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
5-Hiaa (83497) $117 $117 9.1×
Acetaminophen (80143) $248 $248 13.3×
Acetone, quantitative (82010) $228 $228 27.9×
Acth (82024) $245 $245 6.3×
Actin smooth muscle antibody each (86015) $152 $152 12.6×
Acute hepatitis panel (80074) $229 $229 4.8×
Afb concentration (87015) $125 $125 18.7×
Afb culture (87116) $167 $167 15.5×
Albumin serum (82040) $105 $105 21.2×
Aldolase (82085) $148 $148 15.2×
Aldosterone (82088) $245 $245 6.0×
Alkaline phosphatase (84075) $167 $167 32.2×
Alkaline phosphatase isoenzymes (84080) $148 $148 10.0×
Allergen profile perennial allergen (86003) $306 $306 58.6×
Allergen specific IgE; qualitative, multiallergen screen (eg, disk, sponge, card) Other Outpatient (86005) $49 $49 6.1×
Alpha-1-antitrypsin (82103) $148 $148 11.0×
Alpha-fetoprotein serum (82105) $73 $73 4.4×
Alt (84460) $105 $105 19.8×
Ammonia (82140) $152 $152 10.4×
Amylase (82150) $105 $105 16.2×
Ana (86038) $126 $126 10.4×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen (86663) $125 $125 9.5×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear antigen (86664) $125 $125 8.2×
Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid (86665) $148 $148 8.2×
Angiotensin converting enzyme (82164) $217 $217 14.9×
Anti-mitochondrial antibody (86255) $213 $213 17.7×
Antibody identification platelet antibodies (86022) $517 $517 28.1×
Antibody west nile virus igm (86788) $134 $134 8.0×
Antineutrophil cytoplasmic antb screen ea antb (86036) $96 $96 8.0×
Antistreptolysin o titer (86060) $108 $108 14.8×
Antithrombin iii activity (85300) $206 $206 17.4×
Arsenic (82175) $169 $169 8.9×
Assay of vitamin b-2 (84252) $211 $211 10.4×
Assay of vitamin not otherwise specified (84591) $214 $214 12.5×
Ast (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 (86146) $418 $418 16.4×
Bilirubin direct (82248) $105 $105 20.9×
Bilirubin total (82247) $105 $105 20.9×
Blood count leukocyte wbc automated (85048) $38 $38 15.0×
Blood count reticulocyte automated (85045) $79 $79 19.8×
Blood gases any combination (82803) $278 $278 10.7×
Blood gases w/o2 saturation (82805) $349 $349 4.4×
Blood typing serologic abo (86900) $143 $143 47.8×
Blood typing serologic rh (d) (86901) $141 $141 47.2×
Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, feces, 1-3 simultaneous determinations… (82274) $47 $47 3.0×
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 125 (86304) $169 $169 8.1×
Ca 15-3 (86300) $160 $160 7.7×
Cadmium (82300) $167 $167 7.1×
Calcium ionized (82330) $103 $103 7.5×
Calcium total (82310) $105 $105 20.3×
Calcium, random urine (82340) $141 $141 23.4×
Calculus; quantitative analysis, chemical Other Outpatient (82360) $120 $120 9.3×
Calprotectin fecal (83993) $576 $576 29.3×
Cancer antigen 19-9 (86301) $200 $200 9.6×
Carbamazepine total (80156) $171 $171 11.7×
Cardiolipin antibody ea ig class (86147) $85 $85 3.3×
Casein igg (86001) $93 $93 11.9×
Catecholamines fractionated (82384) $231 $231 9.1×
Cea (82378) $175 $175 9.2×
Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood; with differential count… (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) $181 $181 12.0×
Citrate (82507) $199 $199 7.2×
Cns DNA/RNA amp probe multiple subtypes 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×
Complement antigen ea component (86160) $122 $122 10.2×
