Lab & pathology prices at San Luis Valley Health Conejos County Hospital

La Jara, CO · every code in this section with a posted price and a Medicare benchmark.

288 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
17 Hydroxyprogesterone (83498) $99.55 $181 3.7×
Acetaminophen (80143) $61.05 $111 3.3×
Acetone, quantitative (82010) $36.85 $67 4.5×
Acetylcholine receptor binding antibody (86041) $43.45 $79 2.4×
Acetylcholn rcptr blckg antb (86042) $43.45 $79 2.4×
Acth (82024) $30.80 $56 0.8×
Acute hepatitis panel (80074) $237.60 $432 5.0×
Afb culture (87116) $53.35 $97 4.9×
Albumin body fluid (82042) $9.35 $17 1.2×
Albumin serum (82040) $29.15 $53 5.9×
Alcohol (82077) $80.30 $146 4.6×
Aldolase (82085) $53.90 $98 5.6×
Aldosterone (82088) $96.80 $176 2.4×
Alkaline phosphatase (84075) $29.15 $53 5.6×
Alkaline phosphatase isoenzymes (84080) $93.50 $170 6.3×
Allergen profile perennial allergen (86003) $15.95 $29 3.1×
Alpha-1-antitrypsin (82103) $79.20 $144 5.9×
Alpha-fetoprotein serum (82105) $91.30 $166 5.4×
Alt (84460) $39.60 $72 7.5×
Ammonia (82140) $118.80 $216 8.2×
Amylase (82150) $60.50 $110 9.3×
Ana (86038) $116.60 $212 9.6×
Ana titer (86039) $40.15 $73 3.6×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen (86663) $82.50 $150 6.3×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid (86665) $88 $160 4.9×
Angiotensin converting enzyme (82164) $37.95 $69 2.6×
Anti-mitochondrial antibody (86255) $68.75 $125 5.7×
Antithrombin iii activity (85300) $113.85 $207 9.6×
Apolipoprotein each (82172) $29.15 $53 1.4×
Assay anti-mullerian horm (82166) $86.90 $158 2.3×
Ast (84450) $39.60 $72 7.6×
B cells total count (86355) $97.35 $177 2.6×
Bcr/abl1 gene major bp (81206) $437.80 $796 2.7×
Bcr/abl1 gene minor bp (81207) $227.70 $414 1.6×
Beta 2 glycoprotein i antibody (86146) $80.30 $146 3.2×
Beta lactamase (87185) $34.65 $63 7.3×
Beta-2 microglobulin (82232) $72.60 $132 4.5×
Bilirubin direct (82248) $36.30 $66 7.2×
Bilirubin total (82247) $34.65 $63 6.9×
Blood count leukocyte wbc automated (85048) $16.50 $30 6.5×
Blood count reticulocyte automated (85045) $45.65 $83 11.4×
Blood gases any combination (82803) $129.25 $235 5.0×
Blood gases ph only (82800) $32.45 $59 3.0×
Blood gases w/o2 saturation (82805) $184.25 $335 2.3×
Blood typing serologic abo (86900) $34.10 $62 11.4×
Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations… (82274) $58.85 $107 3.7×
BRCA1 (BRCA1, DNA repair associated), BRCA2 (BRCA2, DNA repair associated) (eg, hereditary breast and ovarian cancer)… (81162) $2,122.45 $3,859 1.2×
C diff amplified probe (87493) $91.30 $166 2.4×
C-peptide (84681) $80.30 $146 3.9×
C-reactive protein (86140) $52.25 $95 10.1×
C2 complement functional (86161) $91.30 $166 7.6×
Ca 125 (86304) $77.55 $141 3.7×
Ca 15-3 (86300) $113.85 $207 5.5×
Calcium ionized (82330) $67.65 $123 4.9×
Calcium total (82310) $31.90 $58 6.2×
Calcium, random urine (82340) $72.60 $132 12.0×
