| 1 25 Dihydroxy includes fractions if performed (82652) |
— |
$287.75 |
— |
| 17-Hydroxycorticosteroids (83491) |
— |
$197.80 |
— |
| 5 Hiaa (83497) |
— |
$158.25 |
— |
| 5 Nucleotidase (83915) |
— |
$115.10 |
— |
| Acetylcholinesterase (82013) |
— |
$136.65 |
— |
| Acth stimulation panel (80402) |
— |
$687 |
— |
| Acth stimulation panel adrenal (80400) |
— |
$422.10 |
— |
| ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel must include the following: Cortisol… (80406) |
— |
$722.95 |
— |
| Actinomyces antibody (86602) |
— |
$120.35 |
— |
| Activated protein c resistance (85307) |
— |
$279.15 |
— |
| Acute hepatitis panel (80074) |
— |
$764.25 |
— |
| Acylcarnitine Plasma (82017) |
— |
$176.25 |
— |
| Adamts13 activity (85397) |
— |
$195.95 |
— |
| Adenovirus Ag Ia (87301) |
— |
$93.80 |
— |
| Adenovirus ag, if (87260) |
— |
$117.30 |
— |
| Adenovirus antibody (86603) |
— |
$120.35 |
— |
| Afb culture (87116) |
— |
$88 |
— |
| Agglutinins febrile (86000) |
— |
$72.20 |
— |
| Albumin (protein) level related to restricted heart blood flow (82045) |
— |
$214.15 |
— |
| Albumin Fluid (82042) |
— |
$57.55 |
— |
| Albumin serum (82040) |
— |
$35.95 |
— |
| Aldolase (82085) |
— |
$100.70 |
— |
| Aldosterone suppression evaluation panel (80408) |
— |
$792.80 |
— |
| Aldosterone urine (82088) |
— |
$287.75 |
— |
| Alk phos heat stable (84078) |
— |
$93.50 |
— |
| Alkaline phosphatase isoenzymes (84080) |
— |
$180.65 |
— |
| Allerg sp igg quan or semiquan (86001) |
— |
$37.80 |
— |
| Allergen specific ige (86003) |
— |
$37.80 |
— |
| Allergen specific ige; qualitative, multiallergen screen (86005) |
— |
$137.55 |
— |
| Alpha-1-antitrypsin phenotype (82104) |
— |
$205 |
— |
| Alpha-1-antitrypsin, total (82103) |
— |
$143.85 |
— |
| Alpha-fetoprotein amniotic (82106) |
— |
$169.05 |
— |
| Alpha-Fetoprotein L3 (82107) |
— |
$390.65 |
— |
| Alpha-fetoprotein, serum (82105) |
— |
$169 |
— |
| Alt (sgpt) (84460) |
— |
$39.60 |
— |
| Aluminum (82108) |
— |
$208.60 |
— |
| Amikacin trough (80150) |
— |
$215.50 |
— |
| Amines vaginal fluid qual (82120) |
— |
$88 |
— |
| Amino acid screen urine (82128) |
— |
$89.90 |
— |
| Amino acids 6/> amino acids quantitative ea spe (82139) |
— |
$122.25 |
— |
| Amino Acids Quant 2-5 (82136) |
— |
$3,817.55 |
— |
| Amino Acids, Single Quantitation (82131) |
— |
$460.40 |
— |
| Amino acids; single, qualitative, each specimen Other Outpatient (82127) |
— |
$87.50 |
— |
| Aminolevulinic acid (ala) (82135) |
— |
$154.65 |
— |
| Ammonia (82140) |
— |
$89.90 |
— |
| Amniotic fluid enzyme test (84081) |
— |
$222.95 |
— |
| Amniotic fluid scan (82143) |
— |
$136.65 |
— |
| Amylase urine (82150) |
— |
$61.10 |
— |
| Ana Titer (86039) |
— |
$120.35 |
— |
| Analysis for antibody to borrelia (relapsing fever bacteria) (86619) |
— |
$137.55 |
— |
| Analysis for antibody to shigella (intestinal bacteria) (86771) |
— |
$113.45 |
— |
| Analysis nerve (88356) |
— |
$378.50 |
— |
| Analysis skeletal muscle (88355) |
— |
$841.55 |
— |
| Androstanediol glucuronide (82154) |
— |
$240.90 |
— |
| Androsterone (hormone) level (82160) |
— |
$215.80 |
— |
| Angiotensin i enzyme test (82164) |
— |
$179.80 |
— |
| Angiotensin ll (protein) level (82163) |
— |
$215.80 |
— |
| Animal inoculation, small animal, with observation and dissection Other Outpatient (87003) |
— |
$100.05 |
— |
| Anti-phosphatidylserine antibody (86148) |
— |
$101.85 |
— |
| Antibody aspergillus (86606) |
— |
$120.35 |
— |
| Antibody coxiella burnetii q fever (86638) |
— |
$130.60 |
— |
| Antibody cytomegalovirus cmv (86644) |
— |
$158.15 |
— |
| Antibody cytomegalovirus cmv igm (86645) |
— |
$165.05 |
— |
| Antibody Detection Nos If (87299) |
— |
$129 |
— |
| Antibody Encephalitis Eastern Equine (86652) |
— |
$123.75 |
— |
| Antibody Encephalitis St. Louis (86653) |
— |
$123.75 |
— |
| Antibody epstein-barr eb virus early antigen ea (86663) |
— |
$158.15 |
— |
| Antibody haemophilus influenza (86684) |
— |
$171.90 |
— |
| Antibody helicobacter pylori (86677) |
— |
$171.90 |
— |
| Antibody Herpes Smplx Non-Specific Type Test (86694) |
— |
$151.25 |
— |
| Antibody herpes smplx type 1 (86695) |
— |
$151.25 |
— |
| Antibody HIV-2 (86702) |
— |
$158.15 |
— |
| Antibody hla class ii semiquantitative panel (86835) |
— |
$2,888 |
— |
| Antibody identification leukocyte antibodies (86021) |
— |
$206.25 |
— |
| Antibody influenza virus (86710) |
— |
$113.45 |
— |
| Antibody john cunningham virus (86711) |
— |
$140 |
— |
| Antibody Listeria Monocytogenes (86723) |
— |
$113.45 |
— |
| Antibody mumps (86735) |
— |
$137.55 |
— |
| Antibody neisseria meningitidis (86741) |
— |
$137.55 |
— |
| Antibody Protozoa Nes (86753) |
— |
$171.90 |
— |
| Antibody rubeola (86765) |
— |
$144.35 |
— |
| Antibody screen (86850) |
— |
$71.75 |
— |
| Antibody treponema pallidum (86780) |
— |
$116.85 |
— |
| Antibody; campylobacter (86625) |
— |
$161.55 |
— |
| Antibody; Coccidioides (86635) |
— |
$154.70 |
— |
| Antigen typing (86905) |
— |
$71.75 |
— |
| Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) |
— |
$148.15 |
— |
| Antinuclear antibodies (86038) |
— |
$120.35 |
— |
| Antistreptolysin O Screen - Anti-Streptolysin O (86063) |
— |
$58.45 |
— |
| Antistreptolysin o titer (86060) |
— |
$82.55 |
— |
| Antithrombin iii activity (85300) |
— |
$259.55 |
— |
| Antithrombin iii antigen (85301) |
— |
$254.65 |
— |
| Apolipoprotein b (82172) |
— |
$118.70 |
— |
| Arsenic Urine (82175) |
— |
$179.80 |
— |
| Aspergillus ag eia (87305) |
— |
$93.80 |
— |
| Assay carboxyhb qual (82376) |
— |
$53.95 |
— |
| Assay Duodenal Fluid Trypsin (84485) |
— |
$107.90 |
— |
| Assay free hydroxyproline (83500) |
— |
$176.25 |
— |
| Assay galactose transferase (82775) |
— |
$133.10 |
— |
| Assay Lipoprotein Pla2 (83698) |
— |
$214.40 |
— |
| Assay myeloperoxidase (83876) |
— |
$214.40 |
— |
| Assay Nephelometry Not Spec (83883) |
— |
$133.10 |
— |
| Assay of 17-hydroxypregnenolone (84143) |
— |
$222.95 |
— |
| Assay of acth (82024) |
— |
$323.70 |
— |
| Assay of androstenedione (82157) |
— |
$222.95 |
— |
| Assay of blood chloride (82435) |
— |
$35.95 |
— |
| Assay of blood fatty acids (82725) |
— |
$84.05 |
— |
| Assay of c-peptide (84681) |
— |
$205 |
— |
| Assay of calcitonin (82308) |
— |
$251.75 |
— |
| Assay of ceruloplasmin (82390) |
— |
$115.10 |
— |
| Assay of corticosterone (82528) |
— |
$197.80 |
— |
| Assay of creatine (82540) |
— |
$64.75 |
— |
| Assay of cyclosporine (80158) |
— |
$269.35 |
— |
| Assay of dibucaine number (82638) |
— |
$100.70 |
— |
| Assay of erythropoietin (82668) |
— |
$233.80 |
— |
| Assay of ethosuximide (80168) |
— |
$237.30 |
— |
| Assay of etiocholanolone (82696) |
— |
$215.80 |
— |
| Assay of ferritin (82728) |
— |
$133.10 |
— |
| Assay of fluoride (82735) |
— |
$147.45 |
— |
| Assay of g6pd enzyme (82955) |
— |
$129.45 |
— |
| Assay of gammaglobulin igm (82784) |
— |
$115.10 |
— |
| Assay of gastrin (82941) |
— |
$169.05 |
— |
| Assay of gentamicin (80170) |
— |
$224.55 |
— |
| Assay of glucagon (82943) |
— |
$194.20 |
— |
| Assay of homocystine (83090) |
— |
$136.65 |
— |
| Assay of homovanillic acid (83150) |
— |
$143.85 |
— |
| Assay of ketogenic steroids (83582) |
— |
$143.85 |
— |
| Assay of lipoprotein(a) (83695) |
— |
$82.75 |
— |
| Assay of manganese (83785) |
— |
$155.35 |
— |
| Assay of metanephrines (83835) |
— |
$222.95 |
— |
| Assay of osteocalcin (83937) |
— |
$269.80 |
— |
| Assay of parathormone (83970) |
— |
$327.30 |
— |
| Assay of phenobarbital (80184) |
— |
$179.60 |
— |
| Assay of phosphatase acid total (84060) |
— |
$104.30 |
— |
| Assay of prealbumin (84134) |
— |
$111.50 |
— |
| Assay of procainamide (80190) |
— |
$251.45 |
— |
| Assay of proinsulin (84206) |
— |
$276.95 |
— |
| Assay of prostate specific antigen complexed (84152) |
— |
$116.15 |
— |
| Assay of pyruvate (84210) |
— |
$118.70 |
— |
| Assay of selenium (84255) |
— |
$161.85 |
— |
| Assay of semen fructose (82757) |
— |
$109.50 |
— |
| Assay of serotonin (84260) |
— |
$305.70 |
— |
| Assay of sialic acid (84275) |
— |
$125.90 |
— |
| Assay of somatomedin (84305) |
— |
$287.75 |
— |
| Assay of tacrolimus (80197) |
— |
$278.35 |
— |
| Assay of transcortin (84449) |
— |
$179.80 |
— |
| Assay of urine vma (84585) |
— |
