Pricing Information:
| 2011 Clinical Diagnostic Laboratory | |||
| Fee Schedule | |||
| HCPC | Modifier | Short Description | |
| 36415 | $3.00 | Routine venipuncture | |
| 78267 | $11.06 | Breath tst attain/anal c-14 | |
| 78268 | $94.79 | Breath test analysis c-14 | |
| 80047 | $11.91 | Metabolic panel ionized ca | |
| 80047 | QW | $11.91 | Metabolic panel ionized ca |
| 80048 | $11.91 | Metabolic panel total ca | |
| 80048 | QW | $11.91 | Metabolic panel total ca |
| 80051 | $9.87 | Electrolyte panel | |
| 80051 | QW | $9.87 | Electrolyte panel |
| 80053 | $14.87 | Comprehen metabolic panel | |
| 80053 | QW | $14.87 | Comprehen metabolic panel |
| 80061 | $18.85 | Lipid panel | |
| 80061 | QW | $18.85 | Lipid panel |
| 80069 | $12.22 | Renal function panel | |
| 80069 | QW | $12.22 | Renal function panel |
| 80074 | $67.01 | Acute hepatitis panel | |
| 80076 | $11.49 | Hepatic function panel | |
| 80100 | $20.47 | Drug screen qualitate/multi | |
| 80102 | $18.64 | Drug confirmation | |
| 80150 | $21.21 | Assay of amikacin | |
| 80152 | $25.19 | Assay of amitriptyline | |
| 80154 | $26.03 | Assay of benzodiazepines | |
| 80156 | $20.49 | Assay carbamazepine total | |
| 80157 | $18.66 | Assay carbamazepine free | |
| 80158 | $24.48 | Assay of cyclosporine | |
| 80160 | $24.22 | Assay of desipramine | |
| 80162 | $18.69 | Assay of digoxin | |
| 80164 | $19.06 | Assay dipropylacetic acid | |
| 80166 | $21.82 | Assay of doxepin | |
| 80168 | $23.00 | Assay of ethosuximide | |
| 80170 | $23.07 | Assay of gentamicin | |
| 80172 | $22.93 | Assay of gold | |
| 80173 | $20.49 | Assay of haloperidol | |
| 80174 | $24.22 | Assay of imipramine | |
| 80176 | $16.38 | Assay of lidocaine | |
| 80178 | $9.30 | Assay of lithium | |
| 80178 | QW | $9.30 | Assay of lithium |
| 80182 | $19.06 | Assay of nortriptyline | |
| 80184 | $16.12 | Assay of phenobarbital | |
| 80185 | $18.66 | Assay of phenytoin total | |
| 80186 | $19.37 | Assay of phenytoin free | |
| 80188 | $23.35 | Assay of primidone | |
| 80190 | $23.57 | Assay of procainamide | |
| 80192 | $23.57 | Assay of procainamide | |
| 80194 | $20.54 | Assay of quinidine | |
| 80195 | $19.32 | Assay of sirolimus | |
| 80196 | $9.98 | Assay of salicylate | |
| 80197 | $19.32 | Assay of tacrolimus | |
| 80198 | $19.91 | Assay of theophylline | |
| 80200 | $22.68 | Assay of tobramycin | |
| 80201 | $16.78 | Assay of topiramate | |
| 80202 | $19.06 | Assay of vancomycin | |
| 80299 | $19.27 | Quantitative assay drug | |
| 80400 | $45.90 | Acth stimulation panel | |
| 80402 | $122.36 | Acth stimulation panel | |
| 80406 | $110.14 | Acth stimulation panel | |
| 80408 | $176.60 | Aldosterone suppression eval | |
| 80410 | $113.07 | Calcitonin stimul panel | |
| 80412 | $463.80 | CRH stimulation panel | |
| 80414 | $72.66 | Testosterone response | |
| 80415 | $78.64 | Estradiol response panel | |
| 80416 | $185.70 | Renin stimulation panel | |
| 80417 | $61.90 | Renin stimulation panel | |
| 80418 | $815.56 | Pituitary evaluation panel | |
| 80420 | $101.38 | Dexamethasone panel | |
| 80422 | $64.83 | Glucagon tolerance panel | |
