| 5-Hiaa (83497) |
$98 |
$163 |
7.6× |
| Acetone serum qual (82009) |
$57 |
$95 |
12.6× |
| Acth (82024) |
$105 |
$175 |
2.7× |
| Activated protein c resistance (85307) |
$205 |
$341 |
13.4× |
| Afb culture (87116) |
$136 |
$226 |
12.6× |
| Afb smear (87206) |
$79 |
$131.50 |
14.7× |
| Albumin body fluid (82042) |
$59 |
$98 |
7.6× |
| Albumin serum (82040) |
$50 |
$83 |
10.1× |
| Aldolase (82085) |
$10 |
$16 |
1.0× |
| Aldosterone (82088) |
$7 |
$11 |
0.2× |
| Alkaline phosphatase (84075) |
$59 |
$98 |
11.4× |
| Alpha-1-antitrypsin (82103) |
$74 |
$123 |
5.5× |
| Alpha-fetoprotein serum (82105) |
$88 |
$146 |
5.2× |
| Alt (84460) |
$33.50 |
$55.50 |
6.3× |
| Amikacin level (80150) |
$5 |
$8 |
0.3× |
| Amino acids; single, quantitative, each specimen Other Outpatient (82131) |
$218 |
$363.50 |
9.5× |
| Ammonia (82140) |
$113 |
$189 |
7.8× |
| Amylase (82150) |
$53 |
$88 |
8.2× |
| Ana (86038) |
$99 |
$165 |
8.2× |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen (86663) |
$61 |
$102 |
4.6× |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen (86664) |
$25 |
$42 |
1.6× |
| Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid (86665) |
$25 |
$42 |
1.4× |
| Anti-mitochondrial antibody (86255) |
$104 |
$173 |
8.6× |
| Antibody; Helicobacter pylori (86677) |
$75 |
$124.50 |
4.5× |
| Antistreptolysin o titer (86060) |
$30.50 |
$50.50 |
4.2× |
| Antithrombin iii activity (85300) |
$119 |
$198.50 |
10.0× |
| Assay 17-(17-ks)ketosteroids - 17 ketosteroids,24hr urine (83586) |
$56 |
$94 |
4.4× |
| Assay of corticosteroids - 17-hydroxycorticosteroids, urine, 24 hour (83491) |
$75 |
$125 |
4.2× |
| Ast (84450) |
$73 |
$121 |
14.1× |
| Basic metabolic panel calcium ionized (80047) |
$19 |
$31 |
1.4× |
| Beta 2 glycoprotein i antibody (86146) |
$136 |
$226 |
5.3× |
| Beta lactamase (87185) |
$76 |
$127 |
16.0× |
| Bile acids total (82239) |
$4 |
$6 |
0.2× |
| Bilirubin direct (82248) |
$29 |
$48 |
5.8× |
| Bilirubin total (82247) |
$50 |
$83 |
10.0× |
| Bilirubin total transcutaneous (88720) |
$19 |
$31 |
3.8× |
| Bleeding time (85002) |
$62 |
$103 |
12.9× |
| Blood count leukocyte wbc automated (85048) |
$25 |
$42 |
9.8× |
| Blood gases any combination (82803) |
$39 |
$65 |
1.5× |
| Blood gases w/o2 saturation (82805) |
$166 |
$276 |
2.1× |
| Blood typing serologic abo (86900) |
$48 |
$80 |
16.1× |
| Blood typing serologic rh (d) (86901) |
$48 |
$80 |
16.1× |
| Blood typing, serologic; antigen testing of donor blood using reagent serum, each antigen test Other Outpatient (86902) |
$40 |
$66 |
6.3× |
| Blood unit compatibility test, incubation technique (86921) |
$184 |
$307 |
1.0× |
| Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations… (82274) |
$32 |
$53 |
2.0× |
| C-peptide (84681) |
$79 |
$132 |
3.8× |
| C-reactive protein (86140) |
$49 |
$82 |
9.5× |
| Ca 125 (86304) |
$29 |
$48 |
1.4× |
