| Acute hepatitis panel (80074) |
— |
$270 |
— |
| Albumin serum (82040) |
— |
$27 |
— |
| Aldolase (82085) |
— |
$36 |
— |
| Aldosterone urine (82088) |
— |
$109 |
— |
| Alkaline phosphatase isoenzymes (84080) |
— |
$50 |
— |
| Alpha-Fetoprotein Serum (82105) |
— |
$34 |
— |
| Alt (sgpt) (84460) |
— |
$48 |
— |
| Ammonia (82140) |
— |
$63 |
— |
| Amylase urine (82150) |
— |
$59.50 |
— |
| Anti-Phospholipid Antibody (86148) |
— |
$87.76 |
— |
| Antibody Borrelia Burgdorferi Confirmatory Tst (86617) |
— |
$160 |
— |
| Antibody Epstein-Barr Eb Virus Early Antigen Ea (86663) |
— |
$106 |
— |
| Antibody Epstein-Barr Eb Virus Nuclear Ag Ebna (86664) |
— |
$104 |
— |
| Antibody Epstein-Barr Eb Virus Viral Capsid Vca (86665) |
— |
$104 |
— |
| Antibody helicobacter pylori (86677) |
— |
$45 |
— |
| Antibody HIV-1&HIV-2 single result (86703) |
— |
$60 |
— |
| Antibody Protozoa Nes (86753) |
— |
$76.51 |
— |
| Antibody Titer (86886) |
— |
$45 |
— |
| Antigen typing (86905) |
— |
$12 |
— |
| Antihuman Globulin Indir Qual Ea Reagent Cell (86885) |
— |
$41 |
— |
| Antinuclear antibodies (86038) |
— |
$85 |
— |
| Antistreptolysin O Screen (86063) |
— |
$16 |
— |
| Antistreptolysin o titer (86060) |
— |
$18 |
— |
| Antithrombin iii activity (85300) |
— |
$154 |
— |
| Assay Blood Carbon Dioxide (82374) |
— |
$30 |
— |
| Assay Nephelometry Not Spec (83883) |
— |
$132.50 |
— |
| Assay of blood/uric acid (84550) |
— |
$57 |
— |
| Assay of gammaglobulin igm (82784) |
— |
$210 |
— |
| Assay of lactic acid (83605) |
— |
$114 |
— |
| Assay of metanephrines (83835) |
— |
$70 |
— |
| Assay of serotonin (84260) |
— |
$207 |
— |
| Assay of serum potassium (84132) |
— |
$30 |
— |
| Assay of urea nitrogen (84520) |
— |
$50 |
— |
| Assay of urine vma (84585) |
— |
$62 |
— |
| Assay of vitamin b-1 (84425) |
— |
$175 |
— |
| Autol Bld/Component Collj Storage Predeposited (86890) |
— |
$53 |
— |
| Automated Leukocyte Count (85048) |
— |
$15 |
— |
| Bilirubin direct (82248) |
— |
$67 |
— |
| Bilirubin total (82247) |
— |
$30 |
— |
| Bld Typing Serologic Rh Phnt (86906) |
— |
$48 |
— |
| Blood Count Red Blood Cell Automated (85041) |
— |
$14 |
— |
| Blood Count Smear Mcrscp W/Mnl Difrntl Wbc Count (85007) |
— |
$27 |
— |
| Blood gas (82803) |
— |
$147.50 |
— |
| Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) |
— |
$150 |
— |
| Blood Type Antigen Donor Reagent Serum Each (86902) |
— |
$250 |
— |
| Blood Typing Antigen Screen Patient Serum/Unit (86904) |
— |
$36 |
— |
| Blood typing serologic abo (86900) |
— |
$71 |
— |
| Body fluid cell count (89050) |
— |
$12 |
— |
| Bone marrow smear interpretation (85097) |
— |
$410 |
— |
| Bordetella antibody (86615) |
— |
$244 |
— |
| C diff amplified probe (87493) |
— |
$167 |
— |
| C-Peptide (84681) |
— |
$74 |
— |
