Pricing Information:
2010 Clinical
Diagnostic Laboratory Fee Schedule |
|||
| HCPC | Modifier | Loc 00 | Desc |
| 36415 | $3.00 | Routine venipuncture | |
| 78267 | $11.26 | Breath tst attain/anal c-14 | |
| 78268 | $96.47 | Breath test analysis, c-14 | |
| 80047 | $12.12 | Metabolic panel ionized ca | |
| 80047 | QW | $12.12 | Metabolic panel ionized ca |
| 80048 | $12.12 | Metabolic panel total ca | |
| 80048 | QW | $12.12 | Metabolic panel total ca |
| 80051 | $10.05 | Electrolyte panel | |
| 80051 | QW | $10.05 | Electrolyte panel |
| 80053 | $15.14 | Comprehen metabolic panel | |
| 80053 | QW | $15.14 | Comprehen metabolic panel |
| 80061 | $19.19 | Lipid panel | |
| 80061 | QW | $19.19 | Lipid panel |
| 80069 | $12.43 | Renal function panel | |
| 80069 | QW | $12.43 | Renal function panel |
| 80074 | $68.21 | Acute hepatitis panel | |
| 80076 | $11.70 | Hepatic function panel | |
| 80100 | $20.83 | Drug screen, qualitate/multi | |
| 80101 | $19.72 | Drug screen, single | |
| 80101 | QW | $19.72 | Drug screen, single |
| 80102 | $18.97 | Drug confirmation | |
| 80150 | $21.59 | Assay of amikacin | |
| 80152 | $25.64 | Assay of amitriptyline | |
| 80154 | $26.49 | Assay of benzodiazepines | |
| 80156 | $20.85 | Assay, carbamazepine, total | |
| 80157 | $18.99 | Assay, carbamazepine, free | |
| 80158 | $24.92 | Assay of cyclosporine | |
| 80160 | $24.65 | Assay of desipramine | |
| 80162 | $19.02 | Assay of digoxin | |
| 80164 | $19.40 | Assay, dipropylacetic acid | |
| 80166 | $22.21 | Assay of doxepin | |
| 80168 | $23.41 | Assay of ethosuximide | |
| 80170 | $23.48 | Assay of gentamicin | |
| 80172 | $23.33 | Assay of gold | |
| 80173 | $20.85 | Assay of haloperidol | |
| 80174 | $24.65 | Assay of imipramine | |
| 80176 | $16.67 | Assay of lidocaine | |
| 80178 | $9.46 | Assay of lithium | |
| 80178 | QW | $9.46 | Assay of lithium |
| 80182 | $19.40 | Assay of nortriptyline | |
| 80184 | $16.41 | Assay of phenobarbital | |
| 80185 | $18.99 | Assay of phenytoin, total | |
| 80186 | $19.71 | Assay of phenytoin, free | |
| 80188 | $23.77 | Assay of primidone | |
| 80190 | $23.99 | Assay of procainamide | |
| 80192 | $23.99 | Assay of procainamide | |
| 80194 | $20.91 | Assay of quinidine | |
| 80195 | $19.66 | Assay of sirolimus | |
| 80196 | $10.16 | Assay of salicylate | |
| 80197 | $19.66 | Assay of tacrolimus | |
| 80198 | $20.27 | Assay of theophylline | |
| 80200 | $23.09 | Assay of tobramycin | |
| 80201 | $17.07 | Assay of topiramate | |
| 80202 | $19.40 | Assay of vancomycin | |
| 80299 | $19.61 | Quantitative assay, drug | |
| 80400 | $46.70 | Acth stimulation panel | |
| 80402 | $124.52 | Acth stimulation panel | |
| 80406 | $112.08 | Acth stimulation panel | |
| 80408 | $179.76 | Aldosterone suppression eval | |
| 80410 | $115.08 | Calcitonin stimul panel | |
| 80412 | $472.02 | CRH stimulation panel | |
| 80414 | $73.96 | Testosterone response | |
| 80415 | $80.04 | Estradiol response panel | |
| 80416 | $189.06 | Renin stimulation panel | |
| 80417 | $63.02 | Renin stimulation panel | |
| 80418 | $830.08 | Pituitary evaluation panel | |
| 80420 | $103.16 | Dexamethasone panel | |
