Lab & pathology prices at Texas Scottish Rite Hospital For Children

Dallas, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedurePosted cashPosted gross× Medicare
17 Ketogenic steroids (83582) $69 $69 4.5×
Albumin Fluid (82042) $116 $116 14.9×
Albumin serum (82040) $106 $106 21.4×
Aldolase (82085) $217 $217 22.3×
Alt (sgpt) (84460) $103 $103 19.4×
Amylase urine (82150) $140 $140 21.6×
Analysis skeletal muscle (88355) $263 $263 1.5×
Antibody HIV-1&HIV-2 single result (86703) $200 $200 14.6×
Antihuman Globulin Indir Qual Ea Reagent Cell (86885) $432 $432 75.5×
Assay Blood Carbon Dioxide (82374) $101 $101 20.7×
Assay of calcium in urine (82340) $104 $104 17.2×
Assay of cpk in blood (82552) $64 $64 4.8×
Assay of lactic acid (83605) $233 $233 20.1×
Assay of manganese (83785) $103 $103 3.9×
Assay of serum potassium (84132) $123 $123 25.8×
Assay of urea nitrogen (84520) $108 $108 27.3×
Assay Ph Body Fluid Nos (83986) $63 $63 17.6×
Bilirubin direct (82248) $97 $97 19.3×
Bilirubin total (82247) $106 $106 21.1×
Bilirubin total transcutaneous (88720) $21 $21 4.2×
Blood gases w/02 saturation (82805) $563 $563 7.1×
Blood Occult Peroxidase Actv Qual Feces 1 Deter (82270) $85 $85 19.4×
Blood typing serologic abo (86900) $352 $352 117.7×
Body fluid cell count (89050) $20 $20 4.2×
C-reactive protein (86140) $241 $241 46.5×
Caffeine halothane contracture test (CHCT) for malignant hyperthermia susceptibility, including interpretation and… (89049) $207 $207 1.2×
Calcium ionized (82330) $259 $259 18.9×
Calcium total (82310) $181 $181 35.1×
Carbamazepine total (80156) $278 $278 19.1×
Cell count csf (89051)
range across 2 matching MRF lines		 $21–$23 $21–$23 varies
Chloride Serum (82435) $98 $98 21.3×
Chloride urine (82436) $96 $96 16.7×
Cholesterol total (82465) $161 $161 37.0×
Chrmsm Analysis Addl Cells Counted Each Study (88285) $78 $78 2.9×
Chrmsm Analysis Addl High Resolution Study (88289) $53 $53 1.5×
Chrmsm Analysis Addl Karyotyp Each Study (88280) $94 $94 2.8×
Chrmsm Analysis Addl Specialized Banding (88283) $73 $73 1.1×
Chrmsm Breakage Baseline Breakage 50-100 Cll (88248) $705 $705 4.1×
Chrmsm Breakage Baseline Sister 20-25 Cll (88245) $528 $528 3.0×
Chrmsm Breakage Synds Score 100 Cll (88249) $705 $705 4.1×
Chromium serum (82495) $80 $80 3.9×
Chromosome Analysis 15-20 (88262) $508 $508 4.0×
Chromosome Analysis 20-25 (88264) $354 $354 2.4×
Chromosome analysis 45 cells (88263) $423 $423 2.8×
Chromosome analysis, 5 (88261) $720 $720 2.7×
Clotting Funct Activity (85397) $227 $227 7.4×
Coagulation time activated (85347) $85 $85 19.9×
Consltj Compre Review Reprt Referred Matrl (88325) $399 $399 2.3×
Consltj&Reprt Material Requiring Prepj Slides (88323) $262 $262 5.0×
Consltj&Reprt Slides Prepared Elsewhere (88321) $258 $258 6.9×
Coombs direct (86880) $129 $129 23.9×
Creatine kinase total (82550) $148 $148 22.7×
Creatinine blood (82565) $153 $153 29.9×
Creatinine clearance (82575) $196 $196 20.7×