| Ca 15-3 (86300) |
$12 |
$20.50 |
0.6× |
| Calcium ionized (82330) |
$82 |
$137 |
6.0× |
| Calcium total (82310) |
$50 |
$83 |
9.7× |
| Calcium, random urine (82340) |
$71 |
$119 |
11.8× |
| Calculus; quantitative analysis, chemical Other Outpatient (82360) |
$85 |
$142 |
6.6× |
| Calprotectin fecal (83993) |
$88 |
$147 |
4.5× |
| Cancer antigen 19-9 (86301) |
$11 |
$19 |
0.5× |
| Carbamazepine total (80156) |
$109 |
$182 |
7.5× |
| Carbon dioxide (82374) |
$53 |
$88 |
10.9× |
| Carbon monoxide (82375) |
$97 |
$161 |
7.9× |
| Cardiolipin antibody ea ig class (86147) |
$97 |
$161 |
3.8× |
| Catecholamines fractionated (82384) |
$174 |
$290 |
6.9× |
| Cd4/cd8 count - lymphocyte subset panel 5 - arup (86360) |
$116 |
$194 |
2.5× |
| Cea (82378) |
$21 |
$35 |
1.1× |
| Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count… (89051) |
$84.50 |
$140.50 |
15.1× |
| Chg fresh frozen plasma thawing each unit (86927) |
$374 |
$623 |
2.1× |
| Chloride blood (82435) |
$62 |
$103 |
13.5× |
| Chloride other source (82438) |
$62 |
$103 |
12.4× |
| Chloride urine (82436) |
$53 |
$88 |
9.2× |
| Chorionic gonadotropin test (84702) |
$151 |
$251 |
10.0× |
| Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg,… (88248) |
$339 |
$565 |
2.0× |
| Citrate (82507) |
$169 |
$282 |
6.1× |
| Ck mb fraction (82553) |
$71 |
$119 |
6.1× |
| Clostridium ag eia (87324) |
$95 |
$158 |
7.9× |
| Clot inhibit prot s total (85305) |
$184 |
$306 |
15.8× |
| Cmv antibody (86644) |
$55 |
$91 |
3.8× |
| Cold agglutinins titer (86157) |
$79 |
$132 |
9.8× |
| Complement antigen ea component (86160) |
$106 |
$177 |
8.8× |
| Complement total (ch50) (86162) |
$137 |
$229 |
6.7× |
| Coombs test indirect titer (86886) |
$77 |
$128 |
14.9× |
| Cortisol saliva (82533) |
$59.50 |
$99 |
3.7× |
| Creatine kinase isoenzymes (82552) |
$97 |
$161 |
7.2× |
| Creatine kinase total (82550) |
$43 |
$71 |
6.6× |
| Creatinine (82565) |
$50 |
$83 |
9.8× |
| Creatinine clearance (82575) |
$124 |
$206 |
13.1× |
| Creatinine other source (82570) |
$92 |
$153 |
17.8× |
| Crossmatch ahg (86922) |
$184 |
$307 |
1.0× |
| Cryoglobulins (82595) |
$226 |
$376 |
34.9× |
| Culture anaerobic (87075) |
$175 |
$291 |
18.5× |
| Culture blood (87040) |
$122 |
$203 |
11.8× |
| Culture fungus blood (87103) |
$125 |
$208 |
6.1× |
| Culture fungus skin hair nail (87101) |
$64 |
$107 |
8.3× |
| Culture stool (87045) |
$90 |
$150 |
9.5× |
| Culture urine (87086) |
$36.50 |
$60.50 |
4.5× |
| Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate Other… (87077) |
$44.50 |
$73.50 |
5.5× |
| Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate Other… (87076) |
$49 |
$81 |
6.1× |
| Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each… (87046) |
$26 |
$44 |
2.8× |
| Cyclic citrullinated peptide ab (86200) |
$10 |
$16 |
0.8× |
| Cyclosporine (80158) |
$123 |
$205 |
6.8× |
