Lab & pathology prices at Samuel Mahelona Memorial Hospital
Kapaa, HI · every code in this section with a posted price and a Medicare benchmark.
451 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acth (82024) | $141.05 | $217 | 3.7× |
| Acute hepatitis panel (80074) | $381.55 | $587 | 8.0× |
| Albumin Fluid (82042) | $47.45 | $73 | 6.1× |
| Albumin serum (82040) | $39.65 | $61 | 8.0× |
| Aldosterone urine (82088) | $149.50 | $230 | 3.7× |
| Alkaline phosphatase isoenzymes (84080) | $137.15 | $211 | 9.3× |
| Allergen specific ige (86003) range across 52 matching MRF lines |
$94.90–$96.85 | $146–$149 | varies |
| Allg Spec Ige Recomb Ea (86008) | $50.70 | $78 | 2.8× |
| Alpha-1-antitrypsin total (82103) | $181.35 | $279 | 13.5× |
| Alpha-Fetoprotein Serum (82105) range across 4 matching MRF lines |
$124.80–$261.95 | $192–$403 | varies |
| Alt (sgpt) (84460) | $68.25 | $105 | 12.9× |
| Ammonia (82140) | $120.25 | $185 | 8.3× |
| Amniotic fluid protein test on cervicovaginal fluid (84112) | $136.50 | $210 | 1.4× |
| Amylase urine (82150) | $63.05 | $97 | 9.7× |
| Ana Titer (86039) | $104 | $160 | 9.3× |
| Anca screen each antibody (86036) range across 3 matching MRF lines |
$8.45–$195.65 | $13–$301 | varies |
| Anca Titer Each Antibody (86037) | $84.50 | $130 | 7.0× |
| Angiotensin converting enzyme csf (82164) | $107.90 | $166 | 7.4× |
| Anti-Phospholipid Antibody (86148) | $119.60 | $184 | 7.4× |
| Antibody Borrelia Burgdorferi Confirmatory Tst (86617) | $115.05 | $177 | 7.4× |
| Antibody Epstein-Barr Eb Virus Viral Capsid Vca (86665) | $65.65 | $101 | 3.6× |
| Antibody Fungus Not Elsewhere Specified (86671) | $386.75 | $595 | 31.6× |
| Antibody haemophilus influenza (86684) | $118.95 | $183 | 7.5× |
| Antibody helicobacter pylori (86677) | $107.90 | $166 | 6.4× |
| Antibody Herpes Smplx Type 1 (86695) | $90.35 | $139 | 6.8× |
| Antibody Hla Class I High Definition Panel Qual (86832) | $776.10 | $1,194 | 2.4× |
| Antibody Titer (86886) | $845.65 | $1,301 | 163.3× |
| Antibody Treponema Pallidum (86780) | $98.15 | $151 | 7.4× |
| Antigen typing (86905) range across 16 matching MRF lines |
$15.60–$324.35 | $24–$499 | varies |
| Antinuclear antibodies (86038) | $112.45 | $173 | 9.3× |
| Antistreptolysin O Screen (86063) | $52.65 | $81 | 9.1× |
| Antistreptolysin o titer (86060) | $57.85 | $89 | 7.9× |
| Arsenic (82175) | $268.45 | $413 | 14.2× |
| Aspergillus ag eia (87305) range across 2 matching MRF lines |
$90.35–$150.80 | $139–$232 | varies |
| Assay Blood Carbon Dioxide (82374) range across 2 matching MRF lines |
$35.75–$44.20 | $55–$68 | varies |
| Assay Nephelometry Not Spec (83883) | $65.65 | $101 | 4.8× |
| Assay of 5-hiaa (83497) | $9.10 | $14 | 0.7× |
| Assay of blood/uric acid (84550) | $50.70 | $78 | 11.2× |
| Assay of calcium in urine (82340) | $62.40 | $96 | 10.3× |
| Assay of g6pd enzyme (82955) | $74.10 | $114 | 7.6× |
| Assay of gammaglobulin igm (82784) range across 3 matching MRF lines |
$40.95–$50.70 | $63–$78 | varies |
| Assay of lactic acid (83605) range across 7 matching MRF lines |
$53.95–$104.65 | $83–$161 | varies |
| Assay of metanephrines (83835) | $126.10 | $194 | 7.4× |
| Assay of proinsulin (84206) | $132.60 | $204 | 5.0× |
| Assay of serum potassium (84132) range across 5 matching MRF lines |
$143–$149.50 | $220–$230 | varies |
| Assay of sweat sodium (84302) | $3.25 | $5 | 0.7× |
| Assay of urea nitrogen (84520) range across 5 matching MRF lines |
$29.90–$39.65 | $46–$61 | varies |
| Assay of vitamin b-1 (84425) | $70.85 | $109 | 3.3× |
| Assay Ph Body Fluid Nos (83986) range across 2 matching MRF lines |
$24.05–$29.25 | $37–$45 | varies |
| Assay spec xcp ur&breath ia (82077) | $899.60 | $1,384 | 52.1× |
| Autol Bld/Component Collj Storage Predeposited (86890) | $556.40 | $856 | 2.8× |
| Automated Leukocyte Count (85048) | $24.05 | $37 | 9.5× |
| B cells total count (86355) | $489.45 | $753 | 13.0× |
| Bartonella antibody (86611) range across 2 matching MRF lines |
$73.45–$76.70 | $113–$118 | varies |
| Beta hydroxybutyrate (82010) | $78 | $120 | 9.5× |
