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.
Compare against other hospitals interactively →
| Procedure | Posted cash | Posted gross | × Medicare |
|---|---|---|---|
| Acth (82024) | $245 | $245 | 6.3× |
| Actin smooth muscle antibody each (86015) | $152 | $152 | 12.6× |
| Acute hepatitis panel (80074) | $229 | $229 | 4.8× |
| 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× |
| Allergen spec ige qual multiallergen screen (86005) | $49 | $49 | 6.1× |
| Allergen specific ige (86003) range across 5 matching MRF lines |
$64–$665 | $64–$665 | varies |
| Allergen specific igg (86001) | $93 | $93 | 11.9× |
| 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× |
| Anca screen each antibody (86036) | $96 | $96 | 8.0× |
| Angiotensin converting enzyme csf (82164) | $217 | $217 | 14.9× |
| Antibody Borrelia Burgdorferi Confirmatory Tst (86617) | $436 | $436 | 28.1× |
| Antibody Epstein-Barr Eb Virus Early Antigen Ea (86663) | $125 | $125 | 9.5× |
| Antibody Epstein-Barr Eb Virus Nuclear Ag Ebna (86664) | $125 | $125 | 8.2× |
| Antibody Epstein-Barr Eb Virus Viral Capsid Vca (86665) | $148 | $148 | 8.2× |
| Antibody Fungus Not Elsewhere Specified (86671) | $347 | $347 | 28.3× |
| Antibody Herpes Smplx Type 1 (86695) | $76 | $76 | 5.8× |
| Antibody htlv/HIV antibody confirmatory test (86689) | $100 | $100 | 5.2× |
| Antibody Protozoa Nes (86753) | $121 | $121 | 9.8× |
| Antibody Titer (86886) | $181 | $181 | 34.9× |
| Antibody Treponema Pallidum (86780) | $54 | $54 | 4.1× |
| Antinuclear antibodies (86038) | $126 | $126 | 10.4× |
| Antistreptolysin o titer (86060) | $108 | $108 | 14.8× |
| Antithrombin iii activity (85300) | $206 | $206 | 17.4× |
| Arsenic (82175) | $169 | $169 | 8.9× |
| Assay of 5-hiaa (83497) | $117 | $117 | 9.1× |
| Assay of blood/uric acid (84550) | $105 | $105 | 23.2× |
| Assay of calcium in urine (82340) | $141 | $141 | 23.4× |
| Assay of cpk in blood (82552) | $117 | $117 | 8.7× |
| Assay of g6pd enzyme (82955) | $91 | $91 | 9.4× |
| Assay of gammaglobulin igm (82784) range across 4 matching MRF lines |
$105–$129 | $105–$129 | varies |
| Assay of lactic acid (83605) | $65 | $65 | 5.6× |
| Assay of metanephrines (83835) | $232 | $232 | 13.7× |
| Assay of proinsulin (84206) | $46 | $46 | 1.7× |
| Assay of prostate specific antigen complexed (84152) | $211 | $211 | 11.5× |
| Assay of serum potassium (84132) | $105 | $105 | 22.1× |
| Assay of urea nitrogen (84520) range across 2 matching MRF lines |
$102–$105 | $102–$105 | varies |
| Assay of vitamin b-1 (84425) | $286 | $286 | 13.5× |
| Automated Leukocyte Count (85048) | $38 | $38 | 15.0× |
| 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 each (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× |
| Blood count reticulocyte automated (85045) | $79 | $79 | 19.8× |
| Blood Count Smear Mcrscp W/Mnl Difrntl Wbc Count (85007) | $66 | $66 | 17.4× |
| Blood gas (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 serologic abo (86900) | $143 | $143 | 47.8× |
| Breath Alcohol Test (82075) | $62 | $62 | 2.1× |
| C diff amplified probe (87493) | $160 | $160 | 4.3× |
| C-Peptide (84681) | $166 | $166 | 8.0× |
| C-reactive protein (86140) | $129 | $129 | 24.9× |