| Cystatin c (82610) |
$16 |
$27 |
0.9× |
| Cytomegalovirus antibody igm (86645) |
$55 |
$91 |
3.3× |
| D-dimer quantitative (85379) |
$95 |
$159 |
9.3× |
| Deoxyribonucleic acid (DNA) antibody; native or double stranded Other Outpatient (86225) |
$57 |
$95 |
4.1× |
| Dhea (82626) |
$64 |
$107 |
2.5× |
| Dhea sulfate (82627) |
$36 |
$60 |
1.6× |
| Digoxin (80162) |
$109 |
$181 |
8.2× |
| Direct antiglobulin test (86880) |
$64 |
$107 |
11.9× |
| DNA/RNA amplified probe (87150) |
$1,502 |
$2,504 |
42.8× |
| Drug screen quant levetiracetam (80177) |
$38 |
$64 |
2.9× |
| Drug test prsmv chem anlyzr (80307) |
$34 |
$56 |
0.5× |
| Ear culture (87070) |
$75 |
$125 |
8.7× |
| Elastase pancreatic fecal quantitative (82653) |
$62 |
$104 |
2.7× |
| Electrolytes panel (80051) |
$75 |
$125 |
10.7× |
| Eosinophils urine (87205) |
$30.50 |
$50.50 |
7.1× |
| Erythropoietin (82668) |
$54 |
$90 |
2.9× |
| Estriol (82677) |
$99 |
$165 |
4.1× |
| Estrogen fractionated (82671) |
$90 |
$150 |
2.8× |
| Estrogens total (82672) |
$66 |
$110 |
3.0× |
| Ethosuximide (80168) |
$71 |
$119 |
4.3× |
| Eval amniotic fluid protein (84112) |
$88 |
$146 |
0.9× |
| Extractable nuclear antigen antibody any method (86235) |
$60 |
$100 |
3.3× |
| F2 gene analysis (81240) |
$173 |
$288 |
2.6× |
| Factor vii activity (85230) |
$178 |
$296 |
9.9× |
| Factor viii activity (85240) |
$207 |
$345 |
11.6× |
| Fat, fecal quantitative 72-hour collection (includes homogenization) arup 2002356 (82710) |
$83 |
$139 |
4.9× |
| Fecal fat qualitative (82705) |
$5 |
$8 |
1.0× |
| Ferritin (82728) |
$89 |
$149 |
6.5× |
| Fetal fibronectin (82731) |
$257 |
$428 |
4.0× |
| Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis (85460) |
$53 |
$89 |
6.9× |
| Fibrinogen, activity (85384) |
$99 |
$165 |
10.2× |
| Follicle stimulating hormone (fsh) (83001) |
$84 |
$140 |
4.5× |
| Fructosamine (82985) |
$7 |
$12 |
0.4× |
| Fungus isolation culture (87102) |
$104.50 |
$174 |
12.4× |
| Gamma glutamyl transferase (82977) |
$64 |
$106 |
8.9× |
| Gammaglobulin ige (82785) |
$18 |
$30 |
1.1× |
| Genet virus isolate hsv (87255) |
$13 |
$22 |
0.4× |
| Gentamicin (80170) |
$209 |
$349 |
12.8× |
| Giardia antigen (87329) |
$55 |
$92 |
4.6× |
| Glucose Fasting (82947) |
$66 |
$110 |
16.8× |
| Glucose other fluid (82945) |
$66 |
$110 |
16.8× |
| Glucose post glucose dose (82950) |
$66 |
$110 |
13.9× |
| Glucose tolerance test (gtt) (82951) |
$79 |
$132 |
6.1× |
| Glycated hemoglobin (83036) |
$61 |
$102 |
6.3× |
| Gtt-added samples (82952) |
$28 |
$47 |
7.1× |
| H pylori stool (87338) |
$50 |
$83 |
3.5× |
| Haptoglobin (83010) |
$58 |
$96 |
4.6× |
| Hcg ql (84703) |
$48 |
$80 |
6.4× |
| HDL cholesterol (83718) |
$123 |
$205 |
15.0× |
| Helicobacter pylori; drug administration Other Outpatient (83014) |
$61 |
$101 |
7.8× |
| Hematocrit (hct) (85014) |
$16 |
$26.50 |
6.8× |
