Lab & pathology prices at Sedgwick County Memorial Hospital

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

353 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) $306 $306 7.9×
5 Hiaa (83497) $117 $117 9.1×
Acetaminophen level (80143) $248 $248 13.3×
Actin smooth muscle antibody each (86015) $152 $152 12.6×
Acute hepatitis panel (80074) $229 $229 4.8×
Afb culture (87116) $167 $167 15.5×
Albumin serum (82040) $105 $105 21.2×
Aldolase (82085) $148 $148 15.2×
Aldosterone urine (82088) $245 $245 6.0×
Alkaline phosphatase isoenzymes (84080) $148 $148 10.0×
Allerg sp igg quan or semiquan (86001) $93 $93 11.9×
Allergen specific ige (86003) $306 $306 58.6×
Allergen specific ige; qualitative, multiallergen screen (86005) $49 $49 6.1×
Alpha-1-antitrypsin, total (82103) $148 $148 11.0×
Alpha-fetoprotein, serum (82105) $73 $73 4.4×
Alt (sgpt) (84460) $105 $105 19.8×
Ammonia (82140) $152 $152 10.4×
Amylase urine (82150) $105 $105 16.2×
Angiotensin i enzyme test (82164) $217 $217 14.9×
Antibody epstein-barr eb virus early antigen ea (86663) $125 $125 9.5×
Antibody herpes smplx type 1 (86695) $76 $76 5.8×
Antibody identification (86870) $185 $185 0.5×
Antibody mumps (86735) $98 $98 7.5×
Antibody Protozoa Nes (86753) $121 $121 9.8×
Antibody rubeola (86765) $79 $79 6.1×
Antibody screen (86850) $124 $124 12.7×
Antibody treponema pallidum (86780) $54 $54 4.1×
Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) $181 $181 34.9×
Antineutrophil Cytoplasmic Antb Screen Ea Antb (86036) $96 $96 8.0×
Antinuclear antibodies (86038) $126 $126 10.4×
Antistreptolysin o titer (86060) $108 $108 14.8×
Antithrombin iii activity (85300) $206 $206 17.4×
Arsenic Urine (82175) $169 $169 8.9×
Assay of acth (82024) $245 $245 6.3×
Assay of c-peptide (84681) $166 $166 8.0×
Assay of ceruloplasmin (82390) $74 $74 6.9×
Assay of cyclosporine (80158) $60 $60 3.3×
Assay of erythropoietin (82668) $138 $138 7.3×
Assay of ferritin (82728) $149 $149 10.9×
Assay of g6pd enzyme (82955) $91 $91 9.4×
Assay of gammaglobulin igm (82784) $105 $105 11.3×
Assay of gastrin (82941) $204 $204 11.6×
Assay of glucagon (82943) $200 $200 14.0×
Assay of homocystine (83090) $355 $355 19.8×
Assay of metanephrines (83835) $232 $232 13.7×
Assay of parathormone (83970) $248 $248 6.0×
Assay of phenobarbital (80184) $129 $129 8.4×
Assay of prealbumin (84134) $213 $213 14.6×
Assay of proinsulin (84206) $46 $46 1.7×
Assay of prostate specific antigen complexed (84152) $211 $211 11.5×
Assay of somatomedin (84305) $250 $250 11.8×
Assay of tacrolimus (80197) $245 $245 17.8×
Assay of vitamin k (84597) $518 $518 37.8×
Ast (sgot) (84450) $105 $105 20.3×
B cells total count (86355) $194 $194 5.1×
Bcr/abl1 gene major bp (81206) $1,018 $1,018 6.2×
Beta 2 Glycoprotein I Antibody,Ea (86146) $418 $418 16.4×
Beta hydroxybutyrate (82010) $228 $228 27.9×
Bilirubin direct (82248) $105 $105 20.9×
Bilirubin total (82247) $105 $105 20.9×
Bl Smear W/Diff Wbc Count (85007) $66 $66 17.4×
Blood count reticulocyte automated (85045) $79 $79 19.8×
Blood gases (82803) $278 $278 10.7×
Blood gases w/02 saturation (82805) $349 $349 4.4×
Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) $47 $47 3.0×
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $88 $88 20.1×
Blood typing abo (86900) $143 $143 47.8×
Blood typing serologic rh (d) (86901) $141 $141 47.2×
