| 17 Hydroxypregnenolone (84143) |
$270 |
$270 |
11.8× |
| 17-Ohcs (83491) |
$210 |
$210 |
11.7× |
| 5' Nucleotidase (83915) |
$234 |
$234 |
21.0× |
| 5-Hiaa (83497) |
$244 |
$244 |
18.9× |
| Ab; actinomyces (86602) |
$122 |
$122 |
12.0× |
| Ab; coxiella brunetii (86638) |
$151.50 |
$151.50 |
12.5× |
| Ab; encephalitis calif (86651) |
$74 |
$74 |
5.6× |
| Ab; encephalitis e equine (86652) |
$74 |
$74 |
5.6× |
| Ab; encephalitis w equine (86654) |
$129 |
$129 |
9.8× |
| Ab; htlv or HIV wb (86689) |
$559 |
$559 |
28.9× |
| Ab; htlv-ii (86688) |
$230 |
$230 |
16.4× |
| Ab; rsv (86756) |
$154 |
$154 |
9.7× |
| Abl1 gene (81170) |
$1,276 |
$1,276 |
4.3× |
| Acetaminophen (80143) |
$158 |
$158 |
8.5× |
| Acetone serum qual (82009) |
$64 |
$64 |
14.2× |
| Acetylcholine receptor binding antibody (86041) |
$137 |
$137 |
7.4× |
| Acetylcholine receptor blocking antibody (86042) |
$233 |
$233 |
12.7× |
| Acetylcholine receptor modulating antibody (86043) |
$233 |
$233 |
19.3× |
| Acetylcholinesterase (82013) |
$132 |
$132 |
10.7× |
| Acid fast smear only (87206) |
$82 |
$82 |
15.2× |
| Acid phosphatase (84060) |
$236 |
$236 |
30.9× |
| Acth stimulation panel adrenal (80400) |
$485 |
$485 |
14.9× |
| Actin smooth muscle antibody each (86015) |
$298 |
$298 |
24.7× |
| Activated protein c resistance (85307) |
$216.50 |
$216.50 |
14.1× |
| Acute hepatitis panel (80074) |
$934 |
$934 |
19.6× |
| Acylcarnitines quantitative (82017) |
$199 |
$199 |
11.8× |
| Adamts13 activity (85397) |
$272 |
$272 |
8.8× |
| Adenovirus ag eia (87301) |
$146 |
$146 |
12.2× |
| Adenovirus ag if (87260) |
$120.50 |
$120.50 |
8.4× |
| Adenovirus antibody (86603) |
$1,417.50 |
$1,417.50 |
110.1× |
| Adrenocorticotropic hormone (82024) |
$692 |
$692 |
17.9× |
| Afb culture (87116) |
$177.50 |
$177.50 |
16.4× |
| Albumin csf (82042) |
$46 |
$46 |
5.9× |
| Albumin serum (82040) |
$48 |
$48 |
9.7× |
| Aldolase (82085) |
$118 |
$118 |
12.2× |
| Aldosterone urine (82088) |
$593 |
$593 |
14.6× |
| Alk phos heat stable (84078) |
$88 |
$88 |
10.7× |
| Alkaline phosphatase (84075) |
$81 |
$81 |
15.6× |
| Alkaline phosphatase isoenzymes (84080) |
$300 |
$300 |
20.3× |
| Allerg sp igg quan or semiquan (86001) |
$62 |
$62 |
7.9× |
| Allergen specific ige (86003) |
$203 |
$203 |
38.9× |
| Allergen specific ige (86005) |
$34 |
$34 |
4.3× |
| Alpha 2 antiplasmin (85410) |
$92 |
$92 |
11.9× |
| Alpha defensin synovial fluid (83518) |
$101 |
$101 |
10.5× |
| Alpha fetoprotein serum (82105) |
$294 |
$294 |
17.5× |
| Alpha-1 antitrypsin total (82103) |
$234 |
$234 |
17.4× |
| Alpha-1-antitrypsin phenotype (82104) |
$117.50 |
$117.50 |
8.1× |
| Alpha-fetoprotein amniotic (82106) |
$225.50 |
$225.50 |
13.3× |
| Alt/sgpt (84460) |
$53 |
$53 |
10.0× |
| Aluminum (82108) |
$196 |
$196 |
7.7× |
| Amikacin level (80150) |
$273 |
$273 |
18.1× |
| Amino acids quan 6 or more (82139) |
$140.50 |
$140.50 |
8.3× |
| Amino acids quant 2-5 (82136) |
$199 |
$199 |
10.1× |
| Amino acids; multi qual ea (82128) |
$164 |
$164 |
11.8× |
| Amino acids; sgl quan ea (82131) |
$142 |
$142 |
6.2× |
| Aminolevulinic acid delta (82135) |
$284 |
$284 |
17.3× |
| Amiodarone (80151) |
$123 |
$123 |
6.6× |
| Ammonia (82140) |
$224 |
$224 |
15.4× |
| Amylase (82150) |
$131 |
$131 |
20.2× |
| Ana titer (86039) |
$117 |
$117 |
10.5× |
| Analysis for antibody to Haemophilus influenza (respiratory bacteria) (86684) |
$188 |
$188 |
11.9× |
| Analysis for antibody to Neisseria meningitidis (bacterial meningitis) (86741) |
$157 |
$157 |
11.9× |
| Androstanediol glucuronide (82154) |
$342 |
$342 |
11.9× |
| Androstenedione (82157) |
$594 |
$594 |
20.3× |
| Angiotensin converting enzyme (82164) |
$331 |
$331 |
22.7× |
| Angiotensin ii (82163) |
$242 |
$242 |
11.8× |
| Anti DNA (ss) igg ab qn (86226) |
$143 |
$143 |
11.8× |
| Anti-mitochondrial antibody (86255) |
$216.50 |
$216.50 |
18.0× |
| Anti-phosphatidylserine antibody (86148) |
$92 |
$92 |
5.7× |
| Antibody bacterium nos (86609) |
$44 |
$44 |
3.4× |
| Antibody elution (86860) |
$137 |
$137 |
0.8× |
| Antibody identification (86870) |
$438 |
$438 |
1.1× |
| Antibody screen rbc each (86850) |
$136 |
$136 |
13.9× |
| Antibody toxoplasma (86777) |
$110 |
$110 |
7.6× |
| Antineutrophil cytoplasmic antb screen ea antb (86036) |
$289 |
$289 |
24.0× |
| Antinuclear antibodies (86038) |
$115.50 |
$115.50 |
9.6× |
| Antistreptolysin o screen (86063) |
$100 |
$100 |
17.3× |
| Antistreptolysin o titer (86060) |
$178 |
$178 |
24.4× |
| Antithrombin iii activity (85300) |
$132.50 |
$132.50 |
11.2× |
| Antithrombin iii antigen (85301) |
$130 |
$130 |
12.0× |
| Apolipoprotein b (82172) |
$86 |
$86 |
4.1× |
| Aquaporin-4 antibody cell-based imfluor assay ea (86052) |
$322 |
$322 |
26.7× |
| Arsenic (82175) |
$417 |
$417 |
22.0× |
| Ashkenazi jewish assoc dis (81412) |
$8,960 |
$8,960 |
3.7× |
| Aspergillus antibody (86606) |
$62 |
$62 |
4.1× |
| Aspergillus antigen (87305) |
$312.50 |
$312.50 |
26.1× |
| Assay carboxyhb qual (82376) |
$71 |
$71 |
5.0× |
| Assay dir meas fr estradiol (82681) |
$550 |
$550 |
19.7× |
| Assay of anti-mullerian hormone (82166) |
$157 |
$157 |
4.1× |
| Assay of corticosterone (82528) |
$266 |
$266 |
11.8× |
| Assay of feces porphyrins (84126) |
$302 |
$302 |
7.7× |
| Assay of g6pd enzyme (82955) |
$234 |
$234 |
24.1× |
| Assay of glucosidase (82963) |
$95 |
$95 |
4.4× |
| Assay of procainamide (80192) |
$429 |
$429 |
25.6× |
| Assay of procainamide (80190) |
$429 |
$429 |
7.2× |
| Assay of vitamin b-2 (84252) |
$324 |
$324 |
16.0× |
| Assay spec xcp ur&breath ia (82077) |
$406 |
$406 |
23.5× |
| Assay, free hydroxyproline - hydroxyproline, free (83500) |
$284 |
$284 |
12.5× |
| Assisted embryo hatching, microtechniques (any method) (89253) |
$404 |
$404 |
2.2× |
| Assisted oocyte fertilization (fertility procedure), greater than 10 oocytes (89281) |
$1,989 |
$1,989 |
11.0× |
| Assisted oocyte fertilization (fertility procedure), less than or equal to 10 oocytes (89280) |
$3,081 |
$3,081 |
3.6× |
| Ast/sgot (84450) |
$53 |
$53 |
10.2× |
| Autolog blood predeposited (86890) |
$351 |
$351 |
1.9× |
| Autologous blood op salvage (86891) |
$1,077 |
$1,077 |
1.3× |
| Automated rbc count (85041) |
$75 |
$75 |
24.8× |
| B cells total count (86355) |
$447 |
$447 |
11.8× |
| B-hexosaminidase ea assay (83080) |
$199 |
$199 |
11.8× |
| Bartonella DNA amp probe (87471) |
$458 |
$458 |
13.1× |
| Bartonella henselae igm (86611) |
$42 |
$42 |
4.1× |
| Bc - anaerobe - addtl id (87076) |
$106 |
$106 |
13.1× |
| Bcr/abl 1 gene other bp (81208) |
$2,862 |
$2,862 |
13.3× |
| Bcr/abl1 gene major bp (81206) |
$1,290 |
$1,290 |
7.9× |
| Bcr/abl1 gene minor bp (81207) |
$1,567.50 |
$1,567.50 |
10.8× |
| Beta 2 glycoprotein i ab ea (86146) |
$222 |
$222 |
8.7× |
| Beta hydroxybutyrate (82010) |
$149.50 |
$149.50 |
18.3× |
| Beta-2 microglobulin (82232) |
$48 |
$48 |
3.0× |
| Bile acids total (82239) |
$88 |
$88 |
5.1× |
| Bile acids, cholylglycine - bile acids, cholylglycine (82240) |
$315 |
$315 |
11.9× |
| Bilirubin direct (82248) |
$72.50 |
$72.50 |
14.4× |
| Bilirubin total (82247) |
$35 |
$35 |
7.0× |
| Bilirubin total transcutaneous (88720) |
$60 |
$60 |
12.0× |
| Bill task fungal identification by maldi-tof ms arup 2009257 2007693 (87158) |
$69 |
$69 |
8.9× |
| Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); greater than 5… (89291) |
$1,989 |
$1,989 |
11.0× |
| Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis); less than or… (89290) |
$1,989 |
$1,989 |
11.0× |
| Biotinidase (82261) |
$199 |
$199 |
11.8× |
| Blastomyces antibody (86612) |
$111 |
$111 |
8.6× |
| Bld count smear mcrscp w/o mnl difrntl wbc count (85008) |
$76.50 |
$76.50 |
22.3× |
| Bleeding time (85002) |
$159.50 |
$159.50 |
33.1× |
| Blood bank physician services; difficult cross match and/or evaluation of irregular antibody(s), interpretation and… (86077) |
$175 |
$175 |
5.7× |
| Blood count reticulocyte automated (85044) |
$51 |
$51 |
11.8× |
| Blood gas ph only (82800) |
$33 |
$33 |
3.0× |
| Blood gases 02 sat only (82810) |
$209 |
$209 |
21.4× |
| Blood gases w/o2 saturation (82805) |
$336 |
$336 |
4.3× |
| Blood Smear,Micro Exam,Manual Diff Wbc - Manual Differential (85007) |
$64 |
$64 |
16.8× |
| Blood type antigen donor ea (86902) |
$224 |
$224 |
35.3× |
| Blood typing abo (86900) |
$94 |
$94 |
31.4× |
| Blood typing antigen screen patient serum/unit (86904) |
$81 |
$81 |
5.0× |
| Blood typing rbc antigens oth/thn abo/rh d each (86905) |
$235.50 |
$235.50 |
61.5× |
| Blood typing serologic rh (d) (86901) |
$100.50 |
$100.50 |
33.6× |
| Body Fluid Cell Count W Diff - Body Fluid Cell Count W/Diff (89051) |
$86 |
$86 |
15.4× |
| Bone marrow smear interpretation (85097) |
$87 |
$87 |
0.1× |
| Bordetella pertussis igm (86615) |