| Ca 19-9 (86301) | $200 | $200 | 9.6× |
| Cadmium (82300) | $167 | $167 | 7.1× |
| Calcium ionized (82330) range across 2 matching MRF lines |
$38–$168 | $38–$168 | varies |
| Calcium total (82310) | $105 | $105 | 20.3× |
| Calculus assay quant (82360) | $120 | $120 | 9.3× |
| Calprotectin Fecal (83993) | $576 | $576 | 29.3× |
| Cancer Antigen 125 (86304) | $169 | $169 | 8.1× |
| Cancer Antigen 27.29 (86300) range across 2 matching MRF lines |
$153–$167 | $153–$167 | varies |
| Carbamazepine total (80156) | $171 | $171 | 11.7× |
| Carcinoembryonic antigen (82378) | $175 | $175 | 9.2× |
| Cardiolipin ab iga (86147) | $85 | $85 | 3.3× |
| Catecholamines fractionated (82384) | $231 | $231 | 9.1× |
| Ccp antibody (86200) | $123 | $123 | 9.5× |
| Cell count csf (89051) | $87 | $87 | 15.5× |
| Ceruloplasmin (82390) | $74 | $74 | 6.9× |
| Chemiluminescent assay (82397) | $273 | $273 | 19.3× |
| Chloride urine (82436) | $201 | $201 | 35.0× |
| Cholesterol total (82465) | $105 | $105 | 24.1× |
| Chorionic gonadotropin test (84702) range across 3 matching MRF lines |
$129–$181 | $129–$181 | varies |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) range across 5 matching MRF lines |
$59–$106 | $59–$106 | varies |
| Citric acid urine (82507) | $199 | $199 | 7.2× |
| Cns DNA amp probe type 12-25 (87483) | $769 | $769 | 1.8× |
| Collagen crosslinks (82523) | $351 | $351 | 18.8× |
| Column Chromotography Quant (82542) | $437 | $437 | 18.1× |
| Compatibility test antiglob (86922) | $132 | $132 | 0.7× |
| Complement Antigen Each Component (86160) | $122 | $122 | 10.2× |
| Complement Total (Ch50) (86162) | $156 | $156 | 7.7× |
| Consltj&Reprt Material Requiring Prepj Slides (88323) range across 2 matching MRF lines |
$88–$306 | $88–$306 | varies |
| Coombs direct (86880) | $83 | $83 | 15.4× |
| Copper urine (82525) | $198 | $198 | 16.0× |
| Cortisol saliva (82533) | $103 | $103 | 6.3× |
| Creatinine blood (82565) range across 2 matching MRF lines |
$102–$105 | $102–$105 | varies |
| Creatinine clearance (82575) | $93 | $93 | 9.8× |
| Creatinine Urine (82570) range across 4 matching MRF lines |
$134–$168 | $134–$168 | varies |
| Crossmatch immediate spin (86920) | $115 | $115 | 0.6× |
| Cryptococcus ag titer (87899) | $132 | $132 | 8.2× |
| Cryptosporidium ag eia (87328) | $81 | $81 | 5.9× |
| Cul Bact Aerobic Addl Meths Definitive Ea Isol (87077) | $25 | $25 | 3.1× |
| Cul fngi mold/yeast prsmptv id skn hair/nail (87101) | $121 | $121 | 15.7× |
| Cul Typ ID Bld Pthgn 6+ Trgt (87154) | $377 | $377 | 1.7× |
| Culture afb (87116) | $167 | $167 | 15.5× |
| Culture Anaerobic (87075) | $46 | $46 | 4.9× |
| Culture blood (87040) | $148 | $148 | 14.3× |
| Culture csf (87070) | $66 | $66 | 7.7× |
| Culture fungus (87102) | $123 | $123 | 14.6× |
| Culture screen only (87081) | $79 | $79 | 11.9× |
| Culture stool (87045) | $95 | $95 | 10.1× |
| Culture urine (87086) | $121 | $121 | 15.0× |
| Cyclosporine (80158) | $60 | $60 | 3.3× |
| Cystatin C (82610) | $367 | $367 | 19.8× |
| Cytopath C/V Thin Layer - Lab Cytopath Cerv/Vag Thin Layer (88142) range across 3 matching MRF lines |
$157–$190 | $157–$190 | varies |
| Deoxyribonuclease antibody (86215) | $82 | $82 | 6.2× |
