Lab & pathology prices at Evans Memorial Hospital

Claxton, GA · every code in this section with a posted price and a Medicare benchmark.

531 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) $480
5 Hiaa (83497) $310
5 Nucleotidase (83915) $170
Acute hepatitis panel (80074) $595
Afb culture (87116) $250
Albumin Fluid (82042) $150
Albumin serum (82040) $150
Aldolase (82085) $250
Aldosterone urine (82088) $360
Alkaline phosphatase isoenzymes (84080) $270
Allergen specific ige (86003) $140
Alpha-1-antitrypsin phenotype (82104) $310
Alpha-1-antitrypsin, total (82103) $490
Alpha-fetoprotein amniotic (82106) $230
Alpha-fetoprotein, serum (82105) $277.50
Alt (sgpt) (84460) $185
Aluminum (82108) $250
Amikacin trough (80150) $285
Amino acid screen urine (82128) $1,125
Aminolevulinic acid (ala) (82135) $610
Ammonia (82140) $425
Amylase urine (82150) $310
Ana Titer (86039) $192.50
Angiotensin i enzyme test (82164) $255
Antibody Absorption (86978) $130
Antibody aspergillus (86606) $220
Antibody coxiella burnetii q fever (86638) $545
Antibody cytomegalovirus cmv (86644) $285
Antibody cytomegalovirus cmv igm (86645) $330
Antibody Encephalitis Eastern Equine (86652) $180
Antibody Encephalitis St. Louis (86653) $180
Antibody epstein-barr eb virus early antigen ea (86663) $150
Antibody haemophilus influenza (86684) $360
Antibody helicobacter pylori (86677) $270
Antibody herpes smplx type 1 (86695) $205
Antibody identification (86870) $167.50
Antibody identification leukocyte antibodies (86021) $115
Antibody influenza virus (86710) $360
Antibody mumps (86735) $380
Antibody Protozoa Nes (86753) $267.50
Antibody rubeola (86765) $270
Antibody screen (86850) $162.50
Antibody treponema pallidum (86780) $277.50
Antibody; Coccidioides (86635) $220
Antigen typing (86905) $150
Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) $230
Antinuclear antibodies (86038) $352.50
Antistreptolysin O Screen - Anti-Streptolysin O (86063) $105
Antistreptolysin o titer (86060) $185
Antithrombin iii activity (85300) $390
Antithrombin iii antigen (85301) $310
Arsenic Urine (82175) $380
Assay free hydroxyproline (83500) $750
Assay galactose transferase (82775) $715
Assay Nephelometry Not Spec (83883) $390
Assay of acth (82024) $480
Assay of androstenedione (82157) $90
Assay of blood chloride (82435) $150
Assay of c-peptide (84681) $430
Assay of calcitonin (82308) $430
Assay of ceruloplasmin (82390) $250
Assay of creatine (82540) $330
Assay of cyclosporine (80158) $480
Assay of erythropoietin (82668) $380
Assay of ethosuximide (80168) $305
Assay of ferritin (82728) $225
Assay of g6pd enzyme (82955) $285
Assay of gammaglobulin igm (82784) $185
Assay of gastrin (82941) $270
Assay of gentamicin (80170) $330
Assay of glucagon (82943) $360
Assay of homocystine (83090) $530
Assay of lipoprotein(a) (83695) $380
Assay of manganese (83785) $330
Assay of metanephrines (83835) $380
Assay of osteocalcin (83937) $305
Assay of parathormone (83970) $577.50
Assay of phenobarbital (80184) $330
Assay of prealbumin (84134) $285
Assay of proinsulin (84206) $540
Assay of pyruvate (84210) $700
Assay of selenium (84255) $150
Assay of semen fructose (82757) $380
Assay of serotonin (84260) $655
Assay of sialic acid (84275) $500
Assay of somatomedin (84305) $435
Assay of tacrolimus (80197) $430
Assay of urine vma (84585) $330
Assay of vitamin k (84597) $275
Assay Ph Body Fluid Nos (83986) $140
Ast (sgot) (84450) $185
Automated rbc count (85041) $100
Bartonella antibody (86611) $385
Beta 2 Glycoprotein I Antibody,Ea (86146) $130
Beta hydroxybutyrate (82010) $150
Beta-2 microglobulin (82232) $285
Bilirubin direct (82248) $185
Bilirubin total (82247) $185
Bl Smear W/Diff Wbc Count (85007) $90
Blastomyces antibody (86612) $220
Bleeding time (85002) $205
Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and… (86077) $750
Blood Count Automated Differential Wbc Count (85004) $155