$113.50 |
$113.50 |
8.6× |
| Borrelia miyamotoi amp prb (87478) |
$116 |
$116 |
3.3× |
| Braf gene analysis (81210) |
$933.50 |
$933.50 |
5.3× |
| Brucella antibody (86622) |
$209 |
$209 |
23.4× |
| C diff amplified probe (87493) |
$267 |
$267 |
7.2× |
| C-peptide (84681) |
$380 |
$380 |
18.3× |
| C-reactive protein (86140) |
$94 |
$94 |
18.1× |
| C1 esterase inhibitor functional (86161) |
$82 |
$82 |
6.8× |
| Ca 125 (86304) |
$362 |
$362 |
17.4× |
| Ca 15-3 (86300) |
$323.50 |
$323.50 |
15.5× |
| Cadmium blood (82300) |
$275 |
$275 |
11.6× |
| Caffeine level (80155) |
$168 |
$168 |
4.4× |
| Calcitonin (82308) |
$411 |
$411 |
15.3× |
| Calcium ionized (82330) |
$108 |
$108 |
7.9× |
| Calcium total (82310) |
$77 |
$77 |
14.9× |
| Calcium urine (82340) |
$73 |
$73 |
12.1× |
| Calcium; after calcium infusion test Other Outpatient (82331) |
$490 |
$490 |
36.7× |
| Calculus qual analysis (82355) |
$203 |
$203 |
17.5× |
| Calculus; X-ray diffraction Other Outpatient (82370) |
$222 |
$222 |
17.7× |
| Calprotectin, stool (83993) |
$242 |
$242 |
12.3× |
| Calr gene com variants (81219) |
$1,130 |
$1,130 |
9.3× |
| Campylobacter antibody (86625) |
$156 |
$156 |
11.9× |
| Cancer antigen 19-9 (86301) |
$393 |
$393 |
18.9× |
| Candida antibody (86628) |
$126 |
$126 |
10.5× |
| Candida na amplified probe (87481) |
$161 |
$161 |
4.6× |
| Car ion chnnlpath inc 10 gns (81413) |
$1,708 |
$1,708 |
2.9× |
| Car ion chnnlpath inc 2 gns (81414) |
$331 |
$331 |
0.6× |
| Carbamazepine and Metabolite Component 1 Referred (80161) |
$390 |
$390 |
20.9× |
| Carbamazepine free (80157) |
$490 |
$490 |
37.0× |
| Carbamazepine total (80156) |
$204.50 |
$204.50 |
14.0× |
| Carbon dioxide (82374) |
$98 |
$98 |
20.1× |
| Carboxyhemoglobin quant (82375) |
$236 |
$236 |
19.2× |
| Carcinoembryonic antigen (cea) (82378) |
$362 |
$362 |
19.1× |
| Cardiolipin ab ea ig class (86147) |
$634 |
$634 |
24.9× |
| Carnitine quant ea specimen (82379) |
$199 |
$199 |
11.8× |
| Carotene (82380) |
$170 |
$170 |
18.4× |
| Catecholamines blood (82383) |
$581 |
$581 |
20.0× |
| Catecholamines fraction plasma (82384) |
$746 |
$746 |
29.5× |
| Catecholamines total urine (82382) |
$324 |
$324 |
11.9× |
| Ccp antibody (86200) |
$87 |
$87 |
6.7× |
| Cd4/cd8 count - lymphocyte subset panel 5 - arup (86360) |
$186 |
$186 |
4.0× |
| Cebpa gene full sequence (81218) |
$1,857 |
$1,857 |
7.7× |
| Cell Count,Misc Body Fluids - Body Fluid Cell Count (89050) |
$41.50 |
$41.50 |
8.8× |
| Cell enumeration & id (86152) |
$1,757.50 |
$1,757.50 |
7.0× |
| Cell function assay w/stim (86352) |
$1,606 |
$1,606 |
11.8× |
| Ceruloplasmin (82390) |
$284 |
$284 |
26.4× |
| Cftr gene com variants (81220) |
$772 |
$772 |
1.4× |
| Chemiluminescent assay (82397) |
$218 |
$218 |
15.4× |
| Chimerism anal no cell selec (81267) |
$2,450.50 |
$2,450.50 |
11.8× |
| Chimerism w/comp to baseline w/cell selection ea (81268) |
$935 |
$935 |
3.6× |
| Chlamydia antibody (86631) |
$324 |
$324 |
27.4× |
| Chlamydia trachomatis igm (86632) |
$324 |
$324 |
25.6× |
| Chloramphenicol (82415) |
$238 |
$238 |
18.8× |
| Chloride blood (82435) |
$92 |
$92 |
20.0× |
| Chloride fluid (82438) |
$92 |
$92 |
18.4× |
| Chloride urine (82436) |
$107.50 |
$107.50 |
18.7× |
| Cholesterol total (82465) |
$35 |
$35 |
8.0× |
| Cholinesterase rbc (82482) |
$204 |
$204 |
20.8× |
| Cholinesterase serum (82480) |
$255 |
$255 |
32.4× |
| Chrmsm count 15-20 cll 2karyotyp banding (88262) |
$1,781.50 |
$1,781.50 |
14.2× |
| Chrmsm count 45 cell mosaicism 2karyotype (88263) |
$1,774.50 |
$1,774.50 |
11.8× |
| Chromium (82495) |
$103 |
$103 |
5.1× |
| Chromogenic substrate assay (85130) |
$142 |
$142 |
11.9× |
| Chromogranin a (86316) |
$246 |
$246 |
11.8× |
| Chromosome analys amniotic (88269) |
$1,562 |
$1,562 |
9.0× |
| Chromosome analysis 20-25 cells (88264) |
$673.50 |
$673.50 |
4.7× |
| Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 cells, count 20 cells, 2 karyotypes (eg,… (88248) |
$2,568 |
$2,568 |
14.8× |
| Chromosome analysis for genetic defects, additional cells counted, each study (88285) |
$282 |
$282 |
10.5× |
| Chromosome analysis for genetic defects, additional karyotypes, each study (88280) |
$162 |
$162 |
4.8× |
| Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding Other Outpatient (88267) |
$2,667 |
$2,667 |
14.1× |
| Chromosome analysis; additional specialized banding technique (eg, NOR, C-banding) Other Outpatient (88283) |
$1,018 |
$1,018 |
14.8× |
| Chromosome analysis; count 5 cells, 1 karyotype, with banding Other Outpatient (88261) |
$2,621 |
$2,621 |
9.9× |
| Chromosome study additional (88289) |
$800 |
$800 |
23.2× |
| Chylmd Pneum, Dna, Amp Probe - Chlamydia Pneumoniae Dna Probe, Amp (87486) |
$527 |
$527 |
15.0× |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) |
$207.50 |
$207.50 |
5.9× |
| Citrate (82507) |
$328 |
$328 |
11.8× |
| Ck isoenzymes (82552) |
$320 |
$320 |
23.9× |
| Clot factor xiii fibrin stab (85290) |
$119 |
$119 |
7.3× |
| Clot retraction (85170) |
$66 |
$66 |
4.0× |
| Clotting factor viii multimetric analysis (85247) |
$182.50 |
$182.50 |
8.0× |
| Clotting factor xiii fibrn stabiliz screen solub (85291) |
$96 |
$96 |
10.5× |
| Clotting; hmw kininogen assay (85293) |
$224 |
$224 |
11.8× |
| Clotting; prekallikrein assay (Fletcher factor assay) Other Outpatient (85292) |
$224 |
$224 |
11.8× |
| Cmv Antibody - Cmv Igg (86644) |
$306 |
$306 |
21.3× |
| Cmv PCR quant (87497) |
$370 |
$370 |
8.6× |
| Coagulation time activated (85347) |
$376 |
$376 |
87.9× |
| Coccidioides antibody (86635) |
$119 |
$119 |
10.4× |
| Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) |
$178 |
$178 |
7.4× |
| Cold agglutinin screen (86156) |
$194 |
$194 |
24.0× |
| Cold agglutinins titer (86157) |
$144 |
$144 |
17.9× |
| Collagen cross links (82523) |
$76.50 |
$76.50 |
4.1× |
| Collect sweat for test (89230) |
$304 |
$304 |
5.5× |
| Compatibility each unit immediate spin technique (86920) |
$94 |
$94 |
0.5× |
| Compatibility test antiglob (86922) |
$125 |
$125 |
0.7× |
| Compatibility test incubate (86921) |
$125 |
$125 |
0.7× |
| Complement c3 (86160) |
$307 |
$307 |
25.6× |
| Complement fixation ea ag (86171) |
$138 |
$138 |
13.8× |
| Complement total (ch50) (86162) |
$320 |
$320 |
15.7× |
| Comprehensive consult (88325) |
$840.50 |
$840.50 |
4.6× |
| Concentration infectious agents (87015) |
$94 |
$94 |
14.1× |
| Coombs test indirect qual (86885) |
$207.50 |
$207.50 |
36.3× |
| Coombs test indirect titer (86886) |
$149 |
$149 |
28.8× |
| Copper liver tissue (82525) |
$250 |
$250 |
20.1× |
| Cortisol free (82530) |
$199 |
$199 |
11.9× |
| Cortisol serum (82533) |
$259 |
$259 |
15.9× |
| Coxsackie a9 virus antibodies (86658) |
$854.50 |
$854.50 |
65.6× |
| Cp cerv/vag; atl; manual scrn (88142) |
$363 |
$363 |
17.9× |
| Cp concentr tech smear (88108) |
$264 |
$264 |
6.6× |
| Cp smr othr; > 5 slides (88162) |
$264 |
$264 |
4.8× |
| Cp smr othr; prep scrn int (88161) |
$218 |
$218 |
7.1× |
| Creatine (82540) |
$163 |
$163 |
35.1× |
| Creatine kinase (CK), (CPK); isoforms Other Outpatient (82554) |
$140 |
$140 |
11.8× |
| Creatine kinase mb fraction only (82553) |
$166 |
$166 |
14.4× |
| Creatine kinase total (82550) |
$154 |
$154 |
23.7× |
| Creatinine clearance (82575) |
$154 |
$154 |
16.3× |
| Creatinine other source (82570) |
$50 |
$50 |
9.7× |
| Creatinine serum (82565) |
$147.50 |
$147.50 |
28.8× |
| Crp-high sensitivity (86141) |
$94 |
$94 |
7.3× |
| Cryofibrinogen (82585) |
$106 |
$106 |
7.5× |
| Cryoglobulins (82595) |
$162 |
$162 |
25.0× |
| Cryopreservation embryo(s) (89258) |
$3,081 |
$3,081 |
3.6× |
| Cryopreservation, freezing and storage of cells, each cell line Other Outpatient (88240) |
$150 |
$150 |
11.5× |
| Cryptococcal Antigen (87899) |
$125 |
$125 |
7.8× |
| Cryptococcus antibody (86641) |
$171 |
$171 |
11.9× |
| Cryptococcus neoform ag eia (87327) |
$144 |
$144 |
10.7× |
| Cryptosporidium (87272) |
$120 |
$120 |
10.0× |
| Cryptosporidium antigen (87328) |
$102 |
$102 |
7.4× |
| Cul typ id bld pthgn 6+ trgt (87154) |
$252 |
$252 |
1.2× |
| Cult aerobic defin id ea isol (87077) |
$82.50 |
$82.50 |
10.2× |
| Culture aerobic quant other (87071) |
$72.50 |
$72.50 |
7.3× |
| Culture anaerobic (87075) |
$206 |
$206 |
21.8× |
| Culture blood (87040) |
$233 |
$233 |
22.6× |
| Culture chlamydia (87110) |
$416 |
$416 |
21.2× |
| Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous (87101) |
$171.50 |
$171.50 |
22.2× |
| Culture fungus blood (87103) |
$196 |
$196 |
9.6× |
| Culture fungus id (87106) |
$190 |
$190 |
18.4× |
| Culture fungus other (87102) |
$136.50 |
$136.50 |
16.2× |
| Culture genital (87070) |
$147 |
$147 |
17.1× |
| Culture mycobacterial definitive id ea isol (87118) |
$153 |
$153 |
