Lab & pathology prices at Teton Valley Hospital
Driggs, ID · every code in this section with a posted price and a Medicare benchmark.
563 codes. Prices are the hospital's own posted facility charges.
Compare against other hospitals interactively →
| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| 1 25 Dihydroxy includes fractions if performed (82652) | $211.20 | $264 | 5.5× |
| 5 Nucleotidase (83915) | $97.60 | $122 | 8.8× |
| Activated protein c resistance (85307) | $86.40 | $108 | 5.6× |
| Acute hepatitis panel (80074) | $193.60 | $242 | 4.1× |
| Acylcarnitine Plasma (82017) | $181.60 | $227 | 10.8× |
| Adenovirus antibody (86603) | $70.40 | $88 | 5.5× |
| Adrenocorticotropic hormone (82024) | $187.20 | $234 | 4.8× |
| Afp maternal serum (82105) | $96 | $120 | 5.7× |
| Agglutinins febrile ea antigen (86000) | $50.40 | $63 | 7.2× |
| Albumin body fluid (82042) | $26.40 | $33 | 3.4× |
| Albumin serum (82040) | $64.40 | $80.50 | 13.0× |
| Aldolase (82085) | $60.80 | $76 | 6.3× |
| Aldosterone urine (82088) | $95.20 | $119 | 2.3× |
| Alkaline phosphatase isoenzymes (84080) | $79.20 | $99 | 5.4× |
| Allergen peanut (86003) | $40 | $50 | 7.7× |
| Allergen specific igg (86001) | $38.40 | $48 | 4.9× |
| Allg Spec Ige Recomb Ea (86008) | $66.40 | $83 | 3.7× |
| Alpha-1-antitrypsin, total (82103) | $86.40 | $108 | 6.4× |
| Alt (sgpt) (84460) | $44 | $55 | 8.3× |
| Amino acids 6/> amino acids quantitative ea spe (82139) | $291.20 | $364 | 17.3× |
| Aminolevulinic acid (ala) (82135) | $96.80 | $121 | 5.9× |
| Amylase urine (82150) | $90.40 | $113 | 14.0× |
| Ana titer (86039) | $93.60 | $117 | 8.4× |
| Angiotensin i enzyme test (82164) | $77.60 | $97 | 5.3× |
| Anti-phosphatidylserine antibody (86148) | $103.20 | $129 | 6.4× |
| Antibody aspergillus (86606) | $128.80 | $161 | 8.6× |
| Antibody Borrelia Burgdorferi Confirmatory Tst (86617) | $93.60 | $117 | 6.0× |
| Antibody coxiella burnetii q fever (86638) | $232.80 | $291 | 19.2× |
| Antibody cytomegalovirus cmv (86644) | $71.20 | $89 | 4.9× |
| Antibody Encephalitis Eastern Equine (86652) | $63.20 | $79 | 4.8× |
| Antibody encephalitis st. louis (86653) | $64.80 | $81 | 4.9× |
| Antibody epstein-barr eb virus early antigen ea (86663) | $98.40 | $123 | 7.5× |
| Antibody Fungus Not Elsewhere Specified (86671) | $170.40 | $213 | 13.9× |
| Antibody haemophilus influenza (86684) | $90.40 | $113 | 5.7× |
| Antibody helicobacter pylori (86677) | $88.80 | $111 | 5.3× |
| Antibody Herpes Smplx Non-Specific Type Test (86694) | $80.80 | $101 | 5.6× |
| Antibody Hiv-1&Hiv-2 Single Result (86703) | $88 | $110 | 6.4× |
| Antibody identification (86870) | $141.60 | $177 | 0.4× |
| Antibody identification leukocyte antibodies (86021) | $112 | $140 | 7.4× |
| Antibody Identification Platelet Immunogl Assay (86023) | $100.80 | $126 | 8.1× |
| Antibody mumps (86735) | $74 | $92.50 | 5.7× |
| Antibody Protozoa Nes (86753) | $53.60 | $67 | 4.3× |
| Antibody screen (86850) | $111.20 | $139 | 11.4× |
| Antibody treponema pallidum (86780) | $62.40 | $78 | 4.7× |
| Antibody; Coccidioides (86635) | $90.40 | $113 | 7.9× |
| Antigen typing (86905) | $46.40 | $58 | 12.1× |
| Antihuman Globulin Indirect Ea Antibody Titer - Antibody Titer (86886) | $159.20 | $199 | 30.7× |
| Antineutrophil Cytoplasmic Antb Screen Ea Antb (86036) | $96 | $120 | 8.0× |
| Antineutrophil Cytoplasmic Antb Titer Ea Antb (86037) | $112 | $140 | 9.3× |
| Antinuclear antibodies (86038) | $72 | $90 | 6.0× |
| Antistreptolysin o titer (86060) | $47.20 | $59 | 6.5× |
| Antithrombin iii activity (85300) | $108.80 | $136 | 9.2× |
| Antithrombin iii antigen (85301) | $56.80 | $71 | 5.3× |
| Apc gene full sequence (81201) | $1,669.60 | $2,087 | 2.1× |
| Apolipoprotein each (82172) | $79.20 | $99 | 3.8× |
| Arsenic Urine (82175) | $62.40 | $78 | 3.3× |
| Aspa gene analysis common variants (81200) | $279.20 | $349 | 5.9× |
| Assay 17-(17-Ks)Ketosteroids (83586) | $40.80 | $51 | 3.2× |
| Assay direct measurement free estradiol (82681) | $80 | $100 | 2.9× |
| Assay Lipoprotein Pla2 (83698) | $138.40 | $173 | 3.0× |
| Assay myeloperoxidase (83876) | $86.40 | $108 | 1.7× |
| Assay Nephelometry Not Spec (83883) | $132.80 | $166 | 9.8× |