Body fluid cell count (89051) $87 $87 15.5×
Breath Alcohol Test (82075) $62 $62 2.1×
C diff amplified probe (87493) $160 $160 4.3×
C-reactive protein (86140) $129 $129 24.9×
C1q binding assay (86332) $186 $186 7.6×
Ca 125 (86304) $169 $169 8.1×
Ca 19-9 (86301) $200 $200 9.6×
Ca 27 29 (86300) $160 $160 7.7×
Cadmium level (82300) $167 $167 7.1×
Calcium ionized (82330) $103 $103 7.5×
Calcium total (82310) $105 $105 20.3×
Calcium urine (82340) $141 $141 23.4×
Calculus Quantitative Chemical (82360) $120 $120 9.3×
Calprotectin, fecal (83993) $576 $576 29.3×
Carbamazepine (tegretol) total (80156) $171 $171 11.7×
Carcinoembryonic antigen (82378) $175 $175 9.2×
Cardiolipin ab igg (86147) $85 $85 3.3×
Catecholamines fraction plasma (82384) $231 $231 9.1×
Chemiluminescent assay (82397) $273 $273 19.3×
Chloride urine (82436) $201 $201 35.0×
Cholesterol total (82465) $105 $105 24.1×
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $60 $60 1.7×
Citrate (82507) $199 $199 7.2×
Ck isoenzymes (82552) $117 $117 8.7×
Clot Factor X Stuart-Power - Factor 10 Activity (85260) $351 $351 19.6×
Cns DNA amp probe type 12-25 (87483) $769 $769 1.8×
Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) $437 $437 18.1×
Collagen cross links (82523) $351 $351 18.8×
Compatibility test antiglob (86922) $132 $132 0.7×
Complement c3 (86160) $122 $122 10.2×
Complement total ch50 (86162) $156 $156 7.7×
Concentration Infectious Agent (87015) $125 $125 18.7×
Coombs direct (86880) $83 $83 15.4×
Copper urine (82525) $198 $198 16.0×
Cortisol total (82533) $103 $103 6.3×
Creatinine blood (82565) $103.50 $103.50 20.2×
Creatinine clearance (82575) $93 $93 9.8×
Creatinine other source (82570) $151 $151 29.2×
Crossmatch immediate spin (86920) $115 $115 0.6×
Culture Aerobic Identify (87077) $25 $25 3.1×
Culture anaerobic (87075) $46 $46 4.9×
Culture blood (87040) $148 $148 14.3×
Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous (87101) $121 $121 15.7×
Culture fungus id yeast (87106) $55 $55 5.3×
Culture fungus other (87102) $123 $123 14.6×
Culture genital (87070) $66 $66 7.7×
Culture screen only (87081) $79 $79 11.9×
Culture stool (87045) $95 $95 10.1×
Culture typing id bld pthgn&resist typing 6+trgt (87154) $377 $377 1.7×
Culture urine (87086) $121 $121 15.0×
Culture urine id ea isolate (87088) $25 $25 3.1×
Cyclic Citrullinated Peptide (86200) $123 $123 9.5×
Cystatin c (82610) $367 $367 19.8×
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $1,109 $1,109 25.9×
D-Dimer (85379) $216 $216 21.2×
Deoxyribonuclease antibody (86215) $82 $82 6.2×
Dhea (82626) $299 $299 11.8×
Dhea sulfate (82627) $132 $132 5.9×
Digoxin (80162) $167 $167 12.6×
Dilantin (80185) $167 $167 12.6×
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $62 $62 4.5×
Drug Screen Quantitative Lamotrigine (80175) $282 $282 21.3×
Drug scrn quant oxcarbazepin (80183) $315 $315 23.8×
Drug test prsmv chem anlyzr (80307) $335.50 $335.50 5.4×
Drug Test Prsmv Dir Opt Obs (80305) $32 $32 2.5×
Drug Tst Prsmv Read Instrmnt Asstd Dir Opt Obs (80306) $280 $280 16.3×
Ebv viral capsid (86665) $148 $148 8.2×
Electrolyte panel (80051) $127 $127 18.1×
Endomysial antibody iga (86255) $213 $213 17.7×
Eosinophil count (85048) $38 $38 15.0×
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $125 $125 8.2×