Complement total (ch50) (86162) $156 $156 7.7×
Coombs test indirect titer (86886) $181 $181 34.9×
Copper (82525) $198 $198 16.0×
Cortisol saliva (82533) $103 $103 6.3×
COVID-19 antibody (86769) $148 $148 3.5×
Creatine kinase isoenzymes (82552) $117 $117 8.7×
Creatinine (82565) $103.50 $103.50 20.2×
Creatinine clearance (82575) $93 $93 9.8×
Creatinine other source (82570) $151 $151 29.2×
Crossmatch ahg (86922) $132 $132 0.7×
Cryptosporidium ag eia (87328) $81 $81 5.9×
Crystals fluid (89060) $29 $29 4.0×
Culture anaerobic (87075) $46 $46 4.9×
Culture blood (87040) $148 $148 14.3×
Culture fungus skin hair nail (87101) $121 $121 15.7×
Culture stool (87045) $95 $95 10.1×
Culture urine (87086) $121 $121 15.0×
Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate Other… (87077) $25 $25 3.1×
Culture, bacterial; stool, aerobic, additional pathogens, isolation and presumptive identification of isolates, each… (87046) $69 $69 7.3×
Culture, typing; identification of blood pathogen and resistance typing, when performed, by nucleic acid (DNA or RNA)… (87154) $377 $377 1.7×
Cyclic citrullinated peptide ab (86200) $123 $123 9.5×
Cyclosporine (80158) $60 $60 3.3×
Cystatin c (82610) $367 $367 19.8×
Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer… (88142) $157 $157 7.7×
D-dimer quantitative (85379) $216 $216 21.2×
Deoxyribonuclease antibody (86215) $82 $82 6.2×
Deoxyribonucleic acid (DNA) antibody; native or double stranded Other Outpatient (86225) $62 $62 4.5×
Dhea (82626) $299 $299 11.8×
Dhea sulfate (82627) $132 $132 5.9×
Digoxin (80162) $167 $167 12.6×
Direct antiglobulin test (86880) $83 $83 15.4×
Drug assay salicylate (80179) $109 $109 5.8×
Drug screen quantitative oxcarbazepine (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 test prsmv instrmnt (80306) $280 $280 16.3×
Ear culture (87070) $66 $66 7.7×
Electrolytes panel (80051) $127 $127 18.1×
Eosinophils urine (87205) $67 $67 15.7×
Erythropoietin (82668) $138 $138 7.3×
Estradiol (82670) $157 $157 5.6×
Estrogens total (82672) $161 $161 7.4×
Extractable nuclear antigen antibody any method (86235) $134 $134 7.5×
Factor viii activity (85240) $324 $324 18.1×
Factor x (stuart-prower) (85260) $351 $351 19.6×
Fecal fat qualitative (82705) $80 $80 15.7×
Ferritin (82728) $149 $149 10.9×
Fibrinogen, activity (85384) $132 $132 13.6×
Folate serum (82746) $109 $109 7.4×
Follicle stimulating hormone (fsh) (83001) $135 $135 7.3×
Fungus isolation culture (87102) $123 $123 14.6×
Fungus, antibody - saccharomyces cerevisiae antibodies, igg and iga (86671) $347 $347 28.3×
Gamma glutamyl transferase (82977) $102 $102 14.2×
Gammaglobulin ige (82785) $49 $49 3.0×
Gastrin (82941) $204 $204 11.6×
Giardia antigen (87329) $90 $90 7.5×
Gluc bld gluc mntr dev cleared fda spec home use (82962) $56 $56 17.1×
Glucagon (82943) $200 $200 14.0×
Glucose Fasting (82947) $105 $105 26.7×
Glucose other fluid (82945) $69 $69 17.6×
Glucose post glucose dose (82950) $133 $133 28.0×
Glucose tolerance test (gtt) (82951) $340 $340 26.4×
Glucose-6-pd (82955) $91 $91 9.4×
Glycated hemoglobin (83036) $129 $129 13.3×
Growth hormone (hgh) (83003) $136 $136 8.2×
H pylori breath test (83013) $316 $316 4.7×
H pylori stool (87338) $188 $188 13.1×
Haptoglobin (83010) $166 $166 13.2×
Hcg ql (84703) $97 $97 12.9×
Hematocrit (hct) (85014) $38 $38 16.0×
