antibody (86615) $156
C diff amplified probe (87493) $317
C-reactive protein (86140) $142
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $226
Ca 125 (86304) $213
Ca 19-9 (86301) $204
Ca 27 29 (86300) $260
Cadmium level (82300) $32
Calcium ionized (82330) $172
Calcium total (82310) $90
Calcium urine (82340) $61.50
Calculus Spectroscopy (82365) $183
Calprotectin, fecal (83993) $354
Candida DNA dir probe (87480) $30
Carbamazepine (tegretol) total (80156) $190
Carbon dioxide (82374) $125
Carboxyhemoglobin Quantitative (82375) $214
Carcinoembryonic antigen (82378) $258
Cardiolipin ab igg (86147) $135
Carnitine (82379) $309
Catecholamines fraction plasma (82384) $305
Cd4 absolute count (86361) $254
Cftr gene com variants (81220) $868
Chemiluminescent assay (82397) $191
Chlamydia antibody (86631) $29
Chlamydia Igm Antibody (86632) $29
Chloride other source (82438) $100
Chloride urine (82436) $53
Cholesterol total (82465) $88
Cholinesterase serum (82480) $132
Chromogranin a (86316) $292
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $226
Citrate (82507) $150.50
Ckmb (82553) $224
Clot Factor X Stuart-Power - Factor 10 Activity (85260) $139
Clot factor xiii fibrin stab (85290) $245
Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) $317
Cold agglutinin screen (86156) $112
Cold agglutinin titer (86157) $156
Collagen cross links (82523) $192
Compatibility test antiglob (86922) $307
Complement c3 (86160) $111
Complement total ch50 (86162) $185
Complement/Function Activity - C1 Esterase Inhibitor, Functional (86161) $233
Concentration Infectious Agent (87015) $23
Coombs direct (86880) $103
Copper urine (82525) $202
Cortisol free (82530) $287
Cortisol total (82533) $203
Creatine kinase total (82550) $131
Creatinine blood (82565) $90
Creatinine clearance (82575) $138
Creatinine other source (82570) $117
Cryoglobulin (82595) $95
Culture Aerobic Identify (87077) $114
Culture anaerobic (87075) $115.50
Culture blood (87040) $306
Culture fungus blood (87103) $123
Culture fungus id yeast (87106) $101
Culture fungus other (87102) $221
Culture genital (87070) $194
Culture herpes (87250) $355
Culture screen only (87081) $109
Culture stool (87045) $87
Culture urine (87086) $125
Culture urine id ea isolate (87088) $134
Cultyp nucleic acid sequencing meth ea isolate (87153) $53
Cyclic Citrullinated Peptide (86200) $183
Cystatin c (82610) $38
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $911
Cytopath cell enhance tech (88112) $317
Cytopath Fl Nongyn Smears - Lab Cytopath Fluids,Smear,Interp (88104) $298
Cytp Eval Fine Needle Aspirate Interp & Report (88173) $500
D-Dimer (85379) $122
D-Dimer (85378) $176
Desoxycorticosterone (82633) $98
Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) $85.50
Dhea (82626) $271
Dhea sulfate (82627) $271
Digoxin (80162) $171
Dilantin (80185) $176
Diphtheria antitoxoid (86648) $131
Dipropylacetic acid free (80165) $168
Dna Antibody Single Stranded (86226) $174
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $130
Dna/Rna Amplified Probe (87150) $50
Drug Assay Infliximab (80230) $258
Drug assay itraconazole (80189) $137
Drug Assay Lacosamide (80235) $98
Drug assay methotrexate (80204) $63
Drug assay vedolizumab (80280) $406
Drug assay voriconazole (80285) $122
Drug Screen Quant Gabapentin (80171) $288
Drug screen quant zonisamide (80203) $110
Drug Screen Quantitative Lamotrigine (80175) $215
Drug Scrn Quan Levetiracetam (80177) $274
Drug scrn quant oxcarbazepin (80183) $227
Drug test prsmv chem anlyzr (80307) $244
Drug Test Prsmv Dir Opt Obs (80305) $67
Ebv viral capsid (86665) $198
Ehrlichia antibody (86666) $123
Electrolyte panel (80051) $179
Endomysial antibody iga (86255) $116
Enterovirus antibody (86658) $90
Enterovirus Pcr (87498) $361
Enzyme cell activity (82657) $9
Eosinophil count (85048) $82
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $105
