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
1 25 Dihydroxy includes fractions if performed (82652) $225.75 $301 5.9×
5 Hiaa (83497) $78 $104 6.0×
Acetaminophen level (80143) $101.25 $135 5.4×
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×
Albumin serum (82040) $37.50 $50 7.6×
Aldolase (82085) $57.75 $77 5.9×
Aldosterone urine (82088) $200.25 $267 4.9×
Alkaline phosphatase isoenzymes (84080) $42.75 $57 2.9×
Allergen specific ige (86003) $42 $56 8.0×
Alpha-1-antitrypsin, total (82103) $48.75 $65 3.6×
Alpha-fetoprotein, serum (82105) $141.75 $189 8.5×
Alt (sgpt) (84460) $45.75 $61 8.6×
Aminolevulinic acid (ala) (82135) $56.25 $75 3.4×
Ammonia (82140) $92.25 $123 6.3×
Amylase urine (82150) $123.75 $165 19.1×
Antibody Absorption (86978) $143.25 $191 2.4×
Antibody cytomegalovirus cmv igm (86645) $125.25 $167 7.4×
Antibody helicobacter pylori (86677) $135 $180 8.0×
Antibody Herpes Smplx Non-Specific Type Test (86694) $89.25 $119 6.2×
Antibody herpes smplx type 1 (86695) $61.50 $82 4.7×
Antibody HIV-2 (86702) $65.25 $87 4.8×
Antibody identification (86870) $729.75 $973 2.0×
Antibody mumps (86735) $66.75 $89 5.1×
Antibody rubeola (86765) $41.25 $55 3.2×
Antibody screen (86850) $90.75 $121 9.3×
Antibody treponema pallidum (86780) $100.12 $133.50 7.6×
Antigen typing (86905) $729.75 $973 190.5×
Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) $354 $472 68.3×
Antineutrophil Cytoplasmic Antb Titer Ea Antb (86037) $22.50 $30 1.9×
Antinuclear antibodies (86038) $112.50 $150 9.3×
Antistreptolysin o titer (86060) $135 $180 18.5×
Antithrombin iii activity (85300) $47.25 $63 4.0×
Apolipoprotein b (82172) $85.50 $114 4.1×
Assay of acth (82024) $87 $116 2.3×
Assay of androstenedione (82157) $66 $88 2.3×
Assay of blood fatty acids (82725) $156 $208 8.3×
Assay of c-peptide (84681) $141 $188 6.8×
Assay of ceruloplasmin (82390) $94.50 $126 8.8×
Assay of creatine (82540) $93.75 $125 20.2×
Assay of erythropoietin (82668) $93.75 $125 5.0×
Assay of ferritin (82728) $106.50 $142 7.8×
Assay of gammaglobulin igm (82784) $67.50 $90 7.3×
Assay of gentamicin (80170) $127.50 $170 7.8×
Assay of glucagon (82943) $97.50 $130 6.8×
Assay of homocystine (83090) $221.25 $295 12.3×
Assay of lipoprotein(a) (83695) $66 $88 4.6×
Assay of parathormone (83970) $207.75 $277 5.0×
Assay of prealbumin (84134) $55.50 $74 3.8×
Assay of proinsulin (84206) $60 $80 2.2×
Assay of somatomedin (84305) $112.50 $150 5.3×
Assay of tacrolimus (80197) $245.25 $327 17.9×
Assay Ph Body Fluid Nos (83986) $46.50 $62 13.0×
Ast (sgot) (84450) $45.75 $61 8.8×
Beta 2 Glycoprotein I Antibody,Ea (86146) $69 $92 2.7×
Beta hydroxybutyrate (82010) $42 $56 5.1×
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×
Bl Smear W/Diff Wbc Count (85007) $35.62 $47.50 9.4×
Blood count reticulocyte automated (85045) $99.75 $133 25.0×
Blood gases (82803) $133.50 $178 5.1×
Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) $42.75 $57 2.7×
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $50.25 $67 11.5×
Blood typing abo (86900) $261.75 $349 87.5×
Blood typing serologic rh (d) (86901) $68.25 $91 22.8×
Body fluid cell count (89051) $50.25 $67 9.0×
Body fluid cell count (89050) $58.50 $78 12.4×
Breath Alcohol Test (82075) $39.75 $53 1.3×
C diff amplified probe (87493) $155.25 $207 4.2×
C-reactive protein (86140) $94.50 $126 18.2×
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $66.75 $89 5.2×
Ca 125 (86304) $96.75 $129 4.6×
Ca 19-9 (86301) $96.75 $129 4.6×
Ca 27 29 (86300) $161.25 $215 7.7×
Calcium ionized (82330) $138.75 $185 10.1×
Calcium urine (82340) $111.75 $149 18.5×