| C-reactive protein (86140) |
— |
$90 |
— |
| Ca 19-9 (86301) |
— |
$45.70 |
— |
| Calcium total (82310) |
— |
$51 |
— |
| Calprotectin Fecal (83993) |
— |
$455 |
— |
| Cancer Antigen 125 (86304) |
— |
$165 |
— |
| Cancer Antigen 27.29 (86300) |
— |
$179.15 |
— |
| Candida Dna Dir Probe (87480) |
— |
$105 |
— |
| Carbamazepine total (80156) |
— |
$48 |
— |
| Carboxyhemoglobin (82375) |
— |
$46 |
— |
| Carcinoembryonic antigen (82378) |
— |
$86.23 |
— |
| Carotene (82380) |
— |
$54 |
— |
| Catecholamines fractionated (82384) |
— |
$81 |
— |
| Cell count csf (89051) |
— |
$121 |
— |
| Chloride Serum (82435) |
— |
$30 |
— |
| Chloride urine (82436) |
— |
$33 |
— |
| Cholesterol total (82465) |
— |
$60 |
— |
| Cholinesterase Serum (82480) |
— |
$52 |
— |
| Chorionic gonadotropin test (84702) |
— |
$107 |
— |
| Chromium serum (82495) |
— |
$68 |
— |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) |
— |
$116 |
— |
| Ckmb (82553) |
— |
$329 |
— |
| Clot lysis time, whole blood dilution Facility (85175) |
— |
$11 |
— |
| Cold agglutinin titer (86157) |
— |
$72 |
— |
| Column Chromotography Quant (82542) |
— |
$314.59 |
— |
| Compatibility test antiglob (86922) |
— |
$177 |
— |
| Complement Antigen Each Component (86160) |
— |
$49 |
— |
| Complement Total (Ch50) (86162) |
— |
$168 |
— |
| Coombs direct (86880) |
— |
$36 |
— |
| Copper urine (82525) |
— |
$46 |
— |
| Cortisol saliva (82533) |
— |
$84 |
— |
| Creatine kinase total (82550) |
— |
$63 |
— |
| Creatinine blood (82565) |
— |
$55 |
— |
| Creatinine clearance (82575) |
— |
$25 |
— |
| Creatinine Urine (82570) |
— |
$72 |
— |
| Crossmatch immediate spin (86920) |
— |
$20 |
— |
Cul Bact Aerobic Addl Meths Definitive Ea Isol (87077)
range across 2 matching MRF lines |
— |
$50–$84 |
— |
| Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) |
— |
$60 |
— |
| Cul fngi mold/yeast prsmptv id skn hair/nail (87101) |
— |
$25 |
— |
| Culture afb (87116) |
— |
$61 |
— |
| Culture Anaerobic (87075) |
— |
$90 |
— |
| Culture bacteria anaerobic (87073) |
— |
$131 |
— |
| Culture blood (87040) |
— |
$190 |
— |
| Culture chlamydia (87110) |
— |
$34 |
— |
Culture csf (87070)
range across 2 matching MRF lines |
— |
$22.50–$67 |
— |
| Culture fungus (87102) |
— |
$135 |
— |
| Culture screen only (87081) |
— |
$26 |
— |
| Culture stool (87045) |
— |
$120 |
— |
| Culture urine (87086) |
— |
$97 |
— |
| Cyclosporine (80158) |
— |
$140 |
— |
| Cytopath Cell Enhance Tech (88112) |
— |
$170 |
— |
| Cytp Concentration Smears & Interpretation (88108) |
— |
$180 |
— |
| Cytp Flu Washgs/Brushings Xcpt C/V Smrs Interpj (88104) |
— |
$125 |
— |
| Cytp Slides C/V Mnl Scr Under Phys (88150) |
— |
$17 |
— |
| Detect Agent Nos Dna Amp (87798) |
— |
$193 |
— |
| Dhea (82626) |
— |
$175 |
— |
| Dhea-S (82627) |