| Hematocrit spun (85013) |
$29 |
$49 |
4.1× |
| Hemoglobin (85018) |
$28 |
$47 |
11.8× |
| Hemoglobin electrophoresis (83020) |
$113 |
$189 |
8.8× |
| Hep a ab total (86708) |
$73 |
$121 |
5.9× |
| Hepatitis a antibody igm (86709) |
$244 |
$407 |
21.7× |
| Hepatitis b core antibody igm (86705) |
$61 |
$102 |
5.2× |
| Hepatitis b core antibody total (86704) |
$62 |
$103 |
5.1× |
| Hepatitis b surface ab (86706) |
$129 |
$215 |
12.0× |
| Hepatitis b surface antigen (87340) |
$111 |
$185 |
10.7× |
| Hepatitis be antibody (86707) |
$59 |
$98 |
5.1× |
| Hepatitis be antigen (87350) |
$59 |
$98 |
5.1× |
| Hepatitis c antibody (86803) |
$128 |
$213.50 |
9.0× |
| Hepatitis c RNA quantitative (87522) |
$346 |
$576 |
8.1× |
| Herpes simp virus type 1 &/or 2 ab igg with ref to type 1 & 2 glycoprotein g-spec arup 0051708 (86694) |
$254 |
$424 |
17.7× |
| Herpes simplex virus by PCR (87529) |
$31 |
$52 |
0.9× |
| Heterophile antibody screen (86308) |
$94 |
$156 |
18.1× |
| HIV-1 antibody (86701) |
$79 |
$131 |
8.9× |
| Hla b27 (86812) |
$118 |
$196 |
4.6× |
| Homocysteine level (83090) |
$56 |
$93 |
3.1× |
| Iadna sars-cov-2 COVID-19 amplified probe tq (87635) |
$71 |
$118 |
1.4× |
| Iadna-DNA/RNA probe tq 12-25 (87507) |
$595 |
$992 |
1.4× |
| Immunofixation urine (86335) |
$50 |
$83 |
1.7× |
| Immunoglobulin d (82784) |
$61 |
$102 |
6.6× |
| Immunoperoxidase (88342) |
$73 |
$122 |
0.4× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87420) |
$82 |
$136 |
5.9× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87335) |
$32 |
$53 |
2.5× |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B… (87802) |
$226 |
$376 |
17.8× |
| Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique Other… (87801) |
$22 |
$37 |
0.3× |
| Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism Other… (87799) |
$62 |
$104 |
1.4× |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other… (87491) |
$22 |
$37 |
0.6× |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique Other Outpatient (87490) |
$53 |
$88 |
2.3× |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse… (87521) |
$99 |
$165 |
2.8× |
| Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when… (87536) |
$437 |
$728 |
5.1× |
| Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique Other Outpatient (87590) |
$53 |
$88 |
2.0× |
| Influenza assay w/optic (87804) |
$100 |
$167 |
6.0× |
| Insulin total (83525) |
$135 |
$225 |
11.8× |
| Iron (83540) |
$35 |
$59 |
5.4× |
| Iron binding capacity (83550) |
$40 |
$67 |
4.6× |
| Islet cell antibody (86341) |
$59 |
$98 |
2.5× |
| Lab cytopathology, concentration techniquie, smears and interpretation (saccomanno technique) (88108) |
$56 |
$93 |
1.4× |
| Lab surg cytopathology, fluid, washing or brushing , except cervical or vaginal, smears with interpretation (88104) |
$37.50 |
$62.50 |
1.0× |
| Lactate (83605) |
$121 |
$202 |
