Lab & pathology prices at Plains Memorial Hospital

Dimmitt, TX · every code in this section with a posted price and a Medicare benchmark.

304 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) $154 $205 4.0×
Acute hepatitis panel (80074) $229 $305 4.8×
Afb culture (87116) $55 $73 5.1×
Albumin serum (82040) $24 $32 4.8×
Aldolase (82085) $47 $62 4.8×
Aldosterone urine (82088) $195 $260 4.8×
Alpha-1-antitrypsin, total (82103) $65 $87 4.8×
Alpha-Fetoprotein L3 (82107) $249 $332 3.9×
Alpha-fetoprotein, serum (82105) $82 $109 4.9×
Alt (sgpt) (84460) $26 $35 4.9×
Ammonia (82140) $71 $95 4.9×
Amylase urine (82150) $32 $42 4.9×
Antibody helicobacter pylori (86677) $39 $52 2.3×
Antibody herpes smplx type 1 (86695) $63 $84 4.8×
Antibody identification (86870) $141 $188 0.4×
Antibody identification leukocyte antibodies (86021) $88 $117 5.8×
Antibody mumps (86735) $62 $83 4.8×
Antibody rubeola (86765) $88 $117 6.8×
Antibody screen (86850) $99 $132 10.1×
Antibody treponema pallidum (86780) $41 $54 3.1×
Antigen typing (86905) $159 $212 41.5×
Antinuclear antibodies (86038) $57.50 $76.50 4.8×
Apolipoprotein b (82172) $62 $82 2.9×
Assay myeloperoxidase (83876) $163 $217 3.2×
Assay Nephelometry Not Spec (83883) $63 $84 4.6×
Assay of acth (82024) $195 $260 5.0×
Assay of blood chloride (82435) $23 $30 5.0×
Assay of c-peptide (84681) $100 $133 4.8×
Assay of ceruloplasmin (82390) $54 $72 5.0×
Assay of cyclosporine (80158) $91 $121 5.0×
Assay of erythropoietin (82668) $90 $120 4.8×
Assay of ethosuximide (80168) $78 $104 4.8×
Assay of ferritin (82728) $67 $89 4.9×
Assay of gammaglobulin igm (82784) $45 $60 4.8×
Assay of gentamicin (80170) $79 $105 4.8×
Assay of homocystine (83090) $78 $104 4.4×
Assay of homovanillic acid (83150) $84 $112 3.7×
Assay of lipoprotein(a) (83695) $62 $83 4.3×
Assay of metanephrines (83835) $86 $114 5.1×
Assay of parathormone (83970) $165 $220 4.0×
Assay of phenobarbital (80184) $56 $74 3.7×
Assay of prealbumin (84134) $44 $58 3.0×
Assay of tacrolimus (80197) $68 $90 5.0×
Assay of urine vma (84585) $74 $99 4.8×
Assay of vitamin k (84597) $147 $196 10.7×
Assay Ph Body Fluid Nos (83986) $35 $46.50 9.8×
Ast (sgot) (84450) $26 $34 5.0×
Beta-2 microglobulin (82232) $78 $104 4.8×
Bilirubin direct (82248) $26 $34 5.2×
Bilirubin total (82247) $26 $34 5.2×
Bl Smear W/Diff Wbc Count (85007) $17 $22 4.5×
Blood count reticulocyte automated (85045) $21 $28 5.3×
Blood gases (82803) $101 $134 3.9×
Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) $77 $103 4.8×
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $17 $23 3.9×
Blood typing abo (86900) $44 $58 14.7×
Blood typing serologic rh (d) (86901) $58 $77 19.4×
Body fluid cell count (89051) $28 $37 5.0×
Breath Alcohol Test (82075) $39 $52 1.3×
C diff amplified probe (87493) $176 $234 4.7×
C-reactive protein (86140) $26 $34 5.0×
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $63 $84 4.9×
Ca 125 (86304) $101 $135 4.9×
Ca 19-9 (86301) $100 $133 4.8×
Calcium ionized (82330) $26 $34 1.9×
Calcium total (82310) $24 $32 4.7×
Calcium urine (82340) $29 $39 4.8×
Calprotectin, fecal (83993) $165 $220 8.4×
Carbamazepine (tegretol) total (80156) $71 $95 4.9×
Carbon dioxide (82374) $24 $32 4.9×
Carboxyhemoglobin Quantitative (82375) $23 $31 1.9×
Carcinoembryonic antigen (82378) $92 $123 4.9×
Catecholamines fraction plasma (82384) $121 $161 4.8×
Catecholamines Total Urine (82382) $80 $106 2.9×