— |
$171 |
— |
| Digoxin (80162) |
— |
$118 |
— |
| Dna Antibody Native/Double Stranded (86225) |
— |
$58 |
— |
| Drug Screen Quantitative Lamotrigine (80175) |
— |
$163.80 |
— |
| Drug Screen Quantitative Levetiracetam (80177) |
— |
$208 |
— |
| Drug Screen Quantitative Procainamide Metabolite (80192) |
— |
$43 |
— |
| Drug Test Prsmv Dir Opt Obs (80305) |
— |
$132 |
— |
| Ehrlichia antibody (86666) |
— |
$312.19 |
— |
| Electrolyte panel (80051) |
— |
$130 |
— |
| Erythropoietin (82668) |
— |
$175.83 |
— |
| Estradiol serum (82670) |
— |
$175 |
— |
| Estriol (82677) |
— |
$69 |
— |
| F2 Gene (81240) |
— |
$332 |
— |
| Factor v leiden mutation (81241) |
— |
$312 |
— |
| Factor viii assay (85240) |
— |
$77 |
— |
| Fat/Lipids Feces Quantitative (82710) |
— |
$94 |
— |
| Ferritin (82728) |
— |
$86 |
— |
| Fibrin Degradation Quant (85379) |
— |
$312 |
— |
| Fibrinogen activity (85384) |
— |
$95 |
— |
| Fluorescent antibody screen (86255) |
— |
$58 |
— |
| Folic Acid Serum (82746) |
— |
$36 |
— |
| Follicle Stimulating Hormone (83001) |
— |
$69 |
— |
| Francisella tularensis (86668) |
— |
$191 |
— |
| Fresh Frozen Plasma Thawing Each Unit (86927) |
— |
$50 |
— |
| Fungi Identification Yeast (87106) |
— |
$17 |
— |
| Gammaglobulin ige (82785) |
— |
$119 |
— |
| Gardner vag DNA dir probe (87510) |
— |
$105 |
— |
| Gases blood ph only (82800) |
— |
$68 |
— |
| Gastrin (82941) |
— |
$64 |
— |
| Gastrointestinal pathogen panel by PCR (12 to 25 targets) (87507) |
— |
$1,023.21 |
— |
| Gentamicin (80170) |
— |
$125 |
— |
| Ggt (82977) |
— |
$16 |
— |
| Giardia antigen (87329) |
— |
$118 |
— |
| Glucose Blood Test (82962) |
— |
$40 |
— |
| Glucose Serum (82947) |
— |
$51 |
— |
| Glucose tolerance test (gtt) (82951) |
— |
$73 |
— |
| Gonadotropin Chorionic Qualitative (84703) |
— |
$60 |
— |
| Gtt-added samples (82952) |
— |
$20 |
— |
| Haptoglobin (83010) |
— |
$54 |
— |
| Hdl Cholesterol (83718) |
— |
$40 |
— |
| Helicobacter Pylori Stool (87338) |
— |
$203.75 |
— |
| Hemagglutination Inhibition (86280) |
— |
$40 |
— |
| Hematocrit (85014) |
— |
$36 |
— |
| Hemoglobin (85018) |
— |
$35 |
— |
| Hemoglobin a1c (83036) |
— |
$85 |
— |
| Heparin assay (85520) |
— |
$105 |
— |
| Hepatitis b core ab igm (86705) |
— |
$44.50 |
— |
| Hepatitis b core ab total (86704) |
— |
$95 |
— |
| Hepatitis B Surface Antibody (86706) |
— |
$100 |
— |
| Hepatitis B Surface Antigen (87340) |
— |
$90 |
— |
| Hepatitis C Antibody (86803) |
— |
$100 |
— |
| Hepatitis C Revrs Trnscrpj (87522) |
— |
$481 |
— |
| Heterophile Antibody Screen (86308) |
— |
$35 |
— |
| Hgb/Rbcs Fetal Fetomaternal Hemrrg Difrntl Lysis (85460) |
— |
$101 |
— |
| Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab (87389) |
— |
$99.80 |
— |
| Hsv Dna Amp Probe (87529) |
— |
