Lab & pathology prices at Emanate Health Inter-community Hospital
Covina, CA · every code in this section with a posted price and a Medicare benchmark.
333 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acute hepatitis panel (80074) | $780 | $780 | 16.4× |
| Albumin serum (82040) | $192 | $192 | 38.8× |
| Allergen specific ige (86003) | $19 | $19 | 3.6× |
| Alpha-Fetoprotein Serum (82105) | $415 | $415 | 24.7× |
| Alt (sgpt) (84460) | $191 | $191 | 36.0× |
| Ammonia (82140) | $276 | $276 | 18.9× |
| Amniotic fluid protein test on cervicovaginal fluid (84112) | $557 | $557 | 5.7× |
| Amylase urine (82150) | $254 | $254 | 39.2× |
| Antibody Encephalitis California La Crosse (86651) | $172 | $172 | 13.0× |
| Antibody helicobacter pylori (86677) | $325 | $325 | 19.3× |
| Antibody Herpes Smplx Type 1 (86695) | $57 | $57 | 4.3× |
| Antibody HIV-1&HIV-2 single result (86703) | $485 | $485 | 35.4× |
| Antibody identification leukocyte antibodies (86021) | $164 | $164 | 10.9× |
| Antibody Identification Platelet Immunogl Assay (86023) | $214 | $214 | 17.2× |
| Antibody Lymphocytic Choriomeningitis (86727) | $143 | $143 | 11.1× |
| Antibody Titer (86886) range across 3 matching MRF lines |
$116–$518 | $116–$518 | varies |
| Antibody Treponema Pallidum (86780) | $123 | $123 | 9.3× |
| Antibody; encephalitis, st. louis (86653) | $172 | $172 | 13.0× |
| Antigen typing (86905) | $415 | $415 | 108.4× |
| Antihuman Globulin Indir Qual Ea Reagent Cell (86885) | $21 | $21 | 3.7× |
| Antinuclear antibodies (86038) | $102 | $102 | 8.4× |
| Antistreptolysin O Screen (86063) | $318 | $318 | 55.1× |
| Assay Blood Carbon Dioxide (82374) | $160 | $160 | 32.8× |
| Assay of blood/uric acid (84550) | $218 | $218 | 48.2× |
| Assay of calcium in urine (82340) | $240 | $240 | 39.8× |
| Assay of gammaglobulin igm (82784) | $193 | $193 | 20.8× |
| Assay of lactic acid (83605) | $291 | $291 | 25.2× |
| Assay of serum potassium (84132) | $192 | $192 | 40.3× |
| Assay of urea nitrogen (84520) | $200 | $200 | 50.6× |
| Assay Ph Body Fluid Nos (83986) | $49 | $49 | 13.7× |
| Autol Bld/Component Collj Storage Predeposited (86890) | $518 | $518 | 2.4× |
| Automated Leukocyte Count (85048) | $86 | $86 | 33.9× |
| Beta 2 glycoprotein i antibody each (86146) | $87 | $87 | 3.4× |
| Beta hydroxybutyrate (82010) | $153 | $153 | 18.7× |
| Beta-2 Microglobulin (82232) | $117 | $117 | 7.2× |
| Bilirubin direct (82248) | $156 | $156 | 31.1× |
| Bilirubin total (82247) | $187 | $187 | 37.3× |
| Biotinidase (82261) | $25 | $25 | 1.5× |
| Bl Smear W/O Diff Wbc Count (85008) | $191 | $191 | 55.7× |
| Bld Bank Phys Svcs Invstgj Tfuj Rxn Reprt (86078) range across 2 matching MRF lines |
$223–$1,327 | $223–$1,327 | varies |
| Bld Typing Serologic Rh Phnt (86906) | $88 | $88 | 11.4× |
| Blood Count Manual Cell Count Each (85032) | $48 | $48 | 11.1× |
| Blood Count Red Blood Cell Automated (85041) | $68 | $68 | 22.5× |
| Blood count reticulocyte automated (85045) | $116 | $116 | 29.1× |
