Lab & pathology prices at Mount Graham Regional Medical Center

Safford, AZ · every code in this section with a posted price and a Medicare benchmark.

425 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) $357
5 Hiaa (83497) $119
Acth stimulation panel adrenal (80400) $151
Acute hepatitis panel (80074) $289
Acylcarnitine Plasma (82017) $223
Additional high resolution study (88289) $236
Albumin Fluid (82042) $82
Albumin serum (82040) $46
Aldolase (82085) $91
Aldosterone urine (82088) $411
Alkaline phosphatase isoenzymes (84080) $122
Allerg sp igg quan or semiquan (86001) $43
Allergen specific ige (86003) $1,680
Allergen specific ige; qualitative, multiallergen screen (86005) $133
Alpha-1-antitrypsin phenotype (82104) $147
Alpha-1-antitrypsin, total (82103) $181.50
Alpha-Fetoprotein L3 (82107) $134.98
Alpha-fetoprotein, serum (82105) $149
Alt (sgpt) (84460) $54
Amino acids 6/> amino acids quantitative ea spe (82139) $258
Ammonia (82140) $312
Amylase urine (82150) $218
Ana Titer (86039) $104
Angiotensin i enzyme test (82164) $130
Antibody aspergillus (86606) $83
Antibody cytomegalovirus cmv (86644) $112
Antibody cytomegalovirus cmv igm (86645) $129
Antibody herpes smplx type 1 (86695) $104
Antibody HIV-2 (86702) $89
Antibody identification (86870) $622
Antibody identification leukocyte antibodies (86021) $332
Antibody mumps (86735) $157.50
Antibody rubeola (86765) $142.50
Antibody screen (86850) $312.50
Antibody treponema pallidum (86780) $86
Antibody; Coccidioides (86635) $106.50
Antigen typing (86905) $869
Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) $256
Antinuclear antibodies (86038) $181.50
Antistreptolysin o titer (86060) $78
Antithrombin iii activity (85300) $173
Apolipoprotein b (82172) $172.50
Arsenic Urine (82175) $121
Assay Lipoprotein Pla2 (83698) $191
Assay Nephelometry Not Spec (83883) $199.50
Assay of acth (82024) $263
Assay of c-peptide (84681) $153
Assay of calcitonin (82308) $219
Assay of ceruloplasmin (82390) $102
Assay of cyclosporine (80158) $166
Assay of erythropoietin (82668) $169
Assay of ferritin (82728) $186
Assay of g6pd enzyme (82955) $111
Assay of gammaglobulin igm (82784) $222.50
Assay of gastrin (82941) $174.50
Assay of glucagon (82943) $131
Assay of homocystine (83090) $172
Assay of lipoprotein(a) (83695) $84
Assay of manganese (83785) $103
Assay of metanephrines (83835) $300
Assay of parathormone (83970) $252
Assay of prealbumin (84134) $110
Assay of proinsulin (84206) $188
Assay of serotonin (84260) $218
Assay of somatomedin (84305) $161
Assay of tacrolimus (80197) $404
Assay of vitamin k (84597) $208
Assay Ph Body Fluid Nos (83986) $47
Ast (sgot) (84450) $54
Bcr/abl1 gene major bp (81206) $1,208
Bcr/abl1 gene minor bp (81207) $472
Beta 2 Glycoprotein I Antibody,Ea (86146) $458.50
Beta hydroxybutyrate (82010) $180
Beta-2 microglobulin (82232) $141
Bile acids, total (82239) $116
Bilirubin direct (82248) $60
Bilirubin total (82247) $93.50
Bl Smear W/Diff Wbc Count (85007) $48
Bleeding time (85002) $107
Blood count reticulocyte automated (85045) $70
Blood gases (82803) $735
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $10
Blood typing abo (86900) $121.50
Blood typing serologic rh (d) (86901) $103.50
Blood typing serologic rh phenotyping complete (86906) $144
Body fluid cell count (89051) $127
Body fluid cell count (89050) $102
Bone Marrow Smear Interpretation (85097) $633
Bordetella antibody (86615) $220
Breath Alcohol Test (82075) $35
C-reactive protein (86140) $82
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $115
Ca 125 (86304) $167
Ca 19-9 (86301) $155
Ca 27 29 (86300) $243
Calcium ionized (82330) $178.50
Calcium total (82310) $52
Calcium urine (82340) $67
Calprotectin, fecal (83993) $277
Candida antibody (86628) $297
Candida DNA dir probe (87480) $84
Carbamazepine (tegretol) total (80156) $151
Carbamazepine free (80157) $106.18
Carcinoembryonic antigen (82378) $175
Cardiolipin ab igg (86147) $444
Carnitine (82379) $127
Carotene (82380) $88
Catecholamines fraction plasma (82384) $197