Hemoglobin (85018) $38 $38 16.0×
Hemoglobin plasma (83051) $103 $103 14.1×
Heparin assay (85520) $57 $57 4.4×
Heparin neutralization (85525) $57 $57 4.8×
Hepatitis b core antibody igm (86705) $132 $132 11.2×
Hepatitis b core antibody total (86704) $98 $98 8.1×
Hepatitis b DNA quant (87517) $931 $931 21.7×
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×
Hepatitis c RNA quantitative (87522) $558 $558 13.0×
Herpes simplex virus by PCR (87529) $431 $431 12.3×
Heterophile antibody screen (86308) $101 $101 19.5×
Hexagonal phospholipid neutralization (85598) $57 $57 3.2×
Hfe gene (81256) $442 $442 6.8×
HLA Class I typing, low resolution (eg, antigen equivalents); one antigen equivalent (eg, B*27), each Other Outpatient (81374) $587.50 $587.50 7.9×
Homocysteine level (83090) $355 $355 19.8×
Hpv types 16 & 18 only (87625) $190 $190 4.7×
Human immunodeficiency virus type 1 (HIV-1) antibody confirmation by western blot arup 0020284 (86689) $100 $100 5.2×
Iaad ia sarscov & influenza virus types a&b (87428) $119.50 $119.50 1.7×
Iadna sars-cov-2 COVID-19 amplified probe tq (87635) $128 $128 2.5×
Iadna sarscov2 & inf a&b & rsv mult amp probe tq (87637) $194 $194 1.4×
Iadna-DNA/RNA probe tq 12-25 (87507) $771 $771 1.8×
Igg subclass 1 (82787) $316 $316 39.4×
Immune complex assay (86332) $186 $186 7.6×
Immunoassay analyte quantitative nos (83520) $289 $289 16.7×
Immunoassay infectious agent antibody quan nos (86317) $181.50 $181.50 12.1×
Immunofixation electrophoresis (86334) $211 $211 9.4×
Immunoglobulin d (82784) $105 $105 11.3×
Immunoglobulin light chains free each (83521) $176 $176 10.2×
Immunoperoxidase (88342) $166 $166 0.9×
Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87385) $284 $284 21.4×
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; HIV-1 antigen(s), with… (87806) $199 $199 6.1×
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; not otherwise specified… (87899) $132 $132 8.2×
Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; quantification, each organism Other… (87799) $242 $242 5.6×
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique Other… (87491) $60 $60 1.7×
Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, quantification Other Outpatient (87497) $1,109 $1,109 25.9×
Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified probe technique Other Outpatient (87526) $450 $450 11.5×
Insulin antibody (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 (83605) $65 $65 5.6×
Lactate dehydrogenase (83615) $89 $89 14.7×
Lactoferrin fecal (qual) (83630) $123 $123 6.2×
Lamotrigine (80175) $282 $282 21.3×
Ldh isoenzymes (83625) $123 $123 9.6×
LDL direct (83721) $114 $114 10.9×
Lead (83655) $161 $161 13.3×
Legionella culture (87081) $79 $79 11.9×
Legionella urine antigen (87449) $80 $80 6.7×
Leukocyte alkaline phosphatase (85540) $48 $48 5.6×
Level II - Surgical pathology, gross and microscopic examination Appendix, incidental Fallopian tube, sterilization… (88302) $151 $151 3.8×
Level III - Surgical pathology, gross and microscopic examination Abortion, induced Abscess Aneurysm -… (88304) $169 $169 3.1×
Level IV - surgical pathology, gross and microscopic examination abortion - spontaneous/missed artery, biopsy bone… (88305) $319 $319 5.8×
Level v - surgical pathology, gross and microscopic examination adrenal, resection bone - biopsy/curettings bone… (88307) $359 $359 0.9×