| Assay of 17-hydroxypregnenolone (84143) | $100 | $125 | 4.4× |
| Assay of 5-hiaa (83497) | $63.20 | $79 | 4.9× |
| Assay of ammonia (82140) | $108 | $135 | 7.4× |
| Assay of androstenedione (82157) | $120.80 | $151 | 4.1× |
| Assay of c-peptide (84681) | $112.80 | $141 | 5.4× |
| Assay of ceruloplasmin (82390) | $64 | $80 | 6.0× |
| Assay of citrate (82507) | $111.20 | $139 | 4.0× |
| Assay of cpk in blood (82552) | $37.60 | $47 | 2.8× |
| Assay of cyclosporine (80158) | $90.40 | $113 | 5.0× |
| Assay of erythropoietin (82668) | $111.20 | $139 | 5.9× |
| Assay of estrone (82679) | $131.20 | $164 | 5.3× |
| Assay of ethosuximide (80168) | $119.62 | $149.52 | 7.3× |
| Assay of ferritin (82728) | $86.80 | $108.50 | 6.4× |
| Assay of g6pd enzyme (82955) | $75.20 | $94 | 7.8× |
| Assay of gammaglobulin igm (82784) | $68.80 | $86 | 7.4× |
| Assay of gastrin (82941) | $114.40 | $143 | 6.5× |
| Assay of gentamicin (80170) | $116.80 | $146 | 7.1× |
| Assay of homocystine (83090) | $84 | $105 | 4.7× |
| Assay of lactic acid (83605) | $83.20 | $104 | 7.2× |
| Assay of lipoprotein(a) (83695) | $68 | $85 | 4.7× |
| Assay of metanephrines (83835) | $90.80 | $113.50 | 5.4× |
| Assay of osteocalcin (83937) | $172 | $215 | 5.8× |
| Assay of phenobarbital (80184) | $115.20 | $144 | 7.5× |
| Assay of phosphatase acid total (84060) | $44.80 | $56 | 5.9× |
| Assay of prealbumin (84134) | $100.80 | $126 | 6.9× |
| Assay of proinsulin (84206) | $107.20 | $134 | 4.0× |
| Assay of prolactin (84146) | $47.20 | $59 | 2.4× |
| Assay of pyruvate (84210) | $32.80 | $41 | 2.3× |
| Assay of tacrolimus (80197) | $110.40 | $138 | 8.0× |
| Assay of topiramate (80201) | $88.80 | $111 | 7.4× |
| Assay of urine vma (84585) | $49.60 | $62 | 3.2× |
| Assay of vasopressin anti-diuretic hormone (84588) | $168 | $210 | 4.9× |
| Assay of vitamin k (84597) | $280 | $350 | 20.4× |
| Assay of volatiles (84600) | $95.20 | $119 | 5.6× |
| Assay Phosphatase Acid Prostatic (84066) | $106.05 | $132.56 | 11.0× |
| Ast (sgot) (84450) | $43.20 | $54 | 8.3× |
| B cells total count (86355) | $184 | $230 | 4.9× |
| Bartonella antibody (86611) | $74.40 | $93 | 7.3× |
| Bcr/abl1 gene minor bp (81207) | $388 | $485 | 2.7× |
| Beta 2 glycoprotein 1 igm (86146) | $111.20 | $139 | 4.4× |
| Beta hydroxybutyrate (82010) | $100.80 | $126 | 12.3× |
| Beta lactamase (87185) | $32 | $40 | 6.7× |
| Beta-2 microglobulin (82232) | $108.80 | $136 | 6.7× |
| Bilirubin direct (82248) | $43.20 | $54 | 8.6× |
| Bilirubin total (82247) | $38.80 | $48.50 | 7.7× |
| Bld Bank Phys Svcs Invstgj Tfuj Rxn Reprt (86078) | $172.80 | $216 | 1.0× |
| Bld Typing Serologic Rh Phnt (86906) | $103.20 | $129 | 13.3× |
| Bleeding time (85002) | $68 | $85 | 14.1× |
| Blood Count Reticulocytes Auto 1/> Cell Meas (85046) | $56.80 | $71 | 10.2× |
| Blood gas (82803) | $152 | $190 | 5.8× |
| Blood Occult Fecal Hgb Deter Ia Qual Feces 1-3 (82274) | $63.20 | $79 | 4.0× |
| Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) | $27.40 | $34.25 | 6.3× |
| Blood Ph (82800) | $74.40 | $93 | 6.8× |
| Blood Type Antigen Donor Reagent Serum Each - Blood Typing, Antigen (86902) | $31.20 | $39 | 4.9× |
| Blood typing abo (86900) | $50.40 | $63 | 16.9× |
| Blood Typing Antigen Screen Patient Serum/Unit (86904) | $140.80 | $176 | 8.6× |
| Blood typing serologic rh (d) (86901) | $51.20 | $64 | 17.1× |
| Body fluid cell count (89051) | $112 | $140 | 20.0× |
| Bordetella antibody (86615) | $88 | $110 | 6.7× |
| Brca1&2 seq & full dup/del (81162) | $2,822.40 | $3,528 | 1.5× |
| Brucella antibody (86622) | $86.40 | $108 | 9.7× |
| C diff amplified probe (87493) | $128 | $160 | 3.4× |
| C-reactive protein (86140) | $96.80 | $121 | 18.7× |
| C-Reactive Protein,High Sensitivity - High Sensitivity Crp (86141) | $83.20 | $104 | 6.4× |
| Ca 125 (86304) | $58.40 | $73 | 2.8× |
| Ca 19-9 (86301) | $104 | $130 | 5.0× |
| Ca 27 29 (86300) | $88 | $110 | 4.2× |
| Cadmium level (82300) | $62.40 | $78 | 2.6× |
| Calcitonin (82308) | $114.40 | $143 | 4.3× |
| Calcium ionized (82330) | $82.40 | $103 | 6.0× |
| Calcium total (82310) | $36 | $45 | 7.0× |
| Calcium urine (82340) | $58.40 | $73 | 9.7× |
| Calculus Quantitative Chemical (82360) | $122.40 | $153 | 9.5× |