| Blood gas (82803) | $712 | $712 | 27.3× |
| Blood gases w/02 saturation (82805) | $588 | $588 | 7.5× |
| Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) | $77 | $77 | 4.8× |
| Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) | $85 | $85 | 19.4× |
| Blood Type Antigen Donor Reagent Serum Each (86902) range across 3 matching MRF lines |
$138–$796 | $138–$796 | varies |
| Blood Typing Antigen Screen Patient Serum/Unit (86904) | $89 | $89 | 5.4× |
| Blood typing serologic abo (86900) | $276 | $276 | 92.3× |
| Body fluid cell count (89050) | $128 | $128 | 27.1× |
| Bone marrow smear interpretation (85097) | $882 | $882 | 0.9× |
| Braf gene analysis (81210) | $418 | $418 | 2.4× |
| C diff amplified probe (87493) | $287 | $287 | 7.7× |
| C-reactive protein (86140) | $181 | $181 | 34.9× |
| Ca 19-9 (86301) | $176 | $176 | 8.5× |
| Calcium total (82310) | $200 | $200 | 38.8× |
| Calculus assay quant (82360) | $39 | $39 | 3.0× |
| Calr gene com variants (81219) | $289 | $289 | 2.4× |
| Cancer Antigen 125 (86304) | $176 | $176 | 8.5× |
| Cancer Antigen 27.29 (86300) | $198 | $198 | 9.5× |
| Carbamazepine total (80156) | $330 | $330 | 22.6× |
| Carcinoembryonic antigen (82378) | $237 | $237 | 12.5× |
| Cardiolipin ab iga (86147) | $87 | $87 | 3.4× |
| Ccp antibody (86200) | $44 | $44 | 3.4× |
| Cell count csf (89051) | $596 | $596 | 106.4× |
| Chlamydia trachomatis ag if (87270) | $175 | $175 | 14.6× |
| Chloride Serum (82435) | $200 | $200 | 43.5× |
| Chloride urine (82436) | $160 | $160 | 27.8× |
| Cholesterol total (82465) | $220 | $220 | 50.6× |
| Chorionic gonadotropin test (84702) | $423 | $423 | 28.1× |
| Chrmsm Analysis Addl Cells Counted Each Study (88285) | $6 | $6 | 0.2× |
| Chrmsm Analysis Addl Karyotyp Each Study (88280) | $143 | $143 | 4.3× |
| Chromosome Analysis 15-20 (88262) | $143 | $143 | 1.1× |
| Chromosome Analysis 20-25 (88264) | $317 | $317 | 2.2× |
| Chromosome analysis, 5 (88261) | $237 | $237 | 0.9× |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) | $224 | $224 | 6.4× |
| Ckmb (82553) | $405 | $405 | 35.1× |
| Clostridium Difficile (87324) | $324 | $324 | 27.0× |
| Clot lysis time, whole blood dilution Facility (85175) | $161 | $161 | 7.9× |
| Clot retraction (85170) | $93 | $93 | 5.7× |
| Cns DNA amp probe type 12-25 (87483) | $2,875 | $2,875 | 6.9× |
| Coagulation time activated (85347) | $156 | $156 | 36.4× |
| Coagulation time; Lee and White Facility (85345) | $161 | $161 | 34.3× |
| Cold agglutinin screen (86156) | $45 | $45 | 5.6× |
| Cold agglutinin titer (86157) | $72 | $72 | 8.9× |
| Compatibility Each Unit Incubation (86921) | $281 | $281 | 1.3× |
| Compatibility test antiglob (86922) | $643 | $643 | 2.9× |
| Complement Antigen Each Component (86160) | $123 | $123 | 10.3× |
| Complement/Function Activity (86161) | $123 | $123 | 10.3× |
| Consltj&Reprt Slides Prepared Elsewhere (88321) | $389 | $389 | 8.1× |
| Coombs direct (86880) | $173 | $173 | 32.1× |
| Cortisol saliva (82533) | $338 | $338 | 20.7× |