Blood count reticulocyte automated (85045) $155
Blood gases (82803) $490
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $120
Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen (86902) $750
Blood typing abo (86900) $105
Blood Typing Antigen Screen Patient Serum/Unit - Blood Typing, Pat (86904) $115
Blood typing serologic rh (d) (86901) $90
Blood typing serologic rh phenotyping complete (86906) $155
Body fluid cell count (89051) $140
Body fluid cell count (89050) $140
Bordetella antibody (86615) $230
Brucella antibody (86622) $205
C diff amplified probe (87493) $415
C-reactive protein (86140) $155
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $480
C1q binding assay (86332) $545
Ca 125 (86304) $380
Ca 19-9 (86301) $380
Ca 27 29 (86300) $375
Cadmium level (82300) $90
Calcium ionized (82330) $205
Calcium total (82310) $155
Calculus Spectroscopy (82365) $310
California encephalitis ab (86651) $180
Calprotectin, fecal (83993) $130
Candida antibody (86628) $140
Carb deficient transferrin (82373) $220
Carbamazepine (tegretol) total (80156) $330
Carbon dioxide (82374) $140
Carboxyhemoglobin Quantitative (82375) $250
Carcinoembryonic antigen (82378) $380
Cardiolipin ab igg (86147) $170
Carnitine (82379) $430
Carotene (82380) $270
Catecholamines fraction plasma (82384) $430
Cd4 absolute count (86361) $500
Cell marker study (88182) $542.50
Cftr gene full sequence (81223) $267.50
Chemiluminescent assay (82397) $162.50
Chlamydia antibody (86631) $155
Chlamydia Igm Antibody (86632) $155
Chloride other source (82438) $150
Chloride urine (82436) $150
Cholesterol total (82465) $185
Cholinesterase rbc (82482) $330
Cholinesterase serum (82480) $330
Chrmsm count 15-20 cll 2karyotyp banding (88262) $890
Chrom count break 50-100/20/2 (88248) $1,560
Chromium urine (82495) $125
Chromogranin a (86316) $390
Chromosome analysis 20-25 cells (88264) $1,080
Chromosome karyotype study (88280) $700
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $310
Citrate (82507) $480
Ck isoenzymes (82552) $330
Ckmb (82553) $305
Clot factor viii vw antigen (85246) $255
Clotting time (85345) $205
Cold agglutinin titer (86157) $225
Collagen cross links (82523) $745
Compatibility test antiglob (86922) $215
Compatibility Test Incubate (86921) $225
Complement c3 (86160) $205
Complement total ch50 (86162) $330
Complement/Function Activity - C1 Esterase Inhibitor, Functional (86161) $330
Concentration Infectious Agent (87015) $202.50
Coombs direct (86880) $137.50
Coombs Test Indirect Qual (86885) $45
Copper urine (82525) $230
Cortisol free (82530) $665
Cortisol total (82533) $330
Creatine kinase total (82550) $220
Creatinine blood (82565) $155
Creatinine clearance (82575) $225
Creatinine other source (82570) $155
Crossmatch immediate spin (86920) $275
Cryofibrinogen (82585) $480
Cryoglobulin (82595) $140
Cryptococcus antibody (86641) $90
Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) $70
Culture Aerobic Identify (87077) $70
Culture anaerobic (87075) $320
Culture blood (87040) $310
Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous (87101) $320
Culture fungus blood (87103) $320
Culture fungus other (87102) $195
Culture genital (87070) $320
Culture screen only (87081) $230
Culture stool (87045) $92.50
Culture typing other methods (87158) $55
Culture urine (87086) $230
Culture urine id ea isolate (87088) $285
Cyanocobalamin Vit B-12 Unsat Binding Capacity (82608) $200
Cyclic Citrullinated Peptide (86200) $490
Cystatin c (82610) $155
Cytogenetics DNA probe (88271) $350
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $655
Cytopath Fl Nongyn Smears - Lab Cytopath Fluids,Smear,Interp (88104) $90
Cytp concentration smears & interpretation (88108) $90
Cytp Eval Fine Needle Aspirate Interp & Report (88173) $180
D-Dimer (85379) $360
Deoxyribonuclease antibody (86215) $270
Dhea (82626) $360
Dhea sulfate (82627) $360
Digoxin (80162) $380
Dilantin (80185) $330
Diphtheria antitoxoid (86648) $360