10.5× |
| Culture mycoplasma (87109) |
$651 |
$651 |
42.3× |
| Culture of oocyte(s)/embryo(s), less than 4 days; (89250) |
$1,989 |
$1,989 |
11.0× |
| Culture stool (87045) |
$208.50 |
$208.50 |
22.1× |
| Culture typing glc/hplc (87143) |
$164 |
$164 |
13.1× |
| Culture typing if ea antiserum (87140) |
$73 |
$73 |
13.1× |
| Culture typing nucleic acid probe dir ea organsm (87149) |
$161 |
$161 |
8.0× |
| Culture typing serologic (87147) |
$235.50 |
$235.50 |
45.5× |
| Culture urine (87086) |
$75 |
$75 |
9.3× |
| Culture, typing; identification by pulse field gel typing Other Outpatient (87152) |
$69 |
$69 |
8.9× |
| Cyanide (82600) |
$320 |
$320 |
16.5× |
| Cyclic amp (82030) |
$353.50 |
$353.50 |
13.7× |
| Cyclosporine (80158) |
$330.50 |
$330.50 |
18.3× |
| Cyp2c19 gene analysis common variants (81225) |
$3,804 |
$3,804 |
13.1× |
| Cyp2c9 gene com variants (81227) |
$646 |
$646 |
3.7× |
| Cyp2d6 gene analysis common variants (81226) |
$1,519 |
$1,519 |
3.4× |
| CYP3A4 (cytochrome P450 family 3 subfamily A member 4) (eg, drug metabolism), gene analysis, common variant(s) (eg, *2,… (81230) |
$646 |
$646 |
3.7× |
| Cyp3a5 gene common variants (81231) |
$646 |
$646 |
3.7× |
| Cystatin c (82610) |
$162 |
$162 |
8.7× |
| Cystine and homocystine, urine, qualitative Other Outpatient (82615) |
$67 |
$67 |
7.0× |
| Cytog alys chrmoml abnor cpy number&snp vrnt cgh (81229) |
$4,514 |
$4,514 |
3.9× |
| Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical… (81195) |
$4,106 |
$4,106 |
2.2× |
| Cytogenomic neoplasia microarray analysis (81277) |
$1,609 |
$1,609 |
1.4× |
| Cytomegalov amplif na probe (87496) |
$882.50 |
$882.50 |
25.1× |
| Cytomegalovirus ag eia (87332) |
$179.50 |
$179.50 |
15.0× |
| Cytomegalovirus antibody igm (86645) |
$284 |
$284 |
16.9× |
| Cytopath c/v index add-on (88155) |
$107 |
$107 |
7.3× |
| Cytopath cell enhance technique (88112) |
$487 |
$487 |
8.8× |
| Cytopath fl nongyn filter (88106) |
$264 |
$264 |
8.6× |
| Cytopath fl nongyn smears (88104) |
$164 |
$164 |
4.1× |
| Cytopath tbs c/v manual (88164) |
$190 |
$190 |
10.2× |
| Cytp dx eval fna 1st ea site (88172) |
$156 |
$156 |
0.9× |
| Cytp eval fine needle aspirate interp & report (88173) |
$129 |
$129 |
2.3× |
| Cytp urine 3-5 probes cmptr (88121) |
$990 |
$990 |
5.5× |
| Cytp urne 3-5 probes ea spec (88120) |
$656 |
$656 |
3.6× |
| D-dimer quant (85379) |
$222 |
$222 |
21.8× |
| Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection Other Outpatient (87164) |
$111 |
$111 |
10.3× |
| Deoxycortisol (82634) |
$345 |
$345 |
11.8× |
| Deoxyribonuclease antibody (86215) |
$236.50 |
$236.50 |
17.8× |
| Desoxycorticosterone (82633) |
$335 |
$335 |
10.8× |
| Detect agent nos DNA amp (87798) |
$468.50 |
$468.50 |
13.4× |
| Detect agent nos DNA quant (87799) |
$737 |
$737 |
17.2× |
| Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) |
$144 |
$144 |
8.7× |
| Dhea (82626) |
$300 |
$300 |
11.9× |
| Dhea-s (82627) |
$51 |
$51 |
2.3× |
| Dibucaine number (82638) |
$152 |
$152 |
12.4× |
| Digoxin (80162) |
$335 |
$335 |
25.2× |
| Dihydrotestosterone (82642) |
$152 |
$152 |
5.2× |
| Diphtheria antibody (86648) |
$181 |
$181 |
11.9× |
| Direct antiglobulin test (86880) |
$62 |
$62 |
11.5× |
| DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed… (81161) |
$8,120 |
$8,120 |
29.1× |
| DMPK (DM1 protein kinase) (eg, myotonic dystrophy type 1) gene analysis; evaluation to detect abnormal (expanded)… (81234) |
$543 |
$543 |
4.0× |
| Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) |
$99 |
$99 |
7.2× |
| DNA/RNA amplified probe (87150) |
$100 |
$100 |
2.8× |
| DNA/RNA sequencing (87153) |
$571 |
$571 |
4.9× |
| Donath landsteiner test (86941) |
$216 |
$216 |
17.8× |
| Dpyd gene analysis common variants (81232) |
$646 |
$646 |
3.7× |
| Drug assay adalimumab (80145) |
$155 |
$155 |
4.0× |
| Drug assay felbamate (80167) |
$95 |
$95 |
5.1× |
| Drug assay infliximab (80230) |
$194 |
$194 |
5.0× |
| Drug assay methotrexate (80204) |
$119 |
$119 |
3.1× |
| Drug assay rufinamide (80210) |
$176 |
$176 |
6.5× |
| Drug assay salicylate (80179) |
$158 |
$158 |
8.5× |
| Drug metabolism (eg, pharmacogenomics) genomic sequence analysis panel, must include testing of at least 6 genes,… (81418) |
$1,510 |
$1,510 |
1.6× |
| Drug screen quant clozapine (80159) |
$400 |
$400 |
19.9× |
| Drug screen quant gabapentin (80171) |
$158 |
$158 |
7.3× |
| Drug screen quant zonisamide (80203) |
$157 |
$157 |
11.8× |
| Drug screen quantitative oxcarbazepine (80183) |
$158 |
$158 |
11.9× |
| Drug test prsmv chem anlyzr (80307) |
$296 |
$296 |
4.8× |
| E coli 0157 ag eia (87335) |
$146 |
$146 |
11.5× |
| Echinococcus ab igg (86682) |
$149 |
$149 |
11.5× |
| Egfr gene analysis common variants (81235) |
$1,581 |
$1,581 |
4.9× |
| Ehrlichia antibody (86666) |
$449.50 |
$449.50 |
44.2× |
| Elastase pancreatic fecal quantitative (82653) |
$242 |
$242 |
10.5× |
| Electrolytes panel (80051) |
$124 |
$124 |
17.7× |
| Electron microscopy diagnostic (88348) |
$2,840 |
$2,840 |
3.3× |
| Electronic crossmatch (86923) |
$420 |
$420 |
2.3× |
| Electrophoretic test (82664) |
$227 |
$227 |
3.7× |
| Encephalitis st louis ab (86653) |
$74 |
$74 |
5.6× |
| Endomysial antibody each immunoglobulin class (86231) |
$322 |
$322 |
26.6× |
| Entamoeba histolytica antigen (87337) |
$144 |
$144 |
12.0× |
| Enterovirus by PCR (87498) |
$544 |
$544 |
15.5× |
| Enzyme cell activity (82657) |
$718 |
$718 |
32.4× |
| Enzyme cell activity ra (82658) |
$213 |
$213 |
4.8× |
| Enzyme histochemistry (88319) |
$2,386 |
$2,386 |
2.8× |
| Eosinophil smear (89190) |
$66 |
$66 |
11.4× |
| Epstein-Barr Antibody - Epstein-Barr Virus Early Igg (86663) |
$156 |
$156 |
11.9× |
| Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) |
$159 |
$159 |
10.4× |
| Erythropoietin (82668) |
$349 |
$349 |
18.6× |
| Estradiol (82670) |
$295 |
$295 |
10.6× |
| Estriol serum (82677) |
$160.50 |
$160.50 |
6.6× |
| Estrogen receptor assay (84233) |
$738.50 |
$738.50 |
8.4× |
| Estrogen serum fractionated (82671) |
$506 |
$506 |
15.7× |
| Estrogens total (82672) |
$140 |
$140 |
6.5× |
| Estrone (82679) |
$260 |
$260 |
10.4× |
| Ethosuximide (80168) |
$224 |
$224 |
13.7× |
| Ethylene glycol (82693) |
$60.50 |
$60.50 |
4.1× |
| Euglobulin lysis (85360) |
$94 |
$94 |
11.2× |
| Eval amniotic fluid protein (84112) |
$502 |
$502 |
5.1× |
| Everolimus (80169) |
$162 |
$162 |
11.8× |
| Exam archive tissue molec anal (88363) |
$157 |
$157 |
5.1× |
| Exam,Synovial Fluid Crystals - Synovial Fluid Crystal (89060) |
$126.50 |
$126.50 |
17.3× |
| Exome (eg, unexplained constitutional or heritable disorder or syndrome); re-evaluation of previously obtained exome… (81417) |
$1,108.50 |
$1,108.50 |
3.5× |
| Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis Other Outpatient (81415) |
$2,752 |
$2,752 |
0.6× |
Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg,… (81416) likely a partial charge, not the full procedure |
$1,101 |
$1,101 |
0.1× |
| Extended culture of oocyte(s)/embryo(s), 4-7 days (89272) |
$1,989 |
$1,989 |
2.3× |
| External ECG rec > 48 hr up to 7 days record; incl connect & initial rec (85244) |
$242 |
$242 |
11.9× |
| F2 gene (81240) |
$92 |
$92 |
1.4× |
| Factor ii activity (85210) |
$182 |
$182 |
14.0× |
| Factor ix assay (85250) |
$315 |
$315 |
16.5× |
| Factor v activity (85220) |
$353 |
$353 |
20.0× |
| Factor v leiden (81241) |
$692 |
$692 |
9.4× |
| Factor vii activity (85230) |
$266 |
$266 |
14.9× |
| Factor viii assay (85240) |
$315 |
$315 |
17.6× |
| Factor viii inhibitor (85335) |
$197.50 |
$197.50 |
15.3× |
| Factor viii vw antigen (85246) |
$227.50 |
$227.50 |
9.9× |
| Factor x (stuart-prower) (85260) |
$315 |
$315 |
17.6× |
| Factor xi activity (85270) |
$315 |
$315 |
17.6× |
| Factor xii (hageman) (85280) |
$315 |
$315 |
16.3× |
| Fat differential, feces, quantitative Other Outpatient (82715) |
$70 |
$70 |
3.0× |
| Fat stain urine (89125) |
$64 |
$64 |
10.9× |
| Fatty acids nonesterified (82725) |
$108 |
$108 |
5.8× |
| Fatty acids very long chain (82726) |
$213 |
$213 |
10.8× |
| Fbrnlyc factors&inhibitors plsmng activator (85415) |
$174 |
$174 |
10.1× |
| Fecal fat (82710) |
$322 |
$322 |
19.2× |
| Fecal fat qual (82705) |
$107.50 |
$107.50 |
21.1× |
| Fecal occult blood immunochemical (82274) |
$189 |
$189 |
11.9× |
| Ferritin (82728) |
$304 |
$304 |
22.3× |
| Fetal fibronectin (82731) |
$925 |
$925 |
14.4× |
| Fetal lung maturity assessment; fluorescence polarization Other Outpatient (83663) |
$224 |
$224 |
11.8× |
| Ffp thawing ea unit (86927) |
$47 |
$47 |
0.3× |
| Fibrin degradation products, D-dimer; qualitative or semiquantitative Other Outpatient (85378) |
$150.50 |
$150.50 |
15.5× |
| Fibrin split products (85362) |
$176 |
$176 |
25.5× |