| 80424 | $67.04 | Glucagon tolerance panel | |
| 80426 | $208.84 | Gonadotropin hormone panel | |
| 80428 | $93.88 | Growth hormone panel | |
| 80430 | $110.44 | Growth hormone panel | |
| 80432 | $178.74 | Insulin suppression panel | |
| 80434 | $142.35 | Insulin tolerance panel | |
| 80435 | $144.95 | Insulin tolerance panel | |
| 80436 | $128.30 | Metyrapone panel | |
| 80438 | $70.92 | TRH stimulation panel | |
| 80439 | $94.56 | TRH stimulation panel | |
| 80440 | $81.81 | TRH stimulation panel | |
| 81000 | $4.45 | Urinalysis nonauto w/scope | |
| 81001 | $4.45 | Urinalysis auto w/scope | |
| 81002 | $3.60 | Urinalysis nonauto w/o scope | |
| 81003 | $3.16 | Urinalysis auto w/o scope | |
| 81003 | QW | $3.16 | Urinalysis auto w/o scope |
| 81005 | $3.05 | Urinalysis | |
| 81007 | $3.61 | Urine screen for bacteria | |
| 81007 | QW | $3.61 | Urine screen for bacteria |
| 81015 | $4.05 | Microscopic exam of urine | |
| 81020 | $5.19 | Urinalysis glass test | |
| 81025 | $8.90 | Urine pregnancy test | |
| 81050 | $4.22 | Urinalysis volume measure | |
| 82000 | $17.43 | Assay of blood acetaldehyde | |
| 82003 | $28.48 | Assay of acetaminophen | |
| 82009 | $6.36 | Test for acetone/ketones | |
| 82010 | $10.06 | Acetone assay | |
| 82010 | QW | $10.06 | Acetone assay |
| 82013 | $15.72 | Acetylcholinesterase assay | |
| 82016 | $19.51 | Acylcarnitines qual | |
| 82017 | $23.74 | Acylcarnitines quant | |
| 82024 | $54.35 | Assay of acth | |
| 82030 | $18.21 | Assay of adp & amp | |
| 82040 | $5.78 | Assay of serum albumin | |
| 82040 | QW | $5.78 | Assay of serum albumin |
| 82042 | $2.48 | Assay of urine albumin | |
| 82042 | QW | $2.48 | Assay of urine albumin |
| 82043 | $2.48 | Microalbumin quantitative | |
| 82043 | QW | $2.48 | Microalbumin quantitative |
| 82044 | $6.44 | Microalbumin semiquant | |
| 82044 | QW | $6.44 | Microalbumin semiquant |
| 82045 | $47.77 | Albumin ischemia modified | |
| 82055 | $15.21 | Assay of ethanol | |
| 82055 | QW | $15.21 | Assay of ethanol |
| 82075 | $16.96 | Assay of breath ethanol | |
| 82085 | $13.66 | Assay of aldolase | |
| 82088 | $57.35 | Assay of aldosterone | |
| 82101 | $42.24 | Assay of urine alkaloids | |
| 82103 | $18.91 | Alpha-1-antitrypsin total | |
| 82104 | $20.35 | Alpha-1-antitrypsin pheno | |
| 82105 | $23.61 | Alpha-fetoprotein serum | |
| 82106 | $23.61 | Alpha-fetoprotein amniotic | |
| 82107 | $90.64 | Alpha-fetoprotein l3 | |
| 82108 | $35.85 | Assay of aluminum | |
| 82120 | $4.05 | Amines vaginal fluid qual | |
| 82120 | QW | $4.05 | Amines vaginal fluid qual |
| 82127 | $19.51 | Amino acid single qual | |
| 82128 | $19.51 | Amino acids mult qual | |
| 82131 | $23.74 | Amino acids single quant | |
| 82135 | $23.16 | Assay aminolevulinic acid | |
| 82136 | $23.74 | Amino acids quant 2-5 | |
| 82139 | $23.74 | Amino acids quan 6 or more | |
| 82140 | $20.51 | Assay of ammonia | |
| 82143 | $9.67 | Amniotic fluid scan | |
| 82145 | $21.87 | Assay of amphetamines | |
| 82150 | $9.12 | Assay of amylase | |
| 82150 | QW | $9.12 | Assay of amylase |
| 82154 | $40.57 | Androstanediol glucuronide | |