Catecholamines Total Urine (82382) $175
Cd4 absolute count (86361) $191
Chemiluminescent assay (82397) $175
Cholesterol total (82465) $52
Chorionic gonadotropin stimulation panel; estradiol response This panel must include the following: Estradiol, total… (80415) $187
Chorionic gonadotropin stimulation panel; testosterone response This panel must include the following: Testosterone… (80414) $170
Chrmsm count 15-20 cll 2karyotyp banding (88262) $859
Chromogranin a (86316) $167
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $159
Citrate (82507) $168
Ck isoenzymes (82552) $127
Clot factor viii vw antigen (85246) $202
Cns DNA amp probe type 12-25 (87483) $829
Coagulation time activated (85347) $22.66
Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) $172
Collagen cross links (82523) $167
Compatibility test antiglob (86922) $378
Complement c3 (86160) $333
Complement total ch50 (86162) $168
Concentration Infectious Agent (87015) $63
Coombs direct (86880) $72
Coombs Test Indirect Qual (86885) $393
Copper urine (82525) $153
Cortisol free (82530) $216
Cortisol total (82533) $302
Creatine kinase total (82550) $232.50
Creatinine blood (82565) $58
Creatinine other source (82570) $124
Crossmatch immediate spin (86920) $651
Culture Aerobic Identify (87077) $187.50
Culture anaerobic (87075) $330
Culture blood (87040) $455
Culture fungus id yeast (87106) $102
Culture fungus other (87102) $147
Culture genital (87070) $270
Culture screen only (87081) $120
Culture stool (87045) $127
Culture urine id ea isolate (87088) $117
Cyclic Citrullinated Peptide (86200) $122
Cystatin c (82610) $134
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $354
Cytopath Fl Nongyn Smears - Lab Cytopath Fluids,Smear,Interp (88104) $156
Cytp c/v auto thin lyr prepj scr mnl rescr phys (88175) $119
Cytp Eval Fine Needle Aspirate Interp & Report (88173) $373.50
Cytp fna eval dx 1st each site (88172) $318
D-Dimer (85379) $164
Deoxyribonuclease antibody (86215) $93
Detect agent nos DNA dir (87797) $119
Detect Agent, Mult Orgs, Dna, Dir (87800) $203
Dhea sulfate (82627) $146
Digoxin (80162) $136
Dilantin (80185) $145
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $207
Drug assay vedolizumab (80280) $224.62
Drug screen quant zonisamide (80203) $152
Drug Screen Quantitative Lamotrigine (80175) $129
Drug Scrn Quan Levetiracetam (80177) $158
Drug test prsmv chem anlyzr (80307) $1,718.28
Drug Test Prsmv Dir Opt Obs (80305) $161
Ebv viral capsid (86665) $238
Electrolyte panel (80051) $85
Endomysial antibody iga (86255) $234
Enterovirus antibody (86658) $378
Eosinophil count (85048) $41
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $108
Estradiol (82670) $187
Estriol (82677) $184.50
Estrone (82679) $146
Eval c/v amniotic fluid protein qual ea specimen (84112) $2,620.01
Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) $132
Examination of archival tissue for genetic analysis (88363) $155.64
F2 gene analysis 20210g >a variant (81240) $310
F5 gene (81241) $337
Factor v activity (85220) $210
Factor viii ahg (85240) $292.50
Fecal fat qual (82705) $81.70
Fecal fat quant (82710) $74
Fetal bleed screen (85461) $115
Fibrinogen activity (85384) $236
Fibrinolysins/Coagulopathy Screen Interp&Repor (85390) $83.36
Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) $136
Folate serum (82746) $137
Folic acid rbc (82747) $167
Follicle Stimulating Hormone (83001) $151
Fresh frozen plasma thawing each unit (86927) $241.50
Fructosamine (82985) $102
Gammaglobulin ige (82785) $189
Gardner vag DNA dir probe (87510) $85
Gastric Occult Blood (82271) $58
Ggt (82977) $71
Giardia ag by if (87269) $80
Giardia antigen eia stool (87329) $95
Glucose (82947) $72
Glucose Blood Test (82962) $336
Glucose body fluid (82945) $74
Glucose post dose (82950) $64
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $156
Glycosylated hb home device (83037) $37.76
Growth hormone (83003) $116
Haptoglobin (83010) $117
Hcg qualitative (84703) $352
Hcg quant (84702) $255