| Calculus spectroscopy (82365) | $88 | $110 | 6.8× |
| California encephalitis ab (86651) | $63.20 | $79 | 4.8× |
| Calprotectin, fecal (83993) | $215.20 | $269 | 11.0× |
| Calr gene com variants (81219) | $108 | $135 | 0.9× |
| Candida antibody (86628) | $92 | $115 | 7.7× |
| Carbamazepine total (80156) | $88 | $110 | 6.0× |
| Carbon dioxide (82374) | $46.40 | $58 | 9.5× |
| Carboxyhemoglobin (82375) | $104 | $130 | 8.4× |
| Carcinoembryonic antigen (82378) | $64 | $80 | 3.4× |
| Cardiolipin ab igg (86147) | $76 | $95 | 3.0× |
| Carnitine (82379) | $143.20 | $179 | 8.5× |
| Carotene (82380) | $65.60 | $82 | 7.1× |
| Catecholamines fraction plasma (82384) | $96.80 | $121 | 3.8× |
| Cellular Function Assay Stimul&Detect Biomarker (86352) | $256.80 | $321 | 1.9× |
| Cftr gene com variants (81220) | $435.20 | $544 | 0.8× |
| Chemiluminescent assay (82397) | $92.80 | $116 | 6.6× |
| Chlamydia antibody (86631) | $59.20 | $74 | 5.0× |
| Chlamydia Igm Antibody (86632) | $59.20 | $74 | 4.7× |
| Chloride blood (82435) | $36.80 | $46 | 8.0× |
| Cholesterol HDL (83718) | $25.60 | $32 | 3.1× |
| Cholesterol total (82465) | $32 | $40 | 7.4× |
| Cholinesterase serum (82480) | $52.28 | $65.35 | 6.6× |
| Chrmsm count 15-20 cll 2karyotyp banding (88262) | $402.40 | $503 | 3.2× |
| Chromium urine (82495) | $45.60 | $57 | 2.2× |
| Chromogranin a (86316) | $131.20 | $164 | 6.3× |
| Chylmd Trach, Dna, Amp Probe - Chlamydia Dna Pcr (87491) | $79.44 | $99.30 | 2.3× |
| Ckmb (82553) | $111.20 | $139 | 9.6× |
| Clot Factor VIII Multimetric (85247) | $59.20 | $74 | 2.6× |
| Clot factor viii vw antigen (85246) | $101.60 | $127 | 4.4× |
| Clot Factor X Stuart-Power - Factor 10 Activity (85260) | $150.40 | $188 | 8.4× |
| Clotting Inhibitors Protein S Free (85306) | $115.20 | $144 | 7.5× |
| Cmv ab igm (86645) | $36 | $45 | 2.1× |
| Cmv PCR (87496) | $274.40 | $343 | 7.8× |
| Col-chr/ms nondrug analyte nes qual/quan ea spec (82542) | $165.20 | $206.50 | 6.9× |
| Cold agglutinin screen (86156) | $127.84 | $159.80 | 15.8× |
| Cold agglutinin titer (86157) | $46.40 | $58 | 5.8× |
| Collagen cross links (82523) | $152 | $190 | 8.1× |
| Compatibility test antiglob (86922) | $206.40 | $258 | 1.2× |
| Complement c3 (86160) | $78.40 | $98 | 6.5× |
| Complement total (ch50) (86162) | $103.20 | $129 | 5.1× |
| Complement/Function Activity - C1 Esterase Inhibitor, Functional (86161) | $74.40 | $93 | 6.2× |
| Concentration Infectious Agent (87015) | $40 | $50 | 6.0× |
| Coombs direct (86880) | $67.20 | $84 | 12.5× |
| Copper urine (82525) | $93.60 | $117 | 7.5× |
| Cortisol free (82530) | $89.20 | $111.50 | 5.3× |
| Cortisol total (82533) | $95.20 | $119 | 5.8× |
| Creatine kinase total (82550) | $61.60 | $77 | 9.5× |
| Creatinine blood (82565) | $43.20 | $54 | 8.4× |
| Creatinine clearance (82575) | $72 | $90 | 7.6× |
| Creatinine other source (82570) | $59.20 | $74 | 11.4× |
| Cryofibrinogen (82585) | $58.40 | $73 | 4.1× |
| Cryoglobulin (82595) | $56 | $70 | 8.7× |
| Crystals body fluid (89060) | $72 | $90 | 9.8× |
| Culture Aerobic Identify (87077) | $63.20 | $79 | 7.8× |
| Culture afb (87116) | $60.80 | $76 | 5.6× |
| Culture anaerobic (87075) | $97.20 | $121.50 | 10.3× |
| Culture blood (87040) | $212 | $265 | 20.5× |
| Culture Fungi-Skin Hair Nails - Fungal Culture, Cutaneous (87101) | $72 | $90 | 9.3× |
| Culture fungus blood (87103) | $52 | $65 | 2.5× |
| Culture fungus id yeast (87106) | $203.20 | $254 | 19.7× |
| Culture fungus other (87102) | $66.40 | $83 | 7.9× |
| Culture genital (87070) | $98.40 | $123 | 11.4× |
| Culture screen only (87081) | $38.80 | $48.50 | 5.9× |
| Culture stool (87045) | $82.40 | $103 | 8.7× |
| Culture typing if ea antiserum (87140) | $40 | $50 | 7.2× |
| Culture urine (87086) | $61.60 | $77 | 7.6× |
| Culture virus (87252) | $103.20 | $129 | 4.0× |
| Cyanide (82600) | $95.20 | $119 | 4.9× |
| Cyclic Citrullinated Peptide (86200) | $83.20 | $104 | 6.4× |
| Cyp2c19 gene com variants (81225) | $648 | $810 | 2.2× |
| Cystatin c (82610) | $136.80 | $171 | 7.4× |
| Cysticercosis Antibody (86682) | $244 | $305 | 18.8× |
| Cytogenom const microarray copy number&snp var (81229) | $1,653.60 | $2,067 | 1.4× |
