Lab & pathology prices at Summit Pacific Medical Center

Elma, WA · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
1 25 Dihydroxy includes fractions if performed (82652) $260
5 Nucleotidase (83915) $72
Abl1 gene (81170) $1,039
Acetaminophen level (80143) $108
Acetylcholine receptor binding antibody (86041) $1,673
Acetylcholine receptor blocking antibody (86042) $1,673
Actin smooth muscle antibody each (86015) $64
Activated protein c resistance (85307) $93
Acute hepatitis panel (80074) $273
Acylcarnitine Plasma (82017) $106
Adrenocorticotropic hormone (82024) $94
Afp maternal serum (82105) $57
Albumin body fluid (82042) $186
Albumin serum (82040) $62
Aldolase (82085) $177
Aldosterone urine (82088) $100
Alkaline phosphatase isoenzymes (84080) $266
Allergen peanut (86003) $34
Allergen specific igg (86001) $34
Allg Spec Ige Recomb Ea (86008) $45.50
Alpha-1-antitrypsin phenotype (82104) $213
Alpha-1-antitrypsin, total (82103) $50
Alpha-Fetoprotein L3 (82107) $242
Alt (sgpt) (84460) $95.50
Aluminum (82108) $123
Amino Acids 1 Quantitative Each Specimen (82131) $350
Amylase urine (82150) $83
Angiotensin i enzyme test (82164) $89
Anti-phosphatidylserine antibody (86148) $41
Antibody aspergillus (86606) $21.50
Antibody Borrelia Burgdorferi Confirmatory Tst (86617) $171
Antibody coxiella burnetii q fever (86638) $78
Antibody cytomegalovirus cmv (86644) $57
Antibody epstein-barr eb virus early antigen ea (86663) $59
Antibody Fungus Not Elsewhere Specified (86671) $85
Antibody helicobacter pylori (86677) $33
Antibody Herpes Smplx Non-Specific Type Test (86694) $61
Antibody identification (86870) $28
Antibody mumps (86735) $224
Antibody Protozoa Nes (86753) $79
Antibody screen (86850) $394
Antibody treponema pallidum (86780) $32
Antibody; Coccidioides (86635) $168.50
Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) $27
Antineutrophil Cytoplasmic Antb Screen Ea Antb (86036) $210
Antineutrophil Cytoplasmic Antb Titer Ea Antb (86037) $97.50
Antinomyces antibody (86602) $63
Antinuclear antibodies (86038) $53
Antistreptolysin o titer (86060) $72
Antithrombin iii activity (85300) $72
Antithrombin iii antigen (85301) $70
Apolipoprotein each (82172) $140.50
Aquaporin-4 Antb Elisa (86051) $67
Arsenic Urine (82175) $155
Aspergillus ag eia (87305) $77
Assay Biovlbl Testosterone Direct Measurement (84410) $201
Assay Nephelometry Not Spec (83883) $115
Assay of 17-hydroxypregnenolone (84143) $144
Assay of 5-hiaa (83497) $94
Assay of ammonia (82140) $179
Assay of androstenedione (82157) $213
Assay of anti-mullerian hormone (82166) $120
Assay of c-peptide (84681) $53
Assay of ceruloplasmin (82390) $50
Assay of citrate (82507) $224
Assay of erythropoietin (82668) $65
Assay of estrone (82679) $22
Assay of ferritin (82728) $168
Assay of g6pd enzyme (82955) $111
Assay of gammaglobulin igm (82784) $51.50
Assay of gastrin (82941) $134
Assay of gentamicin (80170) $103
Assay of homocystine (83090) $85.50
Assay of lactic acid (83605) $132
Assay of lipoprotein(a) (83695) $91
Assay of metanephrines (83835) $173
Assay of osteocalcin (83937) $215
Assay of phenobarbital (80184) $50
Assay of prealbumin (84134) $62
Assay of prolactin (84146) $34.50
Assay of serotonin (84260) $231
Assay of tacrolimus (80197) $224
Assay of topiramate (80201) $260
Assay of urine vma (84585) $75
Assay of vitamin k (84597) $133
Assay Phosphatase Acid Prostatic (84066) $61
Ast (sgot) (84450) $47.50
Asy carbamazepin 10,11-epxid (80161) $118
B cells total count (86355) $189
Bartonella antibody (86611) $37
Bcr/abl1 gene major bp (81206) $334
Bcr/abl1 gene minor bp (81207) $334
Beta 2 glycoprotein 1 igm (86146) $65
Beta hydroxybutyrate (82010) $72