| 82157 | $41.20 | Assay of androstenedione | |
| 82160 | $35.19 | Assay of androsterone | |
| 82163 | $28.88 | Assay of angiotensin II | |
| 82164 | $20.54 | Angiotensin I enzyme test | |
| 82172 | $19.94 | Assay of apolipoprotein | |
| 82175 | $26.70 | Assay of arsenic | |
| 82180 | $13.91 | Assay of ascorbic acid | |
| 82190 | $17.20 | Atomic absorption | |
| 82205 | $16.12 | Assay of barbiturates | |
| 82232 | $22.76 | Assay of beta-2 protein | |
| 82239 | $24.11 | Bile acids total | |
| 82240 | $24.48 | Bile acids cholylglycine | |
| 82247 | $7.06 | Bilirubin total | |
| 82247 | QW | $7.06 | Bilirubin total |
| 82248 | $7.06 | Bilirubin direct | |
| 82252 | $2.75 | Fecal bilirubin test | |
| 82261 | $23.74 | Assay of biotinidase | |
| 82270 | $4.58 | Occult blood feces | |
| 82271 | $4.58 | Occult blood other sources | |
| 82271 | QW | $4.58 | Occult blood other sources |
| 82272 | $4.58 | Occult bld feces 1-3 tests | |
| 82272 | QW | $4.58 | Occult bld feces 1-3 tests |
| 82274 | $22.38 | Assay test for blood fecal | |
| 82274 | QW | $22.38 | Assay test for blood fecal |
| 82286 | $9.69 | Assay of bradykinin | |
| 82300 | $13.35 | Assay of cadmium | |
| 82306 | $41.66 | Vitamin d 25 hydroxy | |
| 82308 | $37.69 | Assay of calcitonin | |
| 82310 | $7.26 | Assay of calcium | |
| 82310 | QW | $7.26 | Assay of calcium |
| 82330 | $19.23 | Assay of calcium | |
| 82330 | QW | $19.23 | Assay of calcium |
| 82331 | $7.28 | Calcium infusion test | |
| 82340 | $8.49 | Assay of calcium in urine | |
| 82355 | $16.29 | Calculus analysis qual | |
| 82360 | $12.31 | Calculus assay quant | |
| 82365 | $17.43 | Calculus spectroscopy | |
| 82370 | $17.63 | X-ray assay calculus | |
| 82373 | $24.53 | Assay c-d transfer measure | |
| 82374 | $6.88 | Assay blood carbon dioxide | |
| 82374 | QW | $6.88 | Assay blood carbon dioxide |
| 82375 | $17.35 | Assay carboxyhb quant | |
| 82376 | $8.00 | Assay carboxyhb qual | |
| 82378 | $26.70 | Carcinoembryonic antigen | |
| 82379 | $23.74 | Assay of carnitine | |
| 82380 | $12.98 | Assay of carotene | |
| 82382 | $24.20 | Assay urine catecholamines | |
| 82383 | $35.26 | Assay blood catecholamines | |
| 82384 | $33.52 | Assay three catecholamines | |
| 82387 | $29.28 | Assay of cathepsin-d | |
| 82390 | $15.12 | Assay of ceruloplasmin | |
| 82397 | $19.88 | Chemiluminescent assay | |
| 82415 | $17.83 | Assay of chloramphenicol | |
| 82435 | $6.47 | Assay of blood chloride | |
| 82435 | QW | $6.47 | Assay of blood chloride |
| 82436 | $4.58 | Assay of urine chloride | |
| 82438 | $6.88 | Assay other fluid chlorides | |
| 82441 | $8.45 | Test for chlorohydrocarbons | |
| 82465 | $6.13 | Assay bld/serum cholesterol | |
| 82465 | QW | $6.13 | Assay bld/serum cholesterol |
| 82480 | $10.00 | Assay serum cholinesterase | |
| 82482 | $8.37 | Assay rbc cholinesterase | |
| 82485 | $20.16 | Assay chondroitin sulfate | |
| 82486 | $24.53 | Gas/liquid chromatography | |
| 82487 | $20.16 | Paper chromatography | |
| 82488 | $20.16 | Paper chromatography | |
| 82489 | $20.16 | Thin layer chromatography | |