Chloride urine (82436) $44 $59 7.7×
Cholesterol total (82465) $21 $28 4.8×
Chromium urine (82495) $117 $156 5.8×
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $168 $224 4.8×
Ckmb (82553) $30 $40 2.6×
Collagen cross links (82523) $236 $314 12.6×
Compatibility test antiglob (86922) $234 $312 1.4×
Complement c3 (86160) $58 $77 4.8×
Complement total ch50 (86162) $87 $116 4.3×
Coombs direct (86880) $26 $34 4.8×
Coombs Test Indirect Qual (86885) $62.50 $83.50 10.9×
Cortisol free (82530) $80 $107 4.8×
Cortisol total (82533) $77 $102 4.7×
Creatine kinase total (82550) $32 $42 4.9×
Creatinine blood (82565) $25 $33 4.9×
Creatinine clearance (82575) $48 $64 5.1×
Creatinine other source (82570) $25 $33 4.8×
Crossmatch immediate spin (86920) $305 $407 1.8×
Cryoglobulin (82595) $38 $50 5.9×
Culture Aerobic Identify (87077) $41 $54 5.1×
Culture anaerobic (87075) $44 $59 4.6×
Culture blood (87040) $50 $66 4.8×
Culture fungus other (87102) $42 $56 5.0×
Culture genital (87070) $45 $60 5.2×
Culture screen only (87081) $35 $46 5.3×
Culture stool (87045) $47 $63 5.0×
Culture Typing Immunologic Oth/Thn Immunofluores (87147) $88 $117 17.0×
Culture urine (87086) $39 $52 4.8×
Cyclic Citrullinated Peptide (86200) $141 $188 10.9×
Cyp2c19 gene com variants (81225) $512 $682 1.8×
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $268 $357 6.3×
D-Dimer (85379) $23 $31 2.3×
Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) $61 $81 3.7×
Dhea sulfate (82627) $104 $138 4.7×
Digoxin (80162) $64 $85 4.8×
Dilantin (80185) $65 $86 4.9×
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $234 $312 17.0×
Dna/Rna Amplified Probe (87150) $53 $70 1.5×
Drug screen quant zonisamide (80203) $167 $223 12.6×
Drug Screen Quantitative Lamotrigine (80175) $80 $107 6.0×
Drug Scrn Quan Levetiracetam (80177) $92 $122 6.9×
Drug scrn quant oxcarbazepin (80183) $80 $107 6.0×
Drug test prsmv chem anlyzr (80307) $188 $251 3.0×
Drug Test Prsmv Dir Opt Obs (80305) $39 $52 3.1×
Ebv viral capsid (86665) $84 $112 4.6×
Electrolyte panel (80051) $37 $49 5.3×
Electronic crossmatch (86923) $305 $407 1.8×
Enterovirus Pcr (87498) $258 $344 7.4×
Eosinophil count (85048) $13 $17 5.1×
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $71 $95 4.6×
Estradiol (82670) $137 $182 4.9×
Estriol (82677) $118 $157 4.9×
Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) $35 $46 4.8×
Fecal fat qual (82705) $32 $43 6.3×
Fibrin degradation products (85362) $347 $463 50.4×
Fibrin Degradproducts,D-Dimer, Ultrasens - D-Dimer, Rapid (85380) $63 $84 6.2×
Folate serum (82746) $77 $102 5.2×
Follicle Stimulating Hormone (83001) $89 $119 4.8×
Fresh frozen plasma thawing each unit (86927) $19 $25 0.1×
Gammaglobulin ige (82785) $77 $102 4.7×
Gastric Occult Blood (82271) $15 $20 2.8×
Ggt (82977) $35 $46 4.9×
Glucose (82947) $20 $26 5.1×
Glucose Blood Test (82962) $11 $15 3.4×
Glucose body fluid (82945) $20 $27 5.1×
Glucose post dose (82950) $23 $31 4.8×
Glucose Tolerance Ea Addl Beyond 3 Specimens (82952) $19 $25 4.8×
Haptoglobin (83010) $51 $68 4.1×
Hcg quant (84702) $42 $55.50 2.8×
Hdl Cholesterol (83718) $40 $53 4.9×
Heavy metal quant each (83018) $176 $234 8.0×
Hematocrit (85014) $11 $15 4.6×
Hemoglobin (85018) $11 $15 4.6×
Hemoglobin a1c (83036) $39.50 $52.50 4.1×
Hemoglobin Methemoglobin Quantitative (83050) $16 $21 2.0×
Hepatitis a antibody total (86708) $79 $105 6.4×
Hepatitis a igm (86709) $59 $78 5.2×