| Cytomeg, Dna, Quant - Cmv Dna, Quantitative, Pcr (87497) | $271.20 | $339 | 6.3× |
| Cytopath Smear Other Source (88160) | $73.60 | $92 | 2.6× |
| Cytopath Tbs Cerv/Vag Manual (88164) | $37.60 | $47 | 2.0× |
| Cytp c/v auto thin lyr prepj scr mnl rescr phys (88175) | $96.80 | $121 | 3.6× |
| Cytp concentration smears & interpretation (88108) | $23.20 | $29 | 0.6× |
| Cytp Eval Fine Needle Aspirate Interp & Report (88173) | $173.60 | $217 | 3.4× |
| Deoxyribonuclease antibody (86215) | $31.20 | $39 | 2.4× |
| Detect Agent,Immun,Dir Obs,Influenza - Rapid Flu (87804) | $64 | $80 | 3.9× |
| Detect agnt mult DNA ampli (87801) | $251.20 | $314 | 3.6× |
| Dhea (82626) | $142.40 | $178 | 5.6× |
| Dhea-sulfate (82627) | $100 | $125 | 4.5× |
| Digoxin (80162) | $132 | $165 | 9.9× |
| Dihydrotestosterone (82642) | $182 | $227.50 | 6.2× |
| Dilantin (80185) | $88 | $110 | 6.6× |
| Diphtheria antitoxoid (86648) | $117.60 | $147 | 7.7× |
| Dna Antibody Single Stranded (86226) | $132 | $165 | 10.9× |
| Dna Antibody, Natv/2 Strand - Anti Dna, Double Stranded (86225) | $132.40 | $165.50 | 9.6× |
| Drug assay adalimumab (80145) | $244 | $305 | 6.3× |
| Drug Assay Amiodarone (80151) | $68 | $85 | 3.6× |
| Drug assay flecainide (80181) | $92.80 | $116 | 5.0× |
| Drug Assay Infliximab (80230) | $244 | $305 | 6.3× |
| Drug assay methotrexate (80204) | $76 | $95 | 2.0× |
| Drug quant nes (80299) | $133.60 | $167 | 7.2× |
| Drug screen quant zonisamide (80203) | $56.80 | $71 | 4.3× |
| Drug Screen Quantitative Lamotrigine (80175) | $66.40 | $83 | 5.0× |
| Drug Screen Quantitative Oxcarbazepine (80183) | $64.80 | $81 | 4.9× |
| Drug Scrn Quan Levetiracetam (80177) | $82.40 | $103 | 6.2× |
| Drug test prsmv chem anlyzr (80307) | $156 | $195 | 2.5× |
| Drug Test Prsmv Dir Opt Obs (80305) | $63.20 | $79 | 5.0× |
| Drug tst prsmv read instrmnt asstd dir opt obs (80306) | $84 | $105 | 4.9× |
| Ebv viral capsid (86665) | $97.60 | $122 | 5.4× |
| Ehrlichia antibody (86666) | $108 | $135 | 10.6× |
| Electrolyte panel (80051) | $58.40 | $73 | 8.3× |
| Encephalitis Western Equine (86654) | $169.60 | $212 | 12.9× |
| Enterovirus antibody (86658) | $68 | $85 | 5.2× |
| Enterovirus Pcr (87498) | $238.40 | $298 | 6.8× |
| Enzyme cell activity (82657) | $116.80 | $146 | 5.3× |
| Eosinophil count (85048) | $28.80 | $36 | 11.3× |
| Epstein-Barr Nuclear Antigen - Epstein-Barr Virus Nuclear Antigen Ab (86664) | $98.40 | $123 | 6.4× |
| Estradiol (82670) | $140 | $175 | 5.0× |
| Estriol serum (82677) | $72.80 | $91 | 3.0× |
| Estrogens fractionated (82671) | $204 | $255 | 6.3× |
| Estrogens total (82672) | $129.60 | $162 | 6.0× |
| Everolimus (80169) | $189.60 | $237 | 13.8× |
| F2 gene analysis 20210g >a variant (81240) | $215.20 | $269 | 3.3× |
| F5 gene analysis, leiden variant (81241) | $274.40 | $343 | 3.7× |
| Factor ii activity (85210) | $191.20 | $239 | 14.7× |
| Factor inhibitor test (85335) | $160 | $200 | 12.4× |
| Factor ix activity (85250) | $154.40 | $193 | 8.1× |
| Factor v activity (85220) | $140 | $175 | 7.9× |
| Factor viii ahg (85240) | $110.40 | $138 | 6.2× |
| Factor xi assay (85270) | $153.60 | $192 | 8.6× |
| Fecal fat qual (82705) | $42.40 | $53 | 8.3× |
| Fecal fat quant (82710) | $138.40 | $173 | 8.2× |
| Fetal fibronectin (82731) | $495.20 | $619 | 7.7× |
| Fetal Lung Maturity Fluorescence Polarization (83663) | $176.80 | $221 | 9.3× |
| Fibrin degradation products (85362) | $95.28 | $119.10 | 13.8× |
| Fibrin Degradation Quant (85379) | $93.60 | $117 | 9.2× |
| Fibrinogen activity (85384) | $71.20 | $89 | 7.3× |
| Flow cytometry first marker (88184) | $164 | $205 | 0.5× |
| Fluorescent Antibody Screen (86255) | $88 | $110 | 7.3× |
| Fluorescent Nonnfct Agt Antb Titer Ea Antibody (86256) | $78.40 | $98 | 6.5× |
| Fmr1 gene detection (81243) | $323.20 | $404 | 5.7× |
| Folate serum (82746) | $91.20 | $114 | 6.2× |
| Folic acid rbc (82747) | $79.20 | $99 | 4.5× |
| Follicle Stimulating Hormone (83001) | $128.80 | $161 | 6.9× |
| Fresh frozen plasma thawing each unit (86927) | $32 | $40 | 0.2× |
| Fructosamine (82985) | $48.80 | $61 | 2.9× |
| Fungus Identification, Mold - Fungal Identification, Mold (87107) | $84.80 | $106 | 8.2× |