$228.56 |
— |
| Human Epididymis Protein 4 (86305) |
— |
$30 |
— |
| Hydroxyproline total (83505) |
— |
$65 |
— |
| Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) |
— |
$204 |
— |
| Iaad ia shiga-like toxin (87427) |
— |
$94 |
— |
| Iaad Ia Streptococcus Group A (87430) |
— |
$26 |
— |
| Iadna anaplasma phagocytophilum amplifed prb tq (87468) |
— |
$95 |
— |
| Iadna ehrlichia chaffeensis amplified probe tq (87484) |
— |
$105 |
— |
| Iadna Neisseria Gonorrhoeae Amplified Probe Tq (87591) |
— |
$116 |
— |
| Immunoassay Infectious Agent Antibody Quan Nos (86317) |
— |
$59 |
— |
| Immunoassay nonantibody (83516) |
— |
$90 |
— |
| Immunoelectrophoresis Other Fluids Concentration (86325) |
— |
$68 |
— |
| Immunoelectrophoresis Serum (86320) |
— |
$68 |
— |
| Immunofixation electrophoresis (86334) |
— |
$155 |
— |
| Immunofluorescence per spec 1st singl antb stain (88346) |
— |
$225 |
— |
| Immunohistochemistry (88342) |
— |
$250 |
— |
| In situ hybridization 1st probe stain (88365) |
— |
$400 |
— |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile… (87803) |
— |
$86 |
— |
| Influenza a/b ag eia (87400) |
— |
$68.75 |
— |
| Influenza assay w/optic (87804) |
— |
$47.50 |
— |
| Inhibin b (83520) |
— |
$187 |
— |
| Insulin antibodies (86337) |
— |
$237 |
— |
| Insulin total (83525) |
— |
$71 |
— |
| Iron (83540) |
— |
$62 |
— |
| Iron Binding Capacity (83550) |
— |
$72 |
— |
| Irradiation Blood Product Each Unit (86945) |
— |
$16 |
— |
| Islet cell antibody (86341) |
— |
$175 |
— |
| Jak2 gene analysis p.val617phe variant (81270) |
— |
$409 |
— |
| Kit Gene Analysis D816 Variant(S) (81273) |
— |
$771.75 |
— |
| Koh Prep (87220) |
— |
$28 |
— |
| L/s ratio (83661) |
— |
$74 |
— |
| Lactate (ld) (ldh) enzyme (83615) |
— |
$64 |
— |
| Ldh Isoenzymes (83625) |
— |
$60 |
— |
| LDL direct (83721) |
— |
$37 |
— |
| Lead (83655) |
— |
$80 |
— |
| Level I Surg Pathology Gross Examination Only (88300) |
— |
$90 |
— |
| Level ii surg pathology grossµscopic exam (88302) |
— |
$90 |
— |
| Level V Surg Pathology Gross&Microscopic Exam (88307) |
— |
$560 |
— |
| Lipase (83690) |
— |
$24 |
— |
| Lipoprotein Blood Electrophorectic Sep&Quan (83700) |
— |
$195 |
— |
| Lipoprotein, direct measurement; VLDL cholesterol Facility (83719) |
— |
$35 |
— |
| Lithium (80178) |
— |
$87 |
— |
| Luteinizing Hormone (Lh) (83002) |
— |
$115 |
— |
| Lyme disease antibody (86618) |
— |
$172 |
— |
| Magnesium Urine (83735) |
— |
$79 |
— |
| Microalbumin, quantitative (82043) |
— |
$75 |
— |
| Microsomal Antibodies Each (86376) |
— |
$114 |
— |
| Mrsa Pcr (87641) |
— |
$118 |
— |
| Mthfr Gene Analysis Common Variants (81291) |
— |
$220 |
— |
| Mumps antibody (86735) |
— |
$103 |
— |
| Mycoplasma culture (87109) |
— |
$12 |
— |
| Myoglobin urine (83874) |
— |
$220 |