| 82491 | $24.53 | Chromotography quant sing | |
| 82492 | $24.53 | Chromotography quant mult | |
| 82495 | $28.54 | Assay of chromium | |
| 82507 | $39.13 | Assay of citrate | |
| 82520 | $21.33 | Assay of cocaine | |
| 82523 | $26.31 | Collagen crosslinks | |
| 82523 | QW | $26.31 | Collagen crosslinks |
| 82525 | $17.46 | Assay of copper | |
| 82528 | $31.68 | Assay of corticosterone | |
| 82530 | $23.52 | Cortisol free | |
| 82533 | $22.95 | Total cortisol | |
| 82540 | $6.52 | Assay of creatine | |
| 82541 | $24.53 | Column chromotography qual | |
| 82542 | $24.53 | Column chromotography quant | |
| 82543 | $24.53 | Column chromotograph/isotope | |
| 82544 | $24.53 | Column chromotograph/isotope | |
| 82550 | $9.17 | Assay of ck (cpk) | |
| 82550 | QW | $9.17 | Assay of ck (cpk) |
| 82552 | $18.86 | Assay of cpk in blood | |
| 82553 | $13.10 | Creatine mb fraction | |
| 82554 | $13.10 | Creatine isoforms | |
| 82565 | $7.22 | Assay of creatinine | |
| 82565 | QW | $7.22 | Assay of creatinine |
| 82570 | $7.28 | Assay of urine creatinine | |
| 82570 | QW | $7.28 | Assay of urine creatinine |
| 82575 | $13.30 | Creatinine clearance test | |
| 82585 | $12.07 | Assay of cryofibrinogen | |
| 82595 | $9.11 | Assay of cryoglobulin | |
| 82600 | $27.30 | Assay of cyanide | |
| 82607 | $21.21 | Vitamin B-12 | |
| 82608 | $20.15 | B-12 binding capacity | |
| 82610 | $19.13 | Cystatin c | |
| 82615 | $11.48 | Test for urine cystines | |
| 82626 | $35.56 | Dehydroepiandrosterone | |
| 82627 | $31.29 | Dehydroepiandrosterone | |
| 82633 | $43.59 | Desoxycorticosterone | |
| 82634 | $41.20 | Deoxycortisol | |
| 82638 | $17.23 | Assay of dibucaine number | |
| 82646 | $28.01 | Assay of dihydrocodeinone | |
| 82649 | $36.17 | Assay of dihydromorphinone | |
| 82651 | $36.33 | Assay of dihydrotestosterone | |
| 82652 | $54.18 | Vit d 1 25-dihydroxy | |
| 82654 | $19.25 | Assay of dimethadione | |
| 82656 | $16.24 | Pancreatic elastase fecal | |
| 82657 | $24.53 | Enzyme cell activity | |
| 82658 | $24.53 | Enzyme cell activity ra | |
| 82664 | $48.35 | Electrophoretic test | |
| 82666 | $30.23 | Assay of epiandrosterone | |
| 82668 | $26.46 | Assay of erythropoietin | |
| 82670 | $39.32 | Assay of estradiol | |
| 82671 | $45.45 | Assay of estrogens | |
| 82672 | $30.53 | Assay of estrogen | |
| 82677 | $34.03 | Assay of estriol | |
| 82679 | $35.12 | Assay of estrone | |
| 82679 | QW | $35.12 | Assay of estrone |
| 82690 | $22.15 | Assay of ethchlorvynol | |
| 82693 | $13.85 | Assay of ethylene glycol | |
| 82696 | $33.19 | Assay of etiocholanolone | |
| 82705 | $7.16 | Fats/lipids feces qual | |
| 82710 | $22.28 | Fats/lipids feces quant | |
| 82715 | $24.22 | Assay of fecal fat | |
| 82725 | $12.16 | Assay of blood fatty acids | |
| 82726 | $24.53 | Long chain fatty acids | |
| 82728 | $19.17 | Assay of ferritin | |
| 82731 | $90.64 | Assay of fetal fibronectin | |
| 82735 | $12.71 | Assay of fluoride | |
| 82742 | $27.86 | Assay of flurazepam | |
| 82746 | $20.69 | Blood folic acid serum | |
| 82747 | $4.32 | Assay of folic acid rbc | |
| 82757 | $17.01 | Assay of semen fructose | |