| Detect Agent Nos Dna Amp (87798) range across 6 matching MRF lines |
$280–$506 | $280–$506 | varies |
| Detect Agent Nos Dna Quant (87799) | $242 | $242 | 5.6× |
| Dhea (82626) | $299 | $299 | 11.8× |
| Dhea-S (82627) | $132 | $132 | 5.9× |
| Digoxin (80162) | $167 | $167 | 12.6× |
| Dna Antibody Native/Double Stranded (86225) | $62 | $62 | 4.5× |
| Drug assay acetaminophen (80143) | $248 | $248 | 13.3× |
| Drug Screen Quantitative Lamotrigine (80175) | $282 | $282 | 21.3× |
| Drug Screen Quantitative Oxcarbazepine (80183) | $315 | $315 | 23.8× |
| Drug Test Prsmv Chem Anlyzr (80307) range across 2 matching MRF lines |
$267–$404 | $267–$404 | varies |
| Drug Test Prsmv Dir Opt Obs (80305) | $32 | $32 | 2.5× |
| Drug Test Prsmv Instrmnt (80306) | $280 | $280 | 16.3× |
| Electrolyte panel (80051) | $127 | $127 | 18.1× |
| Eosinophil Smear (89190) | $60 | $60 | 10.4× |
| Erythropoietin (82668) | $138 | $138 | 7.3× |
| Estradiol serum (82670) | $157 | $157 | 5.6× |
| Estrogen total (82672) | $161 | $161 | 7.4× |
| Exam Synovial Fluid Crystals (89060) | $29 | $29 | 4.0× |
| Factor viii assay (85240) | $324 | $324 | 18.1× |
| Factor X (85260) | $351 | $351 | 19.6× |
| Fecal Fat Qualitative (82705) | $80 | $80 | 15.7× |
| Ferritin (82728) | $149 | $149 | 10.9× |
| Fibrin Degradation Quant (85379) | $216 | $216 | 21.2× |
| Fibrinogen activity (85384) | $132 | $132 | 13.6× |
| Fluorescent antibody screen (86255) range across 4 matching MRF lines |
$213–$243 | $213–$243 | varies |
| Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) | $91 | $91 | 7.6× |
| Folic Acid Serum (82746) | $109 | $109 | 7.4× |
| Follicle Stimulating Hormone (83001) | $135 | $135 | 7.3× |
| Fungi Identification Mold (87107) | $81 | $81 | 7.8× |
| Fungi Identification Yeast (87106) | $55 | $55 | 5.3× |
| Gammaglobulin ige (82785) | $49 | $49 | 3.0× |
| Gastrin (82941) | $204 | $204 | 11.6× |
| Gastrointestinal pathogen panel by PCR (12 to 25 targets) (87507) range across 3 matching MRF lines |
$394–$771 | $394–$771 | varies |
| Ggt (82977) | $102 | $102 | 14.2× |
| Giardia antigen (87329) | $90 | $90 | 7.5× |
| Glucagon (82943) | $200 | $200 | 14.0× |
| Glucose 2 hr pp (82950) | $133 | $133 | 28.0× |
| Glucose Blood Test (82962) | $56 | $56 | 17.1× |
| Glucose body fluid (82945) | $69 | $69 | 17.6× |
| Glucose Serum (82947) | $105 | $105 | 26.7× |
| Glucose tolerance test (gtt) (82951) | $340 | $340 | 26.4× |
| Gonadotropin Chorionic Qualitative (84703) range across 3 matching MRF lines |
$87–$97 | $87–$97 | varies |
| Growth hormone (83003) | $136 | $136 | 8.2× |
| H Pylori (C-13) Breath (83013) | $316 | $316 | 4.7× |
| Haptoglobin (83010) | $166 | $166 | 13.2× |
| Helicobacter Pylori Stool (87338) | $188 | $188 | 13.1× |
| Hematocrit (85014) | $38 | $38 | 16.0× |
| Hemoglobin (85018) | $38 | $38 | 16.0× |
| Hemoglobin a1c (83036) range across 5 matching MRF lines |
$37–$129 | $37–$129 | varies |
| 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 ab total (86704) | $98 | $98 | 8.1× |
| Hepatitis B Surface Antibody (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× |
| Hepatitis C Revrs Trnscrpj (87522) | $558 | $558 | 13.0× |