Dna Antibody Single Stranded (86226) $285
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $285
Drug Screen Quant Gabapentin (80171) $360
Drug Scrn Quan Levetiracetam (80177) $595
Drug test prsmv chem anlyzr (80307) $350
Ebv viral capsid (86665) $225
Echinococcus ab igg (86682) $825
Ehrlichia antibody (86666) $310
Electrolyte panel (80051) $360
Electrophoretic Test - Immunofixation Electrophoresis (82664) $520
Encephalitis Western Equine (86654) $180
Endomysial antibody iga (86255) $270
Entamoeba histolytica antigen (87337) $90
Enterovirus antibody (86658) $140
Enterovirus Pcr (87498) $1,180
Eosinophil count (85048) $100
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $145
Estradiol (82670) $465
Estriol (82677) $305
Estrogen receptor analysis (84233) $565
Estrone (82679) $430
Ethylene glycol (82693) $390
Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) $185
F2 gene analysis 20210g >a variant (81240) $310
F5 gene (81241) $310
Factor inhibitor test (85335) $560
Factor v activity (85220) $425
Factor viii ahg (85240) $182.50
Fecal fat qual (82705) $185
Fetal bleed screen (85461) $140
Fetal fibronectin (82731) $1,560
Fibrin degradation products (85362) $250
Fibrinogen activity (85384) $225
Fibrinolytic factors and inhibitors; plasmin Other Outpatient (85400) $330
Flow cytometry first marker (88184) $390
Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) $185
Folate serum (82746) $200
Folic acid rbc (82747) $255
Follicle Stimulating Hormone (83001) $390
Fructosamine (82985) $225
Gastric acid analy w/ph ea spe (82930) $330
Gastric Occult Blood (82271) $140
Ggt (82977) $185
Giardia antigen eia stool (87329) $140
Giardia lamblia antibody (86674) $285
Glucose (82947) $150
Glucose body fluid (82945) $150
Glucose post dose (82950) $150
Glucose Tolerance Ea Addl Beyond 3 Specimens (82952) $150
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $185
Growth hormone (83003) $330
Haloperidol (haldol) (80173) $385
Haptoglobin (83010) $270
Hcg qualitative (84703) $200
Hcg quant (84702) $210
Hdl Cholesterol (83718) $140
Heavy metal quant each (83018) $177.50
Heavy Metal Screen - Heavy Metals Screen (83015) $205
Hematocrit (85014) $210
Hemoglobin (85018) $100
Hemoglobin a1c (83036) $255
Hemoglobin Chromotography - Hemoglobinopathy Eval (83021) $330
Hemoglobin Fetal,Diff Lysis - Kleihauer-Betke Stain (85460) $760
Hemolysins And Agglutinins Incubated (86941) $390
Heparin assay (85520) $410
Hepatitis a antibody total (86708) $380
Hepatitis a igm (86709) $105
Hepatitis b core ab igm (86705) $115
Hepatitis b core antibody total (86704) $250
Hepatitis B Surface Ab (86706) $250
Hepatitis B Surface Antigen (87340) $250
Hepatitis be antibody (86707) $250
Hepatitis Be Antigen (87350) $250
Hepatitis c antibody (86803) $285
Hepatitis C Genotype (87902) $940
Hepatitis delta ab (86692) $820
Herpes culture (87252) $360
Herpes simplex type 2 (86696) $205
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $185
Histamine plasma (83088) $515
Histoplasma antibody (86698) $220
HIV confirmation (86689) $140
HIV-1 genotype (87901) $1,405
Hla I Typing 1 Locus Lr (81373) $285
Hla ii low resolution one antigen equivalent ea (81377) $285
Hla-b27 (86812) $435
Hpylori Breath Anal Urease Act Non-Radact Istope (83013) $150
Hsv Dna Quant (87530) $740
Hydroxyprogesterone 17-d (83498) $390
Ia infectious agt antibody sars-cov-2 COVID-19 (86328) $205
Iaad ia clostridium difficile toxin (87324) $150
Iaad ia cryptosporidium (87328) $140
Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) $105
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $585
Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) $335
Iaad ia rotavirus (87425) $380
Iaad Ia Severe Aqt Respir Synd Coronavirus (87426) $260
Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) $80
Iaad Ia Streptococcus Group A (87430) $100
Iaadiadoo not otherwise specified (87899) $785