Estradiol (82670) $157 $157 5.6×
Estrogens total (82672) $161 $161 7.4×
Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) $29 $29 4.0×
Factor viii ahg (85240) $324 $324 18.1×
Fecal fat qual (82705) $80 $80 15.7×
Fibrinogen activity (85384) $132 $132 13.6×
Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) $91 $91 7.6×
Folate serum (82746) $109 $109 7.4×
Follicle Stimulating Hormone (83001) $135 $135 7.3×
Fungus Identification, Mold - Fungal Identification, Mold (87107) $81 $81 7.8×
Gammaglobulin ige (82785) $49 $49 3.0×
Ggt (82977) $102 $102 14.2×
Giardia antigen eia stool (87329) $90 $90 7.5×
Glucose (82947) $105 $105 26.7×
Glucose Blood Test (82962) $56 $56 17.1×
Glucose body fluid (82945) $69 $69 17.6×
Glucose post dose (82950) $133 $133 28.0×
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $340 $340 26.4×
Growth hormone (83003) $136 $136 8.2×
Haptoglobin (83010) $166 $166 13.2×
Hcg qualitative (84703) $97 $97 12.9×
Hcg quant (84702) $181 $181 12.0×
Hematocrit (85014) $38 $38 16.0×
Hemoglobin (85018) $38 $38 16.0×
Hemoglobin a1c (83036) $129 $129 13.3×
Hemoglobin Methemoglobin Quantitative (83050) $69 $69 8.4×
Hemoglobin plasma (83051) $103 $103 14.1×
Heparin assay (85520) $57 $57 4.4×
Heparin neutralization (85525) $57 $57 4.8×
Hepatitis b core ab igm (86705) $132 $132 11.2×
Hepatitis b core antibody total (86704) $98 $98 8.1×
Hepatitis B Surface Ab (86706) $109 $109 10.1×
Hepatitis B Surface Antigen (87340) $198 $198 19.2×
Hepatitis c antibody (86803) $228 $228 16.0×
Hepatitis C Genotype (87902) $783 $783 3.0×
Herpes culture (87252) $273 $273 10.5×
Herpes simplex type 2 (86696) $76 $76 3.9×
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $101 $101 19.5×
Hfe gene (81256) $442 $442 6.8×
Histoplasma antigen urine (87385) $284 $284 21.4×
HIV confirmation (86689) $100 $100 5.2×
Hla b 27 disease association lc (81374) $587.50 $587.50 7.9×
Hpv types 16 & 18 only (87625) $190 $190 4.7×
Hpylori Breath Anal Urease Act Non-Radact Istope (83013) $316 $316 4.7×
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $431 $431 12.3×
Iaad ia cryptosporidium (87328) $81 $81 5.9×
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $188 $188 13.1×
Iaad Ia Shiga-Like Toxin - Shiga-Like Toxin Antigen, Eia (87427) $66 $66 5.5×
Iaadiadoo hiv1 antigen w/hiv1 & hiv2 antibodies (87806) $199 $199 6.1×
Iaadiadoo not otherwise specified (87899) $132 $132 8.2×
Iadna hepatitis b virus quantification (87517) $931 $931 21.7×
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $558 $558 13.0×
Iadna neisseria gonorrhoeae amplified probe tq (87591) $60 $60 1.7×
Iadna nos amplified probe tq each organism (87798) $419.50 $419.50 12.0×
Iadna nos quantification each organism (87799) $242 $242 5.6×
Iadna trichomonas vaginalis amplified probe tech (87661) $106 $106 3.0×
Iadna-DNA/RNA probe tq 12-25 (87507) $771 $771 1.8×
Igg subclasses (82787) $316 $316 39.4×
Immunoassay infectious agent antibody quan nos (86317) $181.50 $181.50 12.1×
Immunoassay nonantibody (83516) $172 $172 14.9×
Immunofixj Electrophoresis Serum (86334) $211 $211 9.4×
Immunoglobulin light chains free each (83521) $176 $176 10.2×
Immunohistochemistry (88342) $166 $166 0.9×
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique Other Outpatient (87526) $450 $450 11.5×
Inhibin b (83520) $289 $289 16.7×