Calprotectin fecal (83993) $144.65 $263 7.4×
Cancer antigen 19-9 (86301) $113.85 $207 5.5×
Carbamazepine total (80156) $57.20 $104 3.9×
Carbon monoxide (82375) $72.60 $132 5.9×
Cardiolipin antibody ea ig class (86147) $113.85 $207 4.5×
Cea (82378) $75.35 $137 4.0×
Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count… (89051) $53.35 $97 9.5×
Ceruloplasmin (82390) $52.80 $96 4.9×
Chlamydia pneumoniae PCR (87486) $40.15 $73 1.1×
Chloride blood (82435) $25.85 $47 5.6×
Cholesterol total (82465) $36.85 $67 8.5×
Chorionic gonadotropin test (84702) $116.60 $212 7.7×
Ck mb fraction (82553) $82.50 $150 7.1×
Clot inhibit prot s total (85305) $112.75 $205 9.7×
Clotting; factor VIII, von Willebrand factor, multimetric analysis Other Outpatient (85247) $56.65 $103 2.5×
Cmv antibody (86644) $89.10 $162 6.2×
Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) $85.25 $155 3.5×
Collagen cross links (82523) $201.30 $366 10.8×
Complement antigen ea component (86160) $62.15 $113 5.2×
Coombs test indirect titer (86886) $156.75 $285 30.3×
Copper (82525) $67.65 $123 5.5×
Cortisol saliva (82533) $72.60 $132 4.5×
Coxsackie a9 virus antibody (86658) $76.45 $139 5.9×
Creatine kinase total (82550) $64.90 $118 10.0×
Creatinine (82565) $34.65 $63 6.8×
Creatinine other source (82570) $36.85 $67 7.1×
Crystals fluid (89060) $48.95 $89 6.7×
Culture anaerobic (87075) $113.85 $207 12.0×
Culture blood (87040) $87.45 $159 8.5×
Culture urine (87086) $45.65 $83 5.7×
Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate Other… (87077) $49.50 $90 6.1×
Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each… (87046) $63.80 $116 6.8×
Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA)… (87154) $821.15 $1,493 3.8×
Cyclic citrullinated peptide ab (86200) $29.70 $54 2.3×
Cystatin c (82610) $74.25 $135 4.0×
Cytomegalovirus antibody igm (86645) $89.10 $162 5.3×
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer… (88142) $75.35 $137 3.7×
D-dimer quantitative (85379) $95.70 $174 9.4×
Deoxyribonucleic acid (DNA) antibody; native or double stranded Other Outpatient (86225) $48.95 $89 3.6×
Dhea sulfate (82627) $95.70 $174 4.3×
Digoxin (80162) $52.25 $95 3.9×
DNA/RNA amplified probe (87150) $656.70 $1,194 18.7×
Drug assay salicylate (80179) $61.05 $111 3.3×
Drug screen quant everolimus (80169) $106.70 $194 7.8×
Drug screen quant levetiracetam (80177) $64.35 $117 4.9×
Drug screen quantitative oxcarbazepine (80183) $88 $160 6.6×
Drug test prsmv chem anlyzr (80307) $117.15 $213 1.9×
Drug test prsmv dir opt obs (80305) $151.80 $276 12.0×
Ear culture (87070) $66.55 $121 7.7×
Elastase pancreatic fecal quantitative (82653) $152.35 $277 6.6×
Electrolytes panel (80051) $30.25 $55 4.3×
Endomysial antibody each immunoglobulin class (86231) $61.05 $111 5.0×
Eosinophils urine (87205) $50.60 $92 11.9×
Erythropoietin (82668) $84.15 $153 4.5×
Estradiol (82670) $130.90 $238 4.7×