Hdl Cholesterol (83718) $55
Hematocrit (85014) $120
Hemoglobin (85018) $117
Hemoglobin a1c (83036) $190
Hemoglobin Chromotography - Hemoglobinopathy Eval (83021) $116
Hepatitis a antibody total (86708) $116
Hepatitis a igm (86709) $109
Hepatitis b core ab igm (86705) $103
Hepatitis b core antibody total (86704) $106
Hepatitis B Surface Ab (86706) $107
Hepatitis B Surface Antigen (87340) $106
Hepatitis be antibody (86707) $89
Hepatitis Be Antigen (87350) $91
Hepatitis c antibody (86803) $134
Hepatitis C Genotype (87902) $872
Hepatitis delta ab (86692) $176
Herpes simplex type 2 (86696) $118
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $84
Hfe gene (81256) $447
Histamine plasma (83088) $297
Hla class i typing high resolution one allele or allele group (81381) $400
Hla-b27 (86812) $189
Hpv types 16 & 18 only (87625) $116
Hpylori Breath Anal Urease Act Non-Radact Istope (83013) $264
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $630
Human epididymis protein 4 (86305) $278
Hydroxyprogesterone 17-d (83498) $166
Iaad ia clostridium difficile toxin (87324) $204
Iaad Ia Hepatitis B Surface Ag Neutralization (87341) $317
Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) $134
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $168
Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) $142
Iaad Ia Severe Aqt Respir Synd Coronavirus (87426) $116.85
Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) $45
Iadna hepatitis b virus quantification (87517) $387
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $397
Iadna herpes virus-6 quantification (87533) $465
Iadna HIV-1 amplified probe & reverse transcrpj (87535) $408
Iadna HIV-1 quant & reverse transcription (87536) $404
Iadna human papillomavirus high-risk types (87624) $161
Iadna neisseria gonorrhoeae amplified probe tq (87591) $157
Iadna nos amplified probe tq each organism (87798) $243
Iadna nos quantification each organism (87799) $414
Iadna trichomonas vaginalis amplified probe tech (87661) $146
Iadna-DNA/RNA probe tq 12-25 (87507) $708.85
Igg subclasses (82787) $240
Immunfix e-phorsis/urine/csf (86335) $188
Immunoassay nonantibody (83516) $285
Immunodiffusion Ouchterlony (86331) $86
Immunofixj Electrophoresis Serum (86334) $169
Immunoglobulin light chains free each (83521) $211.50
Immunohistochemistry (88342) $270
Influenza a/b ag eia (87400) $248
Inhibin b (83520) $247.50
Insulin antibodies (86337) $166
Insulin free (83527) $99
Insulin total (83525) $105
Iron (83540) $213.50
Islet cell antibody (86341) $633.50
Jak2 gene analysis (81270) $526
Lactic acid (83605) $462
Lactoferrin fecal qualitative (83630) $110
Ldh (83615) $140
LDL cholesterol direct (83721) $76
Lead (83655) $83
Level ii surg pathology gross&microscopic exam (88302) $318
Level v surg pathology gross&microscopic exam (88307) $1,455
Level vi surg pathology gross&microscopic exam (88309) $724
Lh (83002) $151
Lipase (83690) $232
Listeria ab (86609) $636
Lithium (80178) $86
Lyme disease antibody confirm (86617) $264
M/phmtrc alys tumor imhchem ea antibody manual (88360) $1,352
Magnesium (83735) $258
Malaria smear (87207) $87
Mass spectrometry qual/quan (83789) $159
Mercury (83825) $110
Metabolic Panel Ionized Ca (80047) $222
Methotrexate (80299) $279
Methylmalonic acid serum (83921) $197
Microalbumin urine (82043) $121.50
Microsomal antibodies (86376) $177
Molecular pathology procedure level 2 (81401) $601
Mthfr Gene Analysis Common Variants (81291) $365
Mycoplasma antibody (86738) $177
Myoglobin urine (83874) $175
Natriuretic peptide (83880) $494
Nfct agent DNA/RNA gastrointestinal pathogen (87505) $525.33
Nmr Lipoprofile (83704) $133
Nuclear antigen antibody (86235) $345
Obstetric panel (80081) $422
Occult blood stool (82272) $73.50
Oncoprotein dcp (83951) $170.66
Osmolality serum (83930) $88
Osmolality urine (83935) $86
Ova and parasite direct-id lca (87177) $100
Oxalate urine (83945) $97
Pancreatic elastase fecal (82656) $239
Pancreatic polypeptide (83519) $363
Parvovirus antibody (86747) $230