10.5× |
| Lactate dehydrogenase (83615) |
$59 |
$98 |
9.8× |
| Lactoferrin fecal (qual) (83630) |
$62 |
$103 |
3.1× |
| Lamotrigine (80175) |
$155 |
$258 |
11.7× |
| Ldh isoenzymes (83625) |
$66 |
$110 |
5.2× |
| LDL direct (83721) |
$68 |
$113 |
6.5× |
| Lead (83655) |
$54 |
$90 |
4.5× |
| Legionella culture (87081) |
$78.50 |
$130.50 |
11.8× |
| Legionella urine antigen (87449) |
$68 |
$113 |
5.7× |
| Leukocyte antibody id (86021) |
$122 |
$203 |
8.1× |
| Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization… (88302) |
$68 |
$114 |
1.7× |
| Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm -… (88304) |
$88 |
$146 |
1.6× |
| Level IV - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone… (88305) |
$118 |
$196 |
2.1× |
| Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone… (88307) |
$223 |
$371 |
0.6× |
| Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional… (88309) |
$281 |
$468 |
0.3× |
| Lipase (83690) |
$61 |
$102 |
8.9× |
| Lipoprotein (a) (83695) |
$8 |
$14 |
0.6× |
| Lithium (80178) |
$61 |
$102 |
9.2× |
| Luteinizing hormone (lh) (83002) |
$84 |
$140 |
4.5× |
| Lyme disease antibody (86618) |
$154 |
$256 |
9.0× |
| Magnesium (83735) |
$50 |
$83 |
7.5× |
| Malaria smear (87207) |
$62 |
$103 |
10.4× |
| Manual differential (85007) |
$11 |
$19 |
2.9× |
| Manual reticulocyte count (85044) |
$61 |
$101 |
14.2× |
| Metanephrines (83835) |
$83.50 |
$139 |
4.9× |
| Methemoglobin quant (83050) |
$110 |
$183 |
13.4× |
| Microalbumin urine (82043) |
$56 |
$94 |
9.7× |
| Mold id (87107) |
$27 |
$45 |
2.6× |
| Mumps antibody (86735) |
$11 |
$19 |
0.8× |
| Mycoplasma antibody (86738) |
$88 |
$147 |
6.6× |
| Myelin associated glycoprotein (mag) antibody (83516) |
$118 |
$196.50 |
10.2× |
| Myoglobin (83874) |
$65 |
$109 |
5.0× |
| N.gonorrhoeae DNA amp prob (87591) |
$22 |
$37 |
0.6× |
| Natriuretic peptide (83880) |
$61.50 |
$102 |
1.6× |
| Neutralization test viral (86382) |
$70 |
$116 |
4.1× |
| Occult blood screening (82270) |
$37 |
$62 |
8.4× |
| Osmolality serum (83930) |
$91 |
$152 |
13.8× |
| Osmolality urine (83935) |
$67 |
$111 |
9.8× |
| Oxalate urine (83945) |
$70 |
$117 |
4.8× |
| Pancreatic polypeptide (83519) |
$135 |
$225 |
7.3× |
| Parathyroid hormone (83970) |
$176 |
$294 |
4.3× |
| Pertussis ag if (87265) |
$194 |
$323 |
16.2× |
| Pertussis by PCR (87798) |
$86 |
$144 |
2.5× |
| Ph body fluid (83986) |
$24 |
$40 |
6.7× |
| Phenylalanine (84030) |
$148 |
$246 |
26.9× |
| Phenytoin level total (80185) |
$127 |
$211 |
9.6× |
| Phosphorus (84100) |
$56 |
$93 |
11.8× |
| Pinworm exam (87172) |
$62 |
$103 |
14.5× |
| Platelet count automated (85049) |
$35 |
$58 |
7.8× |
| Platelet neutralization (85597) |
$134 |
$223 |
7.5× |
| Potassium (84132) |
$30 |
$50.50 |
6.3× |
| Potassium urine (84133) |
$52 |
$86 |
11.0× |
| Prealbumin (84134) |
$61 |
$101 |
4.2× |