| 80422 | $66.00 | Glucagon tolerance panel | |
| 80424 | $68.24 | Glucagon tolerance panel | |
| 80426 | $212.60 | Gonadotropin hormone panel | |
| 80428 | $95.52 | Growth hormone panel | |
| 80430 | $112.38 | Growth hormone panel | |
| 80432 | $181.93 | Insulin suppression panel | |
| 80434 | $144.85 | Insulin tolerance panel | |
| 80435 | $147.50 | Insulin tolerance panel | |
| 80436 | $130.56 | Metyrapone panel | |
| 80438 | $72.18 | TRH stimulation panel | |
| 80439 | $96.24 | TRH stimulation panel | |
| 80440 | $83.28 | TRH stimulation panel | |
| 81000 | $4.54 | Urinalysis, nonauto w/scope | |
| 81001 | $4.54 | Urinalysis, auto w/scope | |
| 81002 | $3.66 | Urinalysis nonauto w/o scope | |
| 81003 | $3.22 | Urinalysis, auto, w/o scope | |
| 81003 | QW | $3.22 | Urinalysis, auto, w/o scope |
| 81005 | $3.10 | Urinalysis | |
| 81007 | $3.68 | Urine screen for bacteria | |
| 81007 | QW | $3.68 | Urine screen for bacteria |
| 81015 | $4.12 | Microscopic exam of urine | |
| 81020 | $5.28 | Urinalysis, glass test | |
| 81025 | $9.06 | Urine pregnancy test | |
| 81050 | $4.29 | Urinalysis, volume measure | |
| 82000 | $17.75 | Assay of blood acetaldehyde | |
| 82003 | $28.99 | Assay of acetaminophen | |
| 82009 | $6.47 | Test for acetone/ketones | |
| 82010 | $10.24 | Acetone assay | |
| 82010 | QW | $10.24 | Acetone assay |
| 82013 | $16.00 | Acetylcholinesterase assay | |
| 82016 | $19.85 | Acylcarnitines, qual | |
| 82017 | $24.16 | Acylcarnitines, quant | |
| 82024 | $55.32 | Assay of acth | |
| 82030 | $18.53 | Assay of adp & amp | |
| 82040 | $5.88 | Assay of serum albumin | |
| 82040 | QW | $5.88 | Assay of serum albumin |
| 82042 | $2.52 | Assay of urine albumin | |
| 82042 | QW | $2.52 | Assay of urine albumin |
| 82043 | $2.52 | Microalbumin, quantitative | |
| 82043 | QW | $2.52 | Microalbumin, quantitative |
| 82044 | $6.56 | Microalbumin, semiquant | |
| 82044 | QW | $6.56 | Microalbumin, semiquant |
| 82045 | $48.62 | Albumin, ischemia modified | |
| 82055 | $15.47 | Assay of ethanol | |
| 82055 | QW | $15.47 | Assay of ethanol |
| 82075 | $17.26 | Assay of breath ethanol | |
| 82085 | $13.90 | Assay of aldolase | |
| 82088 | $58.37 | Assay of aldosterone | |
| 82101 | $42.99 | Assay of urine alkaloids | |
| 82103 | $19.24 | Alpha-1-antitrypsin, total | |
| 82104 | $20.71 | Alpha-1-antitrypsin, pheno | |
| 82105 | $24.03 | Alpha-fetoprotein, serum | |
| 82106 | $24.03 | Alpha-fetoprotein, amniotic | |
| 82107 | $92.26 | Alpha-fetoprotein l3 | |
| 82108 | $36.49 | Assay of aluminum | |
| 82120 | $4.12 | Amines, vaginal fluid qual | |
| 82120 | QW | $4.12 | Amines, vaginal fluid qual |
| 82127 | $19.85 | Amino acid, single qual | |
| 82128 | $19.85 | Amino acids, mult qual | |
| 82131 | $24.16 | Amino acids, single quant | |
| 82135 | $23.58 | Assay, aminolevulinic acid | |
| 82136 | $24.16 | Amino acids, quant, 2-5 | |
| 82139 | $24.16 | Amino acids, quan, 6 or more | |
| 82140 | $20.87 | Assay of ammonia | |
| 82143 | $9.84 | Amniotic fluid scan | |
| 82145 | $22.27 | Assay of amphetamines | |
| 82150 | $9.29 | Assay of amylase | |
| 82150 | QW | $9.29 | Assay of amylase |