| Creatine kinase total (82550) | $254 | $254 | 39.0× |
| Creatinine blood (82565) | $200 | $200 | 39.1× |
| Creatinine clearance (82575) | $231 | $231 | 24.4× |
| Creatinine Urine (82570) | $236 | $236 | 45.6× |
| Crossmatch immediate spin (86920) | $495 | $495 | 2.3× |
| Crp High Sensitivity (86141) | $176 | $176 | 13.6× |
| Cul Bact Aerobic Addl Meths Definitive Ea Isol (87077) | $57 | $57 | 7.1× |
| Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) | $163 | $163 | 20.2× |
| Culture afb (87116) | $468 | $468 | 43.3× |
| Culture Anaerobic (87075) range across 2 matching MRF lines |
$1,068–$1,283 | $1,068–$1,283 | varies |
| Culture blood (87040) | $499 | $499 | 48.4× |
| Culture csf (87070) | $641 | $641 | 74.4× |
| Culture fungus (87102) | $247 | $247 | 29.4× |
| Culture screen only (87081) | $127 | $127 | 19.2× |
| Culture stool (87045) | $660 | $660 | 69.9× |
| Culture Typing Immunologic Oth/Thn Immunofluores (87147) | $33 | $33 | 6.4× |
| Culture urine (87086) | $428 | $428 | 53.0× |
| Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart Facility (87084) | $194 | $194 | 7.2× |
| Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer (88142) | $123 | $123 | 6.1× |
| Cytopath Fl Nongyn Filter (88106) | $234 | $234 | 6.3× |
| Cytotoxic pra quick (86808) | $62 | $62 | 2.1× |
| Cytp Concentration Smears & Interpretation (88108) | $390 | $390 | 8.1× |
| Cytp Eval Fine Needle Aspirate Interp & Report (88173) | $382 | $382 | 5.7× |
| Cytp fine ndl aspirate immt cytohist std dx 1st (88172) | $240 | $240 | 1.1× |
| Cytp Flu Washgs/Brushings Xcpt C/V Smrs Interpj (88104) | $172 | $172 | 3.6× |
| Cytp Smrs Any Oth Src Scr&Interpj (88160) | $85 | $85 | 2.3× |
| Cytp Urine 3-5 Probes Cmptr (88121) | $972 | $972 | 4.4× |
| Detect Agent Nos Dna Amp (87798) | $330 | $330 | 9.4× |
| Digoxin (80162) | $275 | $275 | 20.7× |
| Dna Antibody Native/Double Stranded (86225) | $47 | $47 | 3.4× |
| Drug Test Prsmv Chem Anlyzr (80307) range across 3 matching MRF lines |
$269–$938 | $269–$938 | varies |
| Electrolyte panel (80051) | $248 | $248 | 35.4× |
| Encephaltis East Eqne Anbdy (86652) | $172 | $172 | 13.0× |
| Encephaltis West Eqne Antbdy (86654) | $172 | $172 | 13.0× |
| Eosinophil Smear (89190) | $128 | $128 | 22.1× |
| Estradiol serum (82670) | $424 | $424 | 15.2× |
| Exam Synovial Fluid Crystals (89060) | $114 | $114 | 15.6× |
| Factor viii assay (85240) | $557 | $557 | 31.1× |
| Ferritin (82728) | $230 | $230 | 16.9× |
| Fetal Fibronectin (82731) | $825 | $825 | 12.8× |
| Fetal hemoglobin assay qual (83033) | $270 | $270 | 33.8× |
| Fibrin Degradation Quant (85379) | $291 | $291 | 28.6× |
| Fibrinogen activity (85384) | $463 | $463 | 47.6× |
| Flow cytometry first marker (88184) | $354 | $354 | 0.8× |
| Flt3 Gene (81245) | $131 | $131 | 0.8× |
| Folic Acid Serum (82746) | $222 | $222 | 15.1× |
| Follicle Stimulating Hormone (83001) | $309 | $309 | 16.6× |
| Fresh Frozen Plasma Thawing Each Unit (86927) | $202 | $202 | 0.9× |
| Frozen Blood Each Unit Thawing (86931) | $415 | $415 | 1.9× |