Level VI - Surgical pathology, gross and microscopic examination Bone resection Breast, mastectomy - with regional… (88309) $492 $492 0.6×
Lipase (83690) $142 $142 20.6×
Lithium (80178) $109 $109 16.5×
Luteinizing hormone (lh) (83002) $135 $135 7.3×
Lyme disease antibody (86617) $436 $436 28.1×
Lyme disease antibody (86618) $183 $183 10.7×
Magnesium (83735) $149 $149 22.2×
Malaria smear (87207) $125 $125 20.9×
Manual differential (85007) $66 $66 17.4×
Mercury (83825) $295 $295 18.1×
Metanephrines (83835) $232 $232 13.7×
Methemoglobin quant (83050) $69 $69 8.4×
Methylmalonic acid serum (83921) $528 $528 24.9×
Microalbumin urine (82043) $201 $201 34.8×
Mitochondrial antibody each (86381) $143 $143 5.6×
Mog-igg1 antb flo cytmtry ea (86363) $1,163 $1,163 30.8×
Mold id (87107) $81 $81 7.8×
Mononuclear cell antigen (86356) $194 $194 7.2×
Mrsa PCR (87641) $177 $177 5.0×
Mthfr gene (81291) $170 $170 2.6×
Mumps antibody (86735) $98 $98 7.5×
Muramidase (85549) $134 $134 7.1×
Mycoplasma antibody (86738) $143 $143 10.8×
Myelin associated glycoprotein (mag) antibody (83516) $172 $172 14.9×
N.gonorrhoeae DNA amp prob (87591) $60 $60 1.7×
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×
Nk cells total count (86357) $194 $194 5.1×
Occult blood screening (82270) $88 $88 20.1×
Organic acids total quant (83918) $340 $340 14.4×
Osmolality serum (83930) $97 $97 14.7×
Osmolality urine (83935) $152 $152 22.3×
Ova and parasite exam (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×
Parathyroid hormone (83970) $248 $248 6.0×
Parvovirus antibody (86747) $99 $99 6.6×
Pertussis by PCR (87798) $419.50 $419.50 12.0×
Phenobarbital (80184) $129 $129 8.4×
Phenylalanine (84030) $268 $268 48.7×
Phenytoin (dilantin) free (80186) $167 $167 12.1×
Phenytoin level total (80185) $167 $167 12.6×
Phosphorus (84100) $105 $105 22.2×
Phosphorus urine (84105) $134 $134 23.2×
Platelet count automated (85049) $38 $38 8.5×
Potassium (84132) $105 $105 22.1×
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×
Proinsulin (84206) $46 $46 1.7×
Prolactin (84146) $166 $166 8.6×
Prostate specific antigen (PSA); complexed (direct measurement) Other Outpatient (84152) $211 $211 11.5×
Protein c activity (85303) $90 $90 6.5×
Protein electrophoresis serum (84165) $129 $129 12.0×
Protein s antigen, free (85306) $149 $149 9.7×
Protein total other source (84157) $69 $69 17.3×
Protein total serum (84155) $105 $105 28.6×
Protein total urine (84156) $100 $100 27.2×
Protozoa antibody nos (86753) $121 $121 9.8×
PSA free (84154) $297 $297 16.2×
Rbc antibody elution (86860) $181 $181 1.0×
Rbc antibody identification (86870) $185 $185 0.5×
Rbc antibody screen (86850) $124 $124 12.7×
Reagent strip/blood glucose (82948) $24 $24 4.8×
Reflex gamma-aminobutyric acid receptor, type a (gaba-ar) antibody titer, igg by cba-ifa, csf arup 3006006 (86256) $91 $91 7.6×
Reflex herpes simplex virus type 1 glycoprotein g-specific antibody, igg by elisa (herpeselect(r) (86695) $76 $76 5.8×
Reflex herpes simplex virus type 2 glycoprotein g-specific antibody, igg by elisa, csf arup 00503 (86696) $76 $76 3.9×
Renin (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×
Rl immediate spin crossmatch (86920) $115 $115 0.6×
Rpr qual (86592) $95 $95 22.2×
Rubella antibody (86762) $197 $197 13.7×
Rubeola antibody (86765) $79 $79 6.1×