Calculus Spectroscopy (82365) $114.75 $153 8.9×
Calprotectin, fecal (83993) $201.75 $269 10.3×
Candida antibody (86628) $53.25 $71 4.4×
Carbamazepine (tegretol) total (80156) $99 $132 6.8×
Carboxyhemoglobin Quantitative (82375) $93.75 $125 7.6×
Carcinoembryonic antigen (82378) $115.50 $154 6.1×
Cardiolipin ab igg (86147) $75.75 $101 3.0×
Cd4 absolute count (86361) $144 $192 5.4×
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×
Chromium urine (82495) $45.75 $61 2.3×
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $141.75 $189 4.0×
Ckmb (82553) $84.75 $113 7.3×
Clot factor viii vw antigen (85246) $55.50 $74 2.4×
Clot Factor X Stuart-Power - Factor 10 Activity (85260) $57 $76 3.2×
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 test antiglob (86922) $354 $472 2.0×
Complement c3 (86160) $156 $208 13.0×
Complement total ch50 (86162) $112.50 $150 5.5×
Coombs direct (86880) $129.75 $173 24.1×
Copper urine (82525) $84.75 $113 6.8×
Cortisol free (82530) $41.25 $55 2.5×
Cortisol total (82533) $43.50 $58 2.7×
Creatine kinase total (82550) $58.50 $78 9.0×
Creatinine blood (82565) $34.50 $46 6.7×
Creatinine clearance (82575) $107.25 $143 11.3×
Creatinine other source (82570) $84.75 $113 16.4×
Crossmatch immediate spin (86920) $354 $472 2.0×
Culture Aerobic Identify (87077) $26.25 $35 3.2×
Culture anaerobic (87075) $79.50 $106 8.4×
Culture blood (87040) $107.25 $143 10.4×
Culture fungus other (87102) $138 $184 16.4×
Culture genital (87070) $122.25 $163 14.2×
Culture screen only (87081) $81.38 $108.50 12.3×
Culture stool (87045) $135 $180 14.3×
Culture urine (87086) $88.50 $118 11.0×
Cyclic Citrullinated Peptide (86200) $60 $80 4.6×
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $297 $396 6.9×
Cytopath Fl Nongyn Smears - Lab Cytopath Fluids,Smear,Interp (88104) $30 $40 0.8×
Cytp concentration smears & interpretation (88108) $30 $40 0.8×
Cytp fna eval dx 1st each site (88172) $30 $40 0.2×
D-Dimer (85379) $163.50 $218 16.1×
Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) $106.50 $142 6.4×
Dhea (82626) $57 $76 2.3×
Dhea sulfate (82627) $166.50 $222 7.5×
Digoxin (80162) $66 $88 5.0×
Dilantin (80185) $108 $144 8.2×
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $31.50 $42 2.3×
Drug Assay Lacosamide (80235) $141 $188 5.2×
Drug Screen Quantitative Lamotrigine (80175) $110.25 $147 8.3×
Drug Scrn Quan 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×
Ebv viral capsid (86665) $144 $192 7.9×
Elastase pancreatic fecal quantitative (82653) $75 $100 3.3×
Electrolyte panel (80051) $54 $72 7.7×
Electronic crossmatch (86923) $354 $472 2.0×
Endomysial Antibody Each Immunoglobulin Class (86231) $22.50 $30 1.9×
Enterovirus antibody (86658) $56.25 $75 4.3×
Enterovirus Pcr (87498) $227.25 $303 6.5×
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $137.25 $183 9.0×
Estradiol (82670) $237.75 $317 8.5×
Estriol (82677) $54.75 $73 2.3×
Estrone (82679) $56.25 $75 2.3×
Eval c/v amniotic fluid protein qual ea specimen (84112) $222.75 $297 2.3×
Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) $87 $116 11.9×
F2 gene analysis 20210g >a variant (81240) $222 $296 3.4×
F5 gene (81241) $181.50 $242 2.5×
Factor viii ahg (85240) $174.75 $233 9.8×
Fecal fat qual (82705) $102 $136 20.0×
Fecal fat quant (82710) $120 $160 7.1×
Fetal bleed screen (85461) $79.50 $106 8.5×
Fetal fibronectin (82731) $803.25 $1,071 12.5×
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 (83001) $129 $172 6.9×
Gammaglobulin ige (82785) $60 $80 3.6×
Ggt (82977) $36.75 $49 5.1×
Giardia antigen eia stool (87329) $66 $88 5.5×
Glucose (82947) $22.50 $30 5.7×