| Gammaglobulin ige (82785) | $104.80 | $131 | 6.4× |
| Ggt (82977) | $47.20 | $59 | 6.6× |
| Giardia antigen eia stool (87329) | $76 | $95 | 6.3× |
| Giardia lamblia antibody (86674) | $148 | $185 | 10.1× |
| Glucose (82947) | $34.80 | $43.50 | 8.9× |
| Glucose body fluid (82945) | $32 | $40 | 8.1× |
| Glucose post dose (82950) | $40.80 | $51 | 8.6× |
| Glucose tolerance ea addl beyond 3 specimens (82952) | $29.60 | $37 | 7.6× |
| Glucose Tolerance Test (Gtt) - Bundled Charge (82951) | $84 | $105 | 6.5× |
| Growth hormone (83003) | $103.20 | $129 | 6.2× |
| H pylori breath test (83013) | $268.80 | $336 | 4.0× |
| Haptoglobin (83010) | $77.60 | $97 | 6.2× |
| Hcg qualitative (84703) | $70.40 | $88 | 9.4× |
| Hcg quant (84702) | $92 | $115 | 6.1× |
| Heavy metal quant each (83018) | $195.20 | $244 | 8.9× |
| Hematocrit (85014) | $25.20 | $31.50 | 10.6× |
| Hematocrit spun (85013) | $24 | $30 | 3.4× |
| Hemoglobin (85018) | $25.20 | $31.50 | 10.6× |
| Hemoglobin a1c (83036) | $55.20 | $69 | 5.7× |
| Hemoglobin Chromotography - Hemoglobinopathy Eval (83021) | $94.40 | $118 | 5.2× |
| Hemoglobin electrophoresis (83020) | $208 | $260 | 16.2× |
| Heparin assay (85520) | $179.20 | $224 | 13.7× |
| Hepatitis a antibody total (86708) | $61.60 | $77 | 5.0× |
| Hepatitis a igm (86709) | $64 | $80 | 5.7× |
| Hepatitis b core ab igm (86705) | $72.80 | $91 | 6.2× |
| Hepatitis b core antibody total (86704) | $96.80 | $121 | 8.0× |
| Hepatitis B Surface Ab (86706) | $84.80 | $106 | 7.9× |
| Hepatitis B Surface Antigen (87340) | $66.40 | $83 | 6.4× |
| Hepatitis be antibody (86707) | $56.80 | $71 | 4.9× |
| Hepatitis Be Antigen (87350) | $72.80 | $91 | 6.3× |
| Hepatitis c antibody (86803) | $110.40 | $138 | 7.7× |
| Hepatitis C Antibody Confirmatory Test (86804) | $165.60 | $207 | 10.7× |
| Hepatitis C Genotype (87902) | $376 | $470 | 1.5× |
| Hepatitis delta ab (86692) | $114.40 | $143 | 6.7× |
| Hepatitis delta ag (87380) | $112.80 | $141 | 6.1× |
| Herpes simplex type i (86695) | $39.20 | $49 | 3.0× |
| Herpes simplex type ii (86696) | $99.20 | $124 | 5.1× |
| Heterophile Antibodies,Screen - Mononucleosis Screen (86308) | $58.40 | $73 | 11.3× |
| Hfe gene (81256) | $491.20 | $614 | 7.5× |
| Histamine plasma (83088) | $183.60 | $229.50 | 6.2× |
| Histoplasma antibody (86698) | $72 | $90 | 5.2× |
| Histoplasma antigen urine (87385) | $152.80 | $191 | 11.5× |
| HIV confirmation (86689) | $116.80 | $146 | 6.0× |
| HIV-2 probe&revrse trnscripj (87538) | $92.80 | $116 | 2.6× |
| Hla class i typing high resolution one allele or allele group (81381) | $163.20 | $204 | 1.0× |
| Hla-b27 (86812) | $172.80 | $216 | 6.7× |
| Homovanillic acid urine (83150) | $156.80 | $196 | 7.0× |
| Hpv low-risk types (87623) | $114.40 | $143 | 3.3× |
| Hsv, Dna, Amp Probe - Hsv Pcr (87529) | $172.80 | $216 | 4.9× |
| Hydroxycorticosteroids 17 (83491) | $90.40 | $113 | 5.1× |
| Hydroxyprogesterone 17-d (83498) | $95.20 | $119 | 3.5× |
| Iaad ia clostridium difficile toxin (87324) | $78.40 | $98 | 6.5× |
| Iaad ia cryptosporidium (87328) | $80.80 | $101 | 5.8× |
| Iaad Ia Hpylori Stool - H Pylori Antigen Stool (87338) | $123.20 | $154 | 8.6× |
| Iaad Ia Respiratory Synctial Virus - Rsv Rapid Antigen Screen (87420) | $106.40 | $133 | 7.6× |
| Iaad ia shiga-like toxin (87427) | $69.60 | $87 | 5.8× |
| Iaad Ia Streptococcus Group A (87430) | $79.20 | $99 | 4.7× |
| Iaadiadoo not otherwise specified (87899) | $84 | $105 | 5.2× |
| Iadna borrelia burgdorferi amplified probe tq (87476) | $344 | $430 | 9.8× |
| Iadna candida species amplified probe tq (87481) | $124.80 | $156 | 3.6× |
| Iadna chlamydia pneumoniae amplified probe tq (87486) | $172 | $215 | 4.9× |
| Iadna hepatitis b virus quantification (87517) | $313.60 | $392 | 7.3× |
| Iadna Hepatitis C Amplified Probe&Revrse Transcr (87521) | $71.20 | $89 | 2.0× |
| Iadna Hepatitis C Quant & Reverse Transcription - Hcv Quant Pcr (87522) | $232 | $290 | 5.4× |
| Iadna HIV-1 quant & reverse transcription (87536) | $71.20 | $89 | 0.8× |
| Iadna human papillomavirus high-risk types (87624) | $107.20 | $134 | 3.1× |
| Iadna mycoplsm pneumoniae amplified probe tq (87581) | $327.20 | $409 | 9.3× |