| 82154 | $41.30 | Androstanediol glucuronide | |
| 82157 | $41.93 | Assay of androstenedione | |
| 82160 | $35.82 | Assay of androsterone | |
| 82163 | $29.40 | Assay of angiotensin II | |
| 82164 | $20.91 | Angiotensin I enzyme test | |
| 82172 | $20.30 | Assay of apolipoprotein | |
| 82175 | $27.17 | Assay of arsenic | |
| 82180 | $14.16 | Assay of ascorbic acid | |
| 82190 | $17.51 | Atomic absorption | |
| 82205 | $16.41 | Assay of barbiturates | |
| 82232 | $23.17 | Assay of beta-2 protein | |
| 82239 | $24.54 | Bile acids, total | |
| 82240 | $24.92 | Bile acids, cholylglycine | |
| 82247 | $7.19 | Bilirubin, total | |
| 82247 | QW | $7.19 | Bilirubin, total |
| 82248 | $7.19 | Bilirubin, direct | |
| 82252 | $2.80 | Fecal bilirubin test | |
| 82261 | $24.16 | Assay of biotinidase | |
| 82270 | $4.66 | Occult blood, feces | |
| 82271 | $4.66 | Occult blood, other sources | |
| 82271 | QW | $4.66 | Occult blood, other sources |
| 82272 | $4.66 | Occult bld feces, 1-3 tests | |
| 82272 | QW | $4.66 | Occult bld feces, 1-3 tests |
| 82274 | $22.78 | Assay test for blood, fecal | |
| 82274 | QW | $22.78 | Assay test for blood, fecal |
| 82286 | $9.86 | Assay of bradykinin | |
| 82300 | $13.59 | Assay of cadmium | |
| 82306 | $42.40 | Vitamin d, 25 hydroxy | |
| 82308 | $38.36 | Assay of calcitonin | |
| 82310 | $7.39 | Assay of calcium | |
| 82310 | QW | $7.39 | Assay of calcium |
| 82330 | $19.57 | Assay of calcium | |
| 82330 | QW | $19.57 | Assay of calcium |
| 82331 | $7.41 | Calcium infusion test | |
| 82340 | $8.64 | Assay of calcium in urine | |
| 82355 | $16.58 | Calculus analysis, qual | |
| 82360 | $12.53 | Calculus assay, quant | |
| 82365 | $17.74 | Calculus spectroscopy | |
| 82370 | $17.95 | X-ray assay, calculus | |
| 82373 | $24.97 | Assay, c-d transfer measure | |
| 82374 | $7.00 | Assay, blood carbon dioxide | |
| 82374 | QW | $7.00 | Assay, blood carbon dioxide |
| 82375 | $17.66 | Assay, carboxyhb, quant | |
| 82376 | $8.14 | Assay, carboxyhb, qual | |
| 82378 | $27.17 | Carcinoembryonic antigen | |
| 82379 | $24.16 | Assay of carnitine | |
| 82380 | $13.21 | Assay of carotene | |
| 82382 | $24.63 | Assay, urine catecholamines | |
| 82383 | $35.89 | Assay, blood catecholamines | |
| 82384 | $34.12 | Assay, three catecholamines | |
| 82387 | $29.80 | Assay of cathepsin-d | |
| 82390 | $15.38 | Assay of ceruloplasmin | |
| 82397 | $20.24 | Chemiluminescent assay | |
| 82415 | $18.15 | Assay of chloramphenicol | |
| 82435 | $6.58 | Assay of blood chloride | |
| 82435 | QW | $6.58 | Assay of blood chloride |
| 82436 | $4.66 | Assay of urine chloride | |
| 82438 | $7.01 | Assay, other fluid chlorides | |
| 82441 | $8.60 | Test for chlorohydrocarbons | |
| 82465 | $6.24 | Assay, bld/serum cholesterol | |
| 82465 | QW | $6.24 | Assay, bld/serum cholesterol |
| 82480 | $10.18 | Assay, serum cholinesterase | |
| 82482 | $8.52 | Assay, rbc cholinesterase | |
| 82485 | $20.52 | Assay, chondroitin sulfate | |
| 82486 | $24.97 | Gas/liquid chromatography | |
| 82487 | $20.52 | Paper chromatography | |
| 82488 | $20.52 | Paper chromatography | |