Glucose Blood Test (82962) $51 $68 15.5×
Glucose body fluid (82945) $41.25 $55 10.5×
Glucose post dose (82950) $44.25 $59 9.3×
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $126.75 $169 9.8×
Glycosylated hb home device (83037) $1,260 $1,680 129.8×
Haptoglobin (83010) $57 $76 4.5×
Hcg qualitative (84703) $90 $120 12.0×
Hcg quant (84702) $34.50 $46 2.3×
Hdl Cholesterol (83718) $39.75 $53 4.9×
Hematocrit (85014) $19.50 $26 8.2×
Hemoglobin (85018) $48 $64 20.3×
Hemoglobin a1c (83036) $35.25 $47 3.6×
Hemoglobin electrophoresis (83020) $113.25 $151 8.8×
Hemoglobin Fetal,Diff Lysis - Kleihauer-Betke Stain (85460) $87 $116 11.3×
Heparin assay (85520) $112.50 $150 8.6×
Hepatitis a antibody total (86708) $99 $132 8.0×
Hepatitis a 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×
Herpes simplex type 2 (86696) $78 $104 4.0×
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $105 $140 20.3×
Hfe gene (81256) $261.75 $349 4.0×
Histamine plasma (83088) $67.50 $90 2.3×
Histoplasma antibody (86698) $107.25 $143 7.8×
Hiv-1/Hiv-2 1 Result Antbdy (86703) $84.75 $113 6.2×
Hla b 27 disease association lc (81374) $210.75 $281 2.8×
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $152.25 $203 4.3×
Iaad ia clostridium difficile toxin (87324) $91.50 $122 7.6×
Iaad ia cryptosporidium (87328) $69.75 $93 5.0×
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $152.25 $203 10.6×
Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) $34.50 $46 2.9×
Iaadiadoo not otherwise specified (87899) $134.25 $179 8.4×
Iadna Dna/Rna Rsv Amplified Probe Technique (87634) $189.75 $253 2.7×
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $290.25 $387 6.8×
Iadna HIV-1 quant & reverse transcription (87536) $543 $724 6.4×
Iadna human papillomavirus high-risk types (87624) $150.75 $201 4.3×
Iadna nos amplified probe tq each organism (87798) $281.25 $375 8.0×
Iadna nos quantification each organism (87799) $323.25 $431 7.5×
Iadna trichomonas vaginalis amplified probe tech (87661) $83.25 $111 2.4×
Iadna-DNA/RNA probe tq 12-25 (87507) $655.50 $874 1.6×
Igg subclasses (82787) $47.25 $63 5.9×
Immunoassay infectious agent antibody quan nos (86317) $27.75 $37 1.9×
Immunoassay nonantibody (83516) $85.50 $114 7.4×
Immunoassay with direct visual observation for streptococcus (87802) $119.25 $159 9.4×
Immunofixj Electrophoresis Serum (86334) $156.75 $209 7.0×
Immunoglobulin light chains free each (83521) $52.50 $70 3.0×
India ink prep (87210) $65.25 $87 11.2×
Influenza DNA amp probe (87502) $220.50 $294 2.3×
Inhibin a (86336) $77.25 $103 5.0×
Inhibin b (83520) $225 $300 13.0×
Insulin antibodies (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 analysis (81270) $347.25 $463 3.8×
Jak2 Targeted Sequence Analysis (81279) $417 $556 2.3×
Lactic acid (83605) $28.50 $38 2.5×
Ldh (83615) $57.75 $77 9.6×
Lead (83655) $60.75 $81 5.0×
Legionella antigen urine (87449) $96.75 $129 8.1×
Leukocyte Assmt Fecal Qual/Semiquantitative (89055) $58.50 $78 13.7×
Lh (83002) $129 $172 7.0×
Lipase (83690) $122.25 $163 17.7×
Lithium (80178) $61.50 $82 9.3×
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×
Microalbumin urine (82043) $82.50 $110 14.3×
Microsomal antibodies (86376) $115.50 $154 7.9×
Mitochondrial antibody each (86381) $48 $64 1.9×
Mycoplasma antibody (86738) $77.25 $103 5.8×
Myelin basic protein csf (83873) $81.75 $109 4.8×
Myoglobin urine (83874) $78 $104 6.0×
Nasal smear for eosinophils (89190) $16.50 $22 2.8×
Natriuretic peptide (83880) $116.25 $155 3.0×
Niacin (84591) $95.25 $127 5.6×
Nuclear antigen antibody (86235) $73.50 $98 4.1×