| Herpes simplex type 2 (86696) | $76 | $76 | 3.9× |
| Heterophile Antibody Screen (86308) | $101 | $101 | 19.5× |
| Hfe Gene (81256) | $442 | $442 | 6.8× |
| Histoplasma antigen urine (87385) | $284 | $284 | 21.4× |
| Hiv Antigen W/Hiv Antibodies (87806) | $199 | $199 | 6.1× |
| Hla I Low Resolution One Antigen Equivalent Each (81374) range across 2 matching MRF lines |
$579–$596 | $579–$596 | varies |
| Homocysteine (83090) | $355 | $355 | 19.8× |
| Hpv Types 16 & 18 Only (87625) | $190 | $190 | 4.7× |
| Hsv Dna Amp Probe (87529) range across 2 matching MRF lines |
$412–$450 | $412–$450 | varies |
| Iaad ia shiga-like toxin (87427) | $66 | $66 | 5.5× |
| Iadna Cytomegalovirus Quantification (87497) | $1,109 | $1,109 | 25.9× |
| Iadna Hepatitis B Virus Quantification (87517) | $931 | $931 | 21.7× |
| Iadna Neisseria Gonorrhoeae Amplified Probe Tq (87591) range across 4 matching MRF lines |
$60–$106 | $60–$106 | varies |
| Iadna Respiratry Probe & Rev Trnscr 3-5 Targets (87631) | $375 | $375 | 2.6× |
| Ig Light Chains Free Each (83521) | $176 | $176 | 10.2× |
| Igg subclasses (82787) | $316 | $316 | 39.4× |
| Immune Complex Assay (86332) | $186 | $186 | 7.6× |
| Immunoassay Analyte Quant Radioimmunoassay (83519) | $134 | $134 | 7.3× |
| Immunoassay Infectious Agent Antibody Quan Nos (86317) range across 4 matching MRF lines |
$150–$264 | $150–$264 | varies |
| Immunoassay nonantibody (83516) range across 7 matching MRF lines |
$134–$578 | $134–$578 | varies |
| Immunofixation electrophoresis (86334) | $211 | $211 | 9.4× |
| Immunohistochemistry (88342) | $166 | $166 | 0.9× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87428) range across 2 matching MRF lines |
$117–$122 | $117–$122 | varies |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique Facility (87526) | $450 | $450 | 11.5× |
| Inhibin b (83520) range across 4 matching MRF lines |
$256–$289 | $256–$289 | varies |
| 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× |
| Lactate (ld) (ldh) enzyme (83615) range across 2 matching MRF lines |
$57–$121 | $57–$121 | varies |
| Lactoferrin fecal qualitative (83630) | $123 | $123 | 6.2× |
| Ldh Isoenzymes (83625) | $123 | $123 | 9.6× |
| LDL direct (83721) | $114 | $114 | 10.9× |
| Lead (83655) | $161 | $161 | 13.3× |
| Legionella antigen urine (87449) | $80 | $80 | 6.7× |
| Level I Surg Pathology Gross Examination Only (88300) range across 2 matching MRF lines |
$121–$279 | $121–$279 | varies |
| Level ii surg pathology grossµscopic exam (88302) | $151 | $151 | 3.8× |
| Level V Surg Pathology Gross&Microscopic Exam (88307) | $359 | $359 | 0.9× |
| Lipase (83690) | $142 | $142 | 20.6× |
| Lithium (80178) | $109 | $109 | 16.5× |
| Luteinizing Hormone (Lh) (83002) | $135 | $135 | 7.3× |
| Lyme disease antibody (86618) | $183 | $183 | 10.7× |
| Lysozyme serum (85549) | $134 | $134 | 7.1× |
| Magnesium Urine (83735) range across 3 matching MRF lines |
$109–$149 | $109–$149 | varies |
| Mass Spectrometry Quant (83789) | $531 | $531 | 22.0× |
| Mercury urine (83825) | $295 | $295 | 18.1× |
| Methylmalonic acid serum (83921) | $528 | $528 | 24.9× |
| Microalbumin, quantitative (82043) | $201 | $201 | 34.8× |
| Microbe Suscept Macrobroth (87188) | $104 | $104 | 15.7× |