| 82489 | $20.52 | Thin layer chromatography | |
| 82491 | $24.97 | Chromotography, quant, sing | |
| 82492 | $24.97 | Chromotography, quant, mult | |
| 82495 | $29.05 | Assay of chromium | |
| 82507 | $39.83 | Assay of citrate | |
| 82520 | $21.70 | Assay of cocaine | |
| 82523 | $26.77 | Collagen crosslinks | |
| 82523 | QW | $26.77 | Collagen crosslinks |
| 82525 | $17.77 | Assay of copper | |
| 82528 | $32.24 | Assay of corticosterone | |
| 82530 | $23.94 | Cortisol, free | |
| 82533 | $23.35 | Total cortisol | |
| 82540 | $6.64 | Assay of creatine | |
| 82541 | $24.97 | Column chromotography, qual | |
| 82542 | $24.97 | Column chromotography, quant | |
| 82543 | $24.97 | Column chromotograph/isotope | |
| 82544 | $24.97 | Column chromotograph/isotope | |
| 82550 | $9.33 | Assay of ck (cpk) | |
| 82550 | QW | $9.33 | Assay of ck (cpk) |
| 82552 | $19.19 | Assay of cpk in blood | |
| 82553 | $13.33 | Creatine, MB fraction | |
| 82554 | $13.33 | Creatine, isoforms | |
| 82565 | $7.34 | Assay of creatinine | |
| 82565 | QW | $7.34 | Assay of creatinine |
| 82570 | $7.41 | Assay of urine creatinine | |
| 82570 | QW | $7.41 | Assay of urine creatinine |
| 82575 | $13.53 | Creatinine clearance test | |
| 82585 | $12.28 | Assay of cryofibrinogen | |
| 82595 | $9.27 | Assay of cryoglobulin | |
| 82600 | $27.79 | Assay of cyanide | |
| 82607 | $21.59 | Vitamin B-12 | |
| 82608 | $20.51 | B-12 binding capacity | |
| 82610 | $19.47 | Cystatin c | |
| 82615 | $11.69 | Test for urine cystines | |
| 82626 | $36.20 | Dehydroepiandrosterone | |
| 82627 | $31.85 | Dehydroepiandrosterone | |
| 82633 | $44.37 | Desoxycorticosterone | |
| 82634 | $41.93 | Deoxycortisol | |
| 82638 | $17.54 | Assay of dibucaine number | |
| 82646 | $28.51 | Assay of dihydrocodeinone | |
| 82649 | $36.82 | Assay of dihydromorphinone | |
| 82651 | $36.97 | Assay of dihydrotestosterone | |
| 82652 | $55.14 | Vit d 1, 25-dihydroxy | |
| 82654 | $19.59 | Assay of dimethadione | |
| 82656 | $16.52 | Pancreatic elastase, fecal | |
| 82657 | $24.97 | Enzyme cell activity | |
| 82658 | $24.97 | Enzyme cell activity, ra | |
| 82664 | $49.21 | Electrophoretic test | |
| 82666 | $30.77 | Assay of epiandrosterone | |
| 82668 | $26.93 | Assay of erythropoietin | |
| 82670 | $40.02 | Assay of estradiol | |
| 82671 | $46.26 | Assay of estrogens | |
| 82672 | $31.07 | Assay of estrogen | |
| 82677 | $34.64 | Assay of estriol | |
| 82679 | $35.75 | Assay of estrone | |
| 82679 | QW | $35.75 | Assay of estrone |
| 82690 | $22.54 | Assay of ethchlorvynol | |
| 82693 | $14.10 | Assay of ethylene glycol | |
| 82696 | $33.78 | Assay of etiocholanolone | |
| 82705 | $7.29 | Fats/lipids, feces, qual | |
| 82710 | $22.68 | Fats/lipids, feces, quant | |
| 82715 | $24.65 | Assay of fecal fat | |
| 82725 | $12.38 | Assay of blood fatty acids | |
| 82726 | $24.97 | Long chain fatty acids | |
| 82728 | $19.51 | Assay of ferritin | |
| 82731 | $92.26 | Assay of fetal fibronectin | |
| 82735 | $12.94 | Assay of fluoride | |
| 82742 | $28.36 | Assay of flurazepam | |
| 82746 | $21.06 | Blood folic acid serum | |
| 82747 | $4.40 | Assay of folic acid, rbc | |