Pathology Clinical Consultation Sf Mdm 5-20 Min (80503) $100
Pbb Iaad Ia Sarscov & Influenza Virus Types a&B (87428) $286
Phosphatase alkaline (84075) $51
Phosphorus blood (84100) $189
Phosphorus urine (84105) $55
Plasminogen (85420) $126
Platelet aggregation (85576) $501.51
Platelet count (85049) $60
Potassium (84132) $81
Potassium urine (84133) $57
Pregnenolone (84140) $130
Pretx serum rbc antibody identification dilution (86976) $232
Procalcitonin (pct) (84145) $213
Progesterone (84144) $141.50
Prolactin (84146) $264
Protein body fluid (84157) $78
Protein c activity (85303) $197
Protein c antigen (85302) $190
Protein electrophoresis serum (84165) $118.43
Protein Electrophoresis Urine (84166) $129
Protein S Functional (85306) $196
Protein s total (85305) $209
Protein total by refractometry any source (84160) $31
Protein Total Serum (84155) $51
Protein urine (84156) $102
PSA free (84154) $202.50
Quantiferon tb gold (86480) $252
Rbc pretx incubatj w/chemicl (86970) $921
Reagent strip/blood glucose (82948) $32
Renin activity plasma (84244) $253.50
Respiratory viral panel PCR (87633) $1,032
Reticulocyte separation (86972) $175
Rheumatoid factor quant (86431) $106.50
Rickettsia antibody (86757) $628.42
Rpr Titer (86593) $55
Rubella antibody (86762) $102
Russell viper venom time diluted (85613) $157.50
Saccharomyces ab iga (86671) $187.50
Sarscov2&inf a&b&rsv amp prb (87637) $355.17
Sed rate automated (85652) $84
Semen analysis (89322) $182
Semen analysis sperm presence&/motility sprm (89321) $93
Sensitivity mic (87186) $251
Serotonin Release Assay (86022) $280
Serpina1 gene (81332) $286.16
Sex hormone binding globulin (84270) $166.50
Sickle cell screen (85660) $73
Sirolimus (rapamycin) (80195) $157
Skin test histoplasmosis (86510) $63
Smear gram stain (87205) $38
Sodium (84295) $64.50
Sodium urine (84300) $93
Soluble transferrin receptor (84238) $442.50
Spcl Stn 2 I&R Excpt Microorg/Enzyme/Imcyt (88313) $144
Special stains group 1 (88312) $344
Spectrophotometry (84311) $92
Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis (89260) $554
Stool Cultr Aerobic Bact Ea (87046) $65
Strep a assay w/optic (87880) $54.50
Strep b DNA amp probe (87653) $156.64
Sugars single quant (84378) $71
Sulfate urine (84392) $67.50
Surg path level iii (88304) $510
Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I (88300) $136.50
Surgical pathology level IV (88305) $1,320
T Cells Absolute Cd4&Cd8 Count Ratio (86360) $180
T cells, total count (86359) $134
T3 free (84481) $205.88
T3 reverse (84482) $165
T3 total (84480) $136.40
T3 uptake (84479) $95
T4 Free (84439) $171
T4 total (84436) $142.50
Tau phosphorylated each (84393) $375
Tb intradermal test (86580) $20
Testosterone free (84402) $170
Testosterone total (84403) $255
Thrombin time plasma (85670) $15.29
Thromboplastin time prtl substit plasma frctj ea (85732) $98
Thyroglobulin (84432) $135
Thyroglobulin Ab (86800) $171
Thyroid Stimulating Immunoglobulin (84445) $323
Thyroxine binding globulin (84442) $112
Tissue Culture Lymphocyte (88230) $651
Topiramate (80201) $138
Toxoplasma ab igm (86778) $146
Toxoplasma antibody igg (86777) $112
Transferrin (84466) $186
Trichomonas vagin dir probe (87660) $85
Triglycerides (84478) $64
Troponin (84484) $534
Urea nitrogen (84520) $82
Urea nitrogen urine (84540) $73
Uric acid blood (84550) $93
Uric acid other source (84560) $57
Urine pregnancy test (81025) $2,132.22
Urnls dip stick/tablet rgnt auto w/o microscopy (81003) $286.10
Valproic acid level (80164) $216
Vancomycin trough (80202) $259.50
Varicella-zoster antibody (86787) $166.50
Vasoactive intestinal peptide (vip) (84586) $240
Vdrl csf (86592) $67
Virus antibody nos (86790) $134
Vitamin A (84590) $101
Vitamin b-12 (82607) $202.50
Vitamin b-2 (riboflavin) (84252) $215
Vitamin b1 (thiamine) (84425) $153
Vitamin b6 (84207) $204
Vitamin C (82180) $105
Vitamin D 25-Hydroxy (82306) $295.50
Vitamin e serum (84446) $109
Von willebrand factor activity (85245) $208
West nile virus ab, igm (86788) $109
Zinc (84630) $94