Lab & pathology prices at Memorial Hospital of Carbon County

Rawlins, WY · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
5-Hiaa (83497) $78 $104 6.0×
Acetaminophen (80143) $101.25 $135 5.4×
Acetone serum qual (82009) $60.75 $81 13.4×
Acetone, quantitative (82010) $42 $56 5.1×
Acth (82024) $87 $116 2.3×
Actin smooth muscle antibody each (86015) $45 $60 3.7×
Acute hepatitis panel (80074) $301.50 $402 6.3×
Afb culture (87116) $130.50 $174 12.1×
Afb smear (87206) $43.50 $58 8.1×
Albumin serum (82040) $37.50 $50 7.6×
Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay) Other Outpatient (82044) $19.50 $26 3.1×
Aldolase (82085) $57.75 $77 5.9×
Aldosterone (82088) $200.25 $267 4.9×
Alkaline phosphatase (84075) $41.25 $55 8.0×
Alkaline phosphatase isoenzymes (84080) $42.75 $57 2.9×
Allergen profile perennial allergen (86003) $42 $56 8.0×
Alpha-1-antitrypsin (82103) $48.75 $65 3.6×
Alpha-fetoprotein serum (82105) $141.75 $189 8.5×
Alt (84460) $45.75 $61 8.6×
Aminolevulinic acid delta (82135) $56.25 $75 3.4×
Ammonia (82140) $92.25 $123 6.3×
Amylase (82150) $123.75 $165 19.1×
Ana (86038) $112.50 $150 9.3×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen (86664) $137.25 $183 9.0×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid (86665) $144 $192 7.9×
Androstenedione (82157) $66 $88 2.3×
Antibody west nile virus igm (86788) $72 $96 4.3×
Antibody; Helicobacter pylori (86677) $135 $180 8.0×
Antineutrophil cytoplasmic antb titer ea antb (86037) $22.50 $30 1.9×
Antistreptolysin o titer (86060) $135 $180 18.5×
Antithrombin iii activity (85300) $47.25 $63 4.0×
Apolipoprotein each (82172) $85.50 $114 4.1×
Assay of vitamin not otherwise specified (84591) $95.25 $127 5.6×
Ast (84450) $45.75 $61 8.8×
Beta 2 glycoprotein i antibody (86146) $69 $92 2.7×
Beta-2 microglobulin (82232) $152.25 $203 9.4×
Bilirubin direct (82248) $24 $32 4.8×
Bilirubin total (82247) $33 $44 6.6×
Bilirubin total transcutaneous (88720) $15 $20 3.0×
Blood count reticulocyte automated (85045) $99.75 $133 25.0×
Blood gases any combination (82803) $133.50 $178 5.1×
Blood typing rbc antigens (86905) $729.75 $973 190.5×
Blood typing serologic abo (86900) $261.75 $349 87.5×
Blood typing serologic rh (d) (86901) $68.25 $91 22.8×
Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations… (82274) $42.75 $57 2.7×
Breath alcohol test (82075) $39.75 $53 1.3×
C diff amplified probe (87493) $155.25 $207 4.2×
C-peptide (84681) $141 $188 6.8×
C-reactive protein (86140) $94.50 $126 18.2×
C-reactive protein high sensitivity (86141) $66.75 $89 5.2×
Ca 125 (86304) $96.75 $129 4.6×
Ca 15-3 (86300) $161.25 $215 7.7×
Calcium ionized (82330) $138.75 $185 10.1×
Calcium, random urine (82340) $111.75 $149 18.5×
Calprotectin fecal (83993) $201.75 $269 10.3×
Cancer antigen 19-9 (86301) $96.75 $129 4.6×
Candida antibody (86628) $53.25 $71 4.4×
Carbamazepine total (80156) $99 $132 6.8×
Carbon monoxide (82375) $93.75 $125 7.6×
Cardiolipin antibody ea ig class (86147) $75.75 $101 3.0×
Cd4/cd8 count - lymphocyte subset panel 5 - arup (86360) $148.50 $198 3.2×
Cea (82378) $115.50 $154 6.1×
Cell count body fluid (89050) $58.50 $78 12.4×
Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count… (89051) $50.25 $67 9.0×
Ceruloplasmin (82390) $94.50 $126 8.8×
Cftr gene com variants (81220) $1,252.50 $1,670 2.3×
Chemiluminescent assay (82397) $90.38 $120.50 6.4×