Creatinine Urine (82570) $130 $130 25.1×
Crossmatch immediate spin (86920) $196 $196 1.1×
Cryoprsrv Frzing&Storage Cells Ea Cell Line (88240) $43 $43 3.3×
Cul Bact Aerobic Addl Meths Definitive Ea Isol (87077) $33 $33 4.1×
Cul Bact Anaerobic Addl Meths Definitive Ea Isol (87076) $178 $178 22.0×
Culture aerobic quant other (87071) $167 $167 16.9×
Culture Anaerobic (87075) $39 $39 4.1×
Culture blood (87040) $248 $248 24.0×
Culture csf (87070) $278 $278 32.3×
Culture screen only (87081) $106 $106 16.0×
Cytogenetics 10-30 (88273) $132 $132 3.8×
Cytogenetics 100-300 (88275) $163 $163 3.2×
Electrolyte panel (80051) $328 $328 46.8×
Electron Microscopy (88348) $232 $232 0.3×
Enzyme histochemistry (88319) $84 $84 0.1×
Eosinophil Smear (89190)
range across 2 matching MRF lines		 $24–$75 $24–$75 varies
Exam Synovial Fluid Crystals (89060) $60 $60 8.2×
Fat stain feces urine/respir secretions (89125) $19 $19 3.2×
Ferritin (82728) $182 $182 13.4×
Fibrinolysins/Coagulopathy Screen Interp&Repor (85390) $72 $72 4.7×
Frozen Section (88331) $189 $189 1.1×
Gentamicin (80170) $193 $193 11.8×
Ggt (82977) $157 $157 21.8×
Glucose body fluid (82945) $108 $108 27.5×
Glucose Serum (82947) $132 $132 33.6×
Glucose tolerance test (gtt) (82951) $200 $200 15.5×
Gonadotropin Chorionic Qualitative (84703) $244 $244 32.4×
Gtt-added samples (82952) $59 $59 15.1×
Hdl Cholesterol (83718) $70.50 $70.50 8.6×
Hematocrit (85014) $60 $60 25.3×
Hemoglobin (85018) $69 $69 29.1×
Hemoglobin quan tc per day carboxyhemoglobin (88740) $21 $21 2.2×
Hemoglobin, quantitative, transcutaneous, per day; methemoglobin Facility (88741) $21 $21 2.2×
Hgb Quantitative Transcutaneous (88738) $21 $21 4.2×
Homogenization Tissue (87176) $18 $18 3.1×
Iadna Bartonella Amplified Probe Technique (87471)
range across 2 matching MRF lines		 $105–$220 $105–$220 varies
Immunofluorescence per spec 1st singl antb stain (88346) $132 $132 0.8×
Immunohistochemistry (88342) $131 $131 0.8×
In situ hybridization 1st probe stain (88365) $181 $181 1.1×
Insitu hybridization auto (88367) $193 $193 0.5×
Insitu hybridization manual (88368) $197 $197 0.5×
Iron (83540) $161 $161 24.9×
Iron Binding Capacity (83550) $200 $200 22.9×
Lactate (ld) (ldh) enzyme (83615) $210 $210 34.8×
Ldh Isoenzymes (83625) $451 $451 35.3×
Leukocyte Assessment Fecal (89055) $17 $17 4.0×
Level I Surg Pathology Gross Examination Only (88300) $15 $15 0.5×
Level ii surg pathology gross&microscopic exam (88302) $21 $21 0.6×
Level V Surg Pathology Gross&Microscopic Exam (88307) $253 $253 0.7×
Lipase (83690) $157 $157 22.8×
Magnesium Urine (83735) $183 $183 27.3×
Meat fibers, feces (89160) $17 $17 3.5×
Molecular Cytogenetics Chrmoml Ish 3-5 Cells (88272) $109 $109 2.7×
Molecular Cytogenetics Dna Probe Each (88271) $87 $87 4.1×
Molecular Cytogenetics Interphase Ish 25-99 Cll (88274) $141 $141 3.3×
Morphometric analysis nerve (88356) $406 $406 7.8×
Morphometric Analysis Tumor (88358) $134 $134 0.8×