Insulin antibodies (86337) $175 $175 8.2×
Insulin total (83525) $129 $129 11.3×
Iron (83540) $135 $135 20.9×
Iron binding capacity (83550) $125 $125 14.3×
Islet cell antibody (86341) $214 $214 9.1×
Lactic acid (83605) $65 $65 5.6×
Lactoferrin fecal qualitative (83630) $123 $123 6.2×
Ldh (83615) $89 $89 14.7×
Ldh isoenzymes (83625) $123 $123 9.6×
LDL cholesterol direct (83721) $114 $114 10.9×
Lead (83655) $161 $161 13.3×
Legionella antigen urine (87449) $80 $80 6.7×
Level ii surg pathology gross&microscopic exam (88302) $151 $151 3.8×
Level v surg pathology gross&microscopic exam (88307) $359 $359 0.9×
Level vi surg pathology gross&microscopic exam (88309) $492 $492 0.6×
Lh (83002) $135 $135 7.3×
Lipase (83690) $142 $142 20.6×
Lithium (80178) $109 $109 16.5×
Lyme disease antibody (86618) $183 $183 10.7×
Lyme disease antibody confirm (86617) $436 $436 28.1×
Magnesium (83735) $149 $149 22.2×
Malaria smear (87207) $125 $125 20.9×
Mass spectrometry qual/quan (83789) $531 $531 22.0×
Mercury (83825) $295 $295 18.1×
Methotrexate (80299) $290 $290 15.6×
Methylmalonic acid serum (83921) $528 $528 24.9×
Microalbumin urine (82043) $201 $201 34.8×
Microbe suscept macrobroth (87188) $104 $104 15.7×
Microslide Consult W Slide Prep - Lab Microslide Consult W Sld Prep (88323) $197 $197 3.6×
Microsomal antibodies (86376) $129 $129 8.9×
Mitochondrial antibody each (86381) $143 $143 5.6×
Mog-igg1 antibody flow cytometry each (86363) $1,163 $1,163 30.8×
Mononuclear cell antigen (86356) $194 $194 7.2×
Mrsa amp probe (87641) $177 $177 5.0×
Mthfr Gene Analysis Common Variants (81291) $170 $170 2.6×
Muramidase (85549) $134 $134 7.1×
Mycoplasma antibody (86738) $143 $143 10.8×
Nasal smear for eosinophils (89190) $60 $60 10.4×
Natriuretic peptide (83880) $200 $200 5.1×
Nfct ds bv&vaginitis DNA alg (81515) $214 $214 0.8×
Niacin (84591) $214 $214 12.5×
Nk cells total count (86357) $194 $194 5.1×
Nuclear antigen antibody (86235) $134 $134 7.5×
Organic Acids Total Quantitative Each Specimen (83918) $340 $340 14.4×
Osmolality serum (83930) $97 $97 14.7×
Osmolality urine (83935) $152 $152 22.3×
Ova and parasite direct-id lca (87177) $127 $127 14.3×
Oxalate urine (83945) $176 $176 12.2×
Pancreatic elastase fecal (82656) $586 $586 50.8×
Pancreatic polypeptide (83519) $134 $134 7.3×
Parvovirus antibody (86747) $99 $99 6.6×
Pbb Iaad Ia Sarscov & Influenza Virus Types a&B (87428) $119.50 $119.50 1.7×
Phenylalanine (84030) $268 $268 48.7×
Phenytoin free (80186) $167 $167 12.1×
Phosphatase alkaline (84075) $167 $167 32.2×
Phospholipid Neutralization Hexagonal (85598) $57 $57 3.2×
Phosphorus blood (84100) $105 $105 22.2×
Phosphorus urine (84105) $134 $134 23.2×
Platelet count (85049) $38 $38 8.5×
Potassium (84132) $105 $105 22.1×
Potassium urine (84133) $127 $127 26.8×
Procalcitonin (pct) (84145) $173 $173 6.4×
Progesterone (84144) $148 $148 7.1×
Prolactin (84146) $166 $166 8.6×
Protein body fluid (84157) $69 $69 17.3×
Protein c activity (85303) $90 $90 6.5×
Protein electrophoresis serum (84165) $129 $129 12.0×
Protein S Functional (85306) $149 $149 9.7×
Protein Total Serum (84155) $105 $105 28.6×
Protein urine (84156) $100 $100 27.2×
PSA free (84154) $297 $297 16.2×
Quantiferon tb gold (86480) $311 $311 5.0×
Rbc antibody elution (86860) $181 $181 1.0×
Reagent strip/blood glucose (82948) $24 $24 4.8×