$161.85 |
— |
| Assay of urobilinogen urine semiquan - urobilinogen semiquant urine (84583) |
— |
$43.15 |
— |
| Assay of vitamin k (84597) |
— |
$208.60 |
— |
| Assay of volatiles (84600) |
— |
$111.50 |
— |
| Assay Ph Body Fluid Nos (83986) |
— |
$35.95 |
— |
| Assay Phosphohexose Enzymes (84087) |
— |
$161.85 |
— |
| Assay rbc glutathione (82979) |
— |
$104.30 |
— |
| Ast (sgot) (84450) |
— |
$39.60 |
— |
| Autologous Blood Process (86890) |
— |
$291.75 |
— |
| Automated rbc count (85041) |
— |
$58.75 |
— |
| B cells total count (86355) |
— |
$238.30 |
— |
| B-hexosaminidase ea assay (83080) |
— |
$122.25 |
— |
| Bartonella antibody (86611) |
— |
$154.70 |
— |
| Bartonella DNA amp probe (87471) |
— |
$126.70 |
— |
| Bcr/abl1 gene major bp (81206) |
— |
$1,035.75 |
— |
| Bcr/abl1 gene minor bp (81207) |
— |
$914.90 |
— |
| Beta 2 Glycoprotein I Antibody,Ea (86146) |
— |
$223.50 |
— |
| Beta hydroxybutyrate (82010) |
— |
$86.30 |
— |
| Beta Lactamase (87185) |
— |
$49.80 |
— |
| Beta-2 microglobulin (82232) |
— |
$197.80 |
— |
| Bile acids, total (82239) |
— |
$122.25 |
— |
| Bile acids; cholylglycine (82240) |
— |
$244.60 |
— |
| Bilirubin direct (82248) |
— |
$39.60 |
— |
| Bilirubin total (82247) |
— |
$39.60 |
— |
| Bilirubin total transcutaneous (88720) |
— |
$491.95 |
— |
| Biotinidase ea specimen (82261) |
— |
$39.60 |
— |
| Bl Smear W/Diff Wbc Count (85007) |
— |
$58.75 |
— |
| Bl Smear W/O Diff Wbc Count (85008) |
— |
$48.95 |
— |
| Blastomyces antibody (86612) |
— |
$151.25 |
— |
| Bld Bank Phys Svcs Authj Devij Standard Reprt (86079) |
— |
$92.60 |
— |
| Bld Bank Phys Svcs Invstgj Tfuj Rxn Reprt (86078) |
— |
$288.20 |
— |
| Bleeding time (85002) |
— |
$97.95 |
— |
| Blm Gene (81209) |
— |
$231.50 |
— |
| Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and… (86077) |
— |
$92.60 |
— |
| Blood clot lysis time (85175) |
— |
$107.80 |
— |
| Blood Count Automated Differential Wbc Count (85004) |
— |
$63.70 |
— |
| Blood count reticulocyte automated (85045) |
— |
$73.50 |
— |
| Blood gases (82803) |
— |
$165.40 |
— |
| Blood gases w/02 saturation (82805) |
— |
$165.40 |
— |
| Blood Gases, O2 Sat Only - Oxygen Saturation, Arterial (82810) |
— |
$93.50 |
— |
| Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) |
— |
$125.90 |
— |
| Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) |
— |
$35.95 |
— |
| Blood Ph - Ph Venous (82800) |
— |
$75.50 |
— |
| Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen (86902) |
— |
$148.15 |
— |
| Blood typing abo (86900) |
— |
$56.70 |
— |
| Blood Typing Antigen Screen Patient Serum/Unit - Blood Typing, Pat (86904) |
— |
$64.85 |
— |
| Blood typing serologic rh (d) (86901) |
— |
$56.70 |
— |
| Blood typing serologic rh phenotyping complete (86906) |
— |
$58.45 |
— |
| Body fluid cell count (89051) |
— |
$63.90 |
— |
| Body fluid cell count (89050) |
— |
$60.55 |
— |
| Bordetella antibody (86615) |
— |
$171.90 |
— |
| Bradykinin (82286) |
— |
$287.75 |
— |
| Braf gene (81210) |
— |
$830 |
— |
| Brca1 Brca2 Gene Analysis Full Sequence Analysis (81163) |
— |
$2,698.25 |
— |
| Brca1 gene analysis full dup/del analysis (81166) |
— |
$6,659.30 |
— |
| Brca1 gene analysis known familial variant (81215) |
— |
$431.75 |
— |
| Brca1&2 185&5385&6174 var (81212) |
— |
$818.20 |
— |
| Brca1&2 seq & full dup/del (81162) |
— |
$6,659.30 |
— |
| Brca2 gene analysis known familial variant (81217) |
— |
$431.75 |
— |
| Breath Alcohol Test (82075) |
— |
$68.40 |
— |
| Brucella antibody (86622) |
— |
$103.10 |
— |
| C diff amplified probe (87493) |
— |
$231.65 |
— |
| C-reactive protein (86140) |
— |
$68.70 |
— |
| C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) |
— |
$89.40 |
— |
| C1q binding assay (86332) |
— |
$189.05 |
— |
| Ca 125 (86304) |
— |
$171.90 |
— |
| Ca 19-9 (86301) |
— |
$165.05 |
— |
| Ca 27 29 (86300) |
— |
$171.90 |
— |
| Cadmium level (82300) |
— |
$151.05 |
— |
| Caffeine (80155) |
— |
$89.15 |
— |
| Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and… (89049) |
— |
$171.30 |
— |
| Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include the following: Calcitonin (82308 x 3)… (80410) |
— |
$651.15 |
— |
| Calcium infusion test (82331) |
— |
$71.90 |
— |
| Calcium ionized (82330) |
— |
$118.70 |
— |
| Calcium total (82310) |
— |
$43.15 |
— |
| Calcium urine (82340) |
— |
$57.55 |
— |
| Calculus analysis (82370) |
— |
$133.10 |
— |
| Calculus Qualitative Analysis (82355) |
— |
$111.50 |
— |
| Calculus Quantitative Chemical (82360) |
— |
$136.65 |
— |
| Calculus Spectroscopy (82365) |
— |
$129.45 |
— |
| California encephalitis ab (86651) |
— |
$123.75 |
— |
| Calprotectin, fecal (83993) |
— |
$194.20 |
— |
| Candida antibody (86628) |
— |
$154.70 |
— |
| Candida DNA dir probe (87480) |
— |
$146.65 |
— |
| Carb deficient transferrin (82373) |
— |
$197.80 |
— |
| Carbamazepine (tegretol) total (80156) |
— |
$215.50 |
— |
| Carbamazepine free (80157) |
— |
$197.55 |
— |
| Carbohydrate (sugar) analysis (84375) |
— |
$136.65 |
— |
| Carbon dioxide (82374) |
— |
$39.60 |
— |
| Carboxyhemoglobin Quantitative (82375) |
— |
$111.50 |
— |
| Carcinoembryonic antigen (82378) |
— |
$187.05 |
— |
| Cardiolipin ab igg (86147) |
— |
$223.50 |
— |
| Carnitine (82379) |
— |
$187.05 |
— |
| Carotene (82380) |
— |
$93.50 |
— |
| Catecholamines fraction plasma (82384) |
— |
$251.75 |
— |
| Catecholamines organic nitrogen blood level (82383) |
— |
$197.80 |
— |
| Catecholamines Total Urine (82382) |
— |
$161.85 |
— |
| Cathepsin-d (enzyme) level (82387) |
— |
$251.75 |
— |
| Cd4 absolute count (86361) |
— |
$216.55 |
— |
| Cell Cryopreserve/Storage (88240) |
— |
$191.75 |
— |
| Cell enumeration & id (86152) |
— |
$983.20 |
— |
| Cell saver (86891) |
— |
$412.10 |
— |
| Cellular Function Assay Stimul&Detect Biomarker (86352) |
— |
$857.80 |
— |
| Cftr gene com variants (81220) |
— |
$1,010.60 |
— |
| Chemical analysis for genetic disorder (82016) |
— |
$115.10 |
— |
| Chemiluminescent assay (82397) |
— |
$100.70 |
— |
| Chemotaxis assay (86155) |
— |
$106.55 |
— |
| Chimerism w/comp to baseline w/cell selection ea (81268) |
— |
$1,647.40 |
— |
| Chimerism w/comp to baseline w/o cell selection (81267) |
— |
$1,310.55 |
— |
| Chlamydia antibody (86631) |
— |
$113.45 |
— |
| Chlamydia antigen gilm (87320) |
— |
$93.80 |
— |
| Chlamydia Igm Antibody (86632) |
— |
$120.35 |
— |
| Chlamydia trachomatis ag if (87270) |
— |
$117.30 |
— |
| Chloramphenicol (82415) |
— |
$118.70 |
— |
| Chloride other source (82438) |
— |
$68.35 |
— |
| Chloride urine (82436) |
— |
$39.60 |
— |
| Chlorinated hydrocarbons screen (82441) |
— |
$107.90 |
— |
| Cholesterol total (82465) |
— |
$35.95 |
— |
| Cholinesterase rbc (82482) |
— |
$111.50 |
— |
| Cholinesterase serum (82480) |
— |
$86.30 |
— |
| Chondroitin b sulfate (protein) level (82485) |
— |
$143.85 |
— |
| Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total… (80415) |
— |
$353 |
— |
| Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone… (80414) |
— |
$336.75 |
— |
| Chrmsm breakage synds score 100 cll (88249) |
— |
$1,094 |
— |
| Chrom count break 50-100/20/2 (88248) |
— |
$1,094 |
— |
| Chromium urine (82495) |
— |
$169.05 |
— |
| Chromogenic substrate assay (85130) |
— |
$186.10 |
— |
| Chromogranin a (86316) |
— |
$178.75 |
— |
| Chromosome analysis 20-25 cells (88264) |
— |
$787.35 |
— |
| Chromosome analysis 45 cells (88263) |
— |
$949.35 |
— |
| Chromosome analysis for breakage syndromes; baseline Sister Chromatid Exchange (SCE), 20-25 cells Other Outpatient (88245) |
— |
$940.40 |
— |
| Chylmd trach assay w/optic (87810) |
— |
$117.30 |
— |
| Chylmd Trach Dna Quant (87492) |
— |
$220.80 |
— |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) |
— |
$221.65 |
— |
| Citrate (82507) |
— |
$251.75 |
— |
| Ck isoenzymes (82552) |
— |
$129.45 |
— |
| Ckmb (82553) |
— |
$82.75 |
— |
| Clot factor viii vw antigen (85246) |
— |
$391.80 |
— |
| Clot Factor X Stuart-Power - Factor 10 Activity (85260) |
— |
$318.35 |
— |
| Clot factor xiii fibrin stab (85290) |
— |
$293.85 |
— |
| Clot retraction (85170) |
— |
$58.75 |
— |
| Clotting prekallikrein assay fletcher fact assay (85292) |
— |
$303.65 |
— |
| Clotting time (85345) |
— |
$122.45 |
— |
| Clozapine level (80159) |
— |
$116.90 |