| Iadna neisseria gonorrhoeae amplified probe tq (87591) | $73.44 | $91.80 | 2.1× |
| Iadna nos amplified probe tq each organism (87798) | $336 | $420 | 9.6× |
| Iadna nos quantification each organism (87799) | $300 | $375 | 7.0× |
| Iadna trichomonas vaginalis amplified probe tech (87661) | $151.20 | $189 | 4.3× |
| Iadna-DNA/RNA probe tq 12-25 (87507) | $1,167.20 | $1,459 | 2.8× |
| Igg subclasses (82787) | $408 | $510 | 50.9× |
| Immunoassay infectious agent antibody quan nos (86317) | $34.80 | $43.50 | 2.3× |
| Immunoassay nonantibody (83516) | $94.80 | $118.50 | 8.2× |
| Immunofixation (86334) | $164 | $205 | 7.3× |
| Immunofixation urine (86335) | $122.40 | $153 | 4.2× |
| Immunohistochemistry (88342) | $193.60 | $242 | 1.2× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87335) | $100.80 | $126 | 8.0× |
| Infectious agent antigen detection by immunoassay technique (eg, enzyme immunoassay ºEIA», enzyme-linked immunosorbent… (87339) | $66.40 | $83 | 4.2× |
| Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group B… (87802) | $69.60 | $87 | 5.5× |
| Influenza a/b ag eia (87400) | $96.80 | $121 | 6.9× |
| Influenza DNA amp probe (87502) | $108.80 | $136 | 1.1× |
| Inhibin a (86336) | $212.80 | $266 | 13.6× |
| Inhibin b (83520) | $124 | $155 | 7.2× |
| Insulin antibodies (86337) | $172.80 | $216 | 8.1× |
| Insulin total (83525) | $70.40 | $88 | 6.2× |
| Intrinsic factor antibody (86340) | $111.20 | $139 | 7.4× |
| Iron (83540) | $44.80 | $56 | 6.9× |
| Iron binding capacity (83550) | $46 | $57.50 | 5.3× |
| Irradiation Blood Product Each Unit (86945) | $159.20 | $199 | 4.3× |
| Islet cell antibody (86341) | $234 | $292.50 | 9.9× |
| Jak2 gene analysis (81270) | $427.20 | $534 | 4.7× |
| Lactoferrin fecal qual (83630) | $106.40 | $133 | 5.4× |
| Ldh body fluid (83615) | $45.60 | $57 | 7.5× |
| Ldh isoenzymes (83625) | $142.40 | $178 | 11.1× |
| LDL cholesterol direct (83721) | $56 | $70 | 5.3× |
| Lead (83655) | $86.40 | $108 | 7.1× |
| Legion pneumo, DNA, amp prob (87541) | $225.60 | $282 | 6.4× |
| Legionella antibody (86713) | $196 | $245 | 12.8× |
| Legionella antigen urine (87449) | $104.80 | $131 | 8.7× |
| Leptospira antibody (86720) | $83.20 | $104 | 5.1× |
| Lh (83002) | $109.60 | $137 | 5.9× |
| Lipase (83690) | $69.60 | $87 | 10.1× |
| Lipopro bld electrophoretic (83700) | $80 | $100 | 7.1× |
| Lipoprotein Blood Quan Numbers & Subclasses (83704) | $126.40 | $158 | 3.7× |
| Listeria ab (86609) | $50.40 | $63 | 3.9× |
| Lithium (80178) | $56 | $70 | 8.5× |
| Lyme disease antibody (86618) | $122.40 | $153 | 7.2× |
| Lymph Choriomeningitis Ab (86727) | $54.40 | $68 | 4.2× |
| Macroscopic exam arthropod (87168) | $92.02 | $115.02 | 21.6× |
| Macroscopic exam parasite (87169) | $43.20 | $54 | 10.0× |
| Magnesium (83735) | $51.20 | $64 | 7.6× |
| Malaria smear (87207) | $144.80 | $181 | 24.2× |
| Manual cell count each (85032) | $55.20 | $69 | 12.8× |
| Mass spectrometry qual/quan (83789) | $169.20 | $211.50 | 7.0× |
| Mercury urine (83825) | $78.40 | $98 | 4.8× |
| Methylmalonic acid serum (83921) | $115.20 | $144 | 5.4× |
| Microalbumin urine (82043) | $43.20 | $54 | 7.5× |
| Microsomal antibodies (86376) | $82 | $102.50 | 5.6× |
| Molecular pathology procedure level 2 (81401) | $527.20 | $659 | 3.8× |
| Mopath procedure level 4 (81403) | $302.40 | $378 | 1.6× |
| Mopath procedure level 5 (81404) | $638 | $797.50 | 2.3× |
| Mopath procedure level 6 (81405) | $820.80 | $1,026 | 2.7× |
| Mrsa PCR (87641) | $61.63 | $77.04 | 1.8× |
| Mthfr Gene Analysis Common Variants (81291) | $440.80 | $551 | 6.7× |
| Muramidase (85549) | $112 | $140 | 6.0× |
| Mycophenolic acid (80180) | $84.80 | $106 | 4.7× |
| Mycoplasma antibody (86738) | $82.40 | $103 | 6.2× |
| Mycoplasma culture (87109) | $105.60 | $132 | 6.9× |
| Mycoplasma genitalium PCR (87563) | $129.60 | $162 | 3.7× |
| Myoglobin urine (83874) | $92.40 | $115.50 | 7.2× |
| Nasal smear for eosinophils (89190) | $64.80 | $81 | 11.2× |
| Natriuretic peptide (83880) | $177.20 | $221.50 | 4.5× |
| Neutralization Test Viral (86382) | $86.40 | $108 | 5.1× |
| Nfct ds bv&vaginitis DNA alg (81515) | $196 | $245 | 0.7× |
| Nickel level (83885) | $56.80 | $71 | 2.3× |