Chloride other source (82438) $38.25 $51 7.7×
Chloride urine (82436) $74.25 $99 12.9×
Cholesterol total (82465) $34.50 $46 7.9×
Chorionic gonadotropin test (84702) $34.50 $46 2.3×
Chromium (82495) $45.75 $61 2.3×
Ck mb fraction (82553) $84.75 $113 7.3×
Clostridium ag eia (87324) $91.50 $122 7.6×
Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) $194.25 $259 8.1×
Cold agglutinin screen (86156) $132 $176 16.4×
Compatibility each unit electronic (86923) $354 $472 2.0×
Complement antigen ea component (86160) $156 $208 13.0×
Complement total (ch50) (86162) $112.50 $150 5.5×
Coombs test indirect titer (86886) $354 $472 68.3×
Copper (82525) $84.75 $113 6.8×
Cortisol free (82530) $41.25 $55 2.5×
Cortisol saliva (82533) $43.50 $58 2.7×
COVID-19 antibody (86769) $81.75 $109 1.9×
Coxsackie a9 virus antibody (86658) $56.25 $75 4.3×
Creatine kinase total (82550) $58.50 $78 9.0×
Creatine serum or plasma arup 2002340 (82540) $93.75 $125 20.2×
Creatinine (82565) $34.50 $46 6.7×
Creatinine clearance (82575) $107.25 $143 11.3×
Creatinine other source (82570) $84.75 $113 16.4×
Crossmatch ahg (86922) $354 $472 2.0×
Cryptosporidium ag eia (87328) $69.75 $93 5.0×
Crystals fluid (89060) $87 $116 11.9×
Culture anaerobic (87075) $79.50 $106 8.4×
Culture blood (87040) $107.25 $143 10.4×
Culture stool (87045) $135 $180 14.3×
Culture urine (87086) $88.50 $118 11.0×
Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate Other… (87077) $26.25 $35 3.2×
Cyclic citrullinated peptide ab (86200) $60 $80 4.6×
Cytomegalovirus antibody igm (86645) $125.25 $167 7.4×
Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic study to determine adequacy for diagnosis,… (88172) $30 $40 0.2×
D-dimer quantitative (85379) $163.50 $218 16.1×
Deoxyribonucleic acid (DNA) antibody; native or double stranded Other Outpatient (86225) $31.50 $42 2.3×
Dhea (82626) $57 $76 2.3×
Dhea sulfate (82627) $166.50 $222 7.5×
Digoxin (80162) $66 $88 5.0×
Direct antiglobulin test (86880) $129.75 $173 24.1×
Drug assay salicylate (80179) $101.25 $135 5.4×
Drug screen quant levetiracetam (80177) $101.25 $135 7.6×
Drug test prsmv chem anlyzr (80307) $142.12 $189.50 2.3×
Drug test prsmv dir opt obs (80305) $114.75 $153 9.1×
Ear culture (87070) $122.25 $163 14.2×
Elastase pancreatic fecal quantitative (82653) $75 $100 3.3×
Electrolytes panel (80051) $54 $72 7.7×
Endomysial antibody each immunoglobulin class (86231) $22.50 $30 1.9×
Enterovirus by PCR (87498) $227.25 $303 6.5×
Eosinophils urine (87205) $58.50 $78 13.7×
Erythropoietin (82668) $93.75 $125 5.0×
Estradiol (82670) $237.75 $317 8.5×
Estriol (82677) $54.75 $73 2.3×
Estrone (82679) $56.25 $75 2.3×
Eval amniotic fluid protein (84112) $222.75 $297 2.3×
Extractable nuclear antigen antibody any method (86235) $73.50 $98 4.1×
F2 gene analysis (81240) $222 $296 3.4×
F5 gene (81241) $181.50 $242 2.5×
Factor viii activity (85240) $174.75 $233 9.8×
Factor viii vw antigen (85246) $55.50 $74 2.4×
Factor x (stuart-prower) (85260) $57 $76 3.2×
Fat, fecal quantitative 72-hour collection (includes homogenization) arup 2002356 (82710) $120 $160 7.1×
Fatty acids nonesterified (82725) $156 $208 8.3×
Fecal fat qualitative (82705) $102 $136 20.0×
Ferritin (82728) $106.50 $142 7.8×
Fetal fibronectin (82731) $803.25 $1,071 12.5×
Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, differential lysis (85460) $87 $116 11.3×