Estradiol (82670) $258
Estriol (82677) $168
Estrogen fractionated (82671) $84
Estrogens total (82672) $129
Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) $126
F2 gene analysis 20210g >a variant (81240) $263
F5 gene (81241) $504
Factor ii activity (85210) $320
Factor ix activity (85250) $139
Factor v activity (85220) $386
Factor vii assay (85230) $368
Factor viii ahg (85240) $350
Factor viii related antigen (85244) $97
Fecal fat quant (82710) $433
Fetal fibronectin (82731) $900
Fetal hemoglobin, chemical (83030) $62
Fetal lung maturity assessment; foam stability test Other Outpatient (83662) $212
Fibrin Degrad Products,Paracoag - Fibrin Monomer (85366) $145
Fibrin degradation products (85362) $223
Fibrinogen activity (85384) $162
Fibrinolysins/Coagulopathy Screen Interp&Repor (85390) $322
Flow cytometry first marker (88184) $307
Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) $222
Folate serum (82746) $180
Follicle Stimulating Hormone (83001) $193
Francisella Tularensis (86668) $43
Ftl cgen abnor four anal (81511) $205
Galactose (82760) $9
Galactose transferase test (82776) $52.50
Gammaglobulin ige (82785) $148
Gardner vag DNA dir probe (87510) $30
Gastric Occult Blood (82271) $42.50
Ggt (82977) $91
Giardia antigen eia stool (87329) $229
Glucose (82947) $60
Glucose Blood Test (82962) $67
Glucose body fluid (82945) $118
Glucose post dose (82950) $72
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $189
Haptoglobin (83010) $214
Hba1/hba2 gene (81257) $958
Hcg free betachain test (84704) $56
Hcg qualitative (84703) $123
Hcg quant (84702) $184
Hdl Cholesterol (83718) $111
Hematocrit (85014) $63
Hemoglobin (85018) $20
Hemoglobin a1c (83036) $128
Hemoglobin Chromotography - Hemoglobinopathy Eval (83021) $62
Hemoglobin electrophoresis (83020) $62
Hemoglobin Fetal,Diff Lysis - Kleihauer-Betke Stain (85460) $159
Hemoglobin Methemoglobin Quantitative (83050) $128
Heparin assay (85520) $162.50
Heparin neutralization (85525) $116
Hepatitis a antibody total (86708) $226
Hepatitis a igm (86709) $130
Hepatitis b core ab igm (86705) $130.50
Hepatitis b core antibody total (86704) $38
Hepatitis B Surface Ab (86706) $113
Hepatitis B Surface Antigen (87340) $130
Hepatitis be antibody (86707) $40
Hepatitis Be Antigen (87350) $96.50
Hepatitis c antibody (86803) $137
Hepatitis C Genotype (87902) $477
Hepatitis delta ab (86692) $334
Herpes culture (87252) $278
Herpes simplex type 2 (86696) $59
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $124
Hfe gene (81256) $326.50
Histoplasma antibody (86698) $55
Histoplasma antigen urine (87385) $389
HIV confirmation (86689) $269
Hla b 27 disease association lc (81374) $374
Hla class i high defin qual (86832) $578
Hla class ii high defin qual (86833) $578
Hla ii low resolution one antigen equivalent ea (81377) $419
Hla ii typing 1 locus lr (81376) $280
Hla typing dr/dq (86817) $1,004
Homogenization tissue (87176) $25
Hpv types 16 & 18 only (87625) $203
Hpylori Breath Anal Urease Act Non-Radact Istope (83013) $151
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $233
Hydroxyprogesterone 17-d (83498) $115.50
Iaad ia cryptosporidium (87328) $141
Iaad Ia Hepatitis B Surface Ag Neutralization (87341) $74
Iaad ia HIV-1 (87390) $44
Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) $168
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $399
Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) $185
Iaad ia rotavirus (87425) $193
Iaad Ia Severe Aqt Respir Synd Coronavirus (87426) $102
Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) $75.50
Iaad Ia Streptococcus Group A (87430) $123
Iadna borrelia burgdorferi amplified probe tq (87476) $612
Iadna hepatitis b virus quantification (87517) $456
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $561
Iadna herpes virus-6 amplified probe tq (87532) $197