| Microsomal Antibodies Each (86376) | $129 | $129 | 8.9× |
| Mitochondrial Antibody Each (86381) | $143 | $143 | 5.6× |
| Mog-Igg1 Antb Flo Cytmtry Ea (86363) | $1,163 | $1,163 | 30.8× |
| Mononuclear cell antigen (86356) | $194 | $194 | 7.2× |
| Mrsa Pcr (87641) | $177 | $177 | 5.0× |
| Mthfr Gene Analysis Common Variants (81291) | $170 | $170 | 2.6× |
| Mumps antibody (86735) | $98 | $98 | 7.5× |
| Mycoplasma antibody (86738) | $143 | $143 | 10.8× |
| 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) range across 5 matching MRF lines |
$66–$659 | $66–$659 | varies |
| Organic acids urine (83918) | $340 | $340 | 14.4× |
| Osmolality serum (83930) | $97 | $97 | 14.7× |
| Osmolality Urine (83935) | $152 | $152 | 22.3× |
| Ova and parasites smears (87177) | $127 | $127 | 14.3× |
| Oxalate urine (83945) | $176 | $176 | 12.2× |
| Pancreatic Elastase Fecal (82656) | $586 | $586 | 50.8× |
| Parvovirus antibody (86747) | $99 | $99 | 6.6× |
| Phenobarbital Level (80184) | $129 | $129 | 8.4× |
| Phenylalanine (84030) | $268 | $268 | 48.7× |
| Phenytoin (Dilantin) (80185) | $167 | $167 | 12.6× |
| Phenytoin free (80186) | $167 | $167 | 12.1× |
| Phosphatase alkaline (84075) | $167 | $167 | 32.2× |
| Phospholipid Neutralization Hexagonal (85598) | $57 | $57 | 3.2× |
| Phosphorus Serum (84100) | $105 | $105 | 22.2× |
| Phosphorus urine (84105) | $134 | $134 | 23.2× |
| Platelet Antibodies (86022) | $517 | $517 | 28.1× |
| Platelet count automated (85049) | $38 | $38 | 8.5× |
| Potassium Urine (84133) | $127 | $127 | 26.8× |
| Prealbumin (84134) | $213 | $213 | 14.6× |
| 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 Electrophoretic Fractj&Quantj Serum (84165) | $129 | $129 | 12.0× |
| Protein S Free (85306) | $149 | $149 | 9.7× |
| Protein total serum (84155) | $105 | $105 | 28.6× |
| Protein Total Urine (84156) | $100 | $100 | 27.2× |
| PSA free (84154) | $297 | $297 | 16.2× |
| Pth Intact (83970) | $248 | $248 | 6.0× |
| Quantiferon tb gold plus (86480) | $311 | $311 | 5.0× |
| Quantitative assay drug (80299) range across 4 matching MRF lines |
$208–$399 | $208–$399 | varies |
| Rbc antibody elution (86860) | $181 | $181 | 1.0× |
| Rbc antibody identification (86870) | $185 | $185 | 0.5× |
| Rbc antibody screen (86850) range across 2 matching MRF lines |
$114–$134 | $114–$134 | varies |
| Reagent Strip/Blood Glucose (82948) | $24 | $24 | 4.8× |
| Renin activity plasma (84244) | $130 | $130 | 5.9× |
| Rh (86901) | $141 | $141 | 47.2× |
| Rheumatoid factor quant (86431) | $80 | $80 | 14.1× |
| Rickettsia antibody (86757) | $166 | $166 | 8.6× |
| Rpr qualitative (86592) | $95 | $95 | 22.2× |
| Rubella Antibody (86762) range across 3 matching MRF lines |
$93–$197 | $93–$197 | varies |
| Rubeola antibody (86765) range across 3 matching MRF lines |
$79–$83 | $79–$83 | varies |
| Russell Viper Venom Time Diluted (85613) range across 2 matching MRF lines |
$57–$112 | $57–$112 | varies |
| Salicylate Level (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 Anal Sperm Detection (89321) | $82 | $82 | 6.8× |
| Sex Hormone Binding Globulin (84270) | $264 | $264 | 12.1× |
| Sickling of rbc reduction (85660) | $76 | $76 | 13.8× |