| 82757 | $17.31 | Assay of semen fructose | |
| 82759 | $30.77 | Assay of rbc galactokinase | |
| 82760 | $16.04 | Assay of galactose | |
| 82775 | $30.17 | Assay galactose transferase | |
| 82776 | $12.01 | Galactose transferase test | |
| 82784 | $13.32 | Assay, iga/igd/igg/igm each | |
| 82785 | $23.59 | Assay of ige | |
| 82787 | $4.47 | Igg 1, 2, 3 or 4, each | |
| 82800 | $5.00 | Blood pH | |
| 82803 | $27.71 | Blood gases: pH, pO2 & pCO2 | |
| 82805 | $40.65 | Blood gases w/02 saturation | |
| 82810 | $12.50 | Blood gases, O2 sat only | |
| 82820 | $14.32 | Hemoglobin-oxygen affinity | |
| 82926 | $7.81 | Assay of gastric acid | |
| 82928 | $7.50 | Assay of gastric acid | |
| 82938 | $25.35 | Gastrin test | |
| 82941 | $25.26 | Assay of gastrin | |
| 82943 | $20.46 | Assay of glucagon | |
| 82945 | $5.62 | Glucose other fluid | |
| 82946 | $21.59 | Glucagon tolerance test | |
| 82947 | $5.62 | Assay, glucose, blood quant | |
| 82947 | QW | $5.62 | Assay, glucose, blood quant |
| 82948 | $4.54 | Reagent strip/blood glucose | |
| 82950 | $6.80 | Glucose test | |
| 82950 | QW | $6.80 | Glucose test |
| 82951 | $18.44 | Glucose tolerance test (GTT) | |
| 82951 | QW | $18.44 | Glucose tolerance test (GTT) |
| 82952 | $5.61 | GTT-added samples | |
| 82952 | QW | $5.61 | GTT-added samples |
| 82953 | $6.80 | Glucose-tolbutamide test | |
| 82955 | $13.89 | Assay of g6pd enzyme | |
| 82960 | $8.33 | Test for G6PD enzyme | |
| 82962 | $3.35 | Glucose blood test | |
| 82963 | $30.77 | Assay of glucosidase | |
| 82965 | $7.47 | Assay of gdh enzyme | |
| 82975 | $22.69 | Assay of glutamine | |
| 82977 | $10.31 | Assay of GGT | |
| 82977 | QW | $10.31 | Assay of GGT |
| 82978 | $20.42 | Assay of glutathione | |
| 82979 | $9.86 | Assay, rbc glutathione | |
| 82980 | $24.92 | Assay of glutethimide | |
| 82985 | $21.59 | Glycated protein | |
| 82985 | QW | $21.59 | Glycated protein |
| 83001 | $26.62 | Gonadotropin (FSH) | |
| 83001 | QW | $26.62 | Gonadotropin (FSH) |
| 83002 | $26.53 | Gonadotropin (LH) | |
| 83002 | QW | $26.53 | Gonadotropin (LH) |
| 83003 | $23.88 | Assay, growth hormone (hgh) | |
| 83008 | $24.04 | Assay of guanosine | |
| 83009 | $96.47 | H pylori (c-13), blood | |
| 83010 | $18.02 | Assay of haptoglobin, quant | |
| 83012 | $24.63 | Assay of haptoglobins | |
| 83013 | $96.47 | H pylori (c-13), breath | |
| 83014 | $11.26 | H pylori drug admin | |
| 83015 | $26.97 | Heavy metal screen | |
| 83018 | $31.46 | Quantitative screen, metals | |
| 83020 | $18.44 | Hemoglobin electrophoresis | |
| 83021 | $24.97 | Hemoglobin chromotography | |
| 83026 | $3.38 | Hemoglobin, copper sulfate | |
| 83030 | $11.85 | Fetal hemoglobin, chemical | |
| 83033 | $6.66 | Fetal hemoglobin assay, qual | |
| 83036 | $13.90 | Glycosylated hemoglobin test | |
| 83036 | QW | $13.90 | Glycosylated hemoglobin test |
| 83037 | $13.90 | Glycosylated hb, home device | |
| 83037 | QW | $13.90 | Glycosylated hb, home device |
| 83045 | $5.00 | Blood methemoglobin test | |
| 83050 | $6.00 | Blood methemoglobin assay | |
| 83051 | $10.47 | Assay of plasma hemoglobin | |
| 83055 | $7.05 | Blood sulfhemoglobin test | |