— |
| Cmv PCR (87496) |
— |
$252.20 |
— |
| Coagulation time (85348) |
— |
$78.40 |
— |
| Coagulation time activated (85347) |
— |
$73.50 |
— |
| Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) |
— |
$161.85 |
— |
| Cold agglutinin screen (86156) |
— |
$65.30 |
— |
| Cold agglutinin titer (86157) |
— |
$79.05 |
— |
| Collagen cross links (82523) |
— |
$172.65 |
— |
| Combined rapid anterior pituitary evaluation panel This panel must include the following: Adrenocorticotropic hormone… (80418) |
— |
$4,490.45 |
— |
| Comparative anal str markers patient&comp spec (81265) |
— |
$1,358.50 |
— |
| Compatibility test antiglob (86922) |
— |
$148.15 |
— |
| Compatibility Test Incubate (86921) |
— |
$92.60 |
— |
| Complement c3 (86160) |
— |
$140.95 |
— |
| Complement total ch50 (86162) |
— |
$213.15 |
— |
| Complement/Function Activity - C1 Esterase Inhibitor, Functional (86161) |
— |
$158.15 |
— |
| Concentration Infectious Agent (87015) |
— |
$61.60 |
— |
| Coombs direct (86880) |
— |
$56.70 |
— |
| Coombs Test Indirect Qual (86885) |
— |
$56.70 |
— |
| Copper urine (82525) |
— |
$107.90 |
— |
| Corticotropic releasing hormone (CRH) stimulation panel This panel must include the following: Cortisol (82533 x 6)… (80412) |
— |
$2,082.30 |
— |
| Cortisol free (82530) |
— |
$172.65 |
— |
| Cortisol total (82533) |
— |
$169.05 |
— |
| Creatine kinase (CK), (CPK); isoforms Other Outpatient (82554) |
— |
$122.25 |
— |
| Creatine kinase total (82550) |
— |
$46.70 |
— |
| Creatinine blood (82565) |
— |
$35.95 |
— |
| Creatinine clearance (82575) |
— |
$104.30 |
— |
| Creatinine other source (82570) |
— |
$57.55 |
— |
| Crossmatch immediate spin (86920) |
— |
$148.15 |
— |
| Cryofibrinogen (82585) |
— |
$82.75 |
— |
| Cryoglobulin (82595) |
— |
$75.50 |
— |
| Cryptococcal Antigen (87327) |
— |
$93.80 |
— |
| Cryptococcus antibody (86641) |
— |
$103.10 |
— |
| Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) |
— |
$88 |
— |
| Culture Aerobic Identify (87077) |
— |
$88 |
— |
| Culture aerobic quant other (87071) |
— |
$82.05 |
— |
| Culture anaerobic (87075) |
— |
$88 |
— |
| Culture Bacteria Anaerobic (87073) |
— |
$88 |
— |
| Culture blood (87040) |
— |
$82.05 |
— |
| Culture chlamydia (87110) |
— |
$123.75 |
— |
| Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous (87101) |
— |
$73.30 |
— |
| Culture fungus blood (87103) |
— |
$76.25 |
— |
| Culture fungus id yeast (87106) |
— |
$79.15 |
— |
| Culture fungus other (87102) |
— |
$76.25 |
— |
| Culture genital (87070) |
— |
$79.15 |
— |
| Culture herpes (87250) |
— |
$146.65 |
— |
| Culture screen only (87081) |
— |
$52.75 |
— |
| Culture stool (87045) |
— |
$82.05 |
— |
| Culture typing if ea antiserum (87140) |
— |
$61.60 |
— |
| Culture Typing Immunologic Oth/Thn Immunofluores (87147) |
— |
$46.90 |
— |
| Culture typing other methods (87158) |
— |
$44 |
— |
| Culture Typing, Glc Method (87143) |
— |
$114.35 |
— |
| Culture urine (87086) |
— |
$73.30 |
— |
| Culture urine id ea isolate (87088) |
— |
$70.35 |
— |
| Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart Other Outpatient (87084) |
— |
$58.65 |
— |
| Culture, typing; identification by pulse field gel typing Other Outpatient (87152) |
— |
$41.05 |
— |
| Cultyp nucleic acid sequencing meth ea isolate (87153) |
— |
$728.75 |
— |
| Cyanide (82600) |
— |
$158.25 |
— |
| Cyanocobalamin Vit B-12 Unsat Binding Capacity (82608) |
— |
$151.05 |
— |
| Cyclic amp (82030) |
— |
$251.75 |
— |
| Cyclic Citrullinated Peptide (86200) |
— |
$144.35 |
— |
| Cyp2c19 gene com variants (81225) |
— |
$1,351.15 |
— |
| Cyp2c9 gene com variants (81227) |
— |
$810.70 |
— |
| Cyp2d6 gene com variants (81226) |
— |
$2,091.05 |
— |
| Cystatin c (82610) |
— |
$69.45 |
— |
| Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) |
— |
$439.85 |
— |
| Cytopath cell enhance tech (88112) |
— |
$171.30 |
— |
| Cytopath Fl Nongyn Filter (88106) |
— |
$92.60 |
— |
| Cytopath smear cerv/vag,index add-on (88155) |
— |
$37.85 |
— |
| Cytopath Smear Other Source (88160) |
— |
$92.60 |
— |
| Cytopath,cerv/vag,auto thin layer,interp (88174) |
— |
$134.95 |
— |
| Cytopathology procedures (88199) |
— |
$92.60 |
— |
| Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision Other Outpatient (88147) |
— |
$71.85 |
— |
| Cytopathology smears, cervical or vaginal; screening by automated system with manual rescreening under physician… (88148) |
— |
$95.95 |
— |
| Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer… (88143) |
— |
$128 |
— |
| Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted… (88166) |
— |
$66.70 |
— |
| Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and computer-assisted… (88167) |
— |
$66.70 |
— |
| Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual screening and rescreening under physician… (88165) |
— |
$66.70 |
— |
| Cytopathology, slides, cervical or vaginal; with manual screening and computer-assisted rescreening under physician… (88152) |
— |
$66.70 |
— |
| Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision Other… (88153) |
— |
$66.70 |
— |
| Cytotoxic pra quick (86808) |
— |
$223.50 |
— |
| Cytp c/v auto thin lyr prepj scr mnl rescr phys (88175) |
— |
$167.35 |
— |
| Cytp concentration smears & interpretation (88108) |
— |
$80 |
— |
| Cytp Insitu Hybrid Urine Spec 3-5 Probes Ea Mnl (88120) |
— |
$699.20 |
— |
| Cytp Slides C/V Mnl Scr Under Phys (88150) |
— |
$66.70 |
— |
| Cytp Smrs Any Oth Src Extnd Std > 5 Slides (88162) |
— |
$92.60 |
— |
| Cytp urine 3-5 probes cmptr (88121) |
— |
$841.55 |
— |
| D-Dimer (85379) |
— |
$171.40 |
— |
| D-Dimer (85378) |
— |
$137.15 |
— |
| Dark field (87164) |
— |
$67.85 |
— |
| Dark field exam w/o collection (87166) |
— |
$82.05 |
— |
| Deoxycortisol (82634) |
— |
$233.80 |
— |
| Deoxyribonuclease antibody (86215) |
— |
$134.10 |
— |
| Desoxycorticosterone (82633) |
— |
$233.80 |
— |
| Detect agent nos DNA dir (87797) |
— |
$126.70 |
— |
| Detect Agent, Mult Orgs, Dna, Dir (87800) |
— |
$253.50 |
— |
| Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) |
— |
$102.65 |
— |
| Detect agnt mult DNA ampli (87801) |
— |
$443.35 |
— |
| Detection test by immunoassay technique for cytomegalovirus (87332) |
— |
$93.80 |
— |
| Detection test by immunoassay technique for HIV-2 antigen (87391) |
— |
$137.80 |
— |
| Detection test by immunofluorescent technique for cytomegalovirus (cmv) (87271) |
— |
$140.75 |
— |
| Dexamethasone panel (80420) |
— |
$561.25 |
— |
| Dhea (82626) |
— |
$244.60 |
— |
| Dhea sulfate (82627) |
— |
$215.80 |
— |
| Digoxin (80162) |
— |
$202.05 |
— |
| Dilantin (80185) |
— |
$202.05 |
— |
| Diphtheria antitoxoid (86648) |
— |
$144.35 |
— |
| Dna Antibody Single Stranded (86226) |
— |
$130.60 |
— |
| Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) |
— |
$147.85 |
— |
| Dna/Rna Amplified Probe (87150) |
— |
$221.65 |
— |
| DNA/RNA direct probe (87149) |
— |
$126.70 |
— |
| Drug Screen Quant Gabapentin (80171) |
— |
$83.75 |
— |
| Drug screen quant zonisamide (80203) |
— |
$83.75 |
— |
| Drug Screen Quantitative Lamotrigine (80175) |
— |
$83.75 |
— |
| Drug Scrn Quan Levetiracetam (80177) |
— |
$83.75 |
— |
| Drug scrn quant oxcarbazepin (80183) |
— |
$83.75 |
— |
| Drug test prsmv chem anlyzr (80307) |
— |
$152.65 |
— |
| Ebv viral capsid (86665) |
— |
$178.75 |
— |
| Echinococcus ab igg (86682) |
— |
$171.90 |
— |
| Egfr Gene Analysis Common Variants (81235) |
— |
$1,528.10 |
— |
| Ehrlichia antibody (86666) |
— |
$158.15 |
— |
| Electrolyte panel (80051) |
— |
$89.75 |
— |
| Electron microscopy diagnostic (88348) |
— |
$995.55 |
— |
| Electronic crossmatch (86923) |
— |
$148.15 |
— |
| Electrophoretic Test - Immunofixation Electrophoresis (82664) |
— |
$217.05 |
— |
| Encephalitis Western Equine (86654) |
— |
$123.75 |
— |
| Endomysial antibody iga (86255) |
— |
$76.10 |
— |
| Entamoeb Hist Dispr Ag Eia (87336) |
— |
$93.80 |
— |
| Entamoeba histolytica antigen (87337) |
— |
$93.80 |
— |
| Enterovirus antibody (86658) |
— |
$123.75 |
— |
| Enterovirus Pcr (87498) |
— |
$322.50 |
— |
| Enzyme activity radioactive (82658) |
— |
$215.80 |
— |
| Enzyme cell activity (82657) |
— |
$72.90 |
— |
| Enzyme histochemistry (88319) |
— |
$841.55 |
— |
| Eosinophil count (85048) |
— |
$58.75 |
— |
| Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) |
— |
$158.15 |
— |
| Estradiol (82670) |
— |
$176.50 |
— |
| Estriol (82677) |
— |
$154.65 |
— |
| Estrogen fractionated (82671) |
— |
$316.50 |
— |
| Estrogen receptor analysis (84233) |
— |
$390.65 |
— |
| Estrogens total (82672) |
— |
$215.80 |
— |
| Estrone (82679) |
— |
$215.80 |
— |
| Ethylene glycol (82693) |
— |
$169.05 |
— |
| Euglobulin lysis (85360) |
— |
$166.55 |
— |
| Eval c/v amniotic fluid protein qual ea specimen (84112) |
— |
$390.65 |
— |
| Everolimus (80169) |
— |
$86.75 |
— |
| Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) |
— |
$45.20 |
— |
| Examination of archival tissue for genetic analysis (88363) |
— |
$92.60 |
— |
| Exhaled breath condensate (83987) |
— |
$81.90 |
— |
| F2 gene analysis 20210g >a variant (81240) |
— |
$310.85 |
— |
| F5 gene (81241) |
— |
$386.05 |
— |
| Factor ii activity (85210) |
— |
$137.15 |
— |
| Factor inhibitor test (85335) |
— |
$195.95 |
— |
| Factor ix activity (85250) |
— |
$318.35 |
— |
| Factor v activity (85220) |
— |
$293.85 |
— |
| Factor vii assay (85230) |
— |
$293.85 |
— |
| Factor viii ahg (85240) |
— |
$318.35 |
— |
| Factor viii related antigen (85244) |
— |
$367.35 |
— |
| Factor viii vw multimetric (85247) |
— |
$401.60 |
— |
| Factor xi assay (85270) |
— |
$313.40 |
— |
| Factor xii assay (85280) |
— |
$318.35 |
— |
| Factor xiii solubility screen (85291) |
— |
$195.95 |
— |
| Fat differential feces quan (82715) |
— |
$90.25 |
— |
| Fat stain (89125) |
— |
$60.55 |
— |
| Fbrnlyc factors&inhibitors alpha-2 antiplasmin (85410) |
— |
$244.85 |
— |
| Fecal fat qual (82705) |
— |
$79.10 |
— |
| Fecal fat quant (82710) |
— |
$176.25 |
— |
| Fetal bleed screen (85461) |
— |
$117.55 |
— |
| Fetal chrmoml aneuploidy (81420) |
— |
$2,026.95 |
— |
| Fetal fibronectin (82731) |
— |
$390.65 |
— |
| Fetal hemoglobin, chemical (83030) |
— |
$79.10 |
— |
| Fetal lung maturity assessment; foam stability test Other Outpatient (83662) |
— |
$119.50 |
— |
| Fetal lung maturity fluorescence polarization (83663) |
— |
$119.50 |
— |
| Fibrin Degrad Products,Paracoag - Fibrin Monomer (85366) |
— |
$146.90 |
— |
| Fibrin degradation products (85362) |
— |
$137.15 |
— |
| Fibrin Degradproducts,D-Dimer, Ultrasens - D-Dimer, Rapid (85380) |
— |
$171.40 |
— |
| Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative Other Outpatient (85370) |
— |
$181.15 |
— |
| Fibrinogen activity (85384) |
— |
$122.45 |
— |
| Fibrinogen antigen (85385) |
— |
$142.05 |
— |
| Fibrinolysins/Coagulopathy Screen Interp&Repor (85390) |
— |
$33.55 |
— |
| Fibrinolytic factors and inhibitors; plasmin Other Outpatient (85400) |
— |
$220.40 |
— |
| Fibrinolytic Plasminogen (85415) |
— |
$244.85 |
— |
| Fitzgerald factor (clotting factor) measurement (85293) |
— |
$293.85 |
— |
| Flt3 gene analysis (81245) |
— |
$768.30 |
— |
| Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) |
— |
$76.10 |
— |
| Folate serum (82746) |
— |
$147.45 |
— |
| Folic acid rbc (82747) |
— |
$176.25 |
— |
| Follicle Stimulating Hormone (83001) |
— |
$179.80 |
— |
| Forensic (investigation) examination of specimen (88125) |
— |
$171.30 |
— |
| Fractionation ketosteroids (83593) |
— |
$280.50 |
— |
| Francisella Tularensis (86668) |
— |
$123.75 |
— |
| Fresh frozen plasma thawing each unit (86927) |
— |
$496.60 |
— |
| Frozen blood each unit thawing (86931) |
— |
$283.60 |
— |
| Frozen blood prep (86930) |
— |
$343.80 |
— |
| Frozen blood, each unit; freezing (includes preparation) and thawing UNSCHEDULED (86932) |
— |
$291.75 |
— |
| Fructosamine (82985) |
— |
$95.20 |
— |
| Fungus Identification, Mold - Fungal Identification, Mold (87107) |
— |
$79.15 |
— |
| G6pd Screen (82960) |
— |
$68.35 |
— |
| Galactokinase (82759) |
— |
$136.65 |
— |
| Galactose (82760) |
— |
$86.30 |
— |
| Galactose transferase test (82776) |
— |
$52.95 |
— |
| Galectin-3 serum (82777) |
— |
$138.95 |
— |
| Gammaglobulin ige (82785) |
— |
$147.45 |
— |
| Gardner vag DNA dir probe (87510) |
— |
$146.65 |
— |
| Gardner Vag Dna Quant (87512) |
— |
$263.75 |
— |
| Gastric acid analy w/ph ea spe (82930) |
— |
$61.10 |
— |
| Gastric Occult Blood (82271) |
— |
$35.95 |
— |
| Gastrin after secretin stim (82938) |
— |
$190.60 |
— |
| Gene rearrangement analysis immunoglobulin heavy chain locus (81262) |
— |
$275.75 |
— |
| Genotype cytomegalovirus (87910) |
— |
$1,626.45 |
— |
| Ggt (82977) |
— |
$45.45 |
— |
| Gh suppression panel (80430) |
— |
$583.75 |
— |
| Giardia ag by if (87269) |
— |
$117.30 |
— |
| Giardia antigen eia stool (87329) |
— |
$93.80 |
— |
| Giardia lamblia antibody (86674) |
— |
$137.55 |
— |
| Glucagon tolerance panel; for insulinoma This panel must include the following: Glucose (82947 x 3) Insulin (83525 x 3)… (80422) |
— |
$381.65 |
— |
| Glucagon tolerance panel; for pheochromocytoma This panel must include the following: Catecholamines, fractionated… (80424) |
— |
$381.65 |
— |
| Glucagon tolerance test (82946) |
— |
$104.30 |
— |
| Glucose (82947) |
— |
$46.70 |
— |
| Glucose Blood Test (82962) |
— |
$35.95 |
— |
| Glucose body fluid (82945) |
— |
$118.70 |
— |
| Glucose post dose (82950) |
— |
$61.10 |
— |
| Glucose Tolerance Ea Addl Beyond 3 Specimens (82952) |
— |
$39.60 |
— |
| Glucose Tolerance Test (Gtt) - Bundled Charge (82951) |
— |
$129.45 |
— |
| Glucosidase beta (82963) |
— |
$161.85 |
— |
| Glutamate dehydrogenase (82965) |
— |
$50.35 |
— |
| Glutathione (82978) |
— |
$118.70 |
— |
| Glycosylated hb home device (83037) |
— |
$86.30 |
— |
| Gonadotropin releasing hormone (83727) |
— |
$197.80 |
— |
| Gonadotropin releasing hormone stimulation panel This panel must include the following: Follicle stimulating hormone… (80426) |
— |
$1,055.25 |
— |
| Growth hormone (83003) |
— |
$172.65 |
— |
| Growth Hormone Antibody (86277) |
— |
$127.20 |
— |
| Growth hormone stim panel (80428) |
— |
$583.75 |
— |
| Haloperidol (haldol) (80173) |
— |
$197.55 |
— |
| Haptoglobin (83010) |
— |
$133.10 |
— |
| Haptoglobin; phenotypes Other Outpatient (83012) |
— |
$161.85 |
— |
| Hba1/hba2 gene dup/del vrnts (81269) |
— |
$1,264.15 |
— |
| Hcg free betachain test (84704) |
— |
$136.65 |
— |
| Hcg qualitative (84703) |
— |
$82.75 |
— |
| Hcg quant (84702) |
— |
$136.65 |
— |
| Hdl Cholesterol (83718) |
— |
$68.35 |
— |
| Heavy metal quant each (83018) |
— |
$208.60 |
— |
| Heavy Metal Screen - Heavy Metals Screen (83015) |
— |
$208.60 |
— |
| Heinz Bodies; Direct - Heinz Body Stain (85441) |
— |
$97.95 |
— |
| Heinz bodies; induced - heinz bodies, induced (85445) |
— |
$83.20 |
— |
| Helicobacter pylori, blood test analysis for urease activity, non-radioactive isotope (eg, C-13) Other Outpatient (83009) |
— |
$426 |
— |
| Hemagglutination inhibition (86280) |
— |
$99.70 |
— |
| Hematocrit (85014) |
— |
$44.10 |
— |
| Hematocrit spun (85013) |
— |
$44.10 |
— |
| Hemoglobin (85018) |
— |
$44.10 |
— |
| Hemoglobin a1c (83036) |
— |
$97.10 |
— |
| Hemoglobin Chromotography - Hemoglobinopathy Eval (83021) |
— |
$161.85 |
— |
| Hemoglobin electrophoresis (83020) |
— |
$125.90 |
— |
| Hemoglobin fetal ql (83033) |
— |
$57.55 |
— |
| Hemoglobin Fetal,Diff Lysis - Kleihauer-Betke Stain (85460) |
— |
$142.05 |
— |
| Hemoglobin level (83026) |
— |
$25.20 |
— |
| Hemoglobin Methemoglobin Quantitative (83050) |
— |
$61.10 |
— |
| Hemoglobin plasma (83051) |
— |
$61.10 |
— |
| Hemoglobin stability screen (83068) |
— |
$61.10 |
— |
| Hemoglobin thermolabile (83065) |
— |
$71.90 |
— |
| Hemoglobin urine (83069) |
— |
$43.15 |
— |
| Hemoglobin-oxygen affinity (82820) |
— |
$111.50 |
— |
| Hemolysins And Agglutinins Incubated (86941) |
— |
$82.15 |
— |
| Hemolysins/agglutinins auto screen (86940) |
— |
$61.35 |
— |
| Hemosiderin urine (83070) |
— |
$50.35 |
— |
| Heparin assay (85520) |
— |
$225.25 |
— |
| Heparin neutralization (85525) |
— |
$181.15 |
— |
| Heparin-protamine tolerance test (85530) |
— |
$171.40 |
— |
| Hepatitis a antibody total (86708) |
— |
$127.20 |
— |
| Hepatitis a igm (86709) |
— |
$120.35 |
— |
| Hepatitis b core ab igm (86705) |
— |
$130.60 |
— |
| Hepatitis b core antibody total (86704) |
— |
$120.35 |
— |
| Hepatitis B Surface Ab (86706) |
— |
$106.55 |
— |
| Hepatitis B Surface Antigen (87340) |
— |
$93.80 |
— |