— |
| Natriuretic peptide (83880) |
— |
$178 |
— |
| Nuclear antigen antibody (86235) |
— |
$26 |
— |
| Occult blood feces (82272) |
— |
$37 |
— |
| Osmolality serum (83930) |
— |
$29 |
— |
| Osmolality Urine (83935) |
— |
$26 |
— |
| Ova and parasites smears (87177) |
— |
$90 |
— |
| Pancreatic Elastase Fecal (82656) |
— |
$298 |
— |
| Parvovirus antibody (86747) |
— |
$115 |
— |
| Phenylalanine (84030) |
— |
$17 |
— |
| Phenytoin (Dilantin) (80185) |
— |
$125 |
— |
| Phosphatase acid prostatic (84066) |
— |
$27 |
— |
| Phosphatase alkaline (84075) |
— |
$50 |
— |
| Phosphorus Serum (84100) |
— |
$56 |
— |
| Platelet count automated (85049) |
— |
$25 |
— |
| Potassium Urine (84133) |
— |
$33 |
— |
| Prealbumin (84134) |
— |
$35 |
— |
| Procalcitonin (Pct) (84145) |
— |
$233.65 |
— |
| Progesterone (84144) |
— |
$83 |
— |
| Prolactin (84146) |
— |
$53 |
— |
| Protein C Activity (85303) |
— |
$200 |
— |
| Protein Electrophoretic Fractj&Quantj Serum (84165) |
— |
$43 |
— |
| Protein S Free (85306) |
— |
$237 |
— |
| Protein s total (85305) |
— |
$263 |
— |
| Protein total serum (84155) |
— |
$29 |
— |
| Protein Total Urine (84156) |
— |
$23 |
— |
| Pth Intact (83970) |
— |
$235 |
— |
| Q Fever Antibody (86638) |
— |
$111.54 |
— |
| Quantiferon tb gold plus (86480) |
— |
$203 |
— |
| Quinine (84228) |
— |
$37 |
— |
| Rbc antibody identification (86870) |
— |
$118 |
— |
| Rbc pretreatment serum (86978) |
— |
$65 |
— |
| Reagent Strip/Blood Glucose (82948) |
— |
$23 |
— |
| Renin activity plasma (84244) |
— |
$90 |
— |
| Resp virus 12-25 targets (87633) |
— |
$612 |
— |
| Reticulocyte Count Manual (85044) |
— |
$55 |
— |
| Rh (86901) |
— |
$34 |
— |
| Rheumatoid Factor Qualitative (86430) |
— |
$18 |
— |
| Rheumatoid factor quant (86431) |
— |
$65 |
— |
| Rickettsia antibody (86757) |
— |
$108 |
— |
| Rpr qualitative (86592) |
— |
$21 |
— |
| Rubella Antibody (86762) |
— |
$18 |
— |
| Rubeola antibody (86765) |
— |
$108 |
— |
| Sars-Cov-2 Covid-19 Amp Prb (87635) |
— |
$208 |
— |
| Sars-cov-2 COVID-19 antibody (86769) |
— |
$65 |
— |
| Sars-Cov-2 Covid19 W/Optic (87811) |
— |
$86 |
— |
| Sarscov2 & inf a&b amp prb (87636) |
— |
$182 |
— |
| Sarscov2&inf a&b&rsv amp prb (87637) |
— |
$420 |
— |
| Sedimentation rate (85651) |
— |
$52 |
— |
| Selenium (84255) |
— |
$154 |
— |
| Semen analysis motility and count (89310) |
— |
$68 |
— |
| Semen analysis; presence and/or motility of sperm including Huhner test (post coital) Facility (89300) |
— |
$32 |
— |
| Sensitivity mic (87186) |
— |
$93 |
— |
| Sex Hormone Binding Globulin (84270) |
— |
$178.65 |
— |
| Skin test tuberculosis intradermal (86580) |
— |
$55 |
— |
| Smear gram stain (87205) |
— |
$75 |
— |
| Smr Prim Src Wet Mount Nfct Agt (87210) |
— |
$21 |
— |
| Sodium Serum (84295) |