| 83060 | $8.33 | Blood sulfhemoglobin assay | |
| 83065 | $6.15 | Assay of hemoglobin heat | |
| 83068 | $12.13 | Hemoglobin stability screen | |
| 83069 | $5.65 | Assay of urine hemoglobin | |
| 83070 | $6.80 | Assay of hemosiderin, qual | |
| 83071 | $9.84 | Assay of hemosiderin, quant | |
| 83080 | $24.16 | Assay of b hexosaminidase | |
| 83088 | $42.30 | Assay of histamine | |
| 83090 | $24.16 | Assay of homocystine | |
| 83150 | $17.74 | Assay of for hva | |
| 83491 | $25.09 | Assay of corticosteroids | |
| 83497 | $18.47 | Assay of 5-hiaa | |
| 83498 | $38.91 | Assay of progesterone | |
| 83499 | $36.10 | Assay of progesterone | |
| 83500 | $32.44 | Assay, free hydroxyproline | |
| 83505 | $34.82 | Assay, total hydroxyproline | |
| 83516 | $16.52 | Immunoassay, nonantibody | |
| 83518 | $12.14 | Immunoassay, dipstick | |
| 83518 | QW | $12.14 | Immunoassay, dipstick |
| 83519 | $19.35 | Ria nonantibody | |
| 83520 | $18.54 | Immunoassay quant nos nonab | |
| 83520 | QW | $18.54 | Immunoassay quant nos nonab |
| 83525 | $16.38 | Assay of insulin | |
| 83527 | $18.55 | Assay of insulin | |
| 83528 | $22.78 | Assay of intrinsic factor | |
| 83540 | $9.28 | Assay of iron | |
| 83550 | $12.52 | Iron binding test | |
| 83570 | $12.67 | Assay of idh enzyme | |
| 83582 | $20.30 | Assay of ketogenic steroids | |
| 83586 | $18.34 | Assay 17- ketosteroids | |
| 83593 | $37.67 | Fractionation, ketosteroids | |
| 83605 | $15.30 | Assay of lactic acid | |
| 83605 | QW | $15.30 | Assay of lactic acid |
| 83615 | $8.64 | Lactate (LD) (LDH) enzyme | |
| 83625 | $18.33 | Assay of ldh enzymes | |
| 83630 | $28.11 | Lactoferrin, fecal (qual) | |
| 83631 | $28.11 | Lactoferrin, fecal (quant) | |
| 83632 | $28.95 | Placental lactogen | |
| 83633 | $7.88 | Test urine for lactose | |
| 83634 | $11.45 | Assay of urine for lactose | |
| 83655 | $17.34 | Assay of lead | |
| 83655 | QW | $17.34 | Assay of lead |
| 83661 | $28.25 | L/s ratio, fetal lung | |
| 83662 | $27.10 | Foam stability, fetal lung | |
| 83663 | $27.10 | Fluoro polarize, fetal lung | |
| 83664 | $27.10 | Lamellar bdy, fetal lung | |
| 83670 | $13.13 | Assay of lap enzyme | |
| 83690 | $9.86 | Assay of lipase | |
| 83695 | $18.54 | Assay of lipoprotein(a) | |
| 83698 | $48.62 | Assay lipoprotein pla2 | |
| 83700 | $16.12 | Lipopro bld, electrophoretic | |
| 83701 | $17.74 | Lipoprotein bld, hr fraction | |
| 83704 | $30.26 | Lipoprotein, bld, by nmr | |
| 83718 | $11.73 | Assay of lipoprotein | |
| 83718 | QW | $11.73 | Assay of lipoprotein |
| 83719 | $16.66 | Assay of blood lipoprotein | |
| 83721 | $13.66 | Assay of blood lipoprotein | |
| 83721 | QW | $13.66 | Assay of blood lipoprotein |
| 83727 | $24.63 | Assay of lrh hormone | |
| 83735 | $9.60 | Assay of magnesium | |
| 83775 | $10.56 | Assay of md enzyme | |
| 83785 | $35.22 | Assay of manganese | |
| 83788 | $24.97 | Mass spectrometry qual | |
| 83789 | $24.97 | Mass spectrometry quant | |
| 83805 | $25.25 | Assay of meprobamate | |
| 83825 | $23.29 | Assay of mercury | |
| 83835 | $24.26 | Assay of metanephrines | |
| 83840 | $23.39 | Assay of methadone | |
| 83857 | $15.38 | Assay of methemalbumin | |