| Hepatitis b virus genotyping (87912) |
— |
$1,626.45 |
— |
| Hepatitis be antibody (86707) |
— |
$116.85 |
— |
| Hepatitis Be Antigen (87350) |
— |
$99.65 |
— |
| Hepatitis c ab confirm (86804) |
— |
$268.15 |
— |
| Hepatitis c antibody (86803) |
— |
$168.45 |
— |
| Hepatitis C Genotype (87902) |
— |
$926.10 |
— |
| Hepatitis C Probe&Rvrs Trnsc (87521) |
— |
$328.45 |
— |
| Hepatitis C Rna Dir Probe (87520) |
— |
$175.85 |
— |
| Hepatitis delta ab (86692) |
— |
$182.20 |
— |
| Hepatitis delta ag (87380) |
— |
$132 |
— |
| Hepatitis G Dna Dir Probe (87525) |
— |
$146.65 |
— |
| Herpes culture (87252) |
— |
$164.65 |
— |
| Herpes simplex type 2 (86696) |
— |
$151.25 |
— |
| Heterophile Antibodies,Screen - Mononucleosis Screen (86308) |
— |
$61.90 |
— |
| Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney Other Outpatient (86310) |
— |
$89.40 |
— |
| Heterophile antibody titer (86309) |
— |
$85.95 |
— |
| Hfe gene (81256) |
— |
$412.85 |
— |
| Histamine plasma (83088) |
— |
$244.60 |
— |
| Histoplasma antibody (86698) |
— |
$137.55 |
— |
| Histoplasma antigen urine (87385) |
— |
$93.80 |
— |
| HIV confirmation (86689) |
— |
$182.20 |
— |
| HIV-1 antibody (86701) |
— |
$116.85 |
— |
| HIV-1 genotype (87901) |
— |
$1,626.30 |
— |
| HIV-1 integrase genotype (87906) |
— |
$813.20 |
— |
| Hiv-1/Hiv-2 1 Result Antbdy (86703) |
— |
$137.55 |
— |
| HIV-2 probe&revrse trnscripj (87538) |
— |
$263.85 |
— |
| Hla antibody screen (86807) |
— |
$275.05 |
— |
| Hla b 27 disease association lc (81374) |
— |
$463.52 |
— |
| Hla class i high defin qual (86832) |
— |
$1,134.55 |
— |
| Hla class i phenotype qual (86830) |
— |
$722.05 |
— |
| Hla class i semiquant panel (86834) |
— |
$3,197.45 |
— |
| Hla class i typing high resolution complete (81379) |
— |
$2,118.65 |
— |
| Hla class i typing high resolution one allele or allele group (81381) |
— |
$597.45 |
— |
| Hla class i&ii antibody qual (86828) |
— |
$385.05 |
— |
| Hla class i&ii low hla-a -b -c -drb1/3/4/5&dqb (81370) |
— |
$2,540.25 |
— |
| Hla class i/ii antibody qual (86829) |
— |
$292.75 |
— |
| Hla class ii high defin qual (86833) |
— |
$1,031.40 |
— |
| Hla class ii phenotype qual (86831) |
— |
$618.85 |
— |
| Hla class ii typing high resolution one locus ea (81382) |
— |
$781.30 |
— |
| Hla i typing 1 locus hr (81380) |
— |
$1,119.70 |
— |
| Hla I Typing 1 Locus Lr (81373) |
— |
$703.50 |
— |
| Hla I Typing Complete Lr (81372) |
— |
$1,395.45 |
— |
| Hla i&ii high resolution hla-a -b -c and -drb1 (81378) |
— |
$2,183 |
— |
| Hla i&li low resolution hla-a -b&-drb1 (81371) |
— |
$1,520.45 |
— |
| Hla ii low resolution one antigen equivalent ea (81377) |
— |
$579.95 |
— |
| Hla ii typing 1 allele hr (81383) |
— |
$689.35 |
— |
| Hla ii typing 1 locus lr (81376) |
— |
$772.05 |
— |
| Hla ii typing ag equiv lr (81375) |
— |
$1,394.50 |
— |
| Hla typing a/b/c multiple antigens (86813) |
— |
$378.20 |
— |
| Hla typing dr/dq (86817) |
— |
$790.75 |
— |
| Hla Typing Dr/Dq Single Antigen (86816) |
— |
$292.20 |
— |
| Hla x-match, non-cyt add-on (86826) |
— |
$114.60 |
— |
| Hla x-match, non-cytotoxic (86825) |
— |
$342.65 |
— |
| Hla-b27 (86812) |
— |
$216.55 |
— |
| Homogenization tissue (87176) |
— |
$52.75 |
— |
| Hormone receptor analysis (84235) |
— |
$330.65 |
— |
| Hpylori Breath Anal Urease Act Non-Radact Istope (83013) |
— |
$426 |
— |
| Hpylori Drug Administration (83014) |
— |
$426 |
— |
| Hsv Dna Quant (87530) |
— |
$270.60 |
— |
| Hsv, Dna, Amp Probe - Hsv Pcr (87529) |
— |
$263.85 |
— |
| Htlv-i antibody (86687) |
— |
$137.55 |
— |
| Htlv-ii antibody (86688) |
— |
$130.60 |
— |
| Human epididymis protein 4 (86305) |
— |
$132 |
— |
| Hydroxyprogesterone 17-d (83498) |
— |
$230.20 |
— |
| Hydroxyproline total (83505) |
— |
$233.80 |
— |
| Ia infectious agt antibody qual/semiq 1step meth (86318) |
— |
$82.55 |
— |
| Ia infectious agt antibody sars-cov-2 COVID-19 (86328) |
— |
$86.85 |
— |
| Iaad ia clostridium difficile toxin (87324) |
— |
$93.80 |
— |
| Iaad ia cryptosporidium (87328) |
— |
$93.80 |
— |
| Iaad Ia Hepatitis B Surface Ag Neutralization (87341) |
— |
$93.80 |
— |
| Iaad ia HIV-1 (87390) |
— |
$146.65 |
— |
| Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) |
— |
$169 |
— |
| Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) |
— |
$93.80 |
— |
| Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) |
— |
$93.80 |
— |
| Iaad ia rotavirus (87425) |
— |
$93.80 |
— |
| Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) |
— |
$93.80 |
— |
| Iaad Ia Streptococcus Group A (87430) |
— |
$75.75 |
— |
| Iaadi herpes smplx virus type 2 (87273) |
— |
$117.30 |
— |
| Iaadi inffluenza a virus (87276) |
— |
$117.30 |
— |
| Iaadi influenza b virus (87275) |
— |
$117.30 |
— |
| Iaadi polyv mlt organisms ea polyv antiserum (87300) |
— |
$93.80 |
— |
| Iaadi respiratory synctial virus (87280) |
— |
$117.30 |
— |
| Iaadiadoo not otherwise specified (87899) |
— |
$102.65 |
— |
| Iaadiadoo trichomonas vaginalis (87808) |
— |
$117.30 |
— |
| Iadna borrelia burgdorferi amplified probe tq (87476) |
— |
$307.85 |
— |
| Iadna candida species amplified probe tq (87481) |
— |
$234.55 |
— |
| Iadna chlamydia pneumoniae amplified probe tq (87486) |
— |
$234.55 |
— |
| Iadna Chlamydia Trachomatis Direct Probe Tq (87490) |
— |
$146.65 |
— |
| Iadna gardnerella vaginalis amplified probe tq (87511) |
— |
$234.55 |
— |
| Iadna hepatitis b virus amplified probe tq (87516) |
— |
$328.45 |
— |
| Iadna hepatitis b virus quantification (87517) |
— |
$175.85 |
— |
| Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) |
— |
$328.45 |
— |
| Iadna herpes virus-6 amplified probe tq (87532) |
— |
$263.85 |
— |
| Iadna herpes virus-6 quantification (87533) |
— |
$263.85 |
— |
| Iadna HIV-1 amplified probe & reverse transcrpj (87535) |
— |
$263.85 |
— |
| Iadna HIV-1 quant & reverse transcription (87536) |
— |
$537.50 |
— |
| Iadna mycobacteria tuberculosis amp prb (87556) |
— |
$263.85 |
— |
| Iadna mycoplsm pneumoniae amplified probe tq (87581) |
— |
$263.85 |
— |
| Iadna neisseria gonorrhoeae amplified probe tq (87591) |
— |
$234.55 |
— |
| Iadna nos amplified probe tq each organism (87798) |
— |
$234.55 |
— |
| Iadna nos quantification each organism (87799) |
— |
$270.60 |
— |
| Iadna respiratry probe & rev trnscr 6-11 targets (87632) |
— |
$1,348.30 |
— |
| Iadna trichomonas vaginalis amplified probe tech (87661) |
— |
$221.05 |
— |
| If cryptosporidium antigen (87272) |
— |
$117.30 |
— |
| If varicella-zoster antigen (87290) |
— |
$117.30 |
— |
| Igg subclasses (82787) |
— |
$323.70 |
— |
| Igh gene rearrange amp meth (81261) |
— |
$1,250.70 |
— |
| Igk rearrangeabn clonal pop (81264) |
— |
$943.30 |
— |
| Igvh somatic hypermutation (81263) |
— |
$1,860.45 |
— |
| Immunfix e-phorsis/urine/csf (86335) |
— |
$185.35 |
— |
| Immunoassay analyte qual/semiqual single step (83518) |
— |
$71.90 |
— |
| Immunoassay infectious agent antibody quan nos (86317) |
— |
$94.70 |
— |
| Immunoassay nonantibody (83516) |
— |
$107.90 |
— |
| Immunoassay technique for escherichia coli 0157 e. coli (87335) |
— |
$93.80 |
— |
| Immunoassay technique for helicobacter pylori gi tract bacteria (87339) |
— |
$93.80 |
— |
| Immunoassay tumor antigen qual/semiquantitative (86294) |
— |
$171.90 |
— |
| Immunoassay with direct visual observation for clostridium (87803) |
— |
$117.30 |
— |
| Immunoassay with direct visual observation for streptococcus (87802) |
— |
$117.30 |
— |
| Immunodiffusion not elsewhere specified (86329) |
— |
$140.95 |
— |
| Immunodiffusion Ouchterlony (86331) |
— |
$140.95 |
— |
| Immunoelectrophoresis Other Fluids Concentration (86325) |
— |
$178.75 |
— |
| Immunoelectrophoresis serum (86320) |
— |
$209.70 |
— |
| Immunofixj Electrophoresis Serum (86334) |
— |
$148.50 |
— |
| Immunofluorescent technique for herpes simplex virus type 1 (87274) |
— |
$117.30 |
— |
| Immunofluorescent technique for pneumocystis carinii (87281) |
— |
$117.30 |
— |
| Immunofluorescent technique for treponema pallidum syphilis organism (87285) |
— |
$132 |
— |
| Immunoglobulin assay (86023) |
— |
$189.05 |
— |
| India ink prep (87210) |
— |
$38.05 |
— |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent… (87451) |
— |
$93.80 |