| Fibrinogen activity (85384) |
$92 |
$92 |
9.5× |
| Fibrinogen antigen (85385) |
$101 |
$101 |
7.0× |
| Fibrinolysins or coag screen (85390) |
$62 |
$62 |
4.0× |
| Flow cytometry first marker (88184) |
$289 |
$289 |
0.8× |
| Flt3 gene analysis (81246) |
$531 |
$531 |
6.4× |
| Flt3 gene analysis (81245) |
$1,466 |
$1,466 |
8.9× |
| Fluorescent antibody titer (86256) |
$206 |
$206 |
17.1× |
| FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability ºXLID») gene… (81244) |
$102 |
$102 |
2.3× |
| Fmr1 gene detection (81243) |
$816 |
$816 |
14.3× |
| Folate rbc (82747) |
$218 |
$218 |
12.4× |
| Folate serum (82746) |
$126 |
$126 |
8.6× |
| Fractionation ketosteroids - 17-ketosteroids, fractionation (83593) |
$312 |
$312 |
10.9× |
| Francisella tularensis ab (86668) |
$134 |
$134 |
9.5× |
| Free t4 (84439) |
$204.50 |
$204.50 |
22.7× |
| Frozen blood prep (86930) |
$728 |
$728 |
4.0× |
| Frozen blood thaw (86931) |
$804 |
$804 |
4.4× |
| Fructosamine (82985) |
$49 |
$49 |
2.9× |
| Fructose semen (82757) |
$206 |
$206 |
11.9× |
| Fsh (83001) |
$456 |
$456 |
24.5× |
| Ftl cgen abnor two proteins (81508) |
$78 |
$78 |
1.4× |
| Fungus Identification, Mold - Fungal Identification, Mold (87107) |
$180 |
$180 |
17.4× |
| G6pd screen (82960) |
$73 |
$73 |
12.1× |
| Galactokinase rbc (82759) |
$254 |
$254 |
11.8× |
| Galactose (82760) |
$256 |
$256 |
22.9× |
| Galactose-1-phosphate uridyl transferase; quantitative Other Outpatient (82775) |
$248 |
$248 |
11.8× |
| Gamma glutamyl transferase (82977) |
$116 |
$116 |
16.1× |
| Gammaglobulin ige (82785) |
$320 |
$320 |
19.4× |
| Gases blood (82803) |
$178 |
$178 |
6.8× |
| Gastric analy w/ph ea spec (82930) |
$54 |
$54 |
8.0× |
| Gastric occult blood (82271) |
$110 |
$110 |
20.7× |
| Gastrin (82941) |
$284 |
$284 |
16.1× |
| Genet virus isolate hsv (87255) |
$445 |
$445 |
13.1× |
Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis Other Outpatient (81425) unusually low: confirm this is the full procedure |
$2,477 |
$2,477 |
0.5× |
| Genome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator genome… (81426) |
$1,238 |
$1,238 |
0.5× |
| Genotype cytomegalovirus (87910) |
$540.50 |
$540.50 |
2.1× |
| Genotype DNA hepatitis b (87912) |
$3,363 |
$3,363 |
13.1× |
| Genotype DNA HIV other region (87906) |
$402 |
$402 |
3.1× |
| Gentamicin (80170) |
$551 |
$551 |
33.6× |
| Giardia antigen eia stool (87329) |
$87 |
$87 |
7.3× |
| Gjb2 gene full sequence (81252) |
$2,863 |
$2,863 |
28.3× |
| Gliadin antibody each immunoglobulin class (86258) |
$322 |
$322 |
26.7× |
| Gluc bld gluc mntr dev cleared fda spec home use (82962) |
$27 |
$27 |
8.2× |
| Glucagon (82943) |
$89 |
$89 |
6.2× |
| Glucose (82947) |
$119 |
$119 |
30.3× |
| Glucose body fluid (82945) |
$78 |
$78 |
19.8× |
| Glucose post glucose dose (82950) |
$107.50 |
$107.50 |
22.6× |
| Glucose Tolerance Test (Gtt) - Bundled Charge (82951) |
$240 |
$240 |
18.6× |
| Glycomark (84378) |
$116 |
$116 |
10.1× |
| Gonadotropin releasing hormone (83727) |
$965 |
$965 |
56.1× |
| Gram stain smear (87205) |
$51 |
$51 |
11.9× |
| Gross & micro level ii (88302) |
$124 |
$124 |
3.1× |
| Gross & micro level iii (88304) |
$135 |
$135 |
2.4× |
| Group a strep PCR (87651) |
$337 |
$337 |
9.6× |
| Growth hormone (83003) |
$410 |
$410 |
24.6× |
| Growth hormone suppression panel (glucose administration) This panel must include the following: Glucose (82947 x 3)… (80430) |
$1,165 |
$1,165 |
9.0× |
| Gtt-added samples (82952) |
$61 |
$61 |
15.6× |
| H pylori (c-13) breath test (83013) |
$795 |
$795 |
11.8× |
| Haloperidol (80173) |
$217 |
$217 |
13.8× |
| Haptoglobin (83010) |
$206 |
$206 |
16.4× |
| Hbsag neutralization (87341) |
$136 |
$136 |
13.2× |
| Hcg free betachain test (84704) |
$85 |
$85 |
5.6× |
| Hcg quant (84702) |
$194.50 |
$194.50 |
12.9× |
| Heavy metal quan each nes (83018) |
$136 |
$136 |
6.2× |
| Heavy metal screen (83015) |
$802 |
$802 |
38.3× |
| Heinz bodies direct (85441) |
$50 |
$50 |
11.9× |
| Heinz bodies induced (85445) |
$68 |
$68 |
10.0× |
| Helicobacter Pylori Antibody Igg (86677) |
$176 |
$176 |
10.4× |
| Hemagglutination inhibition (86280) |
$98 |
$98 |
12.0× |
| Hematocrit (85014) |
$51 |
$51 |
21.5× |
| Hematocrit spun (85013) |
$28 |
$28 |
4.0× |
| Hematolymphoid neoplasm or disorder, genomic sequence analysis panel, 5-50 genes, interrogation for sequence variants,… (81450) |
$4,841.50 |
$4,841.50 |
6.4× |
| Hemoglobin (85018) |
$75 |
$75 |
31.6× |
| Hemoglobin a1c (83036) |
$154 |
$154 |
15.9× |
| Hemoglobin electrophoresis (83020) |
$294 |
$294 |
22.8× |
| Hemoglobin fetal ql (83033) |
$68 |
$68 |
8.5× |
| Hemoglobin Fetal,Rosette - Fetal Bleed Screen (85461) |
$117 |
$117 |
12.5× |
| Hemoglobin fractj/quantj chromotography (83021) |
$213 |
$213 |
11.8× |
| Hemoglobin plasma (83051) |
$203 |
$203 |
27.8× |
| Hemoglobin stability screen (83068) |
$26 |
$26 |
2.7× |
| Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin Other Outpatient (88740) |
$45 |
$45 |
4.8× |
| Hemoglobin-oxygen affinity (82820) |
$118 |
$118 |
8.8× |
| Hemoglobin; methemoglobin, qualitative Other Outpatient (83045) |
$58 |
$58 |
8.9× |
| Hemolysin acid (85475) |
$106 |
$106 |
12.0× |
| Hemosiderin urine (83070) |
$100 |
$100 |
21.1× |
| Hep B Core Ab Test, Igm - Hepatitis B Core Antibody, Igm (86705) |
$171 |
$171 |
14.5× |
| Heparin assay (85520) |
$492 |
$492 |
37.6× |
| Heparin induced platelet ab (86022) |
$227.50 |
$227.50 |
12.4× |
| Heparin neutralization (85525) |
$141 |
$141 |
11.9× |
| Heparin-protamine tolerance - poct heparin dose response (85530) |
$125 |
$125 |
9.5× |
| Hepatitis a antibody (haab) total (86708) |
$142 |
$142 |
11.5× |
| Hepatitis a igm (86709) |
$192 |
$192 |
17.1× |
| Hepatitis b core antibody total (86704) |
$134.50 |
$134.50 |
11.2× |
| Hepatitis b surface antibody (86706) |
$140 |
$140 |
13.0× |
| Hepatitis B Surface Antigen (87340) |
$86 |
$86 |
8.3× |
| Hepatitis b virus DNA, quantitative, real-time PCR (87517) |
$657 |
$657 |
15.3× |
| Hepatitis be antibody (86707) |
$199 |
$199 |
17.2× |
| Hepatitis be antigen (87350) |
$199 |
$199 |
17.3× |
| Hepatitis c antibody (86803) |
$171.50 |
$171.50 |
12.0× |
| Hepatitis C antibody; confirmatory test (eg, immunoblot) Other Outpatient (86804) |
$3,014 |
$3,014 |
194.6× |
| Hepatitis c RNA quantitative (87522) |
$658 |
$658 |
15.4× |
| Hepatitis c virus genotype (87902) |
$763 |
$763 |
3.0× |
| Hepatitis delta antibody (86692) |
$141.50 |
$141.50 |
8.2× |
| Herpes 6 amplif na probe (87532) |
$460 |
$460 |
13.1× |
| Herpes simplex type 1 ab (86695) |
$154 |
$154 |
11.7× |
| Herpes simplex type 2 antibody (86696) |
$93 |
$93 |
4.8× |
| Herpes simplex virus igm ab (86694) |
$138 |
$138 |
9.6× |
| Heterophile ab screen (86308) |
$94 |
$94 |
18.1× |
| Heterophile antibodies; titer Other Outpatient (86309) |
$76 |
$76 |
11.7× |
| Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney Other Outpatient (86310) |
$138 |
$138 |
18.7× |
| Hexagnal phosph pltlt neutrl (85598) |
$213 |
$213 |
11.8× |
| Hfe gene (81256) |
$831.50 |
$831.50 |
12.7× |
| Hgb; fetal chemical (83030) |
$192 |
$192 |
17.9× |
| Hhv-6 DNA quant (87533) |
$370 |
$370 |
8.9× |
| High density lipoprotein (83718) |
$215.50 |
$215.50 |
26.3× |
| Histamine plasma (83088) |
$812 |
$812 |
27.5× |
| Histoplasma antibody (86698) |
$412 |
$412 |
29.9× |
| Histoplasma antigen by eia (87385) |
$373 |
$373 |
28.2× |
| HIV genotype (87901) |
$1,259 |
$1,259 |
4.9× |
| HIV p24 antigen (87390) |
$484 |
$484 |
20.1× |
| HIV-1 antibody (86701) |
$171 |
$171 |
19.2× |
| HIV-1 DNA by PCR (87535) |
$576 |
$576 |
16.4× |
| HIV-1 quant&revrse trnscrpj (87536) |
$658 |
$658 |
7.7× |
| HIV-1/HIV-2 single result (86703) |
$333 |
$333 |
24.3× |
| HIV-2 antibody (86702) |
$171 |
$171 |
12.6× |
| Hla b27 (86812) |
$508.50 |
$508.50 |
19.7× |
| Hla b5701 (81381) |
$1,684 |
$1,684 |
9.9× |
| HLA Class I and II typing, low resolution (eg, antigen equivalents); HLA-A, -B, and -DRB1 (eg, verification typing)… (81371) |
$1,262 |
$1,262 |
3.1× |
| Hla class i high defin qual (86832) |
$734 |
$734 |
2.3× |
| Hla class i phenotype qual (86830) |
$644 |
$644 |
6.7× |
| Hla class i typing high resolution complete (81379) |
$5,964 |
$5,964 |
17.8× |
| Hla class i typing low resolution complete (81372) |
$3,929 |
$3,929 |
9.7× |
| HLA Class I typing, low resolution (eg, antigen equivalents); one locus (eg, HLA-A, -B, or -C), each Other Outpatient (81373) |
$918 |
$918 |
7.2× |
| Hla class i&ii antibody qual (86828) |
$217 |
$217 |
3.4× |
| Hla class ii high defin qual (86833) |
$702 |
$702 |
2.2× |
| Hla class ii phenotype qual (86831) |
$846 |
$846 |
10.3× |
| Hla i typing 1 antigen lr (81374) |
$1,295 |
$1,295 |
17.4× |
| Hla ii low resolution hla-drb1/3/4/5 and -dqb1 (81375) |