Beta-2 microglobulin (82232) $50
Bile acids, total (82239) $213
Bilirubin direct (82248) $59
Bilirubin total (82247) $59
Bl Smear W/Diff Wbc Count (85007) $32
Blastomyces antibody (86612) $112
Blood gas (82803) $125.50
Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) $186
Blood Ph (82800) $63
Blood typing abo (86900) $189
Blood typing serologic rh (d) (86901) $316
Body fluid cell count (89051) $224
Body fluid cell count (89050) $179
Bordetella antibody (86615) $29
Brucella antibody (86622) $30
C diff amplified probe (87493) $226
C-reactive protein (86140) $65
C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) $50
Ca 125 (86304) $89
Ca 19-9 (86301) $134
Ca 27 29 (86300) $115
Cadmium level (82300) $233
Calcitonin (82308) $134
Calcium ionized (82330) $50
Calcium total (82310) $65
Calcium urine (82340) $41
Calculus spectroscopy (82365) $130
Calprotectin, fecal (83993) $424
Calr gene com variants (81219) $303
Candida antibody (86628) $52
Carbamazepine total (80156) $76
Carbon dioxide (82374) $51
Carboxyhemoglobin (82375) $57
Carcinoembryonic antigen (82378) $53
Cardiolipin ab igg (86147) $76
Carnitine (82379) $308
Carotene (82380) $222
Catecholamines fraction plasma (82384) $260
Cftr gene com variants (81220) $859.50
Chemiluminescent assay (82397) $126
Chlamydia antibody (86631) $73
Chlamydia Igm Antibody (86632) $73
Chloride blood (82435) $49
Chloride urine (82436) $65
Cholesterol HDL (83718) $103
Cholesterol total (82465) $48
Chrmsm count 15-20 cll 2karyotyp banding (88262) $223
Chromium urine (82495) $273
Chromogranin a (86316) $285
Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) $135
Ckmb (82553) $143
Clot Factor VIII Multimetric (85247) $488
Clot factor viii vw antigen (85246) $194
Clot Factor X Stuart-Power - Factor 10 Activity (85260) $113
Clotting Inhibitors Protein S Free (85306) $224
Clozapine level (80159) $296
Cmv ab igm (86645) $59
Cmv PCR (87496) $262
Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) $225
Cold agglutinin titer (86157) $125
Collagen cross links (82523) $285
Compatibility test antiglob (86922) $635
Complement c3 (86160) $50
Complement total (ch50) (86162) $87
Complement/Function Activity - C1 Esterase Inhibitor, Functional (86161) $225
Copper urine (82525) $50
Cortisol free (82530) $263
Cortisol total (82533) $57
Creatine kinase total (82550) $83
Creatinine blood (82565) $65
Creatinine other source (82570) $65
Cryoglobulin (82595) $44
Crystals body fluid (89060) $66
Culture Aerobic Identify (87077) $140
Culture afb (87116) $163
Culture anaerobic (87075) $70
Culture blood (87040) $168
Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous (87101) $74.50
Culture fungus id yeast (87106) $65
Culture fungus other (87102) $54
Culture genital (87070) $124
Culture screen only (87081) $132
Culture stool (87045) $260
Culture Typing, Nucleic Acid Amp Probe, Cult/Isolate, Each (87150) $154
Culture urine (87086) $30
Culture virus (87252) $211
Cyanide (82600) $112
Cyclic Citrullinated Peptide (86200) $85
Cystatin c (82610) $317
Cysticercosis Antibody (86682) $82
Cytogenetics 10-30 (88273) $103
Cytogenetics DNA probe (88271) $103
Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) $420
Cytp c/v auto thin lyr prepj scr mnl rescr phys (88175) $276
Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) $149
Detect agnt mult DNA ampli (87801) $43
Dgp antibody each ig class (86258) $111
Dhea (82626) $127
Dhea-sulfate (82627) $53
Digoxin (80162) $165
Dihydrotestosterone (82642) $195
Dilantin (80185) $165
Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) $68
Drug assay adalimumab (80145) $154
Drug Assay Lacosamide (80235) $136
Drug quant nes (80299) $174