| Nk cells total count (86357) | $115.20 | $144 | 3.1× |
| Nuclear antigen antibody (86235) | $86 | $107.50 | 4.8× |
| Occult blood gastric (82271) | $40 | $50 | 7.5× |
| Oligoclonal bands (83916) | $106.40 | $133 | 3.9× |
| Organic acids total quantitative each specimen (83918) | $68 | $85 | 2.9× |
| Osmolality serum (83930) | $84.80 | $106 | 12.8× |
| Osmolality urine (83935) | $86.40 | $108 | 12.7× |
| Ova and parasite direct-id lca (87177) | $60 | $75 | 6.7× |
| Oxalate urine (83945) | $156 | $195 | 10.8× |
| Pancreatic elastase, fecal (82656) | $327.20 | $409 | 28.4× |
| Pancreatic polypeptide (83519) | $199.60 | $249.50 | 10.8× |
| Particle Agglutination Screen Each Antibody (86403) | $89.20 | $111.50 | 7.7× |
| Parvovirus antibody (86747) | $87.60 | $109.50 | 5.8× |
| Ph body fluid (83986) | $34.40 | $43 | 9.6× |
| Ph urine (81003) | $15.60 | $19.50 | 6.9× |
| Phosphatase alkaline (84075) | $40 | $50 | 7.7× |
| Phosphorus blood (84100) | $40.80 | $51 | 8.6× |
| Phosphorus urine (84105) | $27.20 | $34 | 4.7× |
| Pinworm exam (87172) | $82.40 | $103 | 19.3× |
| Plasminogen (85420) | $164.80 | $206 | 25.2× |
| Platelet aggregation (85576) | $155.20 | $194 | 6.2× |
| Platelet count automated (85049) | $46.40 | $58 | 10.4× |
| Platelet neutralization (85597) | $76 | $95 | 4.2× |
| Porphobilinogen urine quant (84110) | $76 | $95 | 9.0× |
| Porphyrins Urine Quantitation & Fractionation (84120) | $134.80 | $168.50 | 9.2× |
| Potassium (84132) | $36.80 | $46 | 7.7× |
| Potassium urine (84133) | $54.40 | $68 | 11.5× |
| Pregnancy associated plasma protein-a (84163) | $244 | $305 | 16.2× |
| Pregnenolone (84140) | $54.40 | $68 | 2.6× |
| Primidone (80188) | $76.80 | $96 | 4.6× |
| Procainamide napa (80192) | $102.40 | $128 | 6.1× |
| Procalcitonin (pct) (84145) | $171.20 | $214 | 6.3× |
| Progesterone (84144) | $127.20 | $159 | 6.1× |
| Protein body fluid (84157) | $54.40 | $68 | 13.6× |
| Protein c activity (85303) | $82.40 | $103 | 6.0× |
| Protein c antigen (85302) | $44 | $55 | 3.7× |
| Protein electrophoresis serum (84165) | $72 | $90 | 6.7× |
| Protein Electrophoresis Urine (84166) | $84.80 | $106 | 4.8× |
| Protein s total (85305) | $89.60 | $112 | 7.7× |
| Protein total serum (84155) | $26.40 | $33 | 7.2× |
| Protein urine (84156) | $74 | $92.50 | 20.2× |
| PSA free (84154) | $99.20 | $124 | 5.4× |
| Pth intact (83970) | $76 | $95 | 1.8× |
| Rbc (85041) | $55.20 | $69 | 18.3× |
| Rbc antibody elution (86860) | $90.40 | $113 | 0.5× |
| Rbc pretreatment serum (86978) | $244.80 | $306 | 4.2× |
| Rbc pretx incubatj w/chemicl (86970) | $16 | $20 | 0.3× |
| Reagent strip/blood glucose (82948) | $20 | $25 | 4.0× |
| Renin activity plasma (84244) | $102.40 | $128 | 4.7× |
| Resp virus 12-25 targets (87633) | $524.80 | $656 | 1.3× |
| Reticulocyte count auto (85045) | $40 | $50 | 10.0× |
| Rheumatoid factor quant (86431) | $112 | $140 | 19.8× |
| Rickettsia antibody (86757) | $78.80 | $98.50 | 4.1× |
| Ristocetin cofactor (85245) | $172 | $215 | 7.5× |
| Rotavirus ag eia (87425) | $64.80 | $81 | 5.4× |
| Rsv (87807) | $28.40 | $35.50 | 2.2× |
| Rubella antibody (86762) | $73.60 | $92 | 5.1× |
| Rubeola Antibody Igg (86765) | $128 | $160 | 9.9× |
| Russell viper venom time diluted (85613) | $72 | $90 | 7.5× |
| Sars-Cov-2 Covid-19 Amp Prb (87635) | $70.90 | $88.62 | 1.4× |
| Sars-Cov-2 Covid-19 Antibody (86769) | $72 | $90 | 1.7× |
| Sedimentation rate (85651) | $45.60 | $57 | 10.7× |
| Selenium (84255) | $144 | $180 | 5.6× |
| Semen analysis complete (89320) | $20.80 | $26 | 1.7× |
| Semen analysis; sperm presence and motility of sperm, if performed Facility (89321) | $25.60 | $32 | 2.1× |
| Sensitivity kb (87184) | $34.40 | $43 | 4.6× |
| SEPT9 (Septin9) (eg, colorectal cancer) promoter methylation analysis Facility (81327) | $297.60 | $372 | 1.6× |
| Serotonin Release Assay (86022) | $89.20 | $111.50 | 4.9× |
| Sex hormone binding globulin (84270) | $98.40 | $123 | 4.5× |
| Sickling of rbc reduction (85660) | $44.80 | $56 | 8.1× |
| Sirolimus (rapamycin) (80195) | $38.40 | $48 | 2.8× |
| Smear acid fast (87206) | $50.80 | $63.50 | 9.4× |
| Smear complex stain (87209) | $85.60 | $107 | 4.8× |