| Frozen Section (88331) | $400 | $400 | 1.8× |
| Galactose transferase test (82776) | $25 | $25 | 2.1× |
| Gammaglobulin ige (82785) | $193 | $193 | 11.7× |
| Gases Blood O2 Saturation Only Direct Meas (82810) | $46 | $46 | 4.7× |
| Gases blood ph only (82800) | $148 | $148 | 13.5× |
| Gastrointestinal pathogen panel by PCR (12 to 25 targets) (87507) | $1,690 | $1,690 | 4.1× |
| Gen Seq Analys Hematolymphoid Neo 5-50 Gene (81450) | $1,809 | $1,809 | 2.4× |
| Gentamicin (80170) | $330 | $330 | 20.1× |
| Ggt (82977) | $225 | $225 | 31.3× |
| Glucose 2 hr pp (82950) | $92 | $92 | 19.4× |
| Glucose body fluid (82945) | $192 | $192 | 48.9× |
| Glucose Serum (82947) | $216 | $216 | 55.0× |
| Glucose tolerance test (gtt) (82951) | $721 | $721 | 56.0× |
| Gonadotropin Chorionic Qualitative (84703) | $369 | $369 | 49.1× |
| H Pylori (C-13) Breath (83013) | $267 | $267 | 4.0× |
| Haptoglobin (83010) | $178 | $178 | 14.1× |
| Hdl Cholesterol (83718) | $251 | $251 | 30.6× |
| Hematocrit (85014) | $82 | $82 | 34.6× |
| Hemoglobin (85018) range across 2 matching MRF lines |
$90–$104 | $90–$104 | varies |
| Hemoglobin a1c (83036) range across 3 matching MRF lines |
$186–$214 | $186–$214 | varies |
| Hemoglobin Chromotography (83021) | $25 | $25 | 1.4× |
| Hemolysin Acid (85475) | $113 | $113 | 12.7× |
| Hemolysins&Agglutinins Auto Screen Each (86940) | $110 | $110 | 12.5× |
| Hemolysins&Agglutinins Incubated (86941) range across 2 matching MRF lines |
$110–$171 | $110–$171 | varies |
| Hep a ab igm (86709) | $268 | $268 | 23.8× |
| Heparin assay (85520) | $290 | $290 | 22.2× |
| Hepatitis a antibody total (86708) | $208 | $208 | 16.8× |
| Hepatitis b core ab igm (86705) | $268 | $268 | 22.8× |
| Hepatitis b core ab total (86704) | $19 | $19 | 1.6× |
| Hepatitis B Surface Antibody (86706) | $233 | $233 | 21.7× |
| Hepatitis B Surface Antigen (87340) | $238 | $238 | 23.0× |
| Heterophile Antibody Screen (86308) | $180 | $180 | 34.7× |
| Hgb/Rbcs Fetal Fetomaternal Hemrrg Difrntl Lysis (85460) | $411 | $411 | 53.2× |
| Hiv-1 Antibody (86701) | $79 | $79 | 8.9× |
| Hla Typing a/B/C Multiple Antigens (86813) | $759 | $759 | 13.1× |
| Homocysteine (83090) | $128 | $128 | 7.1× |
| Hydroxyprogesterone 17-d (83498) | $25 | $25 | 0.9× |
| Ia infectious agt antibody sars-cov-2 COVID-19 (86328) | $416 | $416 | 9.2× |
| Iaad Ia Hepatitis B Surface Ag Neutralization (87341) | $116 | $116 | 11.2× |
| Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) | $155 | $155 | 11.1× |
| Iaad Ia Streptococcus Group A (87430) | $181 | $181 | 10.8× |
| Iaadi inffluenza a virus (87276) | $88 | $88 | 5.5× |
| Iadna Mycobacteria Tuberculosis Amp Prb (87556) | $329 | $329 | 7.9× |
| Imhistochem/Cytchm Ea Multiplex Antibody Slide (88344) | $389 | $389 | 0.8× |
| Immune Complex Assay (86332) | $131 | $131 | 5.4× |
| Immunoassay nonantibody (83516) | $40 | $40 | 3.5× |
| Immunofluorescence per spec 1st singl antb stain (88346) | $353 | $353 | 1.6× |
| Immunohistochemistry (88342) | $511 | $511 | 2.3× |