| Beta Lactamase (87185) | $26.65 | $41 | 5.6× |
| Bile acids total (82239) | $126.75 | $195 | 7.4× |
| Bilirubin direct (82248) | $46.15 | $71 | 9.2× |
| Bilirubin total (82247) range across 5 matching MRF lines |
$30.55–$46.15 | $47–$71 | varies |
| Bilirubin total transcutaneous (88720) range across 2 matching MRF lines |
$8.45–$10.40 | $13–$16 | varies |
| Blood count reticulocyte automated (85045) | $36.40 | $56 | 9.1× |
| Blood Count Smear Mcrscp W/Mnl Difrntl Wbc Count (85007) | $30.55 | $47 | 8.0× |
| Blood gas (82803) range across 7 matching MRF lines |
$168.35–$282.10 | $259–$434 | varies |
| Blood gases w/02 saturation (82805) | $221.65 | $341 | 2.8× |
| Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) | $112.45 | $173 | 7.1× |
| Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) | $24.05 | $37 | 5.5× |
| Blood Type Antigen Donor Reagent Serum Each (86902) | $460.20 | $708 | 72.5× |
| Blood typing serologic abo (86900) | $61.10 | $94 | 20.4× |
| Bordetella antibody (86615) range across 6 matching MRF lines |
$50.70–$98.15 | $78–$151 | varies |
| C diff amplified probe (87493) range across 2 matching MRF lines |
$76.70–$286 | $118–$440 | varies |
| C-reactive protein (86140) | $55.90 | $86 | 10.8× |
| Ca 19-9 (86301) | $154.05 | $237 | 7.4× |
| Calcitonin (82308) | $103.35 | $159 | 3.9× |
| Calcium ionized (82330) range across 4 matching MRF lines |
$61.75–$105.95 | $95–$163 | varies |
| Calcium total (82310) | $50.05 | $77 | 9.7× |
| Calculus Spectroscopy (82365) range across 3 matching MRF lines |
$78.65–$139.75 | $121–$215 | varies |
| Calprotectin Fecal (83993) | $168.35 | $259 | 8.6× |
| Calr gene com variants (81219) | $339.95 | $523 | 2.8× |
| Cancer Antigen 125 (86304) | $91 | $140 | 4.4× |
| Cancer Antigen 27.29 (86300) | $174.20 | $268 | 8.4× |
| Candida Dna Dir Probe (87480) | $149.50 | $230 | 7.5× |
| Carbamazepine total (80156) | $154.05 | $237 | 10.6× |
| Carcinoembryonic antigen (82378) | $140.40 | $216 | 7.4× |
| Cardiolipin ab iga (86147) range across 6 matching MRF lines |
$92.30–$113.10 | $142–$174 | varies |
| Catecholamines fractionated (82384) | $186.55 | $287 | 7.4× |
| Ccp antibody (86200) | $96.20 | $148 | 7.4× |
| Cell count csf (89051) range across 3 matching MRF lines |
$44.85–$55.90 | $69–$86 | varies |
| Cell marker study (88182) | $267.80 | $412 | 4.4× |
| Ceruloplasmin (82390) | $82.55 | $127 | 7.7× |
| Chemiluminescent assay (82397) range across 2 matching MRF lines |
$344.50–$362.05 | $530–$557 | varies |
| Chloride Serum (82435) | $40.95 | $63 | 8.9× |
| Chloride urine (82436) range across 2 matching MRF lines |
$33.15–$107.90 | $51–$166 | varies |
| Cholesterol total (82465) | $39.65 | $61 | 9.1× |
| Chorionic gonadotropin test (84702) | $371.80 | $572 | 24.7× |
| Chromogranin a (86316) range across 2 matching MRF lines |
$102.05–$102.70 | $157–$158 | varies |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) | $237.25 | $365 | 6.8× |
| Citric acid urine (82507) | $205.40 | $316 | 7.4× |
| Ckmb (82553) | $87.10 | $134 | 7.5× |
| Clostridium Difficile (87324) | $112.45 | $173 | 9.4× |
| Collagen crosslinks (82523) | $139.10 | $214 | 7.4× |
| Column Chromotography Quant (82542) | $230.75 | $355 | 9.6× |
| Compatibility test antiglob (86922) range across 2 matching MRF lines |
$187.85–$220.35 | $289–$339 | varies |
| Complement Antigen Each Component (86160) | $179.40 | $276 | 15.0× |
| Complement Total (Ch50) (86162) | $150.15 | $231 | 7.4× |
| Consltj&Reprt Material Requiring Prepj Slides (88323) | $253.50 | $390 | 4.1× |
| Coombs direct (86880) range across 6 matching MRF lines |
$31.85–$96.85 | $49–$149 | varies |
| Copper urine (82525) | $182 | $280 | 14.7× |
| Cortisol free (82530) | $120.25 | $185 | 7.2× |
| Cortisol saliva (82533) range across 7 matching MRF lines |
$83.20–$111.80 | $128–$172 | varies |
| Creatine kinase total (82550) range across 3 matching MRF lines |
$37.05–$63.05 | $57–$97 | varies |
| Creatinine blood (82565) range across 4 matching MRF lines |
$37.70–$46.80 | $58–$72 | varies |
| Creatinine clearance (82575) | $71.50 | $110 | 7.6× |