| Smear gram stain (87205) | $52 | $65 | 12.2× |
| Smr Prim Src Wet Mount Nfct Agt (87210) | $39.20 | $49 | 6.7× |
| Sodium (84295) | $40 | $50 | 8.3× |
| Sodium feces (84302) | $39.20 | $49 | 8.1× |
| Sodium urine (84300) | $52 | $65 | 10.3× |
| Somatomedin (84305) | $75.20 | $94 | 3.5× |
| Somatostatin (84307) | $193.60 | $242 | 10.6× |
| Spcl Stn 2 I&R Excpt Microorg/Enzyme/Imcyt (88313) | $116.80 | $146 | 0.9× |
| Special stains group 1 (88312) | $143.20 | $179 | 2.8× |
| Spectrophotometry (84311) | $73.20 | $91.50 | 9.0× |
| Stool Culture, Addl Pathogens (87046) | $63.20 | $79 | 6.7× |
| Strep a assay w/optic (87880) | $32.80 | $41 | 2.0× |
| Strep a DNA amp probe (87651) | $108.80 | $136 | 3.1× |
| Streptokinase, antibody Facility (86590) | $182.40 | $228 | 14.4× |
| Sulfate urine (84392) | $114.40 | $143 | 20.8× |
| Surg path level iii (88304) | $160 | $200 | 3.1× |
| Surgical pathology level IV (88305) | $296 | $370 | 5.7× |
| T Cell Absolute Count (86361) | $85.60 | $107 | 3.2× |
| T Cells Absolute Cd4&Cd8 Count Ratio (86360) | $91.20 | $114 | 1.9× |
| T cells total count (86359) | $133.60 | $167 | 3.5× |
| T3 free (84481) | $92 | $115 | 5.4× |
| T3 reverse (84482) | $265.60 | $332 | 16.9× |
| T3 total (84480) | $92.80 | $116 | 6.5× |
| T3 uptake (84479) | $43.20 | $54 | 6.7× |
| T4 free (84439) | $66.40 | $83 | 7.4× |
| T4 total (84436) | $60 | $75 | 8.7× |
| Tb intradermal test (86580) | $39.20 | $49 | 1.4× |
| Tb test, cell immun measure (86480) | $80.80 | $101 | 1.3× |
| Testosterone free (84402) | $107.20 | $134 | 4.2× |
| Testosterone total (84403) | $120.40 | $150.50 | 4.7× |
| Tetanus antibody (86774) | $78 | $97.50 | 5.3× |
| Theophylline (80198) | $68.80 | $86 | 4.9× |
| Thin prep pap (88142) | $88 | $110 | 4.3× |
| Thrombin time plasma (85670) | $31.20 | $39 | 5.4× |
| Thromboplastin time prtl substit plasma frctj ea (85732) | $33.60 | $42 | 5.2× |
| Thyroglobulin (84432) | $86.40 | $108 | 5.4× |
| Thyroglobulin antibody (86800) | $76.80 | $96 | 4.8× |
| Thyroid Stimulating Immune Globulins Tsi (84445) | $62.40 | $78 | 1.2× |
| Thyroxine binding globulin (84442) | $63.20 | $79 | 4.3× |
| Tissue culture lymphocyte (88230) | $431.20 | $539 | 3.7× |
| Tobramycin peak (80200) | $140 | $175 | 8.7× |
| Toxoplasma ab igm (86778) | $40.80 | $51 | 2.8× |
| Toxoplasma antibody igg (86777) | $44 | $55 | 3.1× |
| Transferrin (84466) | $88.80 | $111 | 7.0× |
| Triglycerides (84478) | $42.80 | $53.50 | 7.5× |
| Troponin (84484) | $118.40 | $148 | 9.5× |
| Urea nitrogen (84520) | $36 | $45 | 9.1× |
| Urea nitrogen urine (84540) | $52.80 | $66 | 9.5× |
| Uric acid blood (84550) | $38.40 | $48 | 8.5× |
| Uric acid other source (84560) | $100.80 | $126 | 19.8× |
| Urinalysis auto w/scope (81001) | $41.60 | $52 | 13.1× |
| Urinalysis Microscopic Only (81015) | $17.60 | $22 | 5.8× |
| Urine Albumin Semiquantitative (82044) | $12.80 | $16 | 2.1× |
| Urine Bacteria Culture (87088) | $47.20 | $59 | 5.8× |
| Urine pregnancy test (81025) | $50.40 | $63 | 5.9× |
| Urine volume measurement (81050) | $20.80 | $26 | 5.7× |
| Valproic acid (80164) | $109.60 | $137 | 8.1× |
| Vancomycin trough (80202) | $126.40 | $158 | 9.3× |
| Varicella-zoster antibody (86787) | $96.40 | $120.50 | 7.5× |
| Vasoactive intestinal peptide (vip) (84586) | $134.40 | $168 | 3.8× |
| Vdrl csf (86592) | $140.80 | $176 | 33.0× |
| Virus antibody nos (86790) | $122 | $152.50 | 9.5× |
| Virus id non-immunologic oth/thn cytopathic (87255) | $103.20 | $129 | 3.0× |
| Virus inoculation, shell via (87254) | $112.80 | $141 | 5.8× |
| Vitamin A (84590) | $152 | $190 | 13.1× |
| Vitamin b-12 (82607) | $92.80 | $116 | 6.2× |
| Vitamin b1 (thiamine) (84425) | $126.80 | $158.50 | 6.0× |
| Vitamin b2 (84252) | $156 | $195 | 7.7× |
| Vitamin b6 (84207) | $172.80 | $216 | 6.1× |
| Vitamin c (82180) | $92 | $115 | 9.3× |
| Vitamin D 25-Hydroxy (82306) | $160.80 | $201 | 5.4× |
| Vitamin e serum (84446) | $85.60 | $107 | 6.0× |
| Wbc Alkaline Phosphatase - Leukocyte Alkaline Phosphatase (85540) | $73.96 | $92.45 | 8.6× |
| West nile virus antibody (86789) | $101.60 | $127 | 7.1× |
| West nile virus igm (86788) | $84.80 | $106 | 5.0× |
| Zinc (84630) | $73.60 | $92 | 6.5× |