| Procalcitonin (pct) (84145) |
$94 |
$156 |
3.5× |
| Progesterone (84144) |
$90 |
$150 |
4.3× |
| Prolactin (84146) |
$116 |
$194 |
6.0× |
| Prostate specific antigen (PSA); complexed (direct measurement) Other Outpatient (84152) |
$30 |
$50 |
1.6× |
| Protein c activity (85303) |
$174 |
$290 |
12.6× |
| Protein c antigen (85302) |
$214 |
$357 |
17.8× |
| Protein electrophoresis serum (84165) |
$73 |
$121 |
6.8× |
| Protein electrophoresis urine (84166) |
$82 |
$137 |
4.6× |
| Protein s antigen, free (85306) |
$177 |
$295 |
11.6× |
| Protein total other source (84157) |
$74 |
$123.50 |
18.5× |
| Protein total serum (84155) |
$55 |
$92 |
15.0× |
| Protein total urine (84156) |
$73 |
$122 |
19.9× |
| Prothrombin time; substitution, plasma fractions, each Other Outpatient (85611) |
$37 |
$61 |
9.4× |
| PSA free (84154) |
$83 |
$139 |
4.5× |
| Rbc antibody identification (86870) |
$169 |
$282 |
0.4× |
| Receptor assay non-endocrine specify receptor (84238) |
$188 |
$313 |
5.1× |
| Ref john hopkins telomere length measurement flow cytometry and fish (88182) |
$193 |
$322 |
3.5× |
| Reflex gamma-aminobutyric acid receptor, type a (gaba-ar) antibody titer, igg by cba-ifa, csf arup 3006006 (86256) |
$97 |
$162 |
8.0× |
| Reflex herpes simplex virus type 1 glycoprotein g-specific antibody, igg by elisa (herpeselect(r) (86695) |
$62 |
$103 |
4.7× |
| Reflex herpes simplex virus type 2 glycoprotein g-specific antibody, igg by elisa, csf arup 00503 (86696) |
$64.50 |
$107 |
3.3× |
| Renin (84244) |
$8 |
$13 |
0.4× |
| Resp virus 12-25 targets (87633) |
$836 |
$1,393 |
2.0× |
| Rheumatoid factor quant (86431) |
$3 |
$5 |
0.5× |
| Rl immediate spin crossmatch (86920) |
$184 |
$307 |
1.0× |
| Rotavirus ag eia (87425) |
$18 |
$30 |
1.5× |
| Rpr qual (86592) |
$2 |
$3 |
0.5× |
| Rsv DNA/RNA amp probe (87634) |
$82 |
$136 |
1.2× |
| Rubella antibody (86762) |
$41.50 |
$69 |
2.9× |
| Rubeola antibody (86765) |
$60 |
$100 |
4.7× |
| Russell viper venom diluted (85613) |
$84 |
$140 |
8.8× |
| Sedimentation rate rbc non-automated (85651) |
$37 |
$61 |
8.7× |
| Semen analysis; presence and/or motility of sperm including Huhner test (post coital) Other Outpatient (89300) |
$68 |
$114 |
6.9× |
| Serotonin (84260) |
$68 |
$114 |
2.2× |
| Serum immunoelectrophoresis (86320) |
$211 |
$352 |
7.1× |
| Sex hormone binding globulin (84270) |
$13 |
$21 |
0.6× |
| Sirolimus (80195) |
$28 |
$46 |
2.0× |
| Smear wet mount (87210) |
$40 |
$66 |
6.9× |
| Sodium (84295) |
$46 |
$77 |
9.6× |
| Sodium urine (84300) |
$56.50 |
$94 |
11.2× |
| Somatomedin (84305) |
$42 |
$70 |
2.0× |
| Special stains group i (88312) |
$78 |
$130 |
1.4× |
| Special stains group ii (88313) |
$60 |
$100 |
0.4× |
| Specific gravity except urine (84315) |
$23 |
$38 |
7.0× |
| Strep a assay w/optic (87880) |
$51 |
$85 |
3.1× |
| Strep a DNA amp probe (87651) |
$76 |
$127 |