| 82759 | $30.23 | Assay of rbc galactokinase | |
| 82760 | $15.75 | Assay of galactose | |
| 82775 | $29.64 | Assay galactose transferase | |
| 82776 | $11.80 | Galactose transferase test | |
| 82784 | $13.09 | Assay iga/igd/igg/igm each | |
| 82785 | $23.18 | Assay of ige | |
| 82787 | $4.39 | Igg 1 2 3 or 4 each | |
| 82800 | $4.91 | Blood pH | |
| 82803 | $27.22 | Blood gases any combination | |
| 82805 | $39.94 | Blood gases w/o2 saturation | |
| 82810 | $12.28 | Blood gases o2 sat only | |
| 82820 | $14.07 | Hemoglobin-oxygen affinity | |
| 82930 | $7.67 | Gastric analy w/ph ea spec | |
| 82938 | $24.90 | Gastrin test | |
| 82941 | $24.82 | Assay of gastrin | |
| 82943 | $20.11 | Assay of glucagon | |
| 82945 | $5.52 | Glucose other fluid | |
| 82946 | $21.21 | Glucagon tolerance test | |
| 82947 | $5.52 | Assay glucose blood quant | |
| 82947 | QW | $5.52 | Assay glucose blood quant |
| 82948 | $4.45 | Reagent strip/blood glucose | |
| 82950 | $6.68 | Glucose test | |
| 82950 | QW | $6.68 | Glucose test |
| 82951 | $18.12 | Glucose tolerance test (GTT) | |
| 82951 | QW | $18.12 | Glucose tolerance test (GTT) |
| 82952 | $5.51 | GTT-added samples | |
| 82952 | QW | $5.51 | GTT-added samples |
| 82953 | $6.68 | Glucose-tolbutamide test | |
| 82955 | $13.65 | Assay of g6pd enzyme | |
| 82960 | $8.18 | Test for G6PD enzyme | |
| 82962 | $3.29 | Glucose blood test | |
| 82963 | $30.23 | Assay of glucosidase | |
| 82965 | $7.34 | Assay of gdh enzyme | |
| 82975 | $22.29 | Assay of glutamine | |
| 82977 | $10.13 | Assay of GGT | |
| 82977 | QW | $10.13 | Assay of GGT |
| 82978 | $20.06 | Assay of glutathione | |
| 82979 | $9.69 | Assay rbc glutathione | |
| 82980 | $24.48 | Assay of glutethimide | |
| 82985 | $21.21 | Glycated protein | |
| 82985 | QW | $21.21 | Glycated protein |
| 83001 | $26.15 | Gonadotropin (FSH) | |
| 83001 | QW | $26.15 | Gonadotropin (FSH) |
| 83002 | $26.06 | Gonadotropin (LH) | |
| 83002 | QW | $26.06 | Gonadotropin (LH) |
| 83003 | $23.47 | Assay growth hormone (hgh) | |
| 83008 | $23.62 | Assay of guanosine | |
| 83009 | $94.79 | H pylori (c-13) blood | |
| 83010 | $17.70 | Assay of haptoglobin quant | |
| 83012 | $24.20 | Assay of haptoglobins | |
| 83013 | $94.79 | H pylori (c-13) breath | |
| 83014 | $11.06 | H pylori drug admin | |
| 83015 | $26.50 | Heavy metal screen | |
| 83018 | $30.91 | Quantitative screen metals | |
| 83020 | $18.12 | Hemoglobin electrophoresis | |
| 83021 | $24.53 | Hemoglobin chromotography | |
| 83026 | $3.32 | Hemoglobin copper sulfate | |
| 83030 | $11.64 | Fetal hemoglobin chemical | |
| 83033 | $6.54 | Fetal hemoglobin assay qual | |
| 83036 | $13.66 | Glycosylated hemoglobin test | |
| 83036 | QW | $13.66 | Glycosylated hemoglobin test |
| 83037 | $13.66 | Glycosylated hb home device | |
| 83037 | QW | $13.66 | Glycosylated hb home device |
| 83045 | $4.91 | Blood methemoglobin test | |
| 83050 | $5.90 | Blood methemoglobin assay | |
| 83051 | $10.29 | Assay of plasma hemoglobin | |
| 83055 | $6.93 | Blood sulfhemoglobin test | |
| 83060 | $8.18 | Blood sulfhemoglobin assay | |