| In situ hybridization 1st probe stain (88365) | $284 | $284 | 1.3× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87339) | $82 | $82 | 5.1× |
| Infectious agent antigen detection by immunofluorescent technique; influenza b virus (87275) | $88 | $88 | 7.2× |
| Influenza assay w/optic (87804) | $62 | $62 | 3.7× |
| Insitu hybridization auto (88367) | $583 | $583 | 1.3× |
| Insitu hybridization manual (88368) | $428 | $428 | 0.9× |
| Iron (83540) | $178 | $178 | 27.5× |
| Iron Binding Capacity (83550) | $148 | $148 | 16.9× |
| Kit Gene Analysis Targeted Sequence Analysis (81272) | $131 | $131 | 0.4× |
| Koh Prep (87220) | $128 | $128 | 30.0× |
| Kras Gene Analysis Additional Variant(S) (81276) | $131 | $131 | 0.7× |
| Kras Gene Variants Exon 2 (81275) | $461 | $461 | 2.4× |
| Lactate (ld) (ldh) enzyme (83615) | $212 | $212 | 35.1× |
| LDL direct (83721) | $154 | $154 | 14.7× |
| Leukocyte phagocytosis (86344) | $1,339 | $1,339 | 128.9× |
| Level I Surg Pathology Gross Examination Only (88300) | $71 | $71 | 1.9× |
| Level ii surg pathology grossµscopic exam (88302) | $246 | $246 | 5.1× |
| Level V Surg Pathology Gross&Microscopic Exam (88307) | $627 | $627 | 1.4× |
| Lipase (83690) | $254 | $254 | 36.9× |
| Lithium (80178) | $160 | $160 | 24.2× |
| Luteinizing Hormone (Lh) (83002) | $222 | $222 | 12.0× |
| M/phmtrc alys ishquant/semiq (88374) | $543 | $543 | 2.5× |
| Magnesium Urine (83735) | $172 | $172 | 25.7× |
| Mass Spectrometry Quant (83789) | $25 | $25 | 1.0× |
| Metabolic panel ionized ca (80047) | $37 | $37 | 2.7× |
| Microalbumin, quantitative (82043) | $231 | $231 | 40.0× |
| Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity Facility (83861) | $345 | $345 | 15.3× |
| Microsomal Antibodies Each (86376) | $51 | $51 | 3.5× |
| Mopath procedure level 2 (81401) | $326 | $326 | 2.4× |
| Mopath procedure level 4 (81403) | $441 | $441 | 2.4× |
| Mucin Clot Body Fluid (83872) | $75 | $75 | 12.8× |
| Mumps antibody (86735) | $110 | $110 | 8.4× |
| Mycoplasma antibody (86738) | $107 | $107 | 8.1× |
| Natriuretic peptide (83880) | $266 | $266 | 6.8× |
| Npm1 Nucleophosmin Gene Anal Exon 12 Variants (81310) | $587 | $587 | 2.4× |
| Nras gene variants exon 2&3 (81311) | $705 | $705 | 2.4× |
| Nuclear antigen antibody (86235) | $62 | $62 | 3.5× |
| Occult blood feces (82272) | $85 | $85 | 20.1× |
| Occult Blood Other Sources (82271) | $77 | $77 | 14.5× |
| Osmolality serum (83930) | $193 | $193 | 29.2× |
| Osmolality Urine (83935) | $193 | $193 | 28.3× |
| Osmotic Fragility RBC Unincubated (85555) | $468 | $468 | 62.7× |
| Particle Agglutination Screen Each Antibody (86403) | $90 | $90 | 7.8× |
| Path Consltj Surg Cytologic Exam Initial Site (88333) | $811 | $811 | 0.8× |
| Pathology Consultation During Surgery (88329) | $182 | $182 | 2.4× |
| Ph urine (81003) | $121 | $121 | 53.8× |
| Phenobarbital Level (80184) | $275 | $275 | 18.0× |
| Phenylalanine (84030) | $24 | $24 | 4.4× |
| Phenytoin (Dilantin) (80185) | $330 | $330 | 24.9× |