$3,927 |
$3,927 |
17.8× |
| Hla ii typing 1 allele hr (81383) |
$1,040.50 |
$1,040.50 |
9.5× |
| Hla ii typing 1 loc hr (81382) |
$2,198 |
$2,198 |
17.8× |
| Hla ii typing 1 locus lr (81376) |
$1,742 |
$1,742 |
14.3× |
| Hla typing a/b/c multiple antigens (86813) |
$2,075 |
$2,075 |
35.8× |
| Hla typing dr/dq (86817) |
$762 |
$762 |
7.2× |
| Hla typing, dr/dq,single antigen - hla typing, dr/dq, single antigen - tissue (86816) |
$330 |
$330 |
10.9× |
| Hla x-math non-cytotoxic (86825) |
$948 |
$948 |
8.7× |
| Homocystine (83090) |
$456.50 |
$456.50 |
25.5× |
| Homogenization tissue (87176) |
$76 |
$76 |
12.9× |
| Homovanillic acid (83150) |
$519 |
$519 |
23.2× |
| Hpv high-risk types (87624) |
$458 |
$458 |
13.1× |
| Hrdtry cardmypy gene panel (81439) |
$661 |
$661 |
1.1× |
| Hsv, Dna, Amp Probe - Hsv Pcr (87529) |
$400 |
$400 |
11.4× |
| Htlv-i antibody (86687) |
$230 |
$230 |
25.3× |
| Human placental lactogen (83632) |
$400 |
$400 |
19.8× |
| Hydroxychloroquine (80220) |
$356 |
$356 |
19.1× |
| Hydroxyprogesterone 17-d (83498) |
$159 |
$159 |
5.9× |
| Hydroxyproline total (83505) |
$286 |
$286 |
11.8× |
| Ia infectious agent sgl step (86318) |
$154 |
$154 |
8.5× |
| Iaad ia clostridium difficile toxin (87324) |
$211 |
$211 |
17.6× |
| Iaad ia hepatitis delta antigen (87380) |
$216 |
$216 |
11.8× |
| Iaad ia HIV-1 ag w/HIV-1 & HIV-2 antbdy single (87389) |
$172.50 |
$172.50 |
7.2× |
| Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) |
$436 |
$436 |
30.3× |
| Iaad ia severe aqt respir synd coronavirus (87426) |
$204 |
$204 |
5.8× |
| Iaadi polyv mlt organisms ea polyv antiserum (87300) |
$146 |
$146 |
12.2× |
| Iadna HIV-2 amplified probe & reverse transcripj (87538) |
$458 |
$458 |
13.1× |
| Iadna legionella pneumophila amplified probe tq (87541) |
$460 |
$460 |
13.1× |
| Iadna multiple organisms amplified probe tq (87801) |
$918 |
$918 |
13.1× |
| Iadna sars-cov-2 COVID-19 amplified probe tq (87635) |
$242 |
$242 |
4.7× |
| Iadna sarscov2 & inf a&b & rsv mult amp probe tq (87637) |
$494 |
$494 |
3.5× |
| Idh1 common variants (81120) |
$929 |
$929 |
4.8× |
| Idh2 common variants (81121) |
$929 |
$929 |
3.1× |
| Ifnl3 gene (81283) |
$654 |
$654 |
8.9× |
| Igg subclass 4 (82787) |
$180.50 |
$180.50 |
22.5× |
| Igh gene rearrange amp meth (81261) |
$2,125 |
$2,125 |
10.7× |
| Igh vari regional mutation (81263) |
$1,135 |
$1,135 |
3.9× |
| Igk rearrangeabn clonal pop (81264) |
$558 |
$558 |
3.2× |
| Immune complex assay (86332) |
$290 |
$290 |
11.9× |
| Immunoassay infectious agent antibody quan nos (86317) |
$178 |
$178 |
11.9× |
| Immunodiffusion ouchterlony (86331) |
$58.50 |
$58.50 |
4.9× |
| Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration Other Outpatient (86325) |
$382.50 |
$382.50 |
16.5× |
| Immunofixation Electrophoresis Serum (86334) |
$266 |
$266 |
11.9× |
| Immunofixation urine (86335) |
$180 |
$180 |
6.1× |
| Immunofluorescence per spec 1st singl antb stain (88346) |
$983 |
$983 |
5.4× |
| Immunoglobulin assay (86023) |
$107.50 |
$107.50 |
8.6× |
| Immunoglobulin d (82784) |
$113 |
$113 |
12.2× |
| Immunoglobulin light chains free each (83521) |
$96 |
$96 |
5.6× |
| Immunohisto antibody slide (88344) |
$643 |
$643 |
1.7× |
| Immunologic analysis for autoimmune disease, lymphocyte culture, mixed (86821) |
$668 |
$668 |
18.3× |
| Immunoperoxidase (88342) |
$535 |
$535 |
2.9× |
| In situ hybridization 1st probe stain (88365) |
$488 |
$488 |
2.7× |
| In situ hybridization ea multiplex probe stain (88366) |
$448 |
$448 |
2.5× |
| Infec agent det,gi 12-25 targets (87507) |
$2,327 |
$2,327 |
5.6× |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Clostridium difficile… (87803) |
$144 |
$144 |
9.0× |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B… (87802) |
$144 |
$144 |
11.3× |
| Infectious agent antigen detection by immunofluorescent technique; Legionella pneumophila Other Outpatient (87278) |
$287.50 |
$287.50 |
18.4× |
| Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism Other… (87299) |
$146 |
$146 |
9.1× |
| Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; direct probe(s) technique Other Outpatient (87800) |
$522 |
$522 |
12.0× |
| Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; direct probe technique, each organism… (87797) |
$262 |
$262 |
8.7× |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, direct probe technique Other Outpatient (87485) |
$265 |
$265 |
13.2× |
| Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, direct probe technique Other Outpatient (87490) |
$215 |
$215 |
9.5× |
| Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli,… (87506) |
$1,550 |
$1,550 |
5.9× |
| Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli,… (87505) |
$775 |
$775 |
6.0× |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, amplified probe technique Other Outpatient (87516) |
$458 |
$458 |
13.1× |
| Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified probe technique, includes reverse… (87521) |
$458 |
$458 |
13.1× |
| Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, quantification Other Outpatient (87530) |
$372 |
$372 |
8.7× |
| Infectious agent detection by nucleic acid (DNA or RNA); Legionella pneumophila, direct probe technique Other Outpatient (87540) |
$311 |
$311 |
15.5× |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium-intracellulare, amplified probe technique… (87561) |
$790 |
$790 |
22.5× |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, direct probe technique Other Outpatient (87550) |
$262 |
$262 |
13.1× |
| Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria tuberculosis, direct probe technique Other… (87555) |
$265 |
$265 |
9.9× |
| Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, direct probe technique Other Outpatient (87590) |
$262 |
$262 |
9.7× |
| Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug resistance tissue culture analysis, HIV 1;… (87903) |
$6,354 |
$6,354 |
13.0× |
| Influenza a ag if (87276) |
$120.50 |
$120.50 |
7.5× |
| Influenza a/b ag eia (87400) |
$93.50 |
$93.50 |
6.6× |
| Influenza b ag if (87275) |
$120.50 |
$120.50 |
9.8× |
| Influenza DNA amp prob 1+ (87501) |
$667 |
$667 |
13.0× |
| Influenza DNA amp probe (87502) |
$490 |
$490 |
5.1× |
| Influenza virus antibody (86710) |
$152 |
$152 |
11.2× |
| Inhibin a (86336) |
$89 |
$89 |
5.7× |
| Inhibin b (83520) |
$168 |
$168 |
9.7× |
| Insitu hybridization auto (88367) |
$449 |
$449 |
1.2× |
| Insitu hybridization manual (88368) |
$1,714 |
$1,714 |
4.5× |
| Insulin antibody (86337) |
$206 |
$206 |
9.6× |
| Insulin free (83527) |
$144.50 |
$144.50 |
11.2× |
| Insulin tolerance panel; for ACTH insufficiency This panel must include the following: Cortisol (82533 x 5) Glucose… (80434) |
$1,340 |
$1,340 |
4.7× |
| Insulin total (83525) |
$248 |
$248 |
21.7× |
| Interleukin 6 (83529) |
$81 |
$81 |
4.7× |
| Intraop cyto path consult 1 (88333) |
$1,057 |
$1,057 |
1.2× |
| Intrinsic factor ab (86340) |
$269 |
$269 |
17.8× |
| Ip stain (87253) |
$347 |
$347 |
17.2× |
| Iron (83540) |
$102 |
$102 |
15.8× |
| Iron binding capacity total (83550) |
$108 |
$108 |
12.4× |
| Iron stain peripheral blood (85536) |
$76 |
$76 |
11.0× |
| Irradiate bld product ea unit (86945) |
$240 |
$240 |
6.0× |
| Islet cell antibody (86341) |
$128 |
$128 |
5.4× |
| Isocitric dehydrogenase (IDH) Other Outpatient (83570) |
$137 |
$137 |
15.5× |
| Isohemagglutinin titer (86940) |
$356.50 |
$356.50 |
40.6× |
| Itraconazole (80189) |
$88 |
$88 |
3.2× |
| Jak2 gene (81270) |
$1,267 |
$1,267 |
13.8× |
| Ketogenic steroids fract (83582) |
$168 |
$168 |
10.9× |
| Ketosteroids 17 total (83586) |
$363 |
$363 |
28.4× |
| Kit gene targeted seq analys (81272) |
$1,938 |
$1,938 |
5.9× |
| Kleihauer betke stain (85460) |
$93.50 |
$93.50 |
12.1× |
| Koh for fungi/parasites/mites (87220) |
$102 |
$102 |
23.9× |
| Kras gene (81275) |
$1,611.50 |
$1,611.50 |
8.3× |
| Kras gene addl variants (81276) |
$1,257 |
$1,257 |
6.5× |
| L/s ratio fetal lung (83661) |
$481 |
$481 |
21.9× |
| L117054ptt substitut (85732) |
$164 |
$164 |
25.3× |
| L164657fungus ab nos (86671) |
$116 |
$116 |
9.5× |
| L216655epst-barr vca (86665) |
$154 |
$154 |
8.5× |
| Lacosamide (80235) |
$194 |
$194 |
7.2× |
| Lactate dehydrogenase (83615) |
$137 |
$137 |
22.7× |
| Lactic acid (83605) |
$161 |
$161 |
13.9× |
| Lactoferrin fecal qual (83630) |
$209 |
$209 |
10.6× |
| Lamellar body count (83664) |
$226 |
$226 |
11.7× |
| Lamotrigine (80175) |
$158 |
$158 |
11.9× |
| Ldh isoenzymes (83625) |
$745 |
$745 |
58.2× |
| LDL direct (83721) |
$354 |
$354 |
33.7× |
| Lead (83655) |
$322 |
$322 |
26.6× |
| Leflunomide (80193) |
$356 |
$356 |
9.2× |
| Legionella antibody (86713) |
$166 |
$166 |
10.8× |
| Legionella antigen urine (87449) |
$86 |