Fetal hemoglobin or red blood cells measurement for assessment of fetal-maternal circulation, rosette (85461) $79.50 $106 8.5×
Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative Other Outpatient (85370) $10.50 $14 0.8×
Fibrinogen, activity (85384) $114.75 $153 11.8×
Folate serum (82746) $97.50 $130 6.6×
Follicle stimulating hormone (fsh) (83001) $129 $172 6.9×
Fungus isolation culture (87102) $138 $184 16.4×
Gamma glutamyl transferase (82977) $36.75 $49 5.1×
Gammaglobulin ige (82785) $60 $80 3.6×
Genet virus isolate hsv (87255) $100.50 $134 3.0×
Gentamicin (80170) $127.50 $170 7.8×
Giardia antigen (87329) $66 $88 5.5×
Gluc bld gluc mntr dev cleared fda spec home use (82962) $51 $68 15.5×
Glucagon (82943) $97.50 $130 6.8×
Glucose Fasting (82947) $22.50 $30 5.7×
Glucose other fluid (82945) $41.25 $55 10.5×
Glucose post glucose dose (82950) $44.25 $59 9.3×
Glucose tolerance test (gtt) (82951) $126.75 $169 9.8×
Glycated hemoglobin (83036) $35.25 $47 3.6×
Glycosylated hb home device (83037) $1,260 $1,680 129.8×
H pylori stool (87338) $152.25 $203 10.6×
Haptoglobin (83010) $57 $76 4.5×
Hcg ql (84703) $90 $120 12.0×
HDL cholesterol (83718) $39.75 $53 4.9×
Hematocrit (hct) (85014) $19.50 $26 8.2×
Hemoglobin (85018) $48 $64 20.3×
Hemoglobin electrophoresis (83020) $113.25 $151 8.8×
Hep a ab total (86708) $99 $132 8.0×
Heparin assay (85520) $112.50 $150 8.6×
Hepatitis a antibody igm (86709) $78.75 $105 7.0×
Hepatitis b core antibody total (86704) $41.25 $55 3.4×
Hepatitis b surface antigen (87340) $73.50 $98 7.1×
Hepatitis be antibody (86707) $44.25 $59 3.8×
Hepatitis be antigen (87350) $44.25 $59 3.8×
Hepatitis c antibody (86803) $72.75 $97 5.1×
Hepatitis c genotype (87902) $579.75 $773 2.3×
Hepatitis c RNA quantitative (87522) $290.25 $387 6.8×
Herpes simp virus type 1 &/or 2 ab igg with ref to type 1 & 2 glycoprotein g-spec arup 0051708 (86694) $89.25 $119 6.2×
Herpes simplex virus by PCR (87529) $152.25 $203 4.3×
Heterophile antibody screen (86308) $105 $140 20.3×
Hfe gene (81256) $261.75 $349 4.0×
Histamine (83088) $67.50 $90 2.3×
Histoplasma antibody (86698) $107.25 $143 7.8×
Hiv-1/Hiv-2, Single Assay - Rapid Hiv 1 and 2 Screen (Acc Exp/Source) (86703) $84.75 $113 6.2×
HIV-2 antibody (86702) $65.25 $87 4.8×
HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each Other Outpatient (81374) $210.75 $281 2.8×
Homocysteine level (83090) $221.25 $295 12.3×
Hpv high-risk types (87624) $150.75 $201 4.3×
Iadna sars-cov-2 COVID-19 amplified probe tq (87635) $97.50 $130 1.9×
Iadna sarscov2 & inf a&b & rsv mult amp probe tq (87637) $339 $452 2.4×
Iadna-DNA/RNA probe tq 12-25 (87507) $655.50 $874 1.6×
Igg subclass 1 (82787) $47.25 $63 5.9×
Immunoassay analyte quantitative nos (83520) $225 $300 13.0×
Immunoassay infectious agent antibody quan nos (86317) $27.75 $37 1.9×
Immunofixation electrophoresis (86334) $156.75 $209 7.0×
Immunoglobulin d (82784) $67.50 $90 7.3×
Immunoglobulin light chains free each (83521) $52.50 $70 3.0×
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified… (87899) $134.25 $179 8.4×
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B… (87802) $119.25 $159 9.4×
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism Other… (87799) $323.25 $431 7.5×
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other… (87491) $141.75 $189 4.0×
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification Other Outpatient (87497) $297 $396 6.9×
Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when… (87536) $543 $724 6.4×
Influenza assay w/optic (87804) $106.50 $142 6.4×
Influenza DNA amp probe (87502) $220.50 $294 2.3×
Inhibin a (86336) $77.25 $103 5.0×
Insulin antibody (86337) $121.50 $162 5.7×
Insulin total (83525) $141 $188 12.3×
Iron (83540) $78 $104 12.1×
Iron binding capacity (83550) $78 $104 8.9×
Islet cell antibody (86341) $57 $76 2.4×
Jak2 gene (81270) $347.25 $463 3.8×
Jak2 gene trgt sequence alys (81279) $417 $556 2.3×
Lab cytopathology, concentration techniquie, smears and interpretation (saccomanno technique) (88108) $30 $40 0.8×
Lab surg cytopathology, fluid, washing or brushing , except cervical or vaginal, smears with interpretation (88104) $30 $40 0.8×
Lacosamide (80235) $141 $188 5.2×
Lactate (83605) $28.50 $38 2.5×
Lactate dehydrogenase (83615) $57.75 $77 9.6×
Lamotrigine (80175) $110.25 $147 8.3×
Lead (83655) $60.75 $81 5.0×
Legionella culture (87081) $81.38 $108.50 12.3×
Legionella urine antigen (87449) $96.75 $129 8.1×
Leukocyte assessment fecal (89055) $58.50 $78 13.7×
Lipase (83690) $122.25 $163 17.7×
Lipoprotein (a) (83695) $66 $88 4.6×
Lithium (80178) $61.50 $82 9.3×
Luteinizing hormone (lh) (83002) $129 $172 7.0×
Lyme disease antibody (86618) $100.50 $134 5.9×
Magnesium (83735) $77.62 $103.50 11.6×
Malaria smear (87207) $238.50 $318 39.8×
Manual differential (85007) $35.62 $47.50 9.4×
Microalbumin urine (82043) $82.50 $110 14.3×
Mitochondrial antibody each (86381) $48 $64 1.9×
Mumps antibody (86735) $66.75 $89 5.1×
Mycoplasma antibody (86738) $77.25 $103 5.8×
Myelin associated glycoprotein (mag) antibody (83516) $85.50 $114 7.4×
Myelin basic protein (83873) $81.75 $109 4.8×
Myoglobin (83874) $78 $104 6.0×
Nasal smear for eosinophils (89190) $16.50 $22 2.8×
Natriuretic peptide (83880) $116.25 $155 3.0×
Occult bld feces 1-3 tests (82272) $51.75 $69 12.2×
Occult blood screening (82270) $50.25 $67 11.5×
Oligoclonal bands (83916) $108.75 $145 4.0×
Osmolality serum (83930) $66.75 $89 10.1×
Osmolality urine (83935) $66.75 $89 9.8×
Ova and parasite exam (87177) $166.50 $222 18.7×
Pancreatic polypeptide (83519) $105 $140 5.7×
Parathyroid hormone (83970) $207.75 $277 5.0×
Pertussis by PCR (87798) $281.25 $375 8.0×
Ph body fluid (83986) $46.50 $62 13.0×
Phenytoin level total (80185) $108 $144 8.2×
Phosphorus (84100) $12.75 $17 2.7×
Phosphorus urine (84105) $99.75 $133 17.3×
Potassium (84132) $29.25 $39 6.1×
Potassium urine (84133) $74.25 $99 15.7×
Prealbumin (84134) $55.50 $74 3.8×
Pretreatment of serum for use in RBC antibody identification; by differential red cell absorption using patient RBCs or… (86978) $143.25 $191 2.4×
Procalcitonin (pct) (84145) $167.25 $223 6.1×
Progesterone (84144) $47.25 $63 2.3×
Proinsulin (84206) $60 $80 2.2×
Prolactin (84146) $137.25 $183 7.1×
Protein c activity (85303) $39 $52 2.8×
Protein c antigen (85302) $48.75 $65 4.1×
Protein electrophoresis serum (84165) $83.25 $111 7.8×
Protein electrophoresis urine (84166) $119.25 $159 6.7×
Protein s antigen, free (85306) $49.50 $66 3.2×
Protein total other source (84157) $108 $144 27.0×
Protein total serum (84155) $27.75 $37 7.6×
Protein total urine (84156) $90 $120 24.5×
PSA free (84154) $134.25 $179 7.3×
Rbc antibody elution (86860) $354 $472 2.0×
Rbc antibody identification (86870) $729.75 $973 2.0×
Rbc antibody screen (86850) $90.75 $121 9.3×