Renin activity plasma (84244) $130 $130 5.9×
Resp virus 3-5 targets (87631) $375 $375 2.6×
Rheumatoid factor quant (86431) $80 $80 14.1×
Rickettsia antibody (86757) $166 $166 8.6×
Rubella antibody (86762) $197 $197 13.7×
Russell viper venom time diluted (85613) $84.50 $84.50 8.8×
Saccharomyces ab iga (86671) $347 $347 28.3×
Salicylate (80179) $109 $109 5.8×
Sars-Cov-2 Covid-19 Amp Prb (87635) $128 $128 2.5×
Sars-Cov-2 Covid-19 Antibody (86769) $148 $148 3.5×
Sarscov2&inf a&b&rsv amp prb (87637) $194 $194 1.4×
Sedimentation rate (85651) $97 $97 22.7×
Semen analysis sperm presence&/motility sprm (89321) $82 $82 6.8×
Serotonin Release Assay (86022) $517 $517 28.1×
Sex hormone binding globulin (84270) $264 $264 12.1×
Sickle cell screen (85660) $76 $76 13.8×
Smear gram stain (87205) $67 $67 15.7×
Sodium (84295) $105 $105 21.8×
Sodium urine (84300) $134 $134 26.5×
Spcl Stn 2 I&R Excpt Microorg/Enzyme/Imcyt (88313) $169 $169 1.2×
Special stains group 1 (88312) $202 $202 3.7×
Stool Cultr Aerobic Bact Ea (87046) $69 $69 7.3×
Strep a assay w/optic (87880) $50 $50 3.0×
Strep a DNA amp probe (87651) $57 $57 1.6×
Sulfate urine (84392) $130 $130 23.7×
Surg path level iii (88304) $169 $169 3.1×
Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I (88300) $200 $200 6.6×
Surgical pathology level IV (88305) $319 $319 5.8×
T3 free (84481) $127.50 $127.50 7.5×
T3 reverse (84482) $624 $624 39.6×
T3 total (84480) $156 $156 11.0×
T3 uptake (84479) $77 $77 11.9×
T4 Free (84439) $103 $103 11.4×
T4 total (84436) $105 $105 15.3×
Tb intradermal test (86580) $68 $68 2.2×
Testosterone free (84402) $156 $156 6.1×
Testosterone total (84403) $156 $156 6.0×
Theophylline (80198) $171 $171 12.1×
Thin prep pap (88142) $157 $157 7.7×
Thrombin time plasma (85670) $57 $57 9.9×
Thyroglobulin (84432) $125 $125 7.8×
Thyroglobulin Ab (86800) $102.50 $102.50 6.4×
Thyroid Stimulating Immunoglobulin (84445) $238 $238 4.7×
Tiss Trnsgltmnase Ea Ig Clas (86364) $141 $141 12.2×
Topiramate (80201) $273 $273 22.9×
Toxoplasma ab igm (86778) $111 $111 7.7×
Toxoplasma antibody igg (86777) $102 $102 7.1×
Transferrin (84466) $111 $111 8.7×
Trichomonas vagin dir probe (87660) $99 $99 4.9×
Triglycerides (84478) $105 $105 18.3×
Troponin (84484) $215 $215 17.2×
Urea nitrogen (84520) $103.50 $103.50 26.2×
Urea Nitrogen Clearance (84545) $81 $81 11.3×
Uric acid blood (84550) $105 $105 23.2×
Uric acid other source (84560) $130 $130 25.6×
Urinalysis microscopic only (81015) $41 $41 13.4×
Urine pregnancy test (81025) $76 $76 8.8×
Valproic acid level (80164) $194 $194 14.3×
Vancomycin trough (80202) $232 $232 17.1×
Varicella-zoster antibody (86787) $148 $148 11.5×
Vasopressin (84588) $272 $272 8.0×
Vdrl csf (86592) $95 $95 22.2×
Virus antibody nos (86790) $289 $289 22.4×
Virus inoculate tissue addl (87253) $161 $161 8.0×
Vitamin A (84590) $131 $131 11.3×
Vitamin b-12 (82607) $143 $143 9.5×
Vitamin b-2 (riboflavin) (84252) $211 $211 10.4×
Vitamin b1 (thiamine) (84425) $286 $286 13.5×
Vitamin b6 (84207) $258 $258 9.2×
Vitamin D 25-Hydroxy (82306) $184.50 $184.50 6.2×
Vitamin e serum (84446) $103 $103 7.3×
Wbc Alkaline Phosphatase - Leukocyte Alkaline Phosphatase (85540) $48 $48 5.6×
West nile virus ab, igm (86788) $134 $134 8.0×
West nile virus antibody (86789) $134 $134 9.3×
Zinc (84630) $129 $129 11.3×