Russell viper venom diluted (85613) $84.50 $84.50 8.8×
Sedimentation rate rbc non-automated (85651) $97 $97 22.7×
Semen analysis post vasectomy (89321) $82 $82 6.8×
Sex hormone binding globulin (84270) $264 $264 12.1×
Shiga-like toxin ag eia (87427) $66 $66 5.5×
Sickle cell screen (85660) $76 $76 13.8×
Skin test tuberculosis intradermal (86580) $68 $68 2.2×
Sodium (84295) $105 $105 21.8×
Sodium urine (84300) $134 $134 26.5×
Somatomedin (84305) $250 $250 11.8×
Special stains group i (88312) $202 $202 3.7×
Special stains group ii (88313) $169 $169 1.2×
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 1 (88300) $200 $200 6.6×
Surgical pathology consultation and report on referred material requiring preparation of slides (88323) $197 $197 3.6×
Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent Other Outpatient (87188) $104 $104 15.7×
T3 free (84481) $127.50 $127.50 7.5×
T3 reverse (84482) $624 $624 39.6×
T3 uptake (84479) $77 $77 11.9×
T4 (thyroxine) total (84436) $105 $105 15.3×
Tacrolimus (80197) $245 $245 17.8×
Tb test cell immun measure (86480) $311 $311 5.0×
Testosterone free (84402) $156 $156 6.1×
Testosterone total (84403) $156 $156 6.0×
Theophylline (80198) $171 $171 12.1×
Thiopurine drug metabolites (83789) $531 $531 22.0×
Thiopurine metabolites (80299) $290 $290 15.6×
Thrombin time plasma (85670) $57 $57 9.9×
Thyroglobulin (84432) $125 $125 7.8×
Thyroglobulin antibody (86800) $102.50 $102.50 6.4×
Thyroid peroxidase antibody (86376) $129 $129 8.9×
Thyroid stimulating immune globulins (thyroid related protein) level (84445) $238 $238 4.7×
Thyroxine free (ft4) (84439) $103 $103 11.4×
Tissue transglutaminase ea immunoglobulin class (86364) $141 $141 12.2×
Topiramate (80201) $273 $273 22.9×
Toxoplasma antibody igg (86777) $102 $102 7.1×
Toxoplasma antibody igm (86778) $111 $111 7.7×
Transferrin (84466) $111 $111 8.7×
Treponema pallidum antibody (86780) $54 $54 4.1×
Trichomonas vagin dir probe (87660) $99 $99 4.9×
Trichomonas vaginalis amplif (87661) $106 $106 3.0×
Triglycerides (84478) $105 $105 18.3×
Triiodothyronine total assay, tt-3 - t3 (thyroid hormone) (84480) $156 $156 11.0×
Troponin t (84484) $215 $215 17.2×
Urea nitrogen clearance (84545) $81 $81 11.3×
Urea nitrogen quantitative (84520) $103.50 $103.50 26.2×
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 bacteria culture (87088) $25 $25 3.1×
Urine Pregnancy Test POC (81025) $76 $76 8.8×
Valproic acid (80164) $194 $194 14.3×
Vancomycin (80202) $232 $232 17.1×
Varicella zoster antibody igg (86787) $148 $148 11.5×
Vasopressin (antidiuretic hormone, ADH) Other Outpatient (84588) $272 $272 8.0×
Viral culture non-respiratory (87252) $273 $273 10.5×
Virus antibody nos (86790) $289 $289 22.4×
Virus isolation; tissue culture, additional studies or definitive identification (eg, hemabsorption, neutralization,… (87253) $161 $161 8.0×
Vitamin a (84590) $131 $131 11.3×
Vitamin b-12 (82607) $143 $143 9.5×
Vitamin b1 whole blood (84425) $286 $286 13.5×
Vitamin b6 (84207) $258 $258 9.2×
Vitamin d 25 hydroxy (82306) $184.50 $184.50 6.2×
Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed Other Outpatient (82652) $306 $306 7.9×
Vitamin e (84446) $103 $103 7.3×
Vitamin k1 (84597) $518 $518 37.8×
West nile virus antibody (86789) $134 $134 9.3×
Yeast id (87106) $55 $55 5.3×
Zinc (84630) $129 $129 11.3×