Iadna candida species amplified probe tq (87481) $105
Iadna Chlamydia Trachomatis Direct Probe Tq (87490) $200
Iadna hepatitis b virus quantification (87517) $1,560
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $675
Iadna HIV-1 amplified probe & reverse transcrpj (87535) $845
Iadna HIV-1 quant & reverse transcription (87536) $845
Iadna neisseria gonorrhoeae amplified probe tq (87591) $310
Iadna nos amplified probe tq each organism (87798) $427.50
Iadna nos quantification each organism (87799) $745
Iadna trichomonas vaginalis amplified probe tech (87661) $230
Iadna-DNA/RNA probe tq 12-25 (87507) $1,560
Igg subclasses (82787) $115
Immunoassay infectious agent antibody quan nos (86317) $65
Immunoassay nonantibody (83516) $155
Immunoassay technique for helicobacter pylori gi tract bacteria (87339) $250
Immunodiffusion Ouchterlony (86331) $200
Immunofixj Electrophoresis Serum (86334) $307.50
Immunohistochemistry (88342) $180
India ink prep (87210) $115
Influenza a/b ag eia (87400) $140
Inhibin a (86336) $250
Inhibin b (83520) $500
Insitu hybridization (fish) (88365) $330
Insulin antibodies (86337) $430
Insulin total (83525) $250
Intrinsic factor antibody (86340) $275
Iron (83540) $125
Iron binding capacity (83550) $275
Islet cell antibody (86341) $750
Ketosteroids 17; total (83586) $330
Koh Prep (87220) $105
L/s ratio, fetal lung (83661) $435
Lactic acid (83605) $305
Lactoferrin fecal qualitative (83630) $115
Ldh (83615) $220
Ldh isoenzymes (83625) $330
LDL cholesterol direct (83721) $150
Lead (83655) $250
Legionella antibody (86713) $530
Legionella antigen urine (87449) $217.50
Legionella pneumophila dfa (87278) $275
Leukocyte histamine release test (86343) $360
Level v surg pathology gross&microscopic exam (88307) $270
Level vi surg pathology gross&microscopic exam (88309) $270
Lh (83002) $380
Lipase (83690) $310
Lipoprotein Bld Hr Fraction (83701) $230
Listeria ab (86609) $330
Lithium (80178) $205
Lyme disease antibody confirm (86617) $187.50
Magnesium (83735) $200
Malaria smear (87207) $190
Mcg interphase insitu 25 (88274) $570
Mercury (83825) $265
Metabolic Panel Ionized Ca (80047) $155
Methotrexate (80299) $387.50
Methylmalonic acid serum (83921) $545
Microalbumin urine (82043) $220
Microsomal antibodies (86376) $270
Molec cytg interphase ish analyze 100-300 cll (88275) $200
Molecular pathology procedure level 2 (81401) $1,297.50
Mononuclear cell antigen (86356) $390
Mucopolysaccharides acid quantitative (83864) $270
Muramidase (85549) $270
Mycoplasma antibody (86738) $250
Myelin basic protein csf (83873) $530
Myoglobin urine (83874) $330
N.gonorrhoeae, DNA, dir prob (87590) $200
Nasal smear for eosinophils (89190) $155
Natriuretic peptide (83880) $435
Nfct ds chrnc hcv 6 biochem assay srm alg lvr (81596) $380
Niacin (84591) $515
Nmr Lipoprofile (83704) $430
Nocardia antibody (86744) $275
Nuclear antigen antibody (86235) $185
Occult blood stool (82272) $140
Oligoclonal bands (83916) $430
Organic Acids Total Quantitative Each Specimen (83918) $1,125
Osmolality serum (83930) $205
Osmolality urine (83935) $205
Ova and parasite direct-id lca (87177) $140
Oxalate urine (83945) $205
Pancreatic elastase fecal (82656) $915
Pancreatic polypeptide (83519) $480
Parvovirus antibody (86747) $202.50
Phenylalanine (84030) $270
Phenytoin free (80186) $275
Phosphatase acid prostatic (84066) $480
Phosphatase alkaline (84075) $155
Phosphorus blood (84100) $155
Phosphorus urine (84105) $155
Pinworm exam (87172) $140
Plasminogen (85420) $450
Platelet aggregation (85576) $225
Platelet count (85049) $115
Porphobilinogen Urine Qual (84106) $305
Porphobilinogen urine quant (84110) $415
Porphyrins qn & fraction urine (84120) $287.50
Potassium (84132) $150
Potassium urine (84133) $150
Pregnenolone (84140) $225
Pretx rbc antibody incubat w/enzymes each (86971) $45
Primidone (80188) $390
Procainamide napa (80192) $357.50
Procalcitonin (pct) (84145) $430
Progesterone (84144) $380