| Phosphatase alkaline (84075) | $254 | $254 | 49.0× |
| Phosphorus Serum (84100) | $192 | $192 | 40.5× |
| Platelet Aggregation (85576) | $489 | $489 | 19.6× |
| Platelet Antibodies (86022) range across 3 matching MRF lines |
$44–$839 | $44–$839 | varies |
| Platelet count automated (85049) | $92 | $92 | 20.5× |
| Potassium Urine (84133) | $192 | $192 | 40.6× |
| Prealbumin (84134) | $94 | $94 | 6.4× |
| Pretreatment of serum for use in rbc antibody identification; incubation with inhibitors, each (86977) | $72 | $72 | 0.3× |
| Pretx RBC Antibody Incubat W/Chem Agnts/Drugs Ea (86970) | $72 | $72 | 0.9× |
| Pretx serum rbc antibody identification dilution (86976) | $44 | $44 | 1.2× |
| Procalcitonin (Pct) (84145) | $300 | $300 | 11.0× |
| Progesterone (84144) | $200 | $200 | 9.6× |
| Prolactin (84146) | $323 | $323 | 16.7× |
| Protein body fluid (84157) | $192 | $192 | 48.0× |
| Protein total serum (84155) | $192 | $192 | 52.3× |
| Protein Total Urine (84156) | $212 | $212 | 57.8× |
| Prothrombin Time Substitution Plasma Frctj Each (85611) | $243 | $243 | 61.7× |
| Pth Intact (83970) | $317 | $317 | 7.7× |
| Quantiferon tb gold plus (86480) | $520 | $520 | 8.4× |
| Rbc antibody elution (86860) range across 3 matching MRF lines |
$116–$905 | $116–$905 | varies |
| Rbc antibody identification (86870) | $873 | $873 | 1.9× |
| Rbc antibody screen (86850) range across 5 matching MRF lines |
$65–$326 | $65–$326 | varies |
| Rbc pretreatment serum (86978) range across 4 matching MRF lines |
$146–$629 | $146–$629 | varies |
| Rbc pretx incubatj w/enzymes (86971) | $31 | $31 | 0.1× |
| Rbc serum pretx incubj drugs (86975) | $253 | $253 | 0.4× |
| Resp virus 12-25 targets (87633) range across 2 matching MRF lines |
$2,396–$2,875 | $2,396–$2,875 | varies |
| Reticulocyte Count Manual (85044) | $171 | $171 | 39.7× |
| Reticulocyte separation (86972) range across 2 matching MRF lines |
$173–$257 | $173–$257 | varies |
| Rh (86901) | $173 | $173 | 57.9× |
| Rheumatoid factor quant (86431) | $190 | $190 | 33.5× |
| Rotavirus ag eia (87425) | $108 | $108 | 9.0× |
| Rpr qualitative (86592) | $159 | $159 | 37.2× |
| Rsv Assay W/Optic (87807) | $67 | $67 | 5.1× |
| Rubella Antibody (86762) | $407 | $407 | 28.3× |
| Rubeola antibody (86765) | $251 | $251 | 19.5× |
| Sars-Cov-2 Covid-19 Amp Prb (87635) | $251 | $251 | 4.9× |
| Sars-Cov-2 Covid19 W/Optic (87811) | $43 | $43 | 1.0× |
| Sedimentation rate (85651) | $141 | $141 | 33.0× |
| Sedimentation Rate, Automated (85652) | $191 | $191 | 70.7× |
| Sensitivity mic (87186) | $321 | $321 | 37.1× |
| Sickling of rbc reduction (85660) range across 2 matching MRF lines |
$61–$206 | $61–$206 | varies |
| Skin test tuberculosis intradermal (86580) | $39 | $39 | 1.0× |
| Skin test; histoplasmosis (86510) | $139 | $139 | 2.9× |
| Smear acid fast (87206) range across 2 matching MRF lines |
$156–$187 | $156–$187 | varies |
| Smear gram stain (87205) range across 7 matching MRF lines |
$145–$174 | $145–$174 | varies |