Iadna HIV-1 quant & reverse transcription (87536) $546
Iadna mycobacteria tuberculosis amp prb (87556) $153
Iadna mycoplsm pneumoniae amplified probe tq (87581) $163
Iadna neisseria gonorrhoeae amplified probe tq (87591) $226
Iadna nos amplified probe tq each organism (87798) $627
Iadna nos quantification each organism (87799) $374
Iadna-DNA/RNA probe tq 12-25 (87507) $860
Igg subclasses (82787) $71
Igvh somatic hypermutation (81263) $788
Immunfix e-phorsis/urine/csf (86335) $244
Immunoassay infectious agent antibody quan nos (86317) $126
Immunoassay nonantibody (83516) $116
Immunodiffusion Ouchterlony (86331) $23.50
Immunofixj Electrophoresis Serum (86334) $240
Immunohistochemistry (88342) $460
India ink prep (87210) $55
Influenza DNA amp probe (87502) $313.50
Inhibin a (86336) $155
Inhibin b (83520) $175
Insitu hybridization (fish) (88365) $417
Insulin antibodies (86337) $290
Insulin total (83525) $135
Interleukin 6 (83529) $135
Iron (83540) $98
Iron binding capacity (83550) $118
Islet cell antibody (86341) $488
Jak2 gene analysis (81270) $974
Jak2 Targeted Sequence Analysis (81279) $943
Koh Prep (87220) $44.50
Lactic acid (83605) $190
Lactoferrin fecal qualitative (83630) $97
Ldh (83615) $100
Ldh isoenzymes (83625) $162
LDL cholesterol direct (83721) $95
Lead (83655) $112
Legionella antibody (86713) $134
Legionella antigen urine (87449) $313
Leptospira antibody (86720) $189
Level ii surg pathology gross&microscopic exam (88302) $71
Level v surg pathology gross&microscopic exam (88307) $1,340
Level vi surg pathology gross&microscopic exam (88309) $789
Lh (83002) $162
Lipase (83690) $154
Listeria ab (86609) $123
Lithium (80178) $148
Lyme disease antibody (86618) $359
Lyme disease antibody confirm (86617) $96
M/Phmtrc Alys Tumor Imhchem Ea Antbdy Cmptr Asst (88361) $642
M/phmtrc alys tumor imhchem ea antibody manual (88360) $246
Magnesium (83735) $123
Malaria smear (87207) $92
Manual reticulocyte count (85044) $75
Mass spectrometry qual/quan (83789) $203.50
Mercury (83825) $111
Methotrexate (80299) $151
Methylmalonic acid serum (83921) $362
Microalbumin urine (82043) $154
Microbe suscept macrobroth (87188) $133
Microsomal antibodies (86376) $69
Mononuclear cell antigen (86356) $45
Mopath procedure level 4 (81403) $260
Mopath procedure level 9 (81408) $965
Mthfr Gene Analysis Common Variants (81291) $175
Muramidase (85549) $44
Mycobacteria Dna Amp Probe (87551) $153
Mycoplasma antibody (86738) $163
Myelin basic protein csf (83873) $281
Myoglobin urine (83874) $195
Nasal smear for eosinophils (89190) $57
Natriuretic peptide (83880) $343
Neutralization test, viral (86382) $184
Nfct ds bv&vaginitis DNA alg (81515) $161
Niacin (84591) $194
Nk cells total count (86357) $46
Nmr Lipoprofile (83704) $184
Nuclear antigen antibody (86235) $69
Obstetric panel (80081) $353
Occult blood stool (82272) $34.50
Oligoclonal bands (83916) $323
Orthopoxvirus Amp Prb Each (87593) $197
Osmolality serum (83930) $203
Osmolality urine (83935) $167
Ova and parasite direct-id lca (87177) $145
Oxalate urine (83945) $137
Pancreatic polypeptide (83519) $412
Parvovirus antibody (86747) $169
Pbb Iaad Ia Sarscov & Influenza Virus Types a&B (87428) $286
Phenylalanine (84030) $122
Phenytoin free (80186) $197
Phosphatase acid prostatic (84066) $167
Phosphatase alkaline (84075) $65
Phosphorus blood (84100) $113
Phosphorus urine (84105) $52
Pinworm exam (87172) $36
Platelet aggregation (85576) $225
Platelet count (85049) $46.50
Porphobilinogen urine quant (84110) $163
Porphyrins qn & fraction urine (84120) $248
Porphyrins urine qual (84119) $124
Potassium (84132) $96
Potassium urine (84133) $52
Pretx serum rbc antibody identification dilution (86976) $88
Procainamide napa (80192) $184
Procalcitonin (pct) (84145) $329
Progesterone (84144) $169
Prolactin (84146) $213
Prostaglandin Ea (84150) $387