Hepatitis b core antibody total (86704) $77 $103 6.4×
Hepatitis B Surface Ab (86706) $56 $74 5.2×
Hepatitis B Surface Antigen (87340) $50 $66 4.8×
Hepatitis be antibody (86707) $47 $63 4.1×
Hepatitis Be Antigen (87350) $47 $63 4.1×
Hepatitis c antibody (86803) $74 $99 5.2×
Hepatitis C Genotype (87902) $440 $586 1.7×
Herpes culture (87252) $267 $356 10.2×
Herpes simplex type 2 (86696) $36 $48 1.9×
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $26 $34 5.0×
Hla-b27 (86812) $124 $165 4.8×
Hpylori Breath Anal Urease Act Non-Radact Istope (83013) $261 $348 3.9×
Hpylori Drug Administration (83014) $40 $53 5.1×
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $168 $224 4.8×
Hydroxyprogesterone 17-d (83498) $130 $173 4.8×
Iaad ia cryptosporidium (87328) $62 $83 4.5×
Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) $116 $154 4.8×
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $130.50 $173.50 9.1×
Iaad ia rotavirus (87425) $68 $91 5.7×
Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) $106 $141 8.8×
Iadna chlamydia pneumoniae amplified probe tq (87486) $158 $210 4.5×
Iadna Dna/Rna Rsv Amplified Probe Technique (87634) $193 $257 2.7×
Iadna hepatitis b virus quantification (87517) $261 $348 6.1×
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $197 $262 4.6×
Iadna mycoplsm pneumoniae amplified probe tq (87581) $158 $210 4.5×
Iadna neisseria gonorrhoeae amplified probe tq (87591) $168 $224 4.8×
Iadna nos amplified probe tq each organism (87798) $224.50 $299 6.4×
Iadna nos quantification each organism (87799) $307 $409 7.2×
Iadna trichomonas vaginalis amplified probe tech (87661) $129 $172 3.7×
Iadna-DNA/RNA probe tq 6-11 (87506) $493 $657 1.9×
Immunfix e-phorsis/urine/csf (86335) $156 $208 5.3×
Immunoassay nonantibody (83516) $65 $87 5.6×
Immunofixj Electrophoresis Serum (86334) $158 $211 7.1×
Influenza DNA amp prob 1+ (87501) $320 $427 6.2×
Inhibin a (86336) $30 $40 1.9×
Inhibin b (83520) $90.50 $120.50 5.2×
Insulin antibodies (86337) $95 $126 4.4×
Insulin total (83525) $59 $79 5.2×
Intrinsic factor antibody (86340) $53 $71 3.5×
Iron (83540) $33 $44 5.1×
Irradiation of blood product (86945) $150 $200 4.0×
Islet cell antibody (86341) $129 $171.50 5.5×
Lactic acid (83605) $51 $68 4.4×
Ldh (83615) $29 $38 4.8×
LDL cholesterol direct (83721) $47 $62 4.5×
Lead (83655) $58 $77 4.8×
Legionella antigen urine (87449) $67.50 $89.50 5.6×
Leukocyte Assmt Fecal Qual/Semiquantitative (89055) $20 $27 4.7×
Level ii surg pathology gross&microscopic exam (88302) $45 $60 1.2×
Level v surg pathology gross&microscopic exam (88307) $180 $240 0.5×
Lh (83002) $89 $118 4.8×
Lipase (83690) $34 $45 4.9×
Lithium (80178) $32 $42 4.8×
Lyme disease antibody (86618) $81 $108 4.8×
Magnesium (83735) $66.50 $89 9.9×
Mass spectrometry qual/quan (83789) $164 $218 6.8×
Methotrexate (80299) $76 $101 4.1×
Methylmalonic acid serum (83921) $79 $105 3.7×
Microalbumin urine (82043) $27 $36 4.7×
Microsomal antibodies (86376) $73.50 $98 5.1×
Myoglobin urine (83874) $62 $83 4.8×
Natriuretic peptide (83880) $166 $221 4.2×
Nuclear antigen antibody (86235) $305 $407 17.0×
Occult blood stool (82272) $17 $23 4.0×
Osmolality serum (83930) $25 $33 3.8×
Osmolality urine (83935) $24 $32 3.5×
Ova and parasite direct-id lca (87177) $43 $57 4.8×
Phenylalanine (84030) $125 $166 22.7×
Phosphatase alkaline (84075) $27 $36 5.2×
Phosphorus blood (84100) $23 $31 4.9×