Nerve teasing preparations (88362) $343 $343 0.4×
Path Consltj Surg Cytologic Exam Initial Site (88333) $191 $191 0.2×
Pathology Consultation During Surgery (88329) $110 $110 1.9×
Ph urine (81003) $68 $68 30.2×
Phenobarbital Level (80184) $422 $422 27.6×
Phenytoin (Dilantin) (80185) $316 $316 23.8×
Phosphatase alkaline (84075) $99 $99 19.1×
Phosphorus Serum (84100) $146 $146 30.8×
Phosphorus urine (84105) $73 $73 12.6×
Platelet Aggregation (85576) $187 $187 7.5×
Platelet count automated (85049) $134 $134 29.9×
Potassium Urine (84133) $138 $138 29.2×
Prealbumin (84134) $198 $198 13.6×
Procalcitonin (Pct) (84145) $229 $229 8.4×
Protein Alys Wstrn Blot I&R Immunological Ea (88372) $52 $52 2.0×
Protein body fluid (84157) $164 $164 41.0×
Protein c antigen (85302) $143 $143 11.9×
Protein s total (85305) $137 $137 11.8×
Protein total serum (84155) $118 $118 32.2×
Protein Total Urine (84156) $119 $119 32.4×
Protein, western blot tissue (88371) $60 $60 2.7×
Receptor Assay Endocrine Oth/Thn Estrgn/Progst (84235) $251 $251 3.5×
Rh (86901) $106 $106 35.5×
Rheumatoid factor quant (86431) $131 $131 23.1×
Sedimentation Rate, Automated (85652) $92 $92 34.1×
Sensitivity mic (87186) $179 $179 20.7×
Sickling of rbc reduction (85660) $106 $106 19.2×
Smear gram stain (87205) $100 $100 23.4×
Sodium Serum (84295) $100 $100 20.8×
Sodium Urine (84300) $123 $123 24.3×
Special Stains Group 1 (88312) $83 $83 1.6×
Special Stains Group 2 (88313) $37 $37 0.3×
Strep a assay w/optic (87880) $35 $35 2.1×
Surg path level iii (88304) $35 $35 0.7×
Surgical pathology level IV (88305) $115 $115 2.2×
Surgical pathology level vi (88309) $445 $445 0.5×
T3 Uptake (84479) $47 $47 7.3×
T4 Free (84439) $223 $223 24.7×
T4 total (84436) $28 $28 4.1×
Test for acetone/ketones (82009) $64 $64 14.2×
Thawing and expansion of frozen cells, each aliquot Facility (88241) $43 $43 3.6×
Thromboplastin Time Prtl Substit Plasma Frctj Ea (85732) $134 $134 20.7×
Tiss cul neo disorders solid tumor (88239) $600 $600 4.1×
Tissue Culture (88233) $572 $572 4.1×
Transferase Aspartate Amino Ast Sgot (84450) $103 $103 19.9×
Triglycerides (84478) $229 $229 39.9×
Tumor immunohistochem/comput (88361) $179 $179 0.5×
Tumor Immunohistochem/Manual (88360) $163 $163 1.0×
Unlisted Cytogenetic Study (88299) $31 $31 0.6×
Unlisted miscellaneous pathology test (89240) $31 $31 0.6×
Unlisted Surgical Pathology Procedure (88399) $31 $31 0.6×
Unlisted Transfusion Medicine Procedure (86999) $104 $104 3.6×
Urea nitrogen urine (84540) $113 $113 20.3×
Urinalysis Microscopic Only (81015) $55 $55 18.0×
Urinalysis Qual/Semiquant Except Immunoassays (81005) $9 $9 4.1×
Urinalysis Volume Measure (81050) $26 $26 7.1×
Urine Bacteria Culture (87088) $101 $101 12.5×
Urine Pregnancy Test (81025) $36 $36 4.2×
Valproic acid (80164) $210 $210 15.5×
Vancomycin (80202) $317 $317 23.4×
Vitamin D 25-Hydroxy (82306) $356 $356 12.0×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.