Protein body fluid (84157) $114
Protein c activity (85303) $300
Protein electrophoresis serum (84165) $171
Protein Electrophoresis Urine (84166) $242
Protein S Functional (85306) $353
Protein Total Serum (84155) $82
Protein urine (84156) $90
Protein Western Blot (84182) $62
Prothrombin time substitution (85611) $26
PSA free (84154) $185
Quantiferon tb gold (86480) $505
Rbc antibody elution (86860) $272
Renin activity plasma (84244) $179
Rheumatoid factor quant (86431) $102
Rickettsia antibody (86757) $148
Rpr Titer (86593) $26
Rsv (87807) $198
Rubella antibody (86762) $66
Russell viper venom time diluted (85613) $28
Russell Viper Venom Time Undiluted (85612) $210
Salicylate (80179) $342
Sars-Cov-2 Covid-19 Amp Prb (87635) $214
Sars-Cov-2 Covid-19 Antibody (86769) $134
Sars-cov-2 covid19 w/optic (87811) $32
Sarscov2&inf a&b&rsv amp prb (87637) $461
Sed rate automated (85652) $72
Semen analysis complete (89320) $128
Semen analysis sperm presence&/motility sprm (89321) $152
Semen analysis w/count (89310) $122
Sensitivity mic (87186) $155
Sex hormone binding globulin (84270) $202.50
Sickle cell screen (85660) $119
Sirolimus (rapamycin) (80195) $132
Smear acid fast (87206) $315
Smear complex stain (87209) $123
Smear gram stain (87205) $86
Smn1 Gene Dos/Deletion Alys (81329) $9
Sodium (84295) $51
Sodium urine (84300) $55.50
Spcl Stn 2 I&R Excpt Microorg/Enzyme/Imcyt (88313) $378
Special stains group 1 (88312) $449
Spectrophotometry (84311) $12
Stool Cultr Aerobic Bact Ea (87046) $76
Strep a assay w/optic (87880) $32
Strep a DNA amp probe (87651) $212
Strptcs Pneum Antibody Igg Serotypes Mlt Ia Quan (86581) $106
Surg path level iii (88304) $251
Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I (88300) $24
Surgical pathology level IV (88305) $322
Susceptibility study antimicrobial disk method (87184) $23
T Cells Absolute Cd4&Cd8 Count Ratio (86360) $105
T cells, total count (86359) $88
T3 free (84481) $238
T3 reverse (84482) $205
T3 total (84480) $161
T3 uptake (84479) $126
T4 Free (84439) $176.50
T4 total (84436) $100
T4-neonatal (84437) $60
Tau phosphorylated each (84393) $404
Tb ag response t-cell susp (86481) $250
Tb intradermal test (86580) $23
Test for acetone/ketones (82009) $117
Test for urine cystines (82615) $62
Testosterone free (84402) $122.50
Testosterone total (84403) $112
Tetanus antibody (86774) $107
Theophylline (80198) $189
Thin prep pap (88142) $160.50
Thrombin time plasma (85670) $55
Thyroglobulin (84432) $163
Thyroglobulin Ab (86800) $73.50
Thyroid Stimulating Immunoglobulin (84445) $730
Thyroxine binding globulin (84442) $257
Tiss Trnsgltmnase Ea Ig Clas (86364) $59
Tobramycin peak (80200) $205
Topiramate (80201) $307
Toxoplasma ab igm (86778) $144
Toxoplasma antibody igg (86777) $144
Transferrin (84466) $164
Translocation analysis (bcr/abl1) other breakpoint (81208) $362
Trichomonas vagin dir probe (87660) $30
Triglycerides (84478) $82
Troponin (84484) $293
Urea nitrogen (84520) $85
Urea nitrogen urine (84540) $60
Uric acid blood (84550) $90
Uric acid other source (84560) $63.50
Urinalysis microscopic only (81015) $39
Urinalysis w/microscopic (81001) $93
Urine microalbumin (protein) analysis (82044) $59
Urine pregnancy test (81025) $94
Urnls dip stick/tablet rgnt auto w/o microscopy (81003) $66
Valproic acid level (80164) $197
Vancomycin trough (80202) $238
Varicella-zoster antibody (86787) $118
Vdrl csf (86592) $75
Very long chain fatty acids (82726) $9
Virus antibody nos (86790) $208
Virus inoculation, shell via (87254) $342
Vitamin A (84590) $203
Vitamin b-12 (82607) $176
Vitamin b1 (thiamine) (84425) $210
Vitamin b6 (84207) $151
Vitamin C (82180) $90
Vitamin D 25-Hydroxy (82306) $326
Vitamin e serum (84446) $108
Von willebrand factor activity (85245) $116
West nile virus ab, igm (86788) $154
West nile virus antibody (86789) $154
Zinc (84630) $116