Reflex herpes simplex virus type 1 glycoprotein g-specific antibody, igg by elisa (herpeselect(r) (86695) $61.50 $82 4.7×
Reflex herpes simplex virus type 2 glycoprotein g-specific antibody, igg by elisa, csf arup 00503 (86696) $78 $104 4.0×
Renin (84244) $49.50 $66 2.3×
Rheumatoid factor quant (86431) $40.50 $54 7.1×
Rickettsia antibody (86757) $53.25 $71 2.8×
Ristocetin cofactor (85245) $235.50 $314 10.3×
Rl immediate spin crossmatch (86920) $354 $472 2.0×
Rpr qual (86592) $54 $72 12.6×
Rsv DNA/RNA amp probe (87634) $189.75 $253 2.7×
Rubella antibody (86762) $75 $100 5.2×
Rubeola antibody (86765) $41.25 $55 3.2×
Sedimentation rate rbc non-automated (85651) $52.50 $70 12.3×
Semen analysis post vasectomy (89321) $64.50 $86 5.4×
Sex hormone binding globulin (84270) $85.50 $114 3.9×
Shiga-like toxin ag eia (87427) $34.50 $46 2.9×
Sickle cell screen (85660) $66 $88 12.0×
Skin test tuberculosis intradermal (86580) $31.50 $42 1.1×
Smear wet mount (87210) $65.25 $87 11.2×
SMN1 (survival of motor neuron 1, telomeric) (eg, spinal muscular atrophy) gene analysis; dosage/deletion analysis (eg,… (81329) $465.75 $621 3.4×
Sodium (84295) $27.75 $37 5.8×
Sodium urine (84300) $75 $100 14.8×
Somatomedin (84305) $112.50 $150 5.3×
Stone analysis (82365) $114.75 $153 8.9×
Strep a assay w/optic (87880) $53.25 $71 3.2×
Strep a DNA amp probe (87651) $52.50 $70 1.5×
Susceptibility mic per plate (87186) $150 $200 17.3×
T cells cd4 count (86361) $144 $192 5.4×
T3 free (84481) $119.25 $159 7.0×
T3 reverse (84482) $69.75 $93 4.4×
T3 uptake (84479) $79.50 $106 12.3×
T4 (thyroxine) total (84436) $57 $76 8.3×
Tacrolimus (80197) $245.25 $327 17.9×
Tb test cell immun measure (86480) $139.50 $186 2.3×
Testosterone free (84402) $150 $200 5.9×
Testosterone total (84403) $185.25 $247 7.2×
Thyroglobulin antibody (86800) $39.75 $53 2.5×
Thyroid peroxidase antibody (86376) $115.50 $154 7.9×
Thyroxine free (ft4) (84439) $113.25 $151 12.6×
Tissue transglutaminase ea immunoglobulin class (86364) $21.75 $29 1.9×
Topiramate (80201) $115.50 $154 9.7×
Toxoplasma antibody igm (86778) $60.75 $81 4.2×
Tpmt gene com variants (81335) $375 $500 2.1×
Transferrin (84466) $127.50 $170 10.0×
Treponema pallidum antibody (86780) $100.12 $133.50 7.6×
Trichomonas vaginalis amplif (87661) $83.25 $111 2.4×
Trichrome stain (87209) $33.75 $45 1.9×
Triglycerides (84478) $26.25 $35 4.6×
Triiodothyronine total assay, tt-3 - t3 (thyroid hormone) (84480) $155.25 $207 10.9×
Troponin t (84484) $98.25 $131 7.9×
Urea nitrogen quantitative (84520) $25.50 $34 6.5×
Uric acid blood (84550) $45.75 $61 10.1×
Urinalysis auto w/micro (81001) $55.50 $74 17.5×
Urinalysis microscopic only (81015) $18 $24 5.9×
Urine Pregnancy Test POC (81025) $53.62 $71.50 6.2×
Urnls dip stick/tablet rgnt auto w/o microscopy (81003) $32.25 $43 14.3×
Valproic acid (80164) $79.50 $106 5.9×
Vancomycin (80202) $103.50 $138 7.6×
Varicella zoster antibody igg (86787) $126 $168 9.8×
Vasoactive intestinal peptide (vip) (84586) $79.50 $106 2.3×
Virus antibody nos (86790) $55.50 $74 4.3×
Vitamin a (84590) $45.75 $61 3.9×
Vitamin b-12 (82607) $210.75 $281 14.0×
Vitamin b1 whole blood (84425) $108 $144 5.1×
Vitamin d 25 hydroxy (82306) $150 $200 5.1×
Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Other Outpatient (82652) $225.75 $301 5.9×
Vitamin e (84446) $45.75 $61 3.2×
West nile virus antibody (86789) $77.25 $103 5.4×
Zinc (84630) $110.25 $147 9.7×