Drug screen quant zonisamide (80203) $126
Drug Screen Quantitative Lamotrigine (80175) $224
Drug Screen Quantitative Oxcarbazepine (80183) $95
Drug Scrn Quan Levetiracetam (80177) $224
Drug test prsmv chem anlyzr (80307) $203
Drug Test Prsmv Dir Opt Obs (80305) $74
Ebv viral capsid (86665) $62
Ehrlichia antibody (86666) $33
Elastase pancreatic fecal quantitative (82653) $269
Electrolyte panel (80051) $81
Endomysial Antibody Each Immunoglobulin Class (86231) $113.50
Enterovirus Pcr (87498) $303
Enzyme cell activity (82657) $156
Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) $60.50
Estradiol (82670) $36.50
Estriol serum (82677) $50
Estrogens total (82672) $23
Ethylene glycol (82693) $95
Everolimus (80169) $86
F2 gene analysis 20210g >a variant (81240) $265.50
F5 gene analysis, leiden variant (81241) $285
Factor ii activity (85210) $82
Factor viii ahg (85240) $149
Factor xiii solubility screen (85291) $58
Fatty acids free (82725) $119
Fbrnlyc factors&inhibitors alpha-2 antiplasmin (85410) $51
Fbrnlyc Factors&Inhibitors Plsmng Activator (85415) $108
Fecal fat qual (82705) $42
Fecal fat quant (82710) $263
Fetal Chromosomal Aneuploidy Genomic Seq Analys (81420) $792
Fibrin degradation products (85362) $44
Fibrin Degradation Quant (85379) $125
Fibrinogen activity (85384) $37
Fluorescent Antibody Screen (86255) $18
Folate serum (82746) $50
Folic acid rbc (82747) $50
Follicle Stimulating Hormone (83001) $46
Francisella tularensis (86668) $46
Fructosamine (82985) $21
Gabapentin (80171) $137
Gammaglobulin ige (82785) $35
Gases Blood Ph Direct Meas Xcpt Pulse Oximitry (82805) $296
Ggt (82977) $24
Giardia antigen eia stool (87329) $115
Glucagon (82943) $296
Glucose (82947) $53
Glucose Blood Test (82962) $34
Glucose body fluid (82945) $53
Glucose post dose (82950) $62
Glucose tolerance ea addl beyond 3 specimens (82952) $31
Glucose Tolerance Test (Gtt) - Bundled Charge (82951) $160
Glutathione (82978) $98
Growth hormone (83003) $26
H pylori breath test (83013) $242
Haptoglobin (83010) $116.50
Hcg qualitative (84703) $94
Hcg quant (84702) $186
Heavy metal quant each (83018) $293
Hematocrit (85014) $41
Hemoglobin (85018) $41
Hemoglobin a1c (83036) $120
Hemoglobin electrophoresis (83020) $204
Hemoglobin plasma (83051) $47
Heparin assay (85520) $83
Hepatitis a antibody total (86708) $50
Hepatitis a igm (86709) $108
Hepatitis b core ab igm (86705) $79
Hepatitis b core antibody total (86704) $50
Hepatitis B Surface Ab (86706) $50
Hepatitis B Surface Antigen (87340) $59
Hepatitis be antibody (86707) $155
Hepatitis Be Antigen (87350) $72
Hepatitis c antibody (86803) $41
Hepatitis C Genotype (87902) $420
Herpes simplex type i (86695) $59
Herpes simplex type ii (86696) $65
Heterophile Antibodies,Screen - Mononucleosis Screen (86308) $65
Hexagonal phospholipid (85598) $249
Hfe gene (81256) $223
Histamine plasma (83088) $245
Histoplasma antibody (86698) $68
Histoplasma antigen urine (87385) $288
HLA Class II typing, low resolution (eg, antigen equivalents); one antigen equivalent, each Facility (81377) $120
Hla I Low Resolution One Antigen Equivalent Each (81374) $99
Homogenization tissue (87176) $84
Homovanillic acid urine (83150) $103
Hpylori Drug Administration (83014) $157
Hsv, Dna, Amp Probe - Hsv Pcr (87529) $59
Human epididymis protein 4 (86305) $89
Hydroxyprogesterone 17-d (83498) $204
Iaad ia cryptosporidium (87328) $81
Iaad Ia Hiv-1 Ag W/Hiv-1 & Hiv-2 Antbdy Single (87389) $55
Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) $234
Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) $84
Iaad Ia Severe Aqt Respir Synd Coronavirus (87426) $146
Iaad ia shiga-like toxin (87427) $70