Prolactin (84146) $425
Protein body fluid (84157) $140
Protein c activity (85303) $360
Protein c antigen (85302) $360
Protein electrophoresis serum (84165) $140
Protein Electrophoresis Urine (84166) $390
Protein S Functional (85306) $255
Protein s total (85305) $360
Protein Total Serum (84155) $140
Protein urine (84156) $155
Protein Western Blot (84182) $1,100
Protein westrn blot i&r blood/other fluid (84181) $180
Protoporphyrin rbc quantitative (84202) $270
PSA free (84154) $220
Quantiferon tb gold (86480) $380
Quinidine (80194) $285
Rbc antibody elution (86860) $205
Rbc pretx incubatj w/chemicl (86970) $165
Reagent strip/blood glucose (82948) $170
Renin activity plasma (84244) $270
Respiratory Virus (86756) $180
Reticulocyte separation (86972) $865
Rheumatoid Factor Qual (86430) $200
Rheumatoid factor quant (86431) $200
Rickettsia antibody (86757) $180
Rubella antibody (86762) $205
Saccharomyces ab iga (86671) $380
Sars-Cov-2 Covid-19 Amp Prb (87635) $260
Sedimentation rate (85651) $170
Semen analysis complete (89320) $330
Semen analysis sperm presence&/motility sprm (89321) $115
Sensitivity mic (87186) $165
Serotonin Release Assay (86022) $380
Sex hormone binding globulin (84270) $155
Sickle cell screen (85660) $220
Sirolimus (rapamycin) (80195) $585
Smear acid fast (87206) $140
Smear complex stain (87209) $185
Smear gram stain (87205) $150
Sodium (84295) $150
Sodium other source (84302) $150
Sodium urine (84300) $150
Soluble transferrin receptor (84238) $185
Somatostatin (84307) $895
Spcl Stn 2 I&R Excpt Microorg/Enzyme/Imcyt (88313) $90
Special stains group 1 (88312) $240
Spectrophotometry (84311) $100
Staph aureus amplified probe (87640) $105
Stool Cultr Aerobic Bact Ea (87046) $140
Strep b DNA amp probe (87653) $105
Sugars single quant (84378) $760
Surg path level iii (88304) $180
Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I (88300) $55
Surgical pathology level IV (88305) $180
T Cells Absolute Cd4&Cd8 Count Ratio (86360) $500
T cells, total count (86359) $330
T3 free (84481) $255
T3 reverse (84482) $125
T3 total (84480) $250
T3 uptake (84479) $155
T4 Free (84439) $225
T4 total (84436) $130
Tb intradermal test (86580) $100
Test for acetone/ketones (82009) $65
Testosterone free (84402) $170
Testosterone total (84403) $347.50
Tetanus antibody (86774) $330
Theophylline (80198) $310
Thin prep pap (88142) $105
Thrombin time plasma (85670) $360
Thyroglobulin (84432) $225
Thyroglobulin Ab (86800) $225
Thyroid Stimulating Immunoglobulin (84445) $330
Thyroxine binding globulin (84442) $55
Tiagabine (80199) $480
Tissue culture bone marrow (88237) $2,135
Tissue Culture Lymphocyte (88230) $1,170
Tobramycin peak (80200) $330
Topiramate (80201) $430
Toxoplasma ab igm (86778) $360
Toxoplasma antibody igg (86777) $270
Tpmt gene com variants (81335) $140
Transferrin (84466) $220
Triglycerides (84478) $185
Troponin (84484) $305
Urea nitrogen (84520) $155
Urea Nitrogen Clearance (84545) $225
Urea nitrogen urine (84540) $155
Uric acid blood (84550) $205
Uric acid other source (84560) $155
Urinalysis microscopic only (81015) $100
Urinalysis w/microscopic (81001) $120
Urine pregnancy test (81025) $200
Urine volume measurement (81050) $55
Urnls dip stick/tablet rgnt auto w/o microscopy (81003) $115
Valproic acid level (80164) $330
Vancomycin trough (80202) $380
Varicella-zoster antibody (86787) $285
Vasoactive intestinal peptide (vip) (84586) $480
Vasopressin (84588) $235
Vdrl csf (86592) $150
Virus antibody nos (86790) $330
Vitamin A (84590) $410
Vitamin b-12 (82607) $200
Vitamin b-2 (riboflavin) (84252) $670
Vitamin b1 (thiamine) (84425) $330
Vitamin b6 (84207) $230
Vitamin C (82180) $225
Vitamin D 25-Hydroxy (82306) $200
Vitamin e serum (84446) $285
Vkorc1 gene (81355) $25
Von willebrand factor activity (85245) $320
Wbc Alkaline Phosphatase - Leukocyte Alkaline Phosphatase (85540) $270
West nile virus antibody (86789) $500
Zinc (84630) $225