— |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus Other… (87809) |
— |
$117.30 |
— |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Neisseria gonorrhoeae… (87850) |
— |
$117.30 |
— |
| Infectious agent antigen detection by immunofluorescent technique; Enterovirus, direct fluorescent antibody (DFA) Other… (87267) |
— |
$117.30 |
— |
| Infectious agent antigen detection by immunofluorescent technique; Rubeola Other Outpatient (87283) |
— |
$117.30 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae and Bartonella quintana, quantification… (87472) |
— |
$270.60 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, direct probe technique Other Outpatient (87475) |
— |
$270.60 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Candida species, quantification Other Outpatient (87482) |
— |
$263.75 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique Other Outpatient (87485) |
— |
$132 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, quantification Other Outpatient (87487) |
— |
$270.60 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct probe technique Other Outpatient (87495) |
— |
$219.85 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique Other Outpatient (87526) |
— |
$263.85 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, quantification Other Outpatient (87527) |
— |
$263.85 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, direct probe technique Other Outpatient (87528) |
— |
$146.65 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct probe technique Other Outpatient (87531) |
— |
$146.65 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe technique Other Outpatient (87534) |
— |
$146.65 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe technique Other Outpatient (87537) |
— |
$146.65 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification, includes reverse transcription when… (87539) |
— |
$293.20 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, quantification Other Outpatient (87542) |
— |
$263.75 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, quantification Other… (87562) |
— |
$270.60 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique Other Outpatient (87550) |
— |
$126.70 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, quantification Other Outpatient (87557) |
— |
$270.60 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, quantification Other Outpatient (87582) |
— |
$263.75 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, direct probe technique Other Outpatient (87650) |
— |
$126.70 |
— |
| Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, quantification Other Outpatient (87652) |
— |
$263.75 |
— |
| Infectious agent enzymatic activity to detect organism (87905) |
— |
$146.65 |
— |
| Influenza a/b ag eia (87400) |
— |
$93.80 |
— |
| Influenza DNA amp prob 1+ (87501) |
— |
$324.20 |
— |
| Influenza DNA amp probe (87502) |
— |
$146 |
— |
| Inhibin a (86336) |
— |
$171.90 |
— |
| Inhibin b (83520) |
— |
$122.25 |
— |
| Insitu hybridization auto (88367) |
— |
$437.60 |
— |
| Insulin antibodies (86337) |
— |
$216.55 |
— |
| Insulin free (83527) |
— |
$154.65 |
— |
| Insulin t panel; acth insuff (80434) |
— |
$718.45 |
— |
| Insulin tolerance panel for growth hormone deficiency (80435) |
— |
$763.35 |
— |
| Insulin total (83525) |
— |
$136.65 |
— |
| Insulin-induced C-peptide suppression panel This panel must include the following: Insulin (83525) C-peptide (84681 x… (80432) |
— |
$1,145.05 |
— |
| Intrinsic factor (stomach protein) level (83528) |
— |
$179.80 |
— |
| Intrinsic factor antibody (86340) |
— |
$140.95 |
— |
| Iron (83540) |
— |
$40.90 |
— |
| Iron binding capacity (83550) |
— |
$61.10 |
— |
| Iron stain peripheral blood (85536) |
— |
$93.05 |
— |
| Irradiation of blood product (86945) |
— |
$85.70 |
— |
| Islet cell antibody (86341) |
— |
$124.95 |
— |
| Isocitric dehydrogenase (83570) |
— |
$93.50 |
— |
| Jak2 gene analysis (81270) |
— |
$579.05 |
— |
| Ketosteroids 17; total (83586) |
— |
$143.85 |
— |
| Koh Prep (87220) |
— |
$44 |
— |
| Kras gene analysis (81275) |
— |
$914.40 |
— |
| L/s ratio, fetal lung (83661) |
— |
$309.25 |
— |
| Lactic acid (83605) |
— |
$107.90 |
— |
| Lactoferrin fecal qualitative (83630) |
— |
$123.95 |
— |
| Lactoferrin Fecal Quantitative (83631) |
— |
$123.95 |
— |
| Lactogen placental (83632) |
— |
$230.20 |
— |
| Lactose urine qual (83633) |
— |
$86.30 |
— |
| Lamellar Body Count (83664) |
— |
$119.50 |
— |
| Ldh (83615) |
— |
$39.60 |
— |
| Ldh isoenzymes (83625) |
— |
$133.10 |
— |
| LDL cholesterol direct (83721) |
— |
$71.90 |
— |
| Lead (83655) |
— |
$89.90 |
— |
| Legion pneumo, DNA, amp prob (87541) |
— |
$234.55 |
— |
| Legionella antibody (86713) |
— |
$137.55 |
— |
| Legionella antigen urine (87449) |
— |
$93.80 |
— |
| Legionella DNA probe (87540) |
— |
$126.70 |
— |
| Legionella pneumophila dfa (87278) |
— |
$102.65 |
— |
| Leishmania antibody (86717) |
— |
$113.45 |
— |
| Leptospira antibody (86720) |
— |
$113.45 |
— |
| Leucine aminopeptidase (lap) (83670) |
— |
$140.20 |
— |
| Leukocyte Assmt Fecal Qual/Semiquantitative (89055) |
— |
$53.80 |
— |
| Leukocyte histamine release test (86343) |
— |
$161.55 |
— |
| Leukocyte phagocytosis (86344) |
— |
$154.70 |
— |
| Leukocyte transfusion UNSCHEDULED (86950) |
— |
$223.45 |
— |
| Lh (83002) |
— |
$179.80 |
— |
| Lidocaine level (80176) |
— |
$152.65 |
— |
| Lipase (83690) |
— |
$79.10 |
— |
| Lipopro bld electrophoretic (83700) |
— |
$111.50 |
— |
| Lipoprotein Bld Hr Fraction (83701) |
— |
$151.05 |
— |
| Listeria ab (86609) |
— |
$154.70 |
— |
| Lithium (80178) |
— |
$134.70 |
— |
| Lyme disease antibody (86618) |
— |
$171.90 |
— |
| Lyme disease antibody confirm (86617) |
— |
$182.20 |
— |
| Lymph Choriomeningitis Ab (86727) |
— |
$113.45 |
— |
| Lymphocyte culture mixed (86821) |
— |
$584.50 |
— |
| Lymphocyte transformation (86353) |
— |
$601.95 |
— |
| Lymphocytotoxicity assay (86805) |
— |
$412.55 |
— |
| Lymphocytotoxicity assay, visual crossmatch; without titration Other Outpatient (86806) |
— |
$412.55 |
— |
| M avium probe (87560) |
— |
$126.70 |
— |
| M.Avium-Intra, Dna, Amp Prob - M. Avium-Intra Dna Probe, Amplified (87561) |
— |
$263.85 |
— |
| M.tuberculo DNA dir probe (87555) |
— |
$146.65 |
— |
| Macroscopic exam arthropod (87168) |
— |
$44 |
— |
| Macroscopic exam parasite (87169) |
— |
$44 |
— |
| Magnesium (83735) |
— |
$57.55 |
— |
| Malaria antibody (86750) |
— |
$151.25 |
— |
| Malaria smear (87207) |
— |
$82.05 |
— |
| Malate dehydrogenase (83775) |
— |
$82.75 |
— |
| Manual cell count each (85032) |
— |
$68.55 |
— |
| Manual Diff Wbc Count B-Coat (85009) |
— |
$58.75 |
— |
| Manual reticulocyte count (85044) |
— |
$68.55 |
— |
| Mass spectrometry qual/quan (83789) |
— |
$161.85 |
— |
| Measurement of complement fixation tests (immune system proteins) (86171) |
— |
$99.70 |
— |
| Measurement of hemolysin (red blood cell destructive substance) (85475) |
— |
$176.35 |
— |
| Measurement of substance using spectroscopy (light) (82190) |
— |
$215.80 |
— |
| Meat fibers, feces (89160) |
— |
$40.35 |
— |
| Mercury (83825) |
— |
$151.05 |
— |
| Metabolic Panel Ionized Ca (80047) |
— |
$107.80 |
— |
| Methemalbumin (83857) |
— |
$100.70 |
— |
| Methemoglobin Qualitative (83045) |
— |
$46.70 |
— |
| Methotrexate (80299) |
— |
$224.55 |
— |
| Methylmalonic acid serum (83921) |
— |
$143.85 |
— |
| Metyrapone panel This panel must include the following: Cortisol (82533 x 2) 11 deoxycortisol (82634 x 2) Other… (80436) |
— |
$740.95 |
— |
| Microalbumin urine (82043) |
— |
$125.90 |
— |
| Microbe suscept macrobroth (87188) |
— |
$67.40 |
— |
| Microbe Suscept Mycobacteri (87190) |
— |
$46.90 |
— |
| Microbe susceptible diffuse (87181) |
— |
$44 |
— |
| Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity Other Outpatient (83861) |
— |
$104.15 |
— |
| Microsatellite instability (81301) |
— |
$1,829.20 |
— |
| Microslide Consult W Slide Prep - Lab Microslide Consult W Sld Prep (88323) |
— |
$171.30 |
— |
| Microsomal antibodies (86376) |
— |
$137.55 |
— |
| Mlh1 gene analysis duplication/deletion variants (81294) |
— |
$882.95 |
— |
| Mlh1 Gene Analysis Full Sequence Analysis (81292) |
— |
$2,992.40 |
— |
| Mlh1 gene analysis known familial variants (81293) |
— |