Occult blood stool (82272) $51.75 $69 12.2×
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 direct-id lca (87177) $166.50 $222 18.7×
Pancreatic polypeptide (83519) $105 $140 5.7×
Phosphatase alkaline (84075) $41.25 $55 8.0×
Phosphorus blood (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×
Procalcitonin (pct) (84145) $167.25 $223 6.1×
Progesterone (84144) $47.25 $63 2.3×
Prolactin (84146) $137.25 $183 7.1×
Protein body fluid (84157) $108 $144 27.0×
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 Functional (85306) $49.50 $66 3.2×
Protein Total Serum (84155) $27.75 $37 7.6×
Protein urine (84156) $90 $120 24.5×
PSA free (84154) $134.25 $179 7.3×
Quantiferon tb gold (86480) $139.50 $186 2.3×
Rbc antibody elution (86860) $354 $472 2.0×
Renin activity plasma (84244) $49.50 $66 2.3×
Rheumatoid factor quant (86431) $40.50 $54 7.1×
Rickettsia antibody (86757) $53.25 $71 2.8×
Rubella antibody (86762) $75 $100 5.2×
Salicylate (80179) $101.25 $135 5.4×
Sars-Cov-2 Covid-19 Amp Prb (87635) $97.50 $130 1.9×
Sars-Cov-2 Covid-19 Antibody (86769) $81.75 $109 1.9×
Sarscov2&inf a&b&rsv amp prb (87637) $339 $452 2.4×
Sedimentation rate (85651) $52.50 $70 12.3×
Semen analysis sperm presence&/motility sprm (89321) $64.50 $86 5.4×
Sensitivity mic (87186) $150 $200 17.3×
Sex hormone binding globulin (84270) $85.50 $114 3.9×
Sickle cell screen (85660) $66 $88 12.0×
Smear acid fast (87206) $43.50 $58 8.1×
Smear complex stain (87209) $33.75 $45 1.9×
Smear gram stain (87205) $58.50 $78 13.7×
Smn1 Gene Dos/Deletion Alys (81329) $465.75 $621 3.4×
Sodium (84295) $27.75 $37 5.8×
Sodium urine (84300) $75 $100 14.8×
Strep a assay w/optic (87880) $53.25 $71 3.2×
Strep a DNA amp probe (87651) $52.50 $70 1.5×
T Cells Absolute Cd4&Cd8 Count Ratio (86360) $148.50 $198 3.2×
T3 free (84481) $119.25 $159 7.0×
T3 reverse (84482) $69.75 $93 4.4×
T3 total (84480) $155.25 $207 10.9×
T3 uptake (84479) $79.50 $106 12.3×
T4 Free (84439) $113.25 $151 12.6×
T4 total (84436) $57 $76 8.3×
Tb intradermal test (86580) $31.50 $42 1.1×
Test for acetone/ketones (82009) $60.75 $81 13.4×
Testosterone free (84402) $150 $200 5.9×
Testosterone total (84403) $185.25 $247 7.2×
Thyroglobulin Ab (86800) $39.75 $53 2.5×
Tiss Trnsgltmnase Ea Ig Clas (86364) $21.75 $29 1.9×
Topiramate (80201) $115.50 $154 9.7×
Toxoplasma ab igm (86778) $60.75 $81 4.2×
Tpmt gene com variants (81335) $375 $500 2.1×
Transferrin (84466) $127.50 $170 10.0×
Triglycerides (84478) $26.25 $35 4.6×
Troponin (84484) $98.25 $131 7.9×
Urea nitrogen (84520) $25.50 $34 6.5×
Uric acid blood (84550) $45.75 $61 10.1×
Urinalysis microscopic only (81015) $18 $24 5.9×
Urinalysis w/microscopic (81001) $55.50 $74 17.5×
Urine microalbumin (protein) analysis (82044) $19.50 $26 3.1×
Urine pregnancy test (81025) $53.62 $71.50 6.2×
Urnls dip stick/tablet rgnt auto w/o microscopy (81003) $32.25 $43 14.3×
Valproic acid level (80164) $79.50 $106 5.9×
Vancomycin trough (80202) $103.50 $138 7.6×
Varicella-zoster antibody (86787) $126 $168 9.8×
Vasoactive intestinal peptide (vip) (84586) $79.50 $106 2.3×
Vdrl csf (86592) $54 $72 12.6×
Virus antibody nos (86790) $55.50 $74 4.3×
Virus id non-immunologic oth/thn cytopathic (87255) $100.50 $134 3.0×
Vitamin A (84590) $45.75 $61 3.9×
Vitamin b-12 (82607) $210.75 $281 14.0×
Vitamin b1 (thiamine) (84425) $108 $144 5.1×
Vitamin D 25-Hydroxy (82306) $150 $200 5.1×
Vitamin e serum (84446) $45.75 $61 3.2×
Von willebrand factor activity (85245) $235.50 $314 10.3×
West nile virus ab, igm (86788) $72 $96 4.3×
West nile virus antibody (86789) $77.25 $103 5.4×
Zinc (84630) $110.25 $147 9.7×