| Creatinine Urine (82570) range across 6 matching MRF lines |
$56.55–$174.85 | $87–$269 | varies |
| Crossmatch immediate spin (86920) | $220.35 | $339 | 1.1× |
| Crp High Sensitivity (86141) | $96.20 | $148 | 7.4× |
| Cryoglobulin (82595) range across 2 matching MRF lines |
$46.80–$50.05 | $72–$77 | varies |
| Cryptococcus ag titer (87899) range across 5 matching MRF lines |
$39–$90.35 | $60–$139 | varies |
| Cul Bact Aerobic Addl Meths Definitive Ea Isol (87077) range across 12 matching MRF lines |
$5.85–$151.45 | $9–$233 | varies |
| Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) range across 7 matching MRF lines |
$5.85–$206.05 | $9–$317 | varies |
| Culture afb (87116) | $74.75 | $115 | 6.9× |
| Culture Anaerobic (87075) range across 4 matching MRF lines |
$6.50–$89.05 | $10–$137 | varies |
| Culture blood (87040) | $83.20 | $128 | 8.1× |
| Culture chlamydia (87110) | $145.60 | $224 | 7.4× |
| Culture csf (87070) range across 20 matching MRF lines |
$5.85–$82.55 | $9–$127 | varies |
| Culture fungus (87102) | $65 | $100 | 7.7× |
| Culture screen only (87081) range across 9 matching MRF lines |
$42.90–$58.50 | $66–$90 | varies |
| Culture stool (87045) range across 3 matching MRF lines |
$80.60–$154.70 | $124–$238 | varies |
| Culture Typing Immunologic Oth/Thn Immunofluores (87147) range across 3 matching MRF lines |
$3.90–$56.55 | $6–$87 | varies |
| Culture typing other methods (87158) | $68.90 | $106 | 8.9× |
| Culture urine (87086) range across 2 matching MRF lines |
$53.30–$65 | $82–$100 | varies |
| Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart Facility (87084) | $39.65 | $61 | 1.5× |
| Cyanocobalamin Vit B-12 Unsat Binding Capacity (82608) | $106.60 | $164 | 7.4× |
| Cyclosporine (80158) range across 2 matching MRF lines |
$131.30–$133.90 | $202–$206 | varies |
| Cytomegalovirus igg (86644) | $157.30 | $242 | 10.9× |
| Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer (88142) range across 2 matching MRF lines |
$68.90–$150.15 | $106–$231 | varies |
| Cytopath Cell Enhance Tech (88112) | $267.80 | $412 | 4.4× |
| Cytp C/V Auto Thin Lyr Prepj Scr Mnl Rescr Phys (88175) | $205.40 | $316 | 7.7× |
| Cytp Concentration Smears & Interpretation (88108) | $181.35 | $279 | 4.1× |
| Cytp Eval Fine Needle Aspirate Interp & Report (88173) | $267.80 | $412 | 4.4× |
| Cytp fine ndl aspirate immt cytohist std dx 1st (88172) | $292.50 | $450 | 1.5× |
| Cytp Flu Washgs/Brushings Xcpt C/V Smrs Interpj (88104) | $159.25 | $245 | 3.6× |
| Cytp Slides Cerv/Vag Mnl Scrn Physician Supv (88164) | $88.40 | $136 | 4.8× |
| Cytp Smrs Any Oth Src Scr&Interpj (88160) | $136.50 | $210 | 4.0× |
| Detect Agent Nos Dna Amp (87798) range across 7 matching MRF lines |
$196.95–$492.70 | $303–$758 | varies |
| Dhea-S (82627) | $94.90 | $146 | 4.3× |
| Digoxin (80162) | $99.45 | $153 | 7.5× |
| Dihydrotestosterone (82642) | $210.60 | $324 | 7.2× |
| Dna Antibody Native/Double Stranded (86225) | $102.05 | $157 | 7.4× |
| Dna/Rna Amplified Probe (87150) | $237.25 | $365 | 6.8× |
| DNA/RNA direct probe (87149) | $149.50 | $230 | 7.5× |
| Dna/Rna Sequencing (87153) | $696.80 | $1,072 | 6.0× |
| Drug assay acetaminophen (80143) | $899.60 | $1,384 | 48.3× |
| Drug Assay Amiodarone (80151) | $137.80 | $212 | 7.4× |
| Drug Assay Lacosamide (80235) range across 2 matching MRF lines |
$194.35–$204.10 | $299–$314 | varies |
| Drug Screen Quantitative Levetiracetam (80177) | $81.90 | $126 | 6.2× |
| Drug Screen Quantitative Oxcarbazepine (80183) | $102.05 | $157 | 7.7× |
| Drug Test Prsmv Chem Anlyzr (80307) range across 20 matching MRF lines |
$90.35–$899.60 | $139–$1,384 | varies |
| Drug Test Prsmv Dir Opt Obs (80305) range across 3 matching MRF lines |
$96.85–$100.10 | $149–$154 | varies |
| El-1 Fecal Quantitative (82653) | $91 | $140 | 4.0× |
| Electrolyte panel (80051) | $63.05 | $97 | 9.0× |
| Enterovirus Antibody (86658) | $65.65 | $101 | 5.0× |
| Enterovirus PCR (87498) | $254.80 | $392 | 7.3× |
| Enzyme histochemistry (88319) | $1,119.95 | $1,723 | 1.2× |
| Erythropoietin (82668) | $70.85 | $109 | 3.8× |