2.2× |
| Surg path level 1 (88300) |
$49 |
$82 |
1.6× |
| Susceptibility mic per plate (87186) |
$127 |
$212 |
14.7× |
| Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents) Other Outpatient (87184) |
$110 |
$183 |
14.7× |
| T3 free (84481) |
$136 |
$226 |
8.0× |
| T3 uptake (84479) |
$105 |
$175 |
16.2× |
| T4 (thyroxine) total (84436) |
$85 |
$142 |
12.4× |
| Tacrolimus (80197) |
$200 |
$333 |
14.6× |
| Tb test cell immun measure (86480) |
$32 |
$54 |
0.5× |
| Testosterone free (84402) |
$152 |
$254 |
6.0× |
| Testosterone total (84403) |
$158 |
$264 |
6.1× |
| Theophylline (80198) |
$132 |
$220 |
9.3× |
| Thromboplastin time, partial (PTT); substitution, plasma fractions, each Other Outpatient (85732) |
$39 |
$65 |
6.0× |
| Thyroglobulin antibody (86800) |
$121 |
$201 |
7.6× |
| Thyroid peroxidase antibody (86376) |
$67.50 |
$113 |
4.6× |
| Thyroid stimulating immune globulins (thyroid related protein) level (84445) |
$39 |
$65 |
0.8× |
| Thyroxine free (ft4) (84439) |
$73 |
$121 |
8.1× |
| Tissue culture bone marrow (88237) |
$700 |
$1,167 |
4.9× |
| Tobramycin (80200) |
$77 |
$129 |
4.8× |
| Topiramate (80201) |
$199 |
$332 |
16.7× |
| Toxoplasma antibody igg (86777) |
$67 |
$111 |
4.7× |
| Transferrin (84466) |
$66 |
$110 |
5.2× |
| Trichomonas vaginalis amplif (87661) |
$27 |
$45 |
0.8× |
| Triglycerides (84478) |
$76 |
$126 |
13.2× |
| Triiodothyronine total assay, tt-3 - t3 (thyroid hormone) (84480) |
$96 |
$160 |
6.8× |
| Troponin t (84484) |
$20 |
$34 |
1.6× |
| Urea nitrogen quantitative (84520) |
$53 |
$89 |
13.4× |
| Urea nitrogen urine (84540) |
$55 |
$92 |
9.9× |
| Uric acid blood (84550) |
$60 |
$100 |
13.3× |
| Uric acid other source (84560) |
$88 |
$146 |
17.3× |
| Urinalysis auto w/micro (81001) |
$42 |
$70 |
13.2× |
| Urinalysis microscopic only (81015) |
$31 |
$52 |
10.2× |
| Urinalysis volume measure (81050) |
$11 |
$18 |
3.0× |
| Urnls dip stick/tablet rgnt auto w/o microscopy (81003) |
$23 |
$38 |
10.2× |
| Valproic acid (dipropylacetic acid); free (80165) |
$79 |
$132 |
5.8× |
| Vancomycin (80202) |
$130 |
$217 |
9.6× |
| Varicella zoster antibody igg (86787) |
$55 |
$92 |
4.3× |
| Vasopressin (antidiuretic hormone, ADH) Other Outpatient (84588) |
$230 |
$383 |
6.8× |
| Viral culture non-respiratory (87252) |
$147 |
$245 |
5.6× |
| Virus antibody nos (86790) |
$106 |
$176 |
8.2× |
| Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain,… (87254) |
$20 |
$33 |
1.0× |
| Vitamin b-12 (82607) |
$25 |
$41 |
1.7× |
| Vitamin b1 whole blood (84425) |
$184 |
$307 |
8.7× |
| Vitamin b6 (84207) |
$7 |
$12 |
0.2× |
| Vitamin d 25 hydroxy (82306) |
$137 |
$229 |
4.6× |
| Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Other Outpatient (82652) |
$160 |
$266 |
4.2× |
| Vma (84585) |
$89 |
$149 |
5.7× |
| Yeast id (87106) |
$27 |
$45 |
2.6× |
| Zinc (84630) |
$24 |
$40 |
2.1× |