$86 |
7.2× |
| Legionella culture (87081) |
$82 |
$82 |
12.4× |
| Leishmania antibody (86717) |
$146 |
$146 |
11.9× |
| Leptospira antibody (86720) |
$472 |
$472 |
29.1× |
| Leucine aminopeptidase (83670) |
$218 |
$218 |
22.2× |
| Leukocyte (Wbc) Count - White Blood Count (85048) |
$74 |
$74 |
29.1× |
| Leukocyte alkaline phosphatase (85540) |
$142 |
$142 |
16.5× |
| Leukocyte Count,Fecal - Fecal Leukocytes (89055) |
$78 |
$78 |
18.3× |
| Leukocyte histamine release test (86343) |
$147 |
$147 |
11.8× |
| Levetiracetam (keppra) (80177) |
$158 |
$158 |
11.9× |
| Lidocaine (80176) |
$249 |
$249 |
17.0× |
| Lipase (83690) |
$92 |
$92 |
13.4× |
| Lipoprotein (a) (83695) |
$89.50 |
$89.50 |
6.3× |
| Lipoprotein bld hr fraction (83701) |
$68 |
$68 |
2.0× |
| Lipoprotein blood by nmr spect - lipoprotein (83704) |
$286 |
$286 |
8.4× |
| Lipoprotein electrophoresis (83700) |
$506 |
$506 |
44.9× |
| Lipoprotein-associated phospholipase a2 (83698) |
$119 |
$119 |
2.6× |
| Lithium (80178) |
$85.50 |
$85.50 |
12.9× |
| Luteinizing hormone (lh) (83002) |
$318 |
$318 |
17.2× |
| Lyme ab igm western blot (86617) |
$104 |
$104 |
6.7× |
| Lyme disease antibody (86618) |
$108.50 |
$108.50 |
6.4× |
| Lymes amplified na probe (87476) |
$673 |
$673 |
19.2× |
| Lymph choriomeningitis ab (86727) |
$180 |
$180 |
14.0× |
| Lymphocyte transformation (86353) |
$580 |
$580 |
11.8× |
| Lymphocytotoxicity assay (86805) |
$398 |
$398 |
2.1× |
| M genitalium amp probe (87563) |
$942 |
$942 |
26.8× |
| M.Pneumon, Dna, Amp Probe - Mycoplasma Pneumoniae Pcr (87581) |
$460 |
$460 |
13.1× |
| M/phmtrc alys ish quant/semiq mnl each multiprb (88377) |
$523 |
$523 |
2.9× |
| M/phmtrc alys tumor imhchem ea antbdy cmptr asst (88361) |
$304 |
$304 |
0.8× |
| Macroscopic exam arthropod (87168) |
$79 |
$79 |
18.5× |
| Macroscopic exam parasite (87169) |
$118 |
$118 |
27.4× |
| Magnesium urine (83735) |
$80.50 |
$80.50 |
12.0× |
| Malaria smear (87207) |
$174 |
$174 |
29.0× |
| Manganese (83785) |
$197.50 |
$197.50 |
7.4× |
| Manual cell count each (85032) |
$107.50 |
$107.50 |
24.9× |
| Manual diff wbc count b-coat (85009) |
$44 |
$44 |
8.7× |
| Manual tumor im histochem ea ab (88360) |
$487 |
$487 |
2.7× |
| Mcg; ip situ 100-300 cells (88275) |
$893.50 |
$893.50 |
17.5× |
| Mcg; ip situ 25-99 cells (88274) |
$327.50 |
$327.50 |
7.7× |
| Meat fibers feces (89160) |
$56 |
$56 |
11.5× |
| MECP2 (methyl CpG binding protein 2) (eg, Rett syndrome) gene analysis; full sequence analysis Other Outpatient (81302) |
$2,233 |
$2,233 |
4.2× |
| Mercury urine (83825) |
$396 |
$396 |
24.4× |
| Metanephrines (83835) |
$320 |
$320 |
18.9× |
| Methemalbumin (83857) |
$128 |
$128 |
11.9× |
| Methemoglobin quant (83050) |
$170 |
$170 |
20.7× |
| Methylmalonic acid serum (83921) |
$194 |
$194 |
9.1× |
| Mgmt methylation analysis (81287) |
$652 |
$652 |
5.2× |
| Microalbumin urine (82043) |
$145 |
$145 |
25.1× |
| Microalbumin; urine semiquan (82044) |
$110 |
$110 |
17.7× |
| Microsatellite instability (81301) |
$1,112 |
$1,112 |
3.2× |
| Microslide Consult W Slide Prep - Lab Microslide Consult W Sld Prep (88323) |
$604 |
$604 |
10.9× |
| Microsomal Antibody - Thyroid Peroxidase Antibody (86376) |
$76 |
$76 |
5.2× |
| Mitochondrial antibody each (86381) |
$322 |
$322 |
12.7× |
| Mlh1 gene dup/delete variant (81294) |
$2,486 |
$2,486 |
12.3× |
| Mog-igg1 antb flo cytmtry ea (86363) |
$491 |
$491 |
13.0× |
| Mog-igg1 antibody cell-based imfluor assay each (86362) |
$322 |
$322 |
26.7× |
| Molecular cytogenetics DNA probe each (88271) |
$344 |
$344 |
16.1× |
| Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions) Other Outpatient (88273) |
$477 |
$477 |
13.7× |
| Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers) Other… (88272) |
$397 |
$397 |
9.8× |
| Mononuclear cell antigen (86356) |
$122 |
$122 |
4.6× |
| Mopath procedure level 1 (81400) |
$807.50 |
$807.50 |
12.6× |
| Mopath procedure level 2 (81401) |
$699 |
$699 |
5.1× |
| Mopath procedure level 3 (81402) |
$1,335.50 |
$1,335.50 |
8.9× |
| Mopath procedure level 4 (81403) |
$434 |
$434 |
2.3× |
| Mopath procedure level 5 (81404) |
$842 |
$842 |
3.1× |
| Mopath procedure level 6 (81405) |
$276 |
$276 |
0.9× |
| Mopath procedure level 7 (81406) |
$985 |
$985 |
3.5× |
| Mopath procedure level 8 (81407) |
$4,233 |
$4,233 |
5.0× |
| Mopath procedure level 9 (81408) |
$7,851 |
$7,851 |
3.9× |
| Morphometric analysis tumor (88358) |
$1,395 |
$1,395 |
7.7× |
| Morphometric Analysis: Nerve Arkana (Technical Only) (88356) |
$819 |
$819 |
14.8× |
| Mrsa PCR (87641) |
$243.50 |
$243.50 |
6.9× |
| Mthfr gene analysis (81291) |
$456 |
$456 |
7.0× |
| Mucin synovial fluid 301 (83872) |
$158 |
$158 |
27.0× |
| Mucopolysaccharides (83864) |
$389 |
$389 |
13.6× |
| Mumps igg antibody (86735) |
$54 |
$54 |
4.1× |
| Muramidase (85549) |
$172 |
$172 |
9.2× |
| Muscle-specific kinase antibody (86366) |
$233 |
$233 |
12.7× |
| Mycobacteria t amplif na probe (87556) |
$410 |
$410 |
9.8× |
| Mycophenolic Acid (80180) |
$213 |
$213 |
11.8× |
| Mycoplasma antibody (86738) |
$283 |
$283 |
21.4× |
| Myd88 gene p.leu265pro vrnt (81305) |
$695 |
$695 |
4.0× |
| Myelin basic protein csf (83873) |
$533 |
$533 |
31.0× |
| Myeloperoxidase antibody (86021) |
$398.50 |
$398.50 |
26.5× |
| Myoglobin (83874) |
$168 |
$168 |
13.0× |
| N.gonorrhoeae DNA amp prob (87591) |
$207.50 |
$207.50 |
5.9× |
| Natriuretic peptide (83880) |
$572 |
$572 |
14.6× |
| Nerve teasing preparations (88362) |
$1,900.50 |
$1,900.50 |
2.2× |
| Neutralization test viral (86382) |
$255 |
$255 |
15.1× |
| Nfct agt drug suscept phenotype prediction (87900) |
$498.50 |
$498.50 |
3.8× |
| Nfct ds bv&vaginitis DNA alg (81514) |
$1,872 |
$1,872 |
7.1× |
| Nfct ds chrnc hcv 6 assays (81596) |
$291 |
$291 |
4.0× |
| Nitroblue tetrazolium dye (86384) |
$136 |
$136 |
10.0× |
| Nk cells total count (86357) |
$447 |
$447 |
11.8× |
| Nocardia antibody (86744) |
$269 |
$269 |
16.8× |
| Non gyn sputum nipple d/c (88160) |
$264 |
$264 |
8.6× |
| Noonan spectrum disorders (eg, Noonan syndrome, cardio-facio-cutaneous syndrome, Costello syndrome, LEOPARD syndrome,… (81442) |
$661 |
$661 |
0.3× |
| Npm1 gene (81310) |
$2,419.50 |
$2,419.50 |
9.8× |
| Nras gene variants exon 2&3 (81311) |
$1,902 |
$1,902 |
6.4× |
| NUDT15 (nudix hydrolase 15) (eg, drug metabolism) gene analysis, common variant(s) (eg, *2, *3, *4, *5, *6) Other… (81306) |
$1,015 |
$1,015 |
3.5× |
| Occult bld feces 1-3 tests (82272) |
$12 |
$12 |
2.8× |
| Occult blood stool (82270) |
$43 |
$43 |
9.8× |
| Oligoclonal bands (83916) |
$560 |
$560 |
20.4× |
| Oncoprotein dcp (83951) |
$762 |
$762 |
11.8× |
| Oocyte identification from follicular fluid (89254) |
$1,989 |
$1,989 |
11.0× |
| Organic acids total quant (83918) |
$196 |
$196 |
8.3× |
| Orthopoxvirus amp prb each (87593) |
$56 |
$56 |
1.1× |
| Osmolality serum (83930) |
$92 |
$92 |
13.9× |
| Osmolality urine (83935) |
$112 |
$112 |
16.4× |
| Osmotic fragility rbc incubated (85557) |
$62 |
$62 |
4.6× |
| Osmotic fragility rbc unincubated (85555) |
$76 |
$76 |
10.2× |
| Osteocalcin (83937) |
$118 |
$118 |
4.0× |
| Ova and parasite exam (87177) |
$249 |
$249 |
28.0× |
| Oxalate urine (83945) |
$322 |
$322 |
22.3× |
| Pa; screen ea ab (86403) |
$61 |
$61 |
5.3× |
| Pa; titer ea ab (86406) |
$126 |
$126 |
11.8× |
| Pancreatic Elastase, Fecal, Qual/Semi-Quant - Pancreatic Elastase (82656) |
$242 |
$242 |
21.0× |
| Pancreatic polypeptide (83519) |
$234 |
$234 |
12.7× |
| Pap smear (88150) |
$190 |
$190 |
10.2× |
| Pappa serum (84163) |
$85 |
$85 |
5.6× |
| Parainfluenza ag if (87279) |
$120.50 |
$120.50 |
7.3× |
| Parathyroid hormone (83970) |
$726 |
$726 |
17.6× |
| Parietal cell antibody (83516) |
$144.50 |
$144.50 |
12.5× |
| Parvovirus antibody (86747) |
$50 |
$50 |
3.3× |
| Path consult during surgery (88329) |
$106 |
$106 |
1.7× |
| Pathology - unlisted surgical pathology procedure (88399) |
$264 |
$264 |
4.8× |
| Pathology lab procedure (89240) |
$221 |
$221 |
4.0× |
| Pertussis ag if (87265) |
$144 |
$144 |
12.0× |
| Pg cryopreservation semen elective including semen analysis (89259) |
$683 |
$683 |
3.8× |
| Ph body fluid (83986) |
$27 |
$27 |
7.5× |
| Phenobarbital (80184) |
$292.50 |
$292.50 |
19.1× |
| Phenylalanine (84030) |
$190 |
$190 |
34.5× |
| Phenytoin free (80186) |
$206.50 |
$206.50 |
15.0× |
| Phenytoin total (80185) |
$291 |
$291 |
22.0× |
| Phosphatidylglycerol (84081) |
$196 |
$196 |
11.9× |
| Phospholipid pltlt neutraliz (85597) |
$163 |
$163 |
9.1× |
| Phosphorus blood (84100) |
$36 |
$36 |
7.6× |
| Phosphorus urine (84105) |
$86 |
$86 |
14.9× |
| Pinworm exam (87172) |
$94 |
$94 |
22.0× |
| Plasma renin activity (84244) |
$414 |
$414 |
18.8× |
| Plasminogen (85421) |
$122 |
$122 |
12.0× |