Iaadi Legionella Pneumophila (87278) $124
Iaadiadoo not otherwise specified (87899) $112
Iadna chlamydia pneumoniae amplified probe tq (87486) $176
Iadna hepatitis b virus quantification (87517) $379
Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) $201
Iadna HIV-1 quant & reverse transcription (87536) $399
Iadna hpv sep rprt hi-rsk typ&hi-rsk poold rslts (87626) $276
Iadna human papillomavirus high-risk types (87624) $176
Iadna mycoplsm pneumoniae amplified probe tq (87581) $176
Iadna neisseria gonorrhoeae amplified probe tq (87591) $135
Iadna nos amplified probe tq each organism (87798) $243
Iadna nos quantification each organism (87799) $210
Iadna trichomonas vaginalis amplified probe tech (87661) $80
Iadna-DNA/RNA probe tq 12-25 (87507) $1,338
Igg subclasses (82787) $76.50
Immunoassay infectious agent antibody quan nos (86317) $19
Immunoassay nonantibody (83516) $36
Immunodiffusion Ouchterlony (86331) $28
Immunofixation (86334) $250
Immunofixation urine (86335) $103
Immunoglobulin light chains free each (83521) $97.50
Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87428) $177
Inhibin a (86336) $260
Inhibin b (83520) $269
Insulin antibodies (86337) $333
Insulin free (83527) $226
Insulin total (83525) $50
Interleukin 6 (83529) $100
Intrinsic factor antibody (86340) $96
Iron (83540) $41
Iron binding capacity (83550) $43.50
Islet cell antibody (86341) $100
Jak2 gene analysis (81270) $309
Ldh body fluid (83615) $41
Ldh isoenzymes (83625) $60
LDL cholesterol direct (83721) $120
Lead (83655) $79
Legionella antibody (86713) $97
Legionella antigen urine (87449) $188
Leukocyte Assmt Fecal Qual/Semiquantitative (89055) $57
Lh (83002) $53
Lipase (83690) $85
Lipoprotein Blood Quan Numbers & Subclasses (83704) $236
Listeria ab (86609) $424
Lithium (80178) $59
Lyme disease antibody (86618) $277
Macroscopic exam parasite (87169) $91
Magnesium (83735) $85
Malaria smear (87207) $39
Mass spectrometry qual/quan (83789) $315
Mercury urine (83825) $119
Methylmalonic acid serum (83921) $57
Microalbumin urine (82043) $82
Microsomal antibodies (86376) $59
Mitochondrial antibody each (86381) $208
Mog-igg1 antibody cell-based imfluor assay each (86362) $72
Mononuclear cell antigen (86356) $162
Mpl gene common variants (81338) $281
Mrsa PCR (87641) $212
Mthfr Gene Analysis Common Variants (81291) $385
Muscle-specific kinase (musk) antibody (86366) $1,673
Mycophenolic acid (80180) $56
Mycoplasma antibody (86738) $123.50
Myelin basic protein csf (83873) $108
Natriuretic peptide (83880) $401
Nfct ds bv&vaginitis DNA alg (81515) $407
Nfct ds chrnc hcv 6 assays (81596) $248
Nk cells total count (86357) $189
Nuclear antigen antibody (86235) $38
Oligoclonal bands (83916) $137
Organic Acids Qualitative Each Specimen (83919) $226
Orthopoxvirus Amp Prb Each (87593) $192
Osmolality serum (83930) $53
Osmolality urine (83935) $28
Ova and parasite direct-id lca (87177) $266
Oxalate urine (83945) $84
Pancreatic polypeptide (83519) $1,673
Parvovirus antibody (86747) $49
Ph body fluid (83986) $46.50
Ph urine (81003) $41
Phosphatase alkaline (84075) $65
Phosphorus blood (84100) $62
Phosphorus urine (84105) $41
Pinworm exam (87172) $44
Platelet count automated (85049) $57
Platelet neutralization (85597) $109
Porphobilinogen urine quant (84110) $63
Porphyrins Urine Quantitation & Fractionation (84120) $154
Potassium (84132) $59
Potassium urine (84133) $57
Pregnancy associated plasma protein-a (84163) $77
Pregnenolone (84140) $266
Procalcitonin (pct) (84145) $164.50
Progesterone (84144) $50
Protein body fluid (84157) $50
Protein c activity (85303) $174
Protein c antigen (85302) $258
Protein electrophoresis serum (84165) $72