| 83858 | $19.19 | Assay of methsuximide | |
| 83864 | $28.51 | Mucopolysaccharides | |
| 83866 | $14.11 | Mucopolysaccharides screen | |
| 83872 | $8.40 | Assay synovial fluid mucin | |
| 83873 | $24.64 | Assay of csf protein | |
| 83874 | $18.50 | Assay of myoglobin | |
| 83876 | $48.62 | Assay, myeloperoxidase | |
| 83880 | $48.62 | Natriuretic peptide | |
| 83880 | QW | $48.62 | Natriuretic peptide |
| 83883 | $19.47 | Assay, nephelometry not spec | |
| 83885 | $8.14 | Assay of nickel | |
| 83887 | $33.92 | Assay of nicotine | |
| 83890 | $3.65 | Molecule isolate | |
| 83891 | $3.65 | Molecule isolate nucleic | |
| 83892 | $3.65 | Molecular diagnostics | |
| 83893 | $3.65 | Molecule dot/slot/blot | |
| 83894 | $3.65 | Molecule gel electrophor | |
| 83896 | $3.65 | Molecular diagnostics | |
| 83897 | $3.65 | Molecule nucleic transfer | |
| 83898 | $24.01 | Molecule nucleic ampli, each | |
| 83900 | $48.02 | Molecule nucleic ampli 2 seq | |
| 83901 | $24.01 | Molecule nucleic ampli addon | |
| 83902 | $15.55 | Molecular diagnostics | |
| 83903 | $24.01 | Molecule mutation scan | |
| 83904 | $24.01 | Molecule mutation identify | |
| 83905 | $24.01 | Molecule mutation identify | |
| 83906 | $24.01 | Molecule mutation identify | |
| 83907 | $19.13 | Lyse cells for nucleic ext | |
| 83908 | $24.01 | Nucleic acid, signal ampli | |
| 83909 | $24.01 | Nucleic acid, high resolute | |
| 83912 | $3.65 | Genetic examination | |
| 83913 | $19.13 | Molecular, rna stabilization | |
| 83914 | $24.01 | Mutation ident ola/sbce/aspe | |
| 83915 | $15.98 | Assay of nucleotidase | |
| 83916 | $28.11 | Oligoclonal bands | |
| 83918 | $21.72 | Organic acids, total, quant | |
| 83919 | $21.72 | Organic acids, qual, each | |
| 83921 | $21.72 | Organic acid, single, quant | |
| 83925 | $27.87 | Assay of opiates | |
| 83930 | $9.46 | Assay of blood osmolality | |
| 83935 | $9.76 | Assay of urine osmolality | |
| 83937 | $29.45 | Assay of osteocalcin | |
| 83945 | $18.44 | Assay of oxalate | |
| 83950 | $92.26 | Oncoprotein, her-2/neu | |
| 83951 | $92.26 | Oncoprotein, dcp | |
| 83970 | $59.12 | Assay of parathormone | |
| 83986 | $5.13 | Assay ph body fluid nos | |
| 83986 | QW | $5.13 | Assay ph body fluid nos |
| 83987 | $22.74 | Exhaled breath condensate | |
| 83992 | $21.05 | Assay for phencyclidine | |
| 83993 | $28.11 | Assay for calprotectin fecal | |
| 84022 | $22.31 | Assay of phenothiazine | |
| 84030 | $7.88 | Assay of blood pku | |
| 84035 | $5.24 | Assay of phenylketones | |
| 84060 | $10.57 | Assay acid phosphatase | |
| 84061 | $11.33 | Phosphatase, forensic exam | |
| 84066 | $13.84 | Assay prostate phosphatase | |
| 84075 | $7.41 | Assay alkaline phosphatase | |
| 84075 | QW | $7.41 | Assay alkaline phosphatase |
| 84078 | $10.46 | Assay alkaline phosphatase | |
| 84080 | $21.19 | Assay alkaline phosphatases | |
| 84081 | $23.67 | Amniotic fluid enzyme test | |
| 84085 | $9.66 | Assay of rbc pg6d enzyme | |
| 84087 | $11.60 | Assay phosphohexose enzymes | |
| 84100 | $6.79 | Assay of phosphorus | |
| 84105 | $6.66 | Assay of urine phosphorus | |
| 84106 | $6.13 | Test for porphobilinogen | |