| Plasminogen activity (85420) |
$367 |
$367 |
56.2× |
| Platelet Aggregation (85576) |
$439.50 |
$439.50 |
17.6× |
| Platelet count automated (85049) |
$107.50 |
$107.50 |
24.0× |
| Pml/raralpha com breakpoints (81315) |
$1,418 |
$1,418 |
6.8× |
| Pmp22 gene full sequence (81325) |
$3,821 |
$3,821 |
5.0× |
| Pneumocystis c ag by if (87281) |
$146 |
$146 |
12.2× |
| Pooling platelets/other blood products (86965) |
$128.50 |
$128.50 |
0.7× |
| Porphobilinogen urine qual (84106) |
$170 |
$170 |
29.2× |
| Porphobilinogen urine quant (84110) |
$242 |
$242 |
28.7× |
| Porphyrins total plasma (84311) |
$445 |
$445 |
54.9× |
| Porphyrins urine qual (84119) |
$242 |
$242 |
18.1× |
| Porphyrins urine quantitation & fractionation (84120) |
$249 |
$249 |
16.9× |
| Posaconazole (80187) |
$194 |
$194 |
7.2× |
| Potassium serum (84132) |
$46 |
$46 |
9.7× |
| Potassium urine (84133) |
$65 |
$65 |
13.7× |
| Prealbumin (84134) |
$210.50 |
$210.50 |
14.4× |
| Pregnancy test serum (84703) |
$124.50 |
$124.50 |
16.6× |
| Pregnancy test urine (81025) |
$180 |
$180 |
20.9× |
| Pregnanediol (84135) |
$204 |
$204 |
9.6× |
| Pregnanetriol (84138) |
$204 |
$204 |
9.7× |
| Pregnenolone (84140) |
$363.50 |
$363.50 |
17.6× |
| Preparation of embryo for transfer (any method) (89255) |
$404 |
$404 |
7.3× |
| Pretreat serum ab id incubate (86977) |
$438 |
$438 |
2.4× |
| Pretreatment of serum for use in red blood cell antibody analysis and measurement, by dilution (86976) |
$77.50 |
$77.50 |
2.5× |
| Pretreatment of serum for use in red blood cell antibody analysis and measurement, incubation with drugs (86975) |
$285 |
$285 |
0.6× |
| Pretx rbc antibody incubat w/chem agnts/drugs ea (86970) |
$127 |
$127 |
2.0× |
| Pretx rbc antibody incubat w/density grad sep (86972) |
$721 |
$721 |
4.0× |
| Pretx rbc antibody incubat w/enzymes each (86971) |
$449 |
$449 |
2.5× |
| Pretx serum rbc antibody id diffial each absrpj (86978) |
$137 |
$137 |
2.2× |
| Primidone (80188) |
$272 |
$272 |
16.4× |
| Procalcitonin (pct) (84145) |
$317 |
$317 |
11.6× |
| Progesterone (84144) |
$51 |
$51 |
2.4× |
| Proinsulin (84206) |
$278.50 |
$278.50 |
10.4× |
| Prolactin (84146) |
$402 |
$402 |
20.7× |
| Prostaglandin (84150) |
$294 |
$294 |
7.0× |
| Prostatic acid phosphatase (84066) |
$148 |
$148 |
15.3× |
| Protein c antigen (85302) |
$127.50 |
$127.50 |
10.6× |
| Protein c functional (85303) |
$354 |
$354 |
25.6× |
| Protein electrophoresis serum (84165) |
$291 |
$291 |
27.1× |
| Protein electrophoresis urine (84166) |
$102 |
$102 |
5.7× |
| Protein s free (85306) |
$138 |
$138 |
9.0× |
| Protein s total (85305) |
$138 |
$138 |
11.9× |
| Protein total other source (84157) |
$92 |
$92 |
23.0× |
| Protein total serum (84155) |
$99 |
$99 |
27.0× |
| Protein total urine (84156) |
$57.50 |
$57.50 |
15.7× |
| Protein western blot (84181) |
$6,942 |
$6,942 |
407.6× |
| Protein western blot test (84182) |
$746 |
$746 |
25.5× |
| Prothrombin time; substitution, plasma fractions, each Other Outpatient (85611) |
$164 |
$164 |
41.6× |
| PSA complexed (84152) |
$218 |
$218 |
11.9× |
| PSA free (84154) |
$300 |
$300 |
16.3× |
| Pten gene analysis known familial variant (81322) |
$494.50 |
$494.50 |
10.6× |
| Pten gene dup/delet variant (81323) |
$1,143 |
$1,143 |
3.8× |
| Pten gene full sequence (81321) |
$7,833 |
$7,833 |
13.1× |
| Pyruvate (84210) |
$291.50 |
$291.50 |
20.1× |
| Pyruvate kinase (84220) |
$112 |
$112 |
11.9× |
| Qual organic acids ea specim (83919) |
$196 |
$196 |
11.9× |
| Quinidine (80194) |
$351 |
$351 |
24.0× |
| Reagent strip/blood glucose (82948) |
$38 |
$38 |
7.5× |
| Receptor assay progesterone (84234) |
$767 |
$767 |
11.8× |
| Ref consult prep elsewhere (88321) |
$199 |
$199 |
5.0× |
| Reptilase test (85635) |
$84 |
$84 |
8.5× |
| Resp virus 12-25 targets (87633) |
$1,180 |
$1,180 |
2.8× |
| Resp virus 3-5 targets (87631) |
$540 |
$540 |
3.8× |
| Resp virus 6-11 targets (87632) |
$2,789 |
$2,789 |
12.8× |
| Respiratory syncytial vi (87280) |
$120.50 |
$120.50 |
9.0× |
| Reticulated platelet assay (85055) |
$316 |
$316 |
8.8× |
| Reticulocyte count auto (85045) |
$78 |
$78 |
19.5× |
| Reticyte/hgb concentrate (85046) |
$66 |
$66 |
11.8× |
| Retinol binding protein (83883) |
$72 |
$72 |
5.3× |
| Rh phenotyping complete (86906) |
$118 |
$118 |
15.2× |
| Rheumatoid factor qual (86430) |
$63 |
$63 |
10.3× |
| Rheumatoid factor quant (86431) |
$40.50 |
$40.50 |
7.1× |
| Rickettsia antibody (86757) |
$230 |
$230 |
11.9× |
| Rnp antibody (86235) |
$72 |
$72 |
4.0× |
| Rotavirus antigen (87425) |
$67 |
$67 |
5.6× |
| Rpr (86592) |
$82 |
$82 |
19.2× |
| Rpr titer (86593) |
$94 |
$94 |
21.4× |
| Rsv ag eia (87420) |
$67 |
$67 |
4.8× |
| Rsv DNA/RNA amp probe (87634) |
$359 |
$359 |
5.1× |
| Rsv ia w dir observ (87807) |
$144 |
$144 |
11.0× |
| Rubella antibody (86762) |
$249 |
$249 |
17.3× |
| Rubeola antibody (86765) |
$136.50 |
$136.50 |
10.6× |
| Russell viper venom diluted (85613) |
$114 |
$114 |
11.9× |
| Russell viper venom time (includes venom); undiluted Other Outpatient (85612) |
$64 |
$64 |
3.7× |
| Salmonella typhi and paratyphi antibodies (86768) |
$74 |
$74 |
5.6× |
| Sars-cov-2 COVID-19 antibody (86769) |
$190 |
$190 |
4.5× |
| Sed rate (85651) |
$82 |
$82 |
19.2× |
| Sed rate automated (85652) |
$19 |
$19 |
7.0× |
| Selenium serum (84255) |
$197.50 |
$197.50 |
7.7× |
| Semen anal strict criteria (89322) |
$229 |
$229 |
14.8× |
| Semen analysis complete (89320) |
$107.50 |
$107.50 |
8.7× |
| Semen analysis post vasectomy (89321) |
$137 |
$137 |
11.4× |
| Semen analysis; motility and count (not including Huhner test) Other Outpatient (89310) |
$128 |
$128 |
14.9× |
| Semen analysis; presence and/or motility of sperm including Huhner test (post coital) Other Outpatient (89300) |
$134 |
$134 |
13.6× |
| Senstitivity - enzyme detect (87185) |
$62 |
$62 |
13.1× |
| Serotonin (84260) |
$552 |
$552 |
17.8× |
| Serpina1 gene (81332) |
$777 |
$777 |
17.8× |
| Serum bactericidal titer (87197) |
$304 |
$304 |
20.2× |
| Serum immunoelectrophoresis (86320) |
$533 |
$533 |
17.8× |
| Serum screening for cytotoxic percent reactive antibody (PRA); quick method Other Outpatient (86808) |
$76 |
$76 |
2.6× |
| Serum screening for cytotoxic percent reactive antibody (PRA); standard method Other Outpatient (86807) |
$102 |
$102 |
1.3× |
| Sex chromatin id barr bodies (88130) |
$111 |
$111 |
6.2× |
| Sex hormone binding globulin (84270) |
$115 |
$115 |
5.3× |
| Shiga-like toxin ag eia (87427) |
$177.50 |
$177.50 |
14.8× |
| Sickle cell screen (85660) |
$70.50 |
$70.50 |
12.8× |
| Sirolimus (rapamycin) (80195) |
$452 |
$452 |
32.9× |
| Skin test tuberculosis intradermal (86580) |
$110 |
$110 |
3.6× |
| SLCO1B1 (solute carrier organic anion transporter family, member 1B1) (eg, adverse drug reaction), gene analysis,… (81328) |
$646 |
$646 |
3.7× |
| Smear wet mount (87210) |
$49 |
$49 |
8.4× |
| Snrpn/ube3a methylation analysis (81331) |
$1,208 |
$1,208 |
23.7× |
| Sodium feces (84302) |
$46 |
$46 |
9.5× |
| Sodium serum (84295) |
$92 |
$92 |
19.1× |
| Sodium urine (84300) |
$92 |
$92 |
18.2× |
| Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation… (81456) |
$7,711 |
$7,711 |
2.6× |
| Solid organ or hematolymphoid neoplasm or disorder, 51 or greater genes, genomic sequence analysis panel, interrogation… (81455) |
$5,304 |
$5,304 |
1.8× |
| Soluble transferrin receptor (84238) |
$148.50 |
$148.50 |
4.1× |
| Somatomedin-c (84305) |
$92 |
$92 |
4.3× |
| Sp consult; 1st tb w fs sgl sp (88331) |
$152 |
$152 |
0.8× |
| Special stains group i (88312) |
$168 |
$168 |
3.0× |
| Special stains group ii (88313) |
$168 |
$168 |
1.2× |
| Specific gravity except urine (84315) |
$30 |
$30 |
9.1× |
| Sperm antibodies (89325) |
$236 |
$236 |
22.1× |
| Sperm identification from aspiration (other than seminal fluid) (89257) |
$404 |
$404 |
7.3× |
| Sperm identification from testis tissue, fresh or cryopreserved (89264) |
$1,989 |
$1,989 |
35.8× |
| Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for insemination or diagnosis with semen analysis (89261) |
$683 |
$683 |
12.3× |
| Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or diagnosis with semen analysis (89260) |
$404 |
$404 |
7.3× |
| Splitting blood/blood products each unit (86985) |
$139 |
$139 |
0.8× |
| Staph aureus amplified probe (87640) |
$327 |
$327 |
9.3× |
| Stem cells total count (86367) |
$447 |
$447 |
5.7× |
| Stone analysis (82365) |
$154 |
$154 |
11.9× |
| Stone analysis qn chem (82360) |
$154 |
$154 |
12.0× |
| Stool cultr aerobic bact ea (87046) |
$46 |
$46 |
4.9× |
| Storage (per year); embryo(s) (89342) |
$683 |
$683 |
3.8× |
| Storage of sperm or semen per year (89343) |
$404 |
$404 |
2.2× |
| Str markers specimen anal (81265) |
$1,049 |