| Smr Prim Src Wet Mount Nfct Agt (87210) | $185 | $185 | 31.8× |
| Sodium Serum (84295) | $160 | $160 | 33.3× |
| Sodium Urine (84300) | $200 | $200 | 39.5× |
| Special Stains Group 1 (88312) | $133 | $133 | 2.0× |
| Special Stains Group 2 (88313) | $93 | $93 | 0.5× |
| Specific gravity body fluid (84315) | $54 | $54 | 16.5× |
| Splitting Blood/Blood Products Each Unit (86985) | $650 | $650 | 3.0× |
| Strep a assay w/optic (87880) | $704 | $704 | 42.6× |
| Sugars Single Qual (84376) | $55 | $55 | 10.0× |
| Surg path level iii (88304) | $427 | $427 | 6.4× |
| Surgical pathology level IV (88305) range across 3 matching MRF lines |
$292–$494 | $292–$494 | varies |
| Surgical pathology level vi (88309) | $811 | $811 | 0.8× |
| Susceptbilty Stdy Antimicrbial Agnt Agar Dilutj (87181) | $400 | $400 | 84.2× |
| Susceptibility Study Antimicrobial Disk Method (87184) range across 2 matching MRF lines |
$333–$400 | $333–$400 | varies |
| Syphilis Test Non-Trep Quant (86593) | $242 | $242 | 55.0× |
| T3 Free (84481) | $53 | $53 | 3.1× |
| T3 Total (84480) | $378 | $378 | 26.7× |
| T3 Uptake (84479) | $253 | $253 | 39.1× |
| T4 Free (84439) | $378 | $378 | 41.9× |
| T4 total (84436) | $281 | $281 | 40.9× |
| Tacrolimus (80197) | $161 | $161 | 11.7× |
| Testosterone total (84403) | $222 | $222 | 8.6× |
| Theophylline (80198) | $275 | $275 | 19.4× |
| Thrombin Time (85670) | $201 | $201 | 34.8× |
| Thromboplastin Time Prtl Substit Plasma Frctj Ea (85732) | $243 | $243 | 37.6× |
| Tissue culture bone marrow (88237) | $317 | $317 | 2.2× |
| Tobramycin peak (80200) | $330 | $330 | 20.5× |
| Toxin/Antitoxin Assay Tissue Culture (87230) | $178 | $178 | 9.0× |
| Transferase Aspartate Amino Ast Sgot (84450) | $229 | $229 | 44.2× |
| Transferrin (84466) | $93 | $93 | 7.3× |
| Triglycerides (84478) | $200 | $200 | 34.8× |
| Troponin Quant (84484) | $178 | $178 | 14.3× |
| Tumor immunohistochem/comput (88361) | $533 | $533 | 1.2× |
| Tumor Immunohistochem/Manual (88360) | $466 | $466 | 2.1× |
| Unlisted miscellaneous pathology test (89240) | $83 | $83 | 1.2× |
| Unlisted Transfusion Medicine Procedure (86999) range across 4 matching MRF lines |
$285–$5,488 | $285–$5,488 | varies |
| Uric acid other source (84560) | $169 | $169 | 33.3× |
| Urinalysis Microscopic Only (81015) | $99 | $99 | 32.5× |
| Urinalysis Qual/Semiquant Except Immunoassays (81005) | $52 | $52 | 24.0× |
| Urinalysis Volume Measure (81050) | $37 | $37 | 10.2× |
| Urine Pregnancy Test (81025) range across 2 matching MRF lines |
$42–$48 | $42–$48 | varies |
| Urnls Dip Stick/Tablet Reagent Auto Microscopy (81001) | $205 | $205 | 64.7× |
| Valproic acid (80164) | $330 | $330 | 24.4× |
| Vancomycin (80202) | $330 | $330 | 24.4× |
| Varicella-zoster antibody (86787) | $251 | $251 | 19.5× |
| Vitamin b-12 (82607) | $154 | $154 | 10.2× |
| Vitamin D 25-Hydroxy (82306) | $217 | $217 | 7.3× |
| Wbc Alkaline Phosphatase Count (85540) | $116 | $116 | 13.5× |
A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.