| Estradiol serum (82670) | $206.70 | $318 | 7.4× |
| Estrogen total (82672) | $72.80 | $112 | 3.4× |
| Exam Synovial Fluid Crystals (89060) | $80.60 | $124 | 11.0× |
| Factor v leiden mutation (81241) | $187.20 | $288 | 2.6× |
| Factor viii assay (85240) | $188.50 | $290 | 10.5× |
| Ferritin (82728) | $79.95 | $123 | 5.9× |
| Fetal Fibronectin (82731) | $585 | $900 | 9.1× |
| Fibrin degradation products (85362) | $63.05 | $97 | 9.2× |
| Fibrin Degradation Quant (85379) | $94.25 | $145 | 9.3× |
| Fibrinogen activity (85384) | $81.90 | $126 | 8.4× |
| Flow cytometry first marker (88184) | $484.90 | $746 | 1.1× |
| Fluorescent antibody screen (86255) | $90.35 | $139 | 7.5× |
| Folic acid rbc (82747) | $127.40 | $196 | 7.2× |
| Folic Acid Serum (82746) | $108.55 | $167 | 7.4× |
| Follicle Stimulating Hormone (83001) | $138.45 | $213 | 7.5× |
| Fresh Frozen Plasma Thawing Each Unit (86927) | $220.35 | $339 | 1.1× |
| Frozen Section (88331) | $292.50 | $450 | 1.5× |
| Fungi Identification Mold (87107) | $14.95 | $23 | 1.4× |
| Fungi Identification Yeast (87106) | $95.55 | $147 | 9.3× |
| Gammaglobulin ige (82785) | $63.05 | $97 | 3.8× |
| Gardner vag DNA dir probe (87510) | $146.25 | $225 | 7.3× |
| Gentamicin (80170) | $111.80 | $172 | 6.8× |
| Ggt (82977) | $55.90 | $86 | 7.8× |
| Giardia antigen (87329) | $90.35 | $139 | 7.5× |
| Glucose 2 hr pp (82950) range across 4 matching MRF lines |
$26.65–$43.55 | $41–$67 | varies |
| Glucose Blood Test (82962) range across 4 matching MRF lines |
$23.40–$26.65 | $36–$41 | varies |
| Glucose body fluid (82945) | $39.65 | $61 | 10.1× |
| Glucose Serum (82947) | $31.85 | $49 | 8.1× |
| Glucose tolerance test (gtt) (82951) range across 2 matching MRF lines |
$61.75–$95.55 | $95–$147 | varies |
| Glycated Protein (82985) | $112.45 | $173 | 6.7× |
| Gonadotropin Chorionic Hcg Free Beta Chain (84704) | $111.80 | $172 | 7.3× |
| Gonadotropin Chorionic Qualitative (84703) range across 3 matching MRF lines |
$57.85–$71.50 | $89–$110 | varies |
| Growth hormone (83003) | $124.15 | $191 | 7.4× |
| Gtt-added samples (82952) | $31.85 | $49 | 8.1× |
| H Pylori (C-13) Breath (83013) | $406.90 | $626 | 6.0× |
| Haptoglobin (83010) | $115.70 | $178 | 9.2× |
| Hdl Cholesterol (83718) | $78 | $120 | 9.5× |
| Helicobacter Pylori Stool (87338) | $90.35 | $139 | 6.3× |
| Helminth Antibody (86682) | $72.80 | $112 | 5.6× |
| Hematocrit (85014) range across 6 matching MRF lines |
$63.05–$67.60 | $97–$104 | varies |
| Hemoglobin (85018) range across 3 matching MRF lines |
$10.40–$20.80 | $16–$32 | varies |
| Hemoglobin a1c (83036) | $83.20 | $128 | 8.6× |
| Hemoglobin Chromotography (83021) | $25.35 | $39 | 1.4× |
| Hemoglobin electrophoresis (83020) | $95.55 | $147 | 7.4× |
| Hemoglobin plasma (83051) | $57.85 | $89 | 7.9× |
| Hep a ab igm (86709) | $85.15 | $131 | 7.6× |
| Hepatitis a antibody total (86708) | $92.95 | $143 | 7.5× |
| Hepatitis b core ab total (86704) | $113.10 | $174 | 9.4× |
| Hepatitis B Surface Antibody (86706) | $82.55 | $127 | 7.7× |
| Hepatitis B Surface Antigen (87340) | $95.55 | $147 | 9.2× |
| Hepatitis Be Antibody (86707) | $87.75 | $135 | 7.6× |
| Hepatitis Be Antigen (87350) | $87.10 | $134 | 7.6× |
| Hepatitis C Antibody (86803) | $105.95 | $163 | 7.4× |
| Hepatitis C Genotype (87902) | $1,869.40 | $2,876 | 7.3× |
| Hepatitis C Revrs Trnscrpj (87522) | $310.70 | $478 | 7.3× |
| Herpes simplex type 2 (86696) range across 2 matching MRF lines |
$89.70–$141.70 | $138–$218 | varies |
| Heterophile Antibody Screen (86308) | $59.80 | $92 | 11.5× |
| Hgb/Rbcs Fetal Fetomaternal Hemrrg Difrntl Lysis (85460) | $60.45 | $93 | 7.8× |
| Histoplasma antibody (86698) | $318.50 | $490 | 23.1× |
| Hiv Genotype (87901) | $1,869.40 | $2,876 | 7.3× |
| Hiv-1 Ag W/Hiv-1 & Hiv-2 Ab (87389) range across 3 matching MRF lines |
$18.20–$186.55 | $28–$287 | varies |
| Hiv-1 Quant&Revrse Trnscrpj (87536) | $617.50 | $950 | 7.3× |
| Hla class ii high defin qual (86833) | $705.25 | $1,085 | 2.2× |
| Hla I Typing 1 Allele Hr (81381) | $237.25 | $365 | 1.4× |