| Skin test tuberculosis intradermal (86580) | $68 | $68 | 2.2× |
| Smear gram stain (87205) | $67 | $67 | 15.7× |
| Smear Special Stain (87207) | $125 | $125 | 20.9× |
| Sodium Serum (84295) | $105 | $105 | 21.8× |
| Sodium Urine (84300) range across 3 matching MRF lines |
$134–$164 | $134–$164 | varies |
| Somatomedin (84305) | $250 | $250 | 11.8× |
| Special Stains Group 1 (88312) | $202 | $202 | 3.7× |
| Special Stains Group 2 (88313) | $169 | $169 | 1.2× |
| Specimen infect agnt concntj (87015) | $125 | $125 | 18.7× |
| 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× |
| Surgical pathology level IV (88305) range across 2 matching MRF lines |
$279–$359 | $279–$359 | varies |
| Surgical pathology level vi (88309) | $492 | $492 | 0.6× |
| T3 Free (84481) range across 2 matching MRF lines |
$71–$184 | $71–$184 | varies |
| 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× |
| Tacrolimus (80197) | $245 | $245 | 17.8× |
| Testosterone total (84403) | $156 | $156 | 6.0× |
| Testosterone, Free (84402) | $156 | $156 | 6.1× |
| Theophylline (80198) | $171 | $171 | 12.1× |
| Thrombin Time (85670) | $57 | $57 | 9.9× |
| Thyroglobulin (84432) | $125 | $125 | 7.8× |
| Thyroglobulin Antibody (86800) range across 2 matching MRF lines |
$101–$104 | $101–$104 | varies |
| Thyroid Stimulating Immunoglobulin (84445) | $238 | $238 | 4.7× |
| Tiss Trnsgltmnase Ea Ig Clas (86364) range across 3 matching MRF lines |
$137–$141 | $137–$141 | varies |
| Topiramate (80201) | $273 | $273 | 22.9× |
| Toxoplasma ab igm (86778) | $111 | $111 | 7.7× |
| Toxoplasma antibody (86777) | $102 | $102 | 7.1× |
| Transferase Aspartate Amino Ast Sgot (84450) | $105 | $105 | 20.3× |
| Transferrin (84466) | $111 | $111 | 8.7× |
| Trichomonas vagin dir probe (87660) | $99 | $99 | 4.9× |
| Trichomonas Vaginalis Amplif (87661) | $106 | $106 | 3.0× |
| Triglycerides (84478) | $105 | $105 | 18.3× |
| Troponin Quant (84484) | $215 | $215 | 17.2× |
| Urea Nitrogen Clearance (84545) | $81 | $81 | 11.3× |
| Uric acid other source (84560) | $130 | $130 | 25.6× |
| Urinalysis Microscopic Only (81015) | $41 | $41 | 13.4× |
| Urine Bacteria Culture (87088) | $25 | $25 | 3.1× |
| Urine Pregnancy Test (81025) | $76 | $76 | 8.8× |
| Valproic acid (80164) | $194 | $194 | 14.3× |
| Vancomycin (80202) | $232 | $232 | 17.1× |
| Varicella-zoster antibody (86787) | $148 | $148 | 11.5× |
| Vasopressin (84588) | $272 | $272 | 8.0× |
| Viral Culture (87252) | $273 | $273 | 10.5× |
| Virus antibody nos (86790) range across 2 matching MRF lines |
$150–$428 | $150–$428 | varies |
| Virus inoculate tissue addl (87253) | $161 | $161 | 8.0× |
| Vit D 1 25-Dihydroxy (82652) | $306 | $306 | 7.9× |
| Vitamin A (84590) | $131 | $131 | 11.3× |
| Vitamin b-12 (82607) | $143 | $143 | 9.5× |
| Vitamin B2 (Riboflavin) (84252) | $211 | $211 | 10.4× |
| Vitamin B6 (84207) | $258 | $258 | 9.2× |
| Vitamin D 25-Hydroxy (82306) range across 2 matching MRF lines |
$96–$273 | $96–$273 | varies |
| Vitamin E (84446) | $103 | $103 | 7.3× |
| Vitamin K (84597) | $518 | $518 | 37.8× |
| Wbc Alkaline Phosphatase Count (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× |
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.