$1,199.55 |
— |
| Molecular pathology procedure level 2 (81401) |
— |
$1,388.05 |
— |
| Mononuclear cell antigen (86356) |
— |
$171.90 |
— |
| Mrsa amp probe (87641) |
— |
$234.55 |
— |
| Msh2 Gene Analysis Full Sequence Analysis (81295) |
— |
$702.50 |
— |
| Msh2 gene analysis known familial variants (81296) |
— |
$599.75 |
— |
| Msh2 gene dup/delete variant (81297) |
— |
$702.50 |
— |
| Msh6 Gene Analysis Full Sequence Analysis (81298) |
— |
$1,332.80 |
— |
| Msh6 gene analysis known familial variants (81299) |
— |
$746.60 |
— |
| Msh6 gene dup/delete variant (81300) |
— |
$748.65 |
— |
| Mthfr Gene Analysis Common Variants (81291) |
— |
$275.75 |
— |
| Mucin synovial fluid ropes test (83872) |
— |
$64.75 |
— |
| Mucopolysaccharides acid quantitative (83864) |
— |
$187.05 |
— |
| Muramidase (85549) |
— |
$220.40 |
— |
| Mycobacteria Dna Amp Probe (87551) |
— |
$234.55 |
— |
| Mycobacteric Identification (87118) |
— |
$82.05 |
— |
| Mycobacterium avium complex and m.abscessus complex rt-PCR (viracor) - iadna mycobacteria species quantification (87552) |
— |
$270.60 |
— |
| Mycophenolic acid (80180) |
— |
$72.15 |
— |
| Mycoplasma antibody (86738) |
— |
$137.55 |
— |
| Mycoplasma culture (87109) |
— |
$161.30 |
— |
| Mycoplasma DNA probe (87580) |
— |
$126.70 |
— |
| Mycoplasma pneumoniae antibodies, igg & igm - arup (86732) |
— |
$151.25 |
— |
| Myelin basic protein csf (83873) |
— |
$179.80 |
— |
| Myoglobin urine (83874) |
— |
$129.45 |
— |
| N.gonorrhoeae, DNA, dir prob (87590) |
— |
$126.70 |
— |
| Nasal smear for eosinophils (89190) |
— |
$47.10 |
— |
| Natriuretic peptide (83880) |
— |
$215.80 |
— |
| Neutralization test, viral (86382) |
— |
$223.50 |
— |
| Nfct agent DNA/RNA influenza >2 types ea addl (87503) |
— |
$131.20 |
— |
| Nfct phexyp resist tiss cul HIV ea addl drug (87904) |
— |
$263.85 |
— |
| Nfct phexyp resist tiss cul HIV first 1-10 drugs (87903) |
— |
$3,086.90 |
— |
| Niacin (84591) |
— |
$154.65 |
— |
| Nickel level (83885) |
— |
$154.75 |
— |
| Nitroblue tetrazolium dye test to measure white blood cell function (86384) |
— |
$171.90 |
— |
| Nk cells total count (86357) |
— |
$238.30 |
— |
| Nmr Lipoprofile (83704) |
— |
$169.05 |
— |
| Nocardia antibody (86744) |
— |
$137.55 |
— |
| Npm1 Nucleophosmin Gene Anal Exon 12 Variants (81310) |
— |
$1,144.40 |
— |
| Nuclear antigen antibody (86235) |
— |
$130.60 |
— |
| Occult blood stool (82272) |
— |
$32.35 |
— |
| Oligoclonal bands (83916) |
— |
$197.80 |
— |
| Oncoprotein dcp (83951) |
— |
$575.45 |
— |
| Oncoprotein,Her-2/Neu - Her-2/Neu, Serum (83950) |
— |
$575.45 |
— |
| Organic Acids Qual Each (83919) |
— |
$161.85 |
— |
| Organic Acids Total Quantitative Each Specimen (83918) |
— |
$215.80 |
— |
| Osmolality serum (83930) |
— |
$68.35 |
— |
| Osmolality urine (83935) |
— |
$89.90 |
— |
| Osmotic fragility rbc incubated (85557) |
— |
$235.10 |
— |
| Ova and parasite direct-id lca (87177) |
— |
$79.15 |
— |
| Ovulation tests (84830) |
— |
$71.90 |
— |
| Oxalate urine (83945) |
— |
$107.90 |
— |
| Pancreatic elastase fecal (82656) |
— |
$72.90 |
— |
| Pancreatic polypeptide (83519) |
— |
$161.85 |
— |
| Pappa, serum (84163) |
— |
$94.90 |
— |
| Parainfluenza ag if (87279) |
— |
$117.30 |
— |
| Particle Agglutination Screen Each Antibody (86403) |
— |
$64.35 |
— |
| Particle agglutination titer each antibody (86406) |
— |
$89.40 |
— |
| Parvovirus antibody (86747) |
— |
$161.55 |
— |
| Pathology lab procedure (89240) |
— |
$92.60 |
— |
| Peripheral vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 2) Other… (80417) |
— |
$431.05 |
— |
| Pertussis dfa (87265) |
— |
$117.30 |
— |
| Phenotype Infect Agent Drug (87900) |
— |
$823.05 |
— |
| Phenylalanine (84030) |
— |
$57.55 |
— |
| Phenylketones (ketone) analysis (84035) |
— |
$41.30 |
— |
| Phenytoin free (80186) |
— |
$219.95 |
— |
| Phosphatase acid prostatic (84066) |
— |
$107.90 |
— |
| Phosphatase alkaline (84075) |
— |
$35.95 |
— |
| Phosphogluconate, 6-, dehydrogenase, RBC Other Outpatient (84085) |
— |
$89.90 |
— |
| Phospholipid Neutralization Hexagonal (85598) |
— |
$205.75 |
— |
| Phosphorus blood (84100) |
— |
$29.55 |
— |
| Phosphorus urine (84105) |
— |
$57.55 |
— |
| Pinworm exam (87172) |
— |
$44 |
— |
| Plasminogen (85420) |
— |
$220.40 |
— |
| Plasminogen (85421) |
— |
$318.35 |
— |
| Platelet aggregation (85576) |
— |
$149.90 |
— |
| Platelet count (85049) |
— |
$58.75 |
— |
| Pml/raralpha com breakpoints (81315) |
— |
$1,309.65 |
— |
| Pms2 gene analysis duplication/deletion variants (81319) |
— |
$1,026.35 |
— |
| Pms2 gene analysis full sequence (81317) |
— |
$3,617.70 |
— |
| Pms2 gene analysis known familial variants (81318) |
— |
$854.80 |
— |
| Pooling blood platelets (86965) |
— |
$283.60 |
— |
| Porphobilinogen Urine Qual (84106) |
— |
$71.90 |
— |
| Porphobilinogen urine quant (84110) |
— |
$104.30 |
— |
| Porphyrins feces qn (84126) |
— |
$124.12 |
— |
| Porphyrins qn & fraction urine (84120) |
— |
$169.05 |
— |
| Porphyrins urine qual (84119) |
— |
$93.50 |
— |
| Potassium (84132) |
— |
$32.35 |
— |
| Potassium urine (84133) |
— |
$46.70 |
— |
| Pregnanediol (84135) |
— |
$136.65 |
— |
| Pregnanetriol (84138) |
— |
$151.05 |
— |
| Pregnenolone (84140) |
— |
$190.60 |
— |
| Pretx serum rbc antibody identification dilution (86976) |
— |
$283.60 |
— |
| Primidone (80188) |
— |
$251.45 |
— |
| Procainamide napa (80192) |
— |
$251.45 |
— |
| Procalcitonin (pct) (84145) |
— |
$169 |
— |
| Progesterone (84144) |
— |
$192.40 |
— |
| Progesterone (reproductive hormone) receptor analysis (84234) |
— |
$387.20 |
— |
| Prolactin (84146) |
— |
$179.80 |
— |
| Prostaglandin Ea (84150) |
— |
$157.65 |
— |
| Protein Alys Wstrn Blot I&R Immunological Ea (88372) |
— |
$228.65 |
— |
| Protein analysis of tissue by Western Blot, with interpretation and report; Other Outpatient (88371) |
— |
$233.85 |
— |
| Protein body fluid (84157) |
— |
$46.70 |
— |
| Protein c activity (85303) |
— |
$303.65 |
— |
| Protein c antigen (85302) |
— |
$269.35 |
— |
| Protein electrophoresis serum (84165) |
— |
$129.45 |
— |
| Protein Electrophoresis Urine (84166) |
— |
$136.65 |
— |
| Protein S Functional (85306) |
— |
$318.35 |
— |
| Protein s total (85305) |
— |
$308.55 |
— |
| Protein test for diagnosis and monitoring of bladder cancer (86386) |
— |
$71.75 |
— |
| Protein total by refractometry any source (84160) |
— |
$32.70 |
— |
| Protein Total Serum (84155) |
— |
$39.60 |
— |
| Protein urine (84156) |
— |
$50.35 |
— |
| Protein Western Blot (84182) |
— |
$302.15 |
— |
| Protein westrn blot i&r blood/other fluid (84181) |
— |
$187.05 |
— |
| Prothrombin time substitution (85611) |
— |
$78.40 |
— |
| Protoporphyrin rbc quantitative (84202) |
— |
$125.90 |
— |
| PSA free (84154) |
— |
$143.85 |
— |
| Pten gene analysis known familial variant (81322) |
— |
$270.40 |
— |
| Pten Gene Dup/Delet Variant (81323) |
— |
$405.60 |
— |
| Pten Gene Full Sequence (81321) |
— |
$2,781.55 |
— |
| Pyruvate kinase (84220) |
— |
$93.50 |
— |
| Quantiferon tb gold (86480) |
— |
$391.55 |
— |
| Quinidine (80194) |
— |
$215.50 |
— |
| Quinine (84228) |
— |
$143.85 |
— |
| Rbc osmotic fragility (85555) |
— |
$171.40 |
— |
| Rbc serum pretx incubj drugs (86975) |
— |
$148.15 |
— |
| Reagent strip/blood glucose (82948) |
— |
$35.95 |
— |
| Red blood cell fragility measurement (85547) |
— |
$102.85 |
— |
| Reducing substances, stool (84376) |
— |
$34.70 |
— |
| Renal vein renin stimulation panel (eg, captopril) This panel must include the following: Renin (84244 x 6) Other… (80416) |
— |
$833.60 |
— |
| Renin activity plasma (84244) |
— |
$248.15 |
— |
| Reptilase test (85635) |
— |
$156.70 |
— |
| Resp virus 3-5 targets (87631) |
— |
$810.45 |
— |
| Respiratory viral panel PCR (87633) |
— |
$2,632.85 |
— |
| Respiratory Virus (86756) |
— |
$137.55 |
— |
| Reticulated platelet assay (85055) |
— |
$114.60 |
— |
| Reticulocyte Count (85046) |
— |
$34.70 |
— |
| Reticulocyte separation (86972) |
— |
$148.15 |
— |
| Rheumatoid Factor Qual (86430) |
— |
$65.30 |
— |
| Rheumatoid factor quant (86431) |
— |
$68.70 |
— |
| Rickettsia antibody (86757) |
— |
$137.55 |
— |
| Rotavirus (86759) |
— |
$137.55 |
— |
| Rpr Titer (86593) |
— |
$48.15 |
— |
| Rsv (87807) |
— |
$117.30 |