| Homocysteine (83090) | $171.60 | $264 | 9.6× |
| Hpv High-Risk Types (87624) range across 3 matching MRF lines |
$81.90–$254.80 | $126–$392 | varies |
| Hpv Types 16 & 18 Only (87625) | $179.40 | $276 | 4.4× |
| Hsv Dna Amp Probe (87529) | $254.80 | $392 | 7.3× |
| Hydroxycorticosteroids 17 (83491) | $129.35 | $199 | 7.2× |
| Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) | $90.35 | $139 | 6.5× |
| Iaad Ia Severe Aqt Respir Synd Coronavirus (87426) range across 2 matching MRF lines |
$155.35–$158.60 | $239–$244 | varies |
| Iaad ia shiga-like toxin (87427) | $8.45 | $13 | 0.7× |
| Iadna Candida Species Amplified Probe Tq (87481) | $181.35 | $279 | 5.2× |
| Iadna chlamydia pneumoniae amplified probe tq (87486) | $208.65 | $321 | 5.9× |
| Iadna Cytomegalovirus Amplified Probe Tq (87496) range across 2 matching MRF lines |
$254.80–$335.40 | $392–$516 | varies |
| Iadna Dna/Rna Rsv Amplified Probe Technique (87634) range across 3 matching MRF lines |
$50.05–$384.15 | $77–$591 | varies |
| Iadna Herpes Virus-6 Amplified Probe Tq (87532) | $196.95 | $303 | 5.6× |
| Iadna Mycobacteria Avium-Intraclre Dir Prb (87560) | $149.50 | $230 | 5.5× |
| Iadna Mycobacteria Tuberculosis Amp Prb (87556) | $302.90 | $466 | 7.3× |
| Iadna Mycobacteria Tuberculosis Dir Prb (87555) | $149.50 | $230 | 5.6× |
| Iadna mycoplsm pneumoniae amplified probe tq (87581) | $228.80 | $352 | 6.5× |
| Iadna Neisseria Gonorrhoeae Amplified Probe Tq (87591) range across 2 matching MRF lines |
$108.55–$318.50 | $167–$490 | varies |
| Iadna Orthopoxvirus Amplified Probe Technique Ea (87593) | $76.70 | $118 | 1.5× |
| Iadna Respiratry Probe & Rev Trnscr 3-5 Targets (87631) | $461.50 | $710 | 3.2× |
| Imhistochem/Cytchm Ea Multiplex Antibody Slide (88344) | $702 | $1,080 | 1.7× |
| Immunfix e-phorsis/urine/csf (86335) | $162.50 | $250 | 5.5× |
| Immunoassay Analyte Quant Radioimmunoassay (83519) range across 2 matching MRF lines |
$100.10–$135.20 | $154–$208 | varies |
| Immunoassay nonantibody (83516) range across 6 matching MRF lines |
$8.45–$1,301.30 | $13–$2,002 | varies |
| Immunoelectrophoresis Other Fluids Concentration (86325) | $130.65 | $201 | 5.6× |
| Immunofixation electrophoresis (86334) | $162.50 | $250 | 7.3× |
| Immunofluorescence per spec 1st singl antb stain (88346) | $698.75 | $1,075 | 3.5× |
| Immunohistochemistry (88342) | $282.10 | $434 | 1.4× |
| In situ hybridization 1st probe stain (88365) | $436.80 | $672 | 2.2× |
| In situ hybridization ea multiplex probe stain (88366) | $700.70 | $1,078 | 3.5× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87428) | $382.85 | $589 | 5.4× |
| Influenza assay w/optic (87804) range across 8 matching MRF lines |
$49.40–$90.35 | $76–$139 | varies |
| Influenza DNA amp probe (87502) range across 5 matching MRF lines |
$198.25–$615.55 | $305–$947 | varies |
| Inhibin b (83520) range across 4 matching MRF lines |
$96.20–$153.40 | $148–$236 | varies |
| Insitu hybridization auto (88367) | $460.20 | $708 | 1.1× |
| Insitu hybridization manual (88368) | $460.20 | $708 | 1.1× |
| Insulin free (83527) | $96.20 | $148 | 7.4× |
| Insulin total (83525) | $86.45 | $133 | 7.6× |
| Iron (83540) range across 2 matching MRF lines |
$57.20–$111.15 | $88–$171 | varies |
| Iron Binding Capacity (83550) | $83.20 | $128 | 9.5× |
| Jak2 gene analysis p.val617phe variant (81270) range across 3 matching MRF lines |
$289.25–$409.50 | $445–$630 | varies |
| Jak2 Gene Trgt Sequence Alys (81279) range across 2 matching MRF lines |
$334.10–$884 | $514–$1,360 | varies |
| Koh Prep (87220) | $42.25 | $65 | 9.9× |
| Lactate (ld) (ldh) enzyme (83615) | $59.80 | $92 | 9.9× |
| Lactoferrin fecal qualitative (83630) | $31.85 | $49 | 1.6× |
| Lead (83655) range across 4 matching MRF lines |
$8.45–$91 | $13–$140 | varies |
| Legionella antigen urine (87449) range across 6 matching MRF lines |
$8.45–$159.25 | $13–$245 | varies |
| Leptospira antibody (86720) | $123.50 | $190 | 7.6× |
| Level I Surg Pathology Gross Examination Only (88300) | $130.65 | $201 | 3.8× |
| Level ii surg pathology grossµscopic exam (88302) | $140.40 | $216 | 3.2× |