Estrogen fractionated (82671) $96.80 $176 3.0×
Extractable nuclear antigen antibody any method (86235) $72.60 $132 4.0×
F5 gene (81241) $101.20 $184 1.4×
Factor viii activity (85240) $27.50 $50 1.5×
Factor viii vw antigen (85246) $141.90 $258 6.2×
Fecal fat qualitative (82705) $107.25 $195 21.0×
Ferritin (82728) $79.20 $144 5.8×
Fibrinogen, activity (85384) $119.35 $217 12.3×
Folate serum (82746) $79.75 $145 5.4×
Folic acid rbc (82747) $73.15 $133 4.1×
Follicle stimulating hormone (fsh) (83001) $80.30 $146 4.3×
Gamma glutamyl transferase (82977) $41.25 $75 5.7×
Gammaglobulin ige (82785) $65.45 $119 4.0×
Gliadin antibody each immunoglobulin class (86258) $28.05 $51 2.3×
Glucose Fasting (82947) $33.55 $61 8.5×
Glucose other fluid (82945) $36.85 $67 9.4×
Glucose tolerance test (gtt) (82951) $52.80 $96 4.1×
Glycated hemoglobin (83036) $59.95 $109 6.2×
H pylori breath test (83013) $200.75 $365 3.0×
H pylori stool (87338) $128.15 $233 8.9×
Haptoglobin (83010) $75.35 $137 6.0×
Hcg ql (84703) $51.70 $94 6.9×
Hematocrit (hct) (85014) $17.60 $32 7.4×
Hemoglobin (85018) $18.15 $33 7.7×
Hemoglobin fractj/quantj chromotography (83021) $68.20 $124 3.8×
Hep a ab total (86708) $55 $100 4.4×
Heparin assay (85520) $125.95 $229 9.6×
Hepatitis a antibody igm (86709) $74.25 $135 6.6×
Hepatitis b core antibody igm (86705) $74.25 $135 6.3×
Hepatitis b core antibody total (86704) $57.75 $105 4.8×
Hepatitis b DNA quant (87517) $273.35 $497 6.4×
Hepatitis b surface ab (86706) $60.50 $110 5.6×
Hepatitis b surface antigen (87340) $60.50 $110 5.9×
Hepatitis be antigen (87350) $64.90 $118 5.6×
Hepatitis c antibody (86803) $78.10 $142 5.5×
Hepatitis c RNA quantitative (87522) $107.80 $196 2.5×
Herpes simplex virus by PCR (87529) $210.65 $383 6.0×
Heterophile antibody screen (86308) $33.55 $61 6.5×
Hexagonal phospholipid neutralization (85598) $91.30 $166 5.1×
Hfe gene (81256) $156.75 $285 2.4×
Hiv-1/Hiv-2, Single Assay - Rapid Hiv 1 and 2 Screen (Acc Exp/Source) (86703) $63.25 $115 4.6×
Hla b27 (86812) $121.55 $221 4.7×
Homocysteine level (83090) $146.85 $267 8.2×
Iadna sars-cov-2 COVID-19 amplified probe tq (87635) $91.30 $166 1.8×
Iadna sarscov2 & inf a&b & rsv mult amp probe tq (87637) $247.50 $450 1.7×
Iadna-DNA/RNA probe tq 12-25 (87507) $468.60 $852 1.1×
Immunoassay analyte quantitative nos (83520) $91.30 $166 5.3×
Immunofixation electrophoresis (86334) $72.60 $132 3.2×
Immunoglobulin d (82784) $48.95 $89 5.3×
Immunoglobulin light chains free each (83521) $85.25 $155 4.9×
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified… (87899) $22 $40 1.4×
Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique Other… (87801) $100.65 $183 1.4×
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism Other… (87799) $188.10 $342 4.4×
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other… (87491) $77.55 $141 2.2×