Protein Electrophoresis Urine (84166) $202
Protein s total (85305) $346
Protein total serum (84155) $58
Protein urine (84156) $50
Prothrombin Time Substitution Plasma Frctj Each (85611) $40
Protoporphyrin rbc quantitative (84202) $41
PSA free (84154) $46
Pth intact (83970) $79
Rbc (85041) $111
Renin activity plasma (84244) $120
Resp virus 12-25 targets (87633) $776
Reticulated platelet assay (85055) $75
Reticulocyte count auto (85045) $52
Rheumatoid factor quant (86431) $59
Rickettsia antibody (86757) $318
Ristocetin cofactor (85245) $194
Rotavirus ag eia (87425) $99
Rpr Titer (86593) $37
Rsv (87807) $77
Rubella antibody (86762) $50
Rubeola Antibody Igg (86765) $50
Russell viper venom time diluted (85613) $59
Salicylate Level (80179) $108
Sars-Cov-2 Covid-19 Amp Prb (87635) $159
Sars-Cov-2 Covid-19 Antibody (86769) $238
Sarscov2&inf a&b&rsv amp prb (87637) $295
Sedimentation rate auto (85652) $51
Selenium (84255) $316
Semen analysis; sperm presence and motility of sperm, if performed Facility (89321) $44.50
Sensitivity mic (87186) $95
Serotonin Release Assay (86022) $117
Sex hormone binding globulin (84270) $57
Sickling of rbc reduction (85660) $494
Sirolimus (rapamycin) (80195) $74
Smear acid fast (87206) $96
Smear complex stain (87209) $68
Smear gram stain (87205) $57
Smr Prim Src Wet Mount Nfct Agt (87210) $57
Sodium (84295) $62
Sodium feces (84302) $204
Sodium urine (84300) $62
Soluble transferrin receptor (84238) $170
Somatomedin (84305) $263
Spectrophotometry (84311) $53
Staph a DNA amp probe (87640) $146
Stool Culture, Addl Pathogens (87046) $191
Strep a assay w/optic (87880) $152
Strep a DNA amp probe (87651) $151
Surg path level iii (88304) $135
Surgical pathology level IV (88305) $143
T Cell Absolute Count (86361) $120
T Cells Absolute Cd4&Cd8 Count Ratio (86360) $247
T cells total count (86359) $189
T3 free (84481) $41
T3 reverse (84482) $62
T3 total (84480) $23
T3 uptake (84479) $41
T4 free (84439) $112
T4 total (84436) $41
Tb intradermal test (86580) $33
Tb test, cell immun measure (86480) $224
Testosterone free (84402) $125
Testosterone total (84403) $315
Thrombin time plasma (85670) $120
Thromboplastin Inhibition Tissue (85705) $54
Thromboplastin time prtl substit plasma frctj ea (85732) $40
Thyroglobulin (84432) $91
Thyroglobulin antibody (86800) $53
Thyroid Stimulating Immune Globulins Tsi (84445) $356
Thyroxine binding globulin (84442) $94
Tissue culture lymphocyte (88230) $260
Tissue transglutaminase ab iga (86364) $67
Toxin/Antitoxin Assay Tissue Culture (87230) $364
Toxoplasma ab igm (86778) $83
Toxoplasma antibody igg (86777) $83
Transferrin (84466) $59
Triglycerides (84478) $77
Troponin (84484) $123
Urea nitrogen (84520) $53
Urea nitrogen urine (84540) $169
Uric acid blood (84550) $59
Uric acid other source (84560) $33
Urinalysis auto w/scope (81001) $43
Urinalysis Microscopic Only (81015) $41
Urine pregnancy test (81025) $56
Urine volume measurement (81050) $53
Valproic acid (80164) $168
Vancomycin trough (80202) $168
Varicella-zoster antibody (86787) $72
Vasoactive intestinal peptide (vip) (84586) $210
Vdrl csf (86592) $741
Virus antibody nos (86790) $82
Virus id non-immunologic oth/thn cytopathic (87255) $93.50
Virus inoculation, shell via (87254) $95
Viscosity serum (85810) $75
Vitamin A (84590) $129
Vitamin b-12 (82607) $46
Vitamin b1 (thiamine) (84425) $186
Vitamin b2 (84252) $199
Vitamin b3 niacin (84591) $94.50
Vitamin b6 (84207) $224
Vitamin c (82180) $260
Vitamin D 25-Hydroxy (82306) $65
Vitamin e serum (84446) $140
Voltage-gated calcium channel antibody each (86596) $336
West nile virus antibody (86789) $99
West nile virus igm (86788) $99
Zinc (84630) $177