| Level V Surg Pathology Gross&Microscopic Exam (88307) | $605.15 | $931 | 1.4× |
| Lipase (83690) | $61.10 | $94 | 8.9× |
| Lipoprotein A (83695) | $115.05 | $177 | 8.0× |
| Lithium (80178) | $58.50 | $90 | 8.9× |
| Luteinizing Hormone (Lh) (83002) | $137.80 | $212 | 7.4× |
| Lyme disease antibody (86618) | $157.95 | $243 | 9.3× |
| M. Genitalium Amp Probe (87563) range across 2 matching MRF lines |
$153.40–$157.95 | $236–$243 | varies |
| M/Phmtrc Alys Ish Quant/Semiq Mnl Each Multiprb (88377) | $698.75 | $1,075 | 3.5× |
| M/phmtrc alys ishquant/semiq (88374) | $876.85 | $1,349 | 4.4× |
| Macroscopic Exam Parasite (87169) | $34.45 | $53 | 8.0× |
| Magnesium Urine (83735) range across 3 matching MRF lines |
$61.10–$72.15 | $94–$111 | varies |
| Mass Spectrometry Quant (83789) | $133.90 | $206 | 5.6× |
| Mercury urine (83825) range across 3 matching MRF lines |
$11.70–$120.25 | $18–$185 | varies |
| Metabolic panel ionized ca (80047) | $67.60 | $104 | 4.9× |
| Methylmalonic acid serum (83921) | $66.95 | $103 | 3.2× |
| Microalbumin, quantitative (82043) range across 2 matching MRF lines |
$52.65–$63.70 | $81–$98 | varies |
| Microbe Suscept Macrobroth (87188) | $61.10 | $94 | 9.2× |
| Microsomal Antibodies Each (86376) | $107.90 | $166 | 7.4× |
| Mitochondrial Antibody Each (86381) | $70.20 | $108 | 2.8× |
| Morphometric analysis nerve (88356) | $267.80 | $412 | 4.4× |
| Morphometric Analysis Tumor (88358) | $484.90 | $746 | 2.4× |
| Mpl gene common variants (81338) | $334.75 | $515 | 2.2× |
| Mrsa Pcr (87641) range across 2 matching MRF lines |
$136.50–$242.45 | $210–$373 | varies |
| Mthfr Gene Analysis Common Variants (81291) | $266.50 | $410 | 4.1× |
| Mumps antibody (86735) range across 3 matching MRF lines |
$83.20–$96.85 | $128–$149 | varies |
| Mycobacteric Identification (87118) range across 2 matching MRF lines |
$72.15–$83.20 | $111–$128 | varies |
| Mycoplasma culture (87109) | $208.65 | $321 | 13.6× |
| Myoglobin urine (83874) | $95.55 | $147 | 7.4× |
| Natriuretic peptide (83880) | $570.70 | $878 | 14.5× |
| Nfct Ds Bacteral Vaginosis Rna Vaginal-Fluid Alg (81513) | $442.65 | $681 | 3.1× |
| Nuclear antigen antibody (86235) range across 7 matching MRF lines |
$13–$133.25 | $20–$205 | varies |
| Occult blood feces (82272) range across 3 matching MRF lines |
$24.05–$29.90 | $37–$46 | varies |
| Osmolality serum (83930) | $65 | $100 | 9.8× |
| Osmolality Urine (83935) | $62.40 | $96 | 9.1× |
| Ova and parasites smears (87177) | $83.85 | $129 | 9.4× |
| Oxalate urine (83945) | $95.55 | $147 | 6.6× |
| Particle Agglut Antbdy Titr (86406) | $81.90 | $126 | 7.7× |
| Parvovirus antibody (86747) range across 2 matching MRF lines |
$111.80–$156.65 | $172–$241 | varies |
| Path Consltj Surg Cytologic Exam Initial Site (88333) | $1,119.95 | $1,723 | 1.2× |
| Pca3/Klk3 Prostate Specific Antigen Ratio (81313) | $1,095.25 | $1,685 | 4.3× |
| Ph urine (81003) range across 3 matching MRF lines |
$24.05–$43.55 | $37–$67 | varies |
| Phenobarbital Level (80184) | $86.45 | $133 | 5.7× |
| Phenotype Infect Agent Drug (87900) | $622.05 | $957 | 4.8× |
| Phenytoin (Dilantin) (80185) | $98.15 | $151 | 7.4× |
| Phosphatase alkaline (84075) | $59.80 | $92 | 11.5× |
| Phosphorus Serum (84100) | $43.55 | $67 | 9.2× |
| Phosphorus urine (84105) | $37.05 | $57 | 6.4× |
| Pinworm exam (87172) | $34.45 | $53 | 8.1× |
| Platelet Antibodies (86022) | $206.05 | $317 | 11.2× |
| Platelet count automated (85049) | $39.65 | $61 | 8.9× |
| Platelet neutralization (85597) range across 2 matching MRF lines |
$107.90–$133.25 | $166–$205 | varies |
| Porphobilinogen, urine; quantitative (84110) | $66.95 | $103 | 7.9× |
| Potassium Urine (84133) | $34.45 | $53 | 7.3× |
| Prealbumin (84134) | $107.90 | $166 | 7.4× |
| Pregnenolone (84140) | $100.10 | $154 | 4.8× |
| Pretx serum rbc antibody identification dilution (86976) | $158.60 | $244 | 4.6× |
| Procalcitonin (Pct) (84145) | $207.35 | $319 | 7.6× |
| Progesterone (84144) | $155.35 | $239 | 7.4× |
| Prolactin (84146) | $179.40 | $276 | 9.3× |