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification Other Outpatient (87497) $94.60 $172 2.2×
Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification, includes reverse transcription when… (87536) $31.90 $58 0.4×
Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for… (81514) $341.55 $621 1.3×
Influenza DNA amp probe (87502) $125.40 $228 1.3×
Insulin antibody (86337) $131.45 $239 6.1×
Insulin total (83525) $82.50 $150 7.2×
Iron (83540) $50.60 $92 7.8×
Iron binding capacity (83550) $50.60 $92 5.8×
Islet cell antibody (86341) $130.90 $238 5.6×
Jak2 gene (81270) $244.75 $445 2.7×
John cunningham antibody (86711) $72.60 $132 4.3×
Lactate (83605) $78.10 $142 6.8×
Lactate dehydrogenase (83615) $40.15 $73 6.6×
Lamotrigine (80175) $101.20 $184 7.6×
Legionella urine antigen (87449) $64.35 $117 5.4×
Leukocyte assessment fecal (89055) $31.90 $58 7.5×
Lipase (83690) $62.15 $113 9.0×
Lipoprotein (a) (83695) $34.65 $63 2.4×
Lipoprotein bld by nmr (83704) $52.25 $95 1.5×
Lithium (80178) $50.60 $92 7.7×
Luteinizing hormone (lh) (83002) $84.70 $154 4.6×
Lyme disease antibody (86617) $61.05 $111 3.9×
Magnesium (83735) $48.95 $89 7.3×
Manual differential (85007) $24.75 $45 6.5×
Metanephrines (83835) $80.30 $146 4.7×
Microalbumin urine (82043) $39.05 $71 6.8×
Mitochondrial antibody each (86381) $73.15 $133 2.9×
Mononuclear cell antigen (86356) $52.25 $95 2.0×
Mrsa PCR (87641) $47.85 $87 1.4×
Mthfr gene (81291) $105.05 $191 1.6×
Mumps antibody (86735) $80.30 $146 6.2×
Muscle-specific kinase antb (86366) $288.75 $525 15.7×
Mycoplasma pneumoniae by PCR (87581) $40.15 $73 1.1×
Myelin associated glycoprotein (mag) antibody (83516) $75.35 $137 6.5×
N.gonorrhoeae DNA amp prob (87591) $77.55 $141 2.2×
Natriuretic peptide (83880) $157.85 $287 4.0×
Nephelometry ea analyte (83883) $48.40 $88 3.6×
Occult blood other sources (82271) $39.05 $71 7.3×
Osmolality serum (83930) $65.45 $119 9.9×
Osmolality urine (83935) $56.65 $103 8.3×
Ova and parasite exam (87177) $89.10 $162 10.0×
Parathyroid hormone (83970) $183.15 $333 4.4×
Pertussis by PCR (87798) $222.20 $404 6.3×
Phenotype infect agent drug (87900) $364.10 $662 2.8×
Phenytoin level total (80185) $78.10 $142 5.9×
Phosphorus (84100) $28.60 $52 6.0×
Potassium (84132) $20.35 $37 4.3×
Potassium urine (84133) $36.30 $66 7.7×
Prealbumin (84134) $72.60 $132 5.0×
Procalcitonin (pct) (84145) $147.40 $268 5.4×
Progesterone (84144) $77.55 $141 3.7×
Prolactin (84146) $77.55 $141 4.0×
Protein c activity (85303) $133.10 $242 9.6×
Protein c antigen (85302) $112.75 $205 9.4×
Protein electrophoresis serum (84165) $84.15 $153 7.8×
Protein total other source (84157) $39.05 $71 9.8×
Protein total serum (84155) $23.10 $42 6.3×
Protein total urine (84156) $50.60 $92 13.8×
PSA free (84154) $78.10 $142 4.2×
Rbc antibody identification (86870) $171.05 $311 0.5×
Rbc antibody screen (86850) $94.05 $171 9.6×
Reagent strip/blood glucose (82948) $14.30 $26 2.8×