$1,049 |
4.5× |
| Strep a ag eia (87430) |
$146 |
$146 |
8.7× |
| Strep b DNA amp probe (87653) |
$327 |
$327 |
9.3× |
| Strep. gr a immuno w optical (87880) |
$158.50 |
$158.50 |
9.6× |
| Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative Other Outpatient (86581) |
$112 |
$112 |
1.2× |
| Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen Other Outpatient (84377) |
$65 |
$65 |
11.8× |
| Sugars, chromatographic, TLC or paper chromatography Other Outpatient (84375) |
$238.50 |
$238.50 |
6.1× |
| Sugars; single qual ea specimen (84376) |
$53.50 |
$53.50 |
9.7× |
| Sulfate urine (84392) |
$56 |
$56 |
10.2× |
| Surg Path,Gross,Level I - Lab Surg Path,Gross,Level I (88300) |
$70 |
$70 |
2.3× |
| Surg Path,Level V - Lab Surg Path,Level V (88307) |
$342 |
$342 |
0.9× |
| Surgical path level vi (88309) |
$474 |
$474 |
0.6× |
| Surgical pathology level IV (88305) |
$155.50 |
$155.50 |
2.8× |
| Susceptbilty stdy antimicrbial agnt agar dilutj (87181) |
$79 |
$79 |
16.6× |
| Susceptibility broth dilution panel (87186) |
$171 |
$171 |
19.8× |
| Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent Other Outpatient (87188) |
$75 |
$75 |
11.3× |
| Susceptibility studies, antimicrobial agent; microdilution or agar dilution, minimum lethal concentration (MLC), each… (87187) |
$136 |
$136 |
3.4× |
| Susceptibility study antimicrobial disk method (87184) |
$99 |
$99 |
13.2× |
| Susceptiblty stdy antmcrb mycobact proporj mthd (87190) |
$66.50 |
$66.50 |
9.1× |
| T cells cd4 count (86361) |
$317 |
$317 |
11.8× |
| T cells total count (86359) |
$179 |
$179 |
4.7× |
| T3 free (84481) |
$34 |
$34 |
2.0× |
| T3 reverse (84482) |
$171 |
$171 |
10.9× |
| T3 total (84480) |
$291 |
$291 |
20.5× |
| T3 uptake (84479) |
$256 |
$256 |
39.6× |
| Tacrolimus (80197) |
$591 |
$591 |
43.0× |
| Targeted genomic seq analys (81445) |
$2,341.50 |
$2,341.50 |
3.9× |
| Tb ag response t-cell susp (86481) |
$78.50 |
$78.50 |
0.8× |
| Tb test cell immun measure (86480) |
$134 |
$134 |
2.2× |
| Teichoic acid antibodies (86329) |
$482 |
$482 |
34.3× |
| Telomere length testing (88182) |
$530.50 |
$530.50 |
9.6× |
| Testosterone free (84402) |
$461.50 |
$461.50 |
18.1× |
| Testosterone total (84403) |
$270.50 |
$270.50 |
10.5× |
| Tetanus antibody (86774) |
$175 |
$175 |
11.8× |
| Thawing and expansion of frozen cells, each aliquot Other Outpatient (88241) |
$150 |
$150 |
12.4× |
| Thawing of cryopreserved; embryo(s) (89352) |
$1,989 |
$1,989 |
11.0× |
| Thawing of cryopreserved; sperm/semen, each aliquot (89353) |
$404 |
$404 |
7.3× |
| Theophylline (80198) |
$291 |
$291 |
20.6× |
| Thiamine (84425) |
$209.50 |
$209.50 |
9.9× |
| Thiocyanate level (84430) |
$55 |
$55 |
4.7× |
| Thiopurine drug metabolites (83789) |
$216 |
$216 |
9.0× |
| Thiopurine metabolites (80299) |
$204 |
$204 |
10.9× |
| Thrombin time plasma (85670) |
$85 |
$85 |
14.7× |
| Thrombomodulin (85337) |
$123 |
$123 |
7.1× |
| Thromboplastin inhibition (85705) |
$358 |
$358 |
37.2× |
| Thromboxane urine (84431) |
$199 |
$199 |
5.7× |
| Thyroglobulin (84432) |
$264 |
$264 |
16.4× |
| Thyroglobulin antibody (86800) |
$94 |
$94 |
5.9× |
| Thyroid stimulating immunoglob (84445) |
$255 |
$255 |
5.0× |
| Thyroxine binding globulin (84442) |
$248 |
$248 |
16.8× |
| Thyroxine t4 total (84436) |
$166 |
$166 |
24.2× |
| Tissue culture bone marrow (88237) |
$682 |
$682 |
4.7× |
| Tissue culture lymphocyte (88230) |
$802.50 |
$802.50 |
6.9× |
| Tissue culture placenta (88235) |
$1,294.50 |
$1,294.50 |
8.6× |
| Tissue culture skin/biopsy (88233) |
$1,655.50 |
$1,655.50 |
11.8× |
| Tissue culture solid tumor (88239) |
$2,188 |
$2,188 |
14.8× |
| Tissue transglutaminase ea immunoglobulin class (86364) |
$298 |
$298 |
25.8× |
| Tobramycin (80200) |
$291 |
$291 |
18.0× |
| Topiramate (80201) |
$273.50 |
$273.50 |
22.9× |
| Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) Other Outpatient (87230) |
$227 |
$227 |
11.5× |
| Toxoplasma antibody igm (86778) |
$110 |
$110 |
7.6× |
| Tpmt gene com variants (81335) |
$513.50 |
$513.50 |
2.9× |
| Transcortin (84449) |
$213 |
$213 |
11.8× |
| Transferrin (84466) |
$249 |
$249 |
19.5× |
| Transfusion reaction - immediate (86078) |
$127 |
$127 |
0.7× |
| Treponema pallidum antibody (86780) |
$222.50 |
$222.50 |
16.8× |
| Trg gene rearrangement anal (81342) |
$2,257 |
$2,257 |
11.2× |
| Trichinella antibody (86784) |
$199 |
$199 |
15.8× |
| Trichomonas assay w/optic (87808) |
$70.50 |
$70.50 |
4.6× |
| Trichomonas vagin dir probe (87660) |
$208.50 |
$208.50 |
10.4× |
| Trichomonas vaginalis amplif (87661) |
$1,482 |
$1,482 |
42.2× |
| Trichrome stain (87209) |
$74 |
$74 |
4.1× |
| Triglycerides (84478) |
$40 |
$40 |
7.0× |
| Troponin i (84484) |
$233 |
$233 |
18.7× |
| Troponin qual (84512) |
$88 |
$88 |
8.7× |
| Trypanosoma cruzi igg (86753) |
$121 |
$121 |
9.8× |
| Trypsin feces qual (84488) |
$118 |
$118 |
16.2× |
| Trypsin; duodenal fluid Other Outpatient (84485) |
$90 |
$90 |
12.5× |
| Trypsin; feces, quantitative, 24-hour collection Other Outpatient (84490) |
$140 |
$140 |
14.1× |
| Tularemia agglutinins (86000) |
$168 |
$168 |
24.1× |
| Uf hb allergen food alpha gal ige (86008) |
$124 |
$124 |
6.9× |
| UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, drug metabolism, hereditary unconjugated… (81350) |
$773 |
$773 |
3.3× |
| Unlisted cytopathology procedure UNSCHEDULED (88199) |
$264 |
$264 |
4.8× |
| Unlisted transfusion medicine procedure (86999) |
$161 |
$161 |
5.2× |
| Urea nitrogen clearance (84545) |
$140 |
$140 |
19.4× |
| Urea nitrogen quantitative (84520) |
$72 |
$72 |
18.2× |
| Urea nitrogen urine (84540) |
$119 |
$119 |
21.4× |
| Uric acid blood (84550) |
$63.50 |
$63.50 |
14.0× |
| Uric acid other source (84560) |
$92 |
$92 |
18.1× |
| Urinalysis auto w/micro (81001) |
$49 |
$49 |
15.5× |
| Urinalysis microscopic only (81015) |
$92 |
$92 |
30.2× |
| Urinalysis; qualitative or semiquantitative, except immunoassays Other Outpatient (81005) |
$103 |
$103 |
47.5× |
| Urine bacteria culture (87088) |
$142 |
$142 |
17.6× |
| Urine volume measurement (81050) |
$34 |
$34 |
9.3× |
| Urnls dip stick/tablet rgnt auto w/o microscopy (81003) |
$92 |
$92 |
40.9× |
| Urobilinogen, feces, quantitative Other Outpatient (84577) |
$218 |
$218 |
13.0× |
| Urobilinogen, urine; qualitative Other Outpatient (84578) |
$218 |
$218 |
48.8× |
| Urobilinogen, urine; quantitative, timed specimen Other Outpatient (84580) |
$84 |
$84 |
8.8× |
| Valproic acid (80164) |
$218 |
$218 |
16.1× |
| Valproic acid free (80165) |
$367 |
$367 |
27.1× |
| Vancomycin (80202) |
$393 |
$393 |
29.0× |
| Varicella zoster ag if (87290) |
$146 |
$146 |
10.9× |
| Varicella zoster antibody igg (86787) |
$143 |
$143 |
11.1× |
| Vasoactive intestinal polypeptide (84586) |
$313.50 |
$313.50 |
8.9× |
| Vasopressin (84588) |
$107.50 |
$107.50 |
3.2× |
| Viral culture non-respiratory (87252) |
$286 |
$286 |
11.0× |
| Virus antibody nos (86790) |
$264 |
$264 |
20.5× |
| Virus isol shell vial techn (87254) |
$286 |
$286 |
14.6× |
| Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection Other Outpatient (87250) |
$256 |
$256 |
13.1× |
| Viscosity serum (85810) |
$194 |
$194 |
16.6× |
| Vitamin a (84590) |
$202 |
$202 |
17.4× |
| Vitamin b12 (82607) |
$208 |
$208 |
13.8× |
| Vitamin b12 binding capacity (82608) |
$78.50 |
$78.50 |
5.5× |
| Vitamin b5 (84591) |
$215 |
$215 |
12.6× |
| Vitamin b6 (84207) |
$390 |
$390 |
13.9× |
| Vitamin c (82180) |
$148 |
$148 |
15.0× |
| Vitamin d 1 25 dihydroxy (82652) |
$776 |
$776 |
20.2× |
| Vitamin d, 25-hydroxy, labcorp (82306) |
$578 |
$578 |
19.5× |
| Vitamin e (84446) |
$322 |
$322 |
22.7× |
| Vitamin k1 (84597) |
$536.50 |
$536.50 |
39.1× |
| Vkorc1 gene (81355) |
$287.50 |
$287.50 |
3.3× |
| Vma (84585) |
$396 |
$396 |
25.5× |
| Vol reduction of blood/prod (86960) |
$421 |
$421 |
2.3× |
| Volatiles (84600) |
$140 |
$140 |
8.2× |
| Voltage-gated calcium channel antibody each (86596) |
$99 |
$99 |
8.2× |
| Von willebrand factor activity (85245) |
$473.50 |
$473.50 |
20.6× |
| Voriconazole (80285) |
$194 |
$194 |
7.2× |
| Wbc w auto diff (85004) |
$87 |
$87 |
13.4× |
| West nile virus ab igm (86788) |
$136 |
$136 |
8.1× |
| West nile virus antibody (86789) |
$136 |
$136 |
9.5× |
| Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like… (81460) |
$331 |
$331 |
0.3× |
| Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external… (81465) |
$331 |
$331 |
0.4× |
| Xylose absorption urine (84620) |
$329 |
$329 |
25.5× |
| Yersinia antibody (86793) |
$104 |
$104 |
7.9× |
| Zika virus DNA/RNA amp probe (87662) |
$705 |
$705 |
13.7× |
| Zika virus igm (86794) |
$710 |
$710 |
42.1× |
| Zinc (84630) |
$236 |
$236 |
20.7× |
| Zinc protoporphyrin blood (84202) |
$370 |
$370 |
25.8× |