| Protein body fluid (84157) | $40.95 | $63 | 10.2× |
| Protein C Activity (85303) | $102.70 | $158 | 7.4× |
| Protein Electrophoresis Urine (84166) | $132.60 | $204 | 7.4× |
| Protein Electrophoretic Fractj&Quantj Serum (84165) | $82.55 | $127 | 7.7× |
| Protein S Free (85306) | $114.40 | $176 | 7.5× |
| Protein total serum (84155) | $40.95 | $63 | 11.2× |
| Protein Total Urine (84156) range across 3 matching MRF lines |
$36.40–$40.95 | $56–$63 | varies |
| PSA free (84154) range across 2 matching MRF lines |
$87.10–$137.80 | $134–$212 | varies |
| Pth Intact (83970) | $299.65 | $461 | 7.3× |
| Quantiferon tb gold plus (86480) | $254.80 | $392 | 4.1× |
| Quantitative assay drug (80299) range across 5 matching MRF lines |
$102.05–$239.20 | $157–$368 | varies |
| Quantitative Screen Metals (83018) | $81.90 | $126 | 3.7× |
| Rbc antibody elution (86860) | $152.75 | $235 | 0.8× |
| Rbc antibody identification (86870) range across 2 matching MRF lines |
$59.15–$112.45 | $91–$173 | varies |
| Rbc antibody screen (86850) range across 4 matching MRF lines |
$104–$153.40 | $160–$236 | varies |
| Reagent Strip/Blood Glucose (82948) | $24.05 | $37 | 4.8× |
| Reptilase test (85635) | $62.40 | $96 | 6.3× |
| Rh (86901) | $80.60 | $124 | 27.0× |
| Rheumatoid factor quant (86431) | $40.95 | $63 | 7.2× |
| Rickettsia antibody (86757) | $141.70 | $218 | 7.3× |
| Ristocetin cofactor (85245) | $170.30 | $262 | 7.4× |
| Rpr qualitative (86592) range across 5 matching MRF lines |
$37.05–$57.85 | $57–$89 | varies |
| Rsv Assay W/Optic (87807) | $90.35 | $139 | 6.9× |
| Rubella Antibody (86762) | $134.55 | $207 | 9.4× |
| Rubeola antibody (86765) | $95.55 | $147 | 7.4× |
| Russell Viper Venom Time Diluted (85613) | $71.50 | $110 | 7.5× |
| Sars-Cov-2 Covid-19 Amp Prb (87635) range across 9 matching MRF lines |
$116.35–$172.25 | $179–$265 | varies |
| Sars-cov-2 COVID-19 antibody (86769) range across 2 matching MRF lines |
$70.85–$92.95 | $109–$143 | varies |
| Sars-Cov-2 Covid19 W/Optic (87811) | $27.30 | $42 | 0.7× |
| Sarscov2 & inf a&b amp prb (87636) | $364.65 | $561 | 2.6× |
| Sarscov2&inf a&b&rsv amp prb (87637) | $376.35 | $579 | 2.6× |
| Sedimentation rate (85651) | $35.75 | $55 | 8.4× |
| Selenium (84255) | $189.15 | $291 | 7.4× |
| Semen analysis; presence and/or motility of sperm including Huhner test (post coital) Facility (89300) | $68.25 | $105 | 6.9× |
| Sensitivity mic (87186) range across 17 matching MRF lines |
$67.60–$120.25 | $104–$185 | varies |
| Sickling of rbc reduction (85660) | $50.05 | $77 | 9.1× |
| Skin test tuberculosis intradermal (86580) range across 2 matching MRF lines |
$47.45–$72.15 | $73–$111 | varies |
| Smear acid fast (87206) range across 2 matching MRF lines |
$10.40–$52 | $16–$80 | varies |
| Smear complex stain (87209) | $202.80 | $312 | 11.3× |
| Smear gram stain (87205) range across 8 matching MRF lines |
$3.25–$156 | $5–$240 | varies |
| Smear Special Stain (87207) | $4.55 | $7 | 0.8× |
| Sodium Serum (84295) range across 5 matching MRF lines |
$143–$149.50 | $220–$230 | varies |
| Sodium Urine (84300) | $44.20 | $68 | 8.7× |
| Soluble Transferrin Receptor (84238) | $265.20 | $408 | 7.3× |
| Somatomedin (84305) | $157.30 | $242 | 7.4× |
| Special Stains Group 1 (88312) | $178.10 | $274 | 2.9× |
| Special Stains Group 2 (88313) | $178.10 | $274 | 1.1× |
| Specific gravity body fluid (84315) | $21.45 | $33 | 6.5× |
| Specimen infect agnt concntj (87015) range across 4 matching MRF lines |
$4.55–$91 | $7–$140 | varies |
| Spectrophotometry (84311) range across 3 matching MRF lines |
$63.05–$220.35 | $97–$339 | varies |
| Sputum Obtaining Spec Aerosol Induced Tx Spx (89220) | $245.70 | $378 | 1.2× |
| Stool cultr aerobic bact ea (87046) range across 2 matching MRF lines |
$6.50–$80.60 | $10–$124 | varies |
| Strep a assay w/optic (87880) range across 3 matching MRF lines |
$87.10–$90.35 | $134–$139 | varies |
| Strep a DNA amp probe (87651) | $150.15 | $231 | 4.3× |
| Strep b DNA amp probe (87653) | $254.80 | $392 | 7.3× |
| Surg path level iii (88304) | $267.80 | $412 | 4.4× |