Reflex gamma-aminobutyric acid receptor, type a (gaba-ar) antibody titer, igg by cba-ifa, csf arup 3006006 (86256) $130.35 $237 10.8×
Renin (84244) $96.80 $176 4.4×
Resp virus 12-25 targets (87633) $447.70 $814 1.1×
Rheumatoid factor quant (86431) $33.55 $61 5.9×
Ristocetin cofactor (85245) $111.65 $203 4.9×
Rl immediate spin crossmatch (86920) $80.85 $147 0.4×
Rpr qual (86592) $47.30 $86 11.1×
Rpr titer (86593) $23.10 $42 5.3×
Rubella antibody (86762) $107.25 $195 7.5×
Rubeola antibody (86765) $113.85 $207 8.8×
Russell viper venom diluted (85613) $57.20 $104 6.0×
Sedimentation rate rbc automated (85652) $33.55 $61 12.4×
Sex hormone binding globulin (84270) $45.10 $82 2.1×
Sickle cell screen (85660) $36.85 $67 6.7×
Smear wet mount (87210) $29.70 $54 5.1×
Sodium (84295) $19.25 $35 4.0×
Sodium urine (84300) $37.95 $69 7.5×
Somatomedin (84305) $122.65 $223 5.8×
Staph a DNA amp probe (87640) $47.85 $87 1.4×
Strep a DNA amp probe (87651) $70.40 $128 2.0×
Strep b DNA amp probe (87653) $53.90 $98 1.5×
Susceptibility mic per plate (87186) $50.05 $91 5.8×
T cells cd4 count (86361) $37.95 $69 1.4×
T3 free (84481) $132 $240 7.8×
T3 reverse (84482) $142.45 $259 9.0×
T3 uptake (84479) $53.35 $97 8.2×
T4 (thyroxine) total (84436) $53.35 $97 7.8×
Tacrolimus (80197) $147.40 $268 10.7×
Tb test cell immun measure (86480) $93.50 $170 1.5×
Testosterone free (84402) $88 $160 3.5×
Testosterone total (84403) $107.25 $195 4.2×
Thiopurine drug metabolites (83789) $75.35 $137 3.1×
Thiopurine metabolites (80299) $84.70 $154 4.5×
Thrombin time plasma (85670) $36.85 $67 6.4×
Thyroglobulin antibody (86800) $99.55 $181 6.3×
Thyroid peroxidase antibody (86376) $60.50 $110 4.2×
Thyroid stimulating immune globulins (thyroid related protein) level (84445) $121.55 $221 2.4×
Thyroxine free (ft4) (84439) $75.35 $137 8.4×
Tissue transglutaminase ea immunoglobulin class (86364) $30.80 $56 2.7×
Transferrin (84466) $249.70 $454 19.6×
Treponema pallidum antibody (86780) $58.85 $107 4.4×
Trichomonas vaginalis amplif (87661) $63.25 $115 1.8×
Triglycerides (84478) $45.10 $82 7.9×
Triiodothyronine total assay, tt-3 - t3 (thyroid hormone) (84480) $91.30 $166 6.4×
Troponin t (84484) $100.65 $183 8.1×
Urea nitrogen quantitative (84520) $32.45 $59 8.2×
Urea nitrogen urine (84540) $62.15 $113 11.2×
Uric acid blood (84550) $32.45 $59 7.2×
Urinalysis auto w/micro (81001) $37.95 $69 12.0×
Urine Pregnancy Test POC (81025) $28.05 $51 3.3×
Valproic acid (80164) $82.50 $150 6.1×
Vancomycin (80202) $95.15 $173 7.0×
Varicella zoster antibody igg (86787) $70.95 $129 5.5×
Vitamin b-12 (82607) $75.35 $137 5.0×
Vitamin b1 whole blood (84425) $121.55 $221 5.7×
Vitamin b6 (84207) $103.95 $189 3.7×
Vitamin d 25 hydroxy (82306) $85.25 $155 2.9×
Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Other Outpatient (82652) $105.05 $191 2.7×
Vitamin e (84446) $72.60 $132 5.1×
Yeast id (87106) $62.70 $114 6.1×
Zinc (84630) $60.50 $110 5.3×