— |
| Rubella antibody (86762) |
— |
$90.95 |
— |
| Russell viper venom time diluted (85613) |
— |
$151.85 |
— |
| Russell Viper Venom Time Undiluted (85612) |
— |
$166.55 |
— |
| Saccharomyces ab iga (86671) |
— |
$171.90 |
— |
| Salmonella antibody (86768) |
— |
$113.45 |
— |
| Sars-Cov-2 Covid-19 Amp Prb (87635) |
— |
$280.70 |
— |
| Sars-Cov-2 Covid-19 Antibody (86769) |
— |
$115.75 |
— |
| Sed rate automated (85652) |
— |
$58.75 |
— |
| Sedimentation rate (85651) |
— |
$61.20 |
— |
| Sensitivity - mlc ea plate (87187) |
— |
$67.40 |
— |
| Sensitivity mic (87186) |
— |
$67.40 |
— |
| Serotonin Release Assay (86022) |
— |
$292.20 |
— |
| Serpina1 gene (81332) |
— |
$275.75 |
— |
| Serum bactericidal titer (87197) |
— |
$94.90 |
— |
| Sex chromatin id barr bodies (88130) |
— |
$95.05 |
— |
| Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks Other Outpatient (88140) |
— |
$46.85 |
— |
| Sex hormone binding globulin (84270) |
— |
$208.60 |
— |
| Sickle cell screen (85660) |
— |
$75.90 |
— |
| Silica (84285) |
— |
$197.80 |
— |
| Sirolimus (rapamycin) (80195) |
— |
$278.35 |
— |
| Skin test candida (86485) |
— |
$59 |
— |
| Skin test histoplasmosis (86510) |
— |
$59 |
— |
| Skin test unlisted antigen (86486) |
— |
$59 |
— |
| Smear acid fast (87206) |
— |
$52.75 |
— |
| Smear gram stain (87205) |
— |
$44 |
— |
| Sodium (84295) |
— |
$35.95 |
— |
| Sodium other source (84302) |
— |
$50.35 |
— |
| Sodium urine (84300) |
— |
$50.35 |
— |
| Soluble transferrin receptor (84238) |
— |
$395.65 |
— |
| Somatostatin (84307) |
— |
$222.95 |
— |
| Spcl Stn 2 I&R Excpt Microorg/Enzyme/Imcyt (88313) |
— |
$129.65 |
— |
| Specific gravity body fluid (84315) |
— |
$32.35 |
— |
| Spectrophotometry (84311) |
— |
$75.50 |
— |
| Sputum Obtaining Spec Aerosol Induced Tx Spx (89220) |
— |
$171.30 |
— |
| Staph aureus amplified probe (87640) |
— |
$234.55 |
— |
| Stem cells total count (86367) |
— |
$238.30 |
— |
| Stool analysis for bilirubin (82252) |
— |
$39.60 |
— |
| Stool Cultr Aerobic Bact Ea (87046) |
— |
$82.05 |
— |
| Strep a assay w/optic (87880) |
— |
$102.65 |
— |
| Strep a DNA amp probe (87651) |
— |
$87.60 |
— |
| Strep b DNA amp probe (87653) |
— |
$234.55 |
— |
| Streptozyme (86590) |
— |
$69.75 |
— |
| Sugars mono di&oligos mlt quantitative ea spec (84379) |
— |
$70.60 |
— |
| Sugars Multiple Qual (84377) |
— |
$34.70 |
— |
| Sugars single quant (84378) |
— |
$70.60 |
— |
| Sulfate urine (84392) |
— |
$144.70 |
— |
| Sulfhemoglobin quant (83060) |
— |
$75.50 |
— |
| Surgical pathology level IV (88305) |
— |
$187.55 |
— |
| Susceptibility study antimicrobial disk method (87184) |
— |
$58.65 |
— |
| Sweat collection (89230) |
— |
$171.30 |
— |
| T Cells Absolute Cd4&Cd8 Count Ratio (86360) |
— |
$296.80 |
— |
| T cells, total count (86359) |
— |
$238.30 |
— |
| T3 free (84481) |
— |
$190.60 |
— |
| T3 reverse (84482) |
— |
$179.80 |
— |
| T3 total (84480) |
— |
$143.85 |
— |
| T3 uptake (84479) |
— |
$64.75 |
— |
| T4 Free (84439) |
— |
$100.70 |
— |
| T4 total (84436) |
— |
$57.55 |
— |
| T4-neonatal (84437) |
— |
$64.75 |
— |
| Tb ag response t-cell susp (86481) |
— |
$473.30 |
— |
| Tb intradermal test (86580) |
— |
$59 |
— |
| Test for acetone/ketones (82009) |
— |
$53.95 |
— |
| Test for urine cystines (82615) |
— |
$107.90 |
— |
| Test rbc protoporphyrin (84203) |
— |
$68.35 |
— |
| Testosterone free (84402) |
— |
$201.45 |
— |
| Testosterone total (84403) |
— |
$163.05 |
— |
| Tetanus antibody (86774) |
— |
$154.70 |
— |
| Thawing and expansion of frozen cells (88241) |
— |
$143.75 |
— |
| Theophylline (80198) |
— |
$211 |
— |
| Thiocyanate (84430) |
— |
$115.10 |
— |
| Thrombin time plasma (85670) |
— |
$102.85 |
— |
| Thrombin time titer (85675) |
— |
$112.60 |
— |
| Thrombomodulin (85337) |
— |
$235.10 |
— |
| Thromboplastin Inhibition Tissue (85705) |
— |
$195.95 |
— |
| Thromboplastin time prtl substit plasma frctj ea (85732) |
— |
$107.80 |
— |
| Thromboxane urine (84431) |
— |
$104.15 |
— |
| Thyroglobulin (84432) |
— |
$165.40 |
— |
| Thyroglobulin Ab (86800) |
— |
$147.85 |
— |
| Thyroid Stimulating Immunoglobulin (84445) |
— |
$438.80 |
— |
| Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must include the following: Thyroid… (80439) |
— |
$449.05 |
— |
| Thyroxine binding globulin (84442) |
— |
$129.45 |
— |
| Tiagabine (80199) |
— |
$72.40 |
— |
| Tobramycin peak (80200) |
— |
$224.55 |
— |
| Topiramate (80201) |
— |
$219.95 |
— |
| Toxin or antitoxin assay (87230) |
— |
$132 |
— |
| Toxoplasma ab igm (86778) |
— |
$147.85 |
— |
| Toxoplasma antibody igg (86777) |
— |
$113.45 |
— |
| Transferrin (84466) |
— |
$136.65 |
— |
| Translocation analysis (bcr/abl1) other breakpoint (81208) |
— |
$1,016.10 |
— |
| Translocation analysis pml-rara regulated adaptor molecule 1 single (81316) |
— |
$1,997.55 |
— |
| Trb@ gene rearrange dirprobe (81341) |
— |
$313.25 |
— |
| Trb@ Rearrangement Anal Amplification Method (81340) |
— |
$1,319.80 |
— |
| Trg gene rearrangement analysis (81342) |
— |
$1,272.95 |
— |
| Trh stimulation panel (80438) |
— |
$426.60 |
— |
| Trichinella antibody (86784) |
— |
$123.75 |
— |
| Trichomonas vagin dir probe (87660) |
— |
$126.70 |
— |
| Triglycerides (84478) |
— |
$39.60 |
— |
| Troponin (84484) |
— |
$107.65 |
— |
| Troponin i qualitative (84512) |
— |
$48.60 |
— |
| Trypsin feces qual (84488) |
— |
$107.90 |
— |
| Trypsin feces quantitative 24-hr collection (84490) |
— |
$64.75 |
— |
| Tyrosine (84510) |
— |
$71.90 |
— |
| Unlisted cytogenetic study (88299) |
— |
$92.60 |
— |
| Unlisted transfusion medicine procedure (86999) |
— |
$56.70 |
— |
| Urea nitrogen (84520) |
— |
$39.60 |
— |
| Urea Nitrogen Clearance (84545) |
— |
$75.50 |
— |
| Urea nitrogen urine (84540) |
— |
$61.10 |
— |
| Urea nitrogen; semiquantitative (eg, reagent strip test) Other Outpatient (84525) |
— |
$43.15 |
— |
| Uric acid blood (84550) |
— |
$39.60 |
— |
| Uric acid other source (84560) |
— |
$57.55 |
— |
| Urinalysis microscopic only (81015) |
— |
$39.35 |
— |
| Urinalysis qual/semiquant except immunoassays (81005) |
— |
$39.35 |
— |
| Urinalysis w/microscopic (81001) |
— |
$50.30 |
— |
| Urinalysis; bacteriuria screen, except by culture or dipstick Other Outpatient (81007) |
— |
$48.10 |
— |
| Urine microalbumin (protein) analysis (82044) |
— |
$61.10 |
— |
| Urine pregnancy test (81025) |
— |
$74.30 |
— |
| Urine volume measurement (81050) |
— |
$39.35 |
— |
| Urnls dip stick/tablet rgnt auto w/o microscopy (81003) |
— |
$41.50 |
— |
| Urobilinogen (84578) |
— |
$43.15 |
— |
| Urobilinogen quantitative (84580) |
— |
$64.75 |
— |
| Urobilinogen, feces, quantitative Other Outpatient (84577) |
— |
$78.80 |
— |
| Valproic acid level (80164) |
— |
$211 |
— |
| Vancomycin trough (80202) |
— |
$202.05 |
— |
| Vanomycin DNA amp probe (87500) |
— |
$322.50 |
— |
| Varicella-zoster antibody (86787) |
— |
$140.95 |
— |
| Vasoactive intestinal peptide (vip) (84586) |
— |
$276.95 |
— |
| Vasopressin (84588) |
— |
$287.75 |
— |
| Vdrl csf (86592) |
— |
$48.15 |
— |
| Very long chain fatty acids (82726) |
— |
$72.90 |
— |
| Virus antibody nos (86790) |
— |
$137.55 |
— |
| Virus id non-immunologic oth/thn cytopathic (87255) |
— |
$213.95 |
— |
| Virus inoculate tissue addl (87253) |
— |
$146.65 |
— |
| Virus inoculation, shell via (87254) |
— |
$146.65 |
— |
| Viscosity serum (85810) |
— |
$122.45 |
— |
| Vitamin A (84590) |
— |
$161.85 |
— |
| Vitamin b-12 (82607) |
— |
$143.85 |
— |
| Vitamin b-2 (riboflavin) (84252) |
— |
$161.85 |
— |
| Vitamin b1 (thiamine) (84425) |
— |
$183.45 |
— |
| Vitamin b6 (84207) |
— |
$269.80 |
— |
| Vitamin C (82180) |
— |
$115.10 |
— |
| Vitamin D 25-Hydroxy (82306) |
— |
$269.80 |
— |
| Vitamin e serum (84446) |
— |
$115.10 |
— |
| Vldl cholesterol level (83719) |
— |
$82.75 |
— |
| Vol reduction of blood/prod (86960) |
— |
$202.60 |
— |
| Von willebrand factor activity (85245) |
— |
$264.50 |
— |
| Wbc Alkaline Phosphatase - Leukocyte Alkaline Phosphatase (85540) |
— |
$132.25 |
— |
| West nile virus ab, igm (86788) |
— |
$147.85 |
— |
| West nile virus antibody (86789) |
— |
$147.85 |
— |
| Xylose Absorption Test (84620) |
— |
$147.45 |
— |
| Yersinia antibody (86793) |
— |
$120.35 |
— |
| Zinc (84630) |
— |
$136.65 |
— |