| Surgical pathology level IV (88305) | $253.50 | $390 | 4.1× |
| Surgical pathology level vi (88309) | $1,119.95 | $1,723 | 1.2× |
| Susceptbilty Stdy Antimicrbial Agnt Agar Dilutj (87181) range across 5 matching MRF lines |
$3.25–$46.15 | $5–$71 | varies |
| Susceptibility Study Antimicrobial Disk Method (87184) range across 8 matching MRF lines |
$5.20–$67.60 | $8–$104 | varies |
| Susceptiblty Stdy Antmcrb Mycobact Proporj Mthd (87190) | $50.70 | $78 | 6.9× |
| Syphilis Test Non-Trep Quant (86593) range across 2 matching MRF lines |
$13–$26.65 | $20–$41 | varies |
| T cells absolute cd4 count (86361) | $18.85 | $29 | 0.7× |
| T Cells Absolute Cd4&Cd8 Count Ratio (86360) | $286 | $440 | 6.1× |
| T cells total count (86359) range across 2 matching MRF lines |
$93.60–$229.45 | $144–$353 | varies |
| T3 Free (84481) | $126.10 | $194 | 7.4× |
| T3 reverse (84482) | $116.35 | $179 | 7.4× |
| T3 Total (84480) | $130.65 | $201 | 9.2× |
| T4 Free (84439) | $172.90 | $266 | 19.2× |
| T4 total (84436) | $67.60 | $104 | 9.8× |
| Tacrolimus (80197) | $102.05 | $157 | 7.4× |
| Test for acetone/ketones (82009) | $35.75 | $55 | 7.9× |
| Testosterone total (84403) | $191.10 | $294 | 7.4× |
| Testosterone, Free (84402) | $185.25 | $285 | 7.3× |
| Tetanus antibody (86774) | $110.50 | $170 | 7.5× |
| Theophylline (80198) | $104.65 | $161 | 7.4× |
| Thrombin Time (85670) range across 2 matching MRF lines |
$39.65–$42.90 | $61–$66 | varies |
| Thromboplastin Time Prtl Substit Plasma Frctj Ea (85732) range across 2 matching MRF lines |
$44.85–$50.05 | $69–$77 | varies |
| Thyroglobulin (84432) | $149.50 | $230 | 9.3× |
| Thyroglobulin Antibody (86800) | $118.95 | $183 | 7.5× |
| Thyroid Stimulating Immunoglobulin (84445) | $219.70 | $338 | 4.3× |
| Tissue Culture Lymphocyte (88230) | $109.85 | $169 | 0.9× |
| Topiramate (80201) | $89.70 | $138 | 7.5× |
| Touch prep (88161) | $136.50 | $210 | 4.0× |
| Toxoplasma ab igm (86778) range across 3 matching MRF lines |
$70.85–$107.25 | $109–$165 | varies |
| Toxoplasma antibody (86777) range across 5 matching MRF lines |
$74.10–$107.25 | $114–$165 | varies |
| Transferase Aspartate Amino Ast Sgot (84450) | $59.80 | $92 | 11.5× |
| Transferrin (84466) | $95.55 | $147 | 7.5× |
| Trichomonas vagin dir probe (87660) | $133.90 | $206 | 6.7× |
| Trichomonas Vaginalis Amplif (87661) | $243.10 | $374 | 6.9× |
| Triglycerides (84478) | $55.90 | $86 | 9.7× |
| Troponin Quant (84484) range across 9 matching MRF lines |
$81.25–$104.65 | $125–$161 | varies |
| Tumor immunohistochem/comput (88361) | $605.15 | $931 | 1.4× |
| Urea nitrogen urine (84540) range across 3 matching MRF lines |
$12.35–$43.55 | $19–$67 | varies |
| Uric acid other source (84560) | $63.05 | $97 | 12.4× |
| Urinalysis Microscopic Only (81015) range across 4 matching MRF lines |
$7.80–$27.95 | $12–$43 | varies |
| Urinalysis Volume Measure (81050) | $26.65 | $41 | 7.3× |
| Urine Bacteria Culture (87088) range across 8 matching MRF lines |
$52–$55.90 | $80–$86 | varies |
| Urine Pregnancy Test (81025) range across 3 matching MRF lines |
$55.25–$61.75 | $85–$95 | varies |
| Urnls Dip Stick/Tablet Reagent Auto Microscopy (81001) | $36.40 | $56 | 11.5× |
| Valproic acid (80164) | $100.75 | $155 | 7.4× |
| Vancomycin (80202) range across 4 matching MRF lines |
$100.75–$109.85 | $155–$169 | varies |
| Varicella-zoster antibody (86787) | $95.55 | $147 | 7.4× |
| Viral Culture (87252) | $193.05 | $297 | 7.4× |
| Virus inoculate tissue addl (87253) | $97.50 | $150 | 4.8× |
| Virus inoculation, shell via (87254) range across 2 matching MRF lines |
$105.95–$157.95 | $163–$243 | varies |
| Vit D 1 25-Dihydroxy (82652) | $141.05 | $217 | 3.7× |
| Vitamin A (84590) | $87.75 | $135 | 7.6× |
| Vitamin b-12 (82607) | $112.45 | $173 | 7.5× |
| Vitamin D 25-Hydroxy (82306) | $206.05 | $317 | 7.0× |
| Vitamin E (84446) | $104.65 | $161 | 7.4× |
| Vitamin K (84597) | $102.05 | $157 | 7.4× |
| Volatiles (84600) | $119.60 | $184 | 7.0× |
| Zinc (84630) | $85.80 | $132 | 7.5× |
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.