— |
$33 |
— |
| Sodium Urine (84300) |
— |
$33 |
— |
| Special Stains Group 1 (88312) |
— |
$250 |
— |
| Special Stains Group 2 (88313) |
— |
$200 |
— |
| Spectrophotometry (84311) |
— |
$268 |
— |
| Staph a DNA amp probe (87640) |
— |
$118 |
— |
| Stone Analysis (82355) |
— |
$56 |
— |
| Stool cultr aerobic bact ea (87046) |
— |
$71 |
— |
| Strep a assay w/optic (87880) |
— |
$86 |
— |
| Surg path level iii (88304) |
— |
$185 |
— |
Surgical pathology level IV (88305)
range across 2 matching MRF lines |
— |
$75–$400 |
— |
| Surgical pathology level vi (88309) |
— |
$775 |
— |
| Susceptibility Study Antimicrobial Disk Method (87184) |
— |
$65 |
— |
| Susceptiblty Stdy Antmcrb Mycobact Proporj Mthd (87190) |
— |
$2 |
— |
| T3 Free (84481) |
— |
$85 |
— |
| T3 reverse (84482) |
— |
$170 |
— |
| T3 Total (84480) |
— |
$106 |
— |
| T3 Uptake (84479) |
— |
$85 |
— |
| T4 Free (84439) |
— |
$49 |
— |
| T4 total (84436) |
— |
$64 |
— |
| Testosterone total (84403) |
— |
$141 |
— |
| Theophylline (80198) |
— |
$68 |
— |
| Thyroglobulin (84432) |
— |
$137 |
— |
| Thyroglobulin Antibody (86800) |
— |
$109 |
— |
| Thyroid Stimulating Immunoglobulin (84445) |
— |
$282 |
— |
| Tiss Trnsgltmnase Ea Ig Clas (86364) |
— |
$123 |
— |
| Tobramycin peak (80200) |
— |
$60 |
— |
| Topiramate (80201) |
— |
$87 |
— |
| Toxin/Antitoxin Assay Tissue Culture (87230) |
— |
$468 |
— |
| Transferase Aspartate Amino Ast Sgot (84450) |
— |
$61 |
— |
| Transferrin (84466) |
— |
$108 |
— |
| Trichomonas vagin dir probe (87660) |
— |
$105 |
— |
| Triglycerides (84478) |
— |
$32 |
— |
| Troponin Quant (84484) |
— |
$186 |
— |
| Tumor immunohistochem/comput (88361) |
— |
$350 |
— |
| Tumor Immunohistochem/Manual (88360) |
— |
$250 |
— |
| Unlisted Surgical Pathology Procedure (88399) |
— |
$21 |
— |
| Unlisted Transfusion Medicine Procedure (86999) |
— |
$125 |
— |
| Urinalysis Microscopic Only (81015) |
— |
$28 |
— |
| Urinalysis Volume Measure (81050) |
— |
$32 |
— |
| Urine Bacteria Culture (87088) |
— |
$110 |
— |
| Urine Pregnancy Test (81025) |
— |
$41 |
— |
| Urnls Dip Stick/Tablet Reagent Auto Microscopy (81001) |
— |
$42 |
— |
| Valproic acid (80164) |
— |
$100 |
— |
| Vancomycin (80202) |
— |
$200 |
— |
| Varicella-zoster antibody (86787) |
— |
$35 |
— |
| Vasopressin (84588) |
— |
$148 |
— |
| Viral Culture (87252) |
— |
$49 |
— |
| Virus antibody nos (86790) |
— |
$65 |
— |
| Vit D 1 25-Dihydroxy (82652) |
— |
$208.50 |
— |
| Vitamin b-12 (82607) |
— |
$83 |
— |
| Vitamin D 25-Hydroxy (82306) |
— |
$313 |
— |
| Vitamin E (84446) |
— |
$176 |
— |
West nile virus ab igm (86788)
range across 2 matching MRF lines |
— |
$37–$120 |
— |
West Nile Virus Antibody (86789)
range across 2 matching MRF lines |
— |
$37–$120 |
— |
| Zinc (84630) |
— |
$53 |
— |