Phosphorus urine (84105) $32 $42 5.5×
Pinworm exam (87172) $53 $70 12.4×
Platelet count (85049) $22 $29 4.9×
Potassium (84132) $23 $30 4.8×
Potassium urine (84133) $43.50 $58 9.2×
Procalcitonin (pct) (84145) $77 $102 2.8×
Progesterone (84144) $102 $136 4.9×
Prolactin (84146) $95 $126 4.9×
Protein body fluid (84157) $19 $25 4.8×
Protein c activity (85303) $49 $65 3.5×
Protein electrophoresis serum (84165) $51 $68 4.7×
Protein Electrophoresis Urine (84166) $86.50 $115 4.9×
Protein S Functional (85306) $49 $65 3.2×
Protein Total Serum (84155) $17 $23 4.6×
Protein urine (84156) $18 $24 4.9×
PSA free (84154) $88 $117 4.8×
Quantiferon tb gold (86480) $248 $330 4.0×
Renin activity plasma (84244) $105 $140 4.8×
Respiratory viral panel PCR (87633) $859 $1,145 2.1×
Rheumatoid Factor Qual (86430) $29 $39 4.7×
Rheumatoid factor quant (86431) $35 $46 6.2×
Rpr Titer (86593) $21 $28 4.8×
Rsv (87807) $52.50 $69.50 4.0×
Rubella antibody (86762) $69 $92 4.8×
Salmonella antibody (86768) $86 $115 6.5×
Sars-Cov-2 Covid-19 Amp Prb (87635) $77 $103 1.5×
Sars-cov-2 covid19 w/optic (87811) $31 $41 0.7×
Sed rate automated (85652) $18 $24 6.7×
Sedimentation rate (85651) $18 $24 4.2×
Sensitivity mic (87186) $42 $56 4.9×
Sex hormone binding globulin (84270) $51 $68 2.3×
Sickle cell screen (85660) $63 $84 11.4×
Sirolimus (rapamycin) (80195) $82 $109 6.0×
Smear acid fast (87206) $55 $73 10.2×
Smear gram stain (87205) $22 $29 5.2×
Sodium (84295) $23 $31 4.8×
Sodium urine (84300) $23 $31 4.5×
Stool Cultr Aerobic Bact Ea (87046) $21 $28 2.2×
Strep a assay w/optic (87880) $52.50 $69.50 3.2×
Strep a DNA amp probe (87651) $107.50 $143 3.1×
Surg path level iii (88304) $56 $75 1.1×
Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I (88300) $23 $30 0.8×
Surgical pathology level IV (88305) $88 $117 1.7×
T3 free (84481) $83 $110 4.9×
T3 reverse (84482) $45 $60 2.9×
T3 total (84480) $74 $98 5.2×
T3 uptake (84479) $36 $48 5.6×
T4 Free (84439) $44 $59 4.9×
T4 total (84436) $33 $44 4.8×
Tb ag response t-cell susp (86481) $239 $319 2.4×
Tb intradermal test (86580) $53 $71 1.8×
Test for acetone/ketones (82009) $37 $49 8.2×
Testosterone total (84403) $124 $165 4.8×
Theophylline (80198) $74 $98 5.2×
Thyroglobulin Ab (86800) $74 $99 4.7×
Tobramycin peak (80200) $57 $76 3.5×
Toxin or antitoxin assay (87230) $163 $217 8.3×
Transferrin (84466) $45 $60 3.5×
Triglycerides (84478) $29 $38 5.1×
Troponin (84484) $41.50 $55 3.3×
Urea nitrogen (84520) $20 $26 5.1×
Uric acid blood (84550) $23 $30 5.1×
Uric acid other source (84560) $37 $49 7.3×
Urinalysis microscopic only (81015) $16 $21 5.2×
Urinalysis w/microscopic (81001) $16 $21 5.0×
Urine microalbumin (protein) analysis (82044) $23 $30 3.7×
Urine pregnancy test (81025) $31 $41 3.6×
Urnls dip stick/tablet rgnt auto w/o microscopy (81003) $11 $15 4.9×
Valproic acid level (80164) $66 $88 4.9×
Vancomycin trough (80202) $74 $99 5.5×
Varicella-zoster antibody (86787) $48 $64 3.7×
Vasopressin (84588) $166 $221 4.9×
Vdrl csf (86592) $23 $30 5.4×
Virus antibody nos (86790) $208.50 $277.50 16.2×
Virus id non-immunologic oth/thn cytopathic (87255) $163 $217 4.8×
Vitamin A (84590) $56 $74 4.8×
Vitamin b-12 (82607) $72 $96 4.8×
Vitamin b1 (thiamine) (84425) $80 $107 3.8×
Vitamin b6 (84207) $137 $183 4.9×
Vitamin D 25-Hydroxy (82306) $93 $123.50 3.1×
Vitamin e serum (84446) $147 $196 10.4×
West nile virus ab, igm (86788) $115 $153 6.8×
Zinc (84630) $53 $71 4.7×