| 84110 | $12.10 | Assay of porphobilinogen | |
| 84119 | $12.34 | Test urine for porphyrins | |
| 84120 | $21.07 | Assay of urine porphyrins | |
| 84126 | $36.48 | Assay of feces porphyrins | |
| 84127 | $16.69 | Assay of feces porphyrins | |
| 84132 | $6.58 | Assay of serum potassium | |
| 84132 | QW | $6.58 | Assay of serum potassium |
| 84133 | $6.16 | Assay of urine potassium | |
| 84134 | $20.89 | Assay of prealbumin | |
| 84135 | $27.40 | Assay of pregnanediol | |
| 84138 | $27.12 | Assay of pregnanetriol | |
| 84140 | $24.12 | Assay of pregnenolone | |
| 84143 | $32.69 | Assay of 17-hydroxypregneno | |
| 84144 | $29.88 | Assay of progesterone | |
| 84145 | $27.76 | Procalcitonin (pct) | |
| 84146 | $27.76 | Assay of prolactin | |
| 84150 | $35.75 | Assay of prostaglandin | |
| 84152 | $26.34 | Assay of psa, complexed | |
| 84153 | $26.34 | Assay of psa, total | |
| 84154 | $26.34 | Assay of psa, free | |
| 84155 | $5.25 | Assay of protein, serum | |
| 84156 | $5.25 | Assay of protein, urine | |
| 84157 | $5.25 | Assay of protein, other | |
| 84157 | QW | $5.25 | Assay of protein, other |
| 84160 | $7.41 | Assay of protein, any source | |
| 84163 | $21.56 | Pappa, serum | |
| 84165 | $15.38 | Protein e-phoresis, serum | |
| 84166 | $25.54 | Protein e-phoresis/urine/csf | |
| 84181 | $24.40 | Western blot test | |
| 84182 | $25.78 | Protein, western blot test | |
| 84202 | $10.94 | Assay RBC protoporphyrin | |
| 84203 | $10.94 | Test RBC protoporphyrin | |
| 84206 | $19.19 | Assay of proinsulin | |
| 84207 | $26.65 | Assay of vitamin b-6 | |
| 84210 | $15.55 | Assay of pyruvate | |
| 84220 | $7.47 | Assay of pyruvate kinase | |
| 84228 | $8.14 | Assay of quinine | |
| 84233 | $92.26 | Assay of estrogen | |
| 84234 | $92.92 | Assay of progesterone | |
| 84235 | $74.96 | Assay of endocrine hormone | |
| 84238 | $52.38 | Assay, nonendocrine receptor | |
| 84244 | $31.51 | Assay of renin | |
| 84252 | $18.26 | Assay of vitamin b-2 | |
| 84255 | $36.56 | Assay of selenium | |
| 84260 | $21.72 | Assay of serotonin | |
| 84270 | $11.45 | Assay of sex hormone globul | |
| 84275 | $10.54 | Assay of sialic acid | |
| 84285 | $33.73 | Assay of silica | |
| 84295 | $6.89 | Assay of serum sodium | |
| 84295 | QW | $6.89 | Assay of serum sodium |
| 84300 | $6.96 | Assay of urine sodium | |
| 84302 | $6.96 | Assay of sweat sodium | |
| 84305 | $28.24 | Assay of somatomedin | |
| 84307 | $22.15 | Assay of somatostatin | |
| 84311 | $10.01 | Spectrophotometry | |
| 84315 | $3.59 | Body fluid specific gravity | |
| 84375 | $12.53 | Chromatogram assay, sugars | |
| 84376 | $7.88 | Sugars, single, qual | |
| 84377 | $7.88 | Sugars, multiple, qual | |
| 84378 | $11.45 | Sugars, single, quant | |
| 84379 | $11.45 | Sugars multiple quant | |
| 84392 | $6.80 | Assay of urine sulfate | |
| 84402 | $36.47 | Assay of testosterone | |
| 84403 | $36.98 | Assay of total testosterone | |
| 84425 | $12.53 | Assay of vitamin b-1 | |
| 84430 | $16.66 | Assay of thiocyanate | |
| 84431 | $18.54 | Thromboxane, urine | |
| 84432 | $23.01 | Assay of thyroglobulin | |
| 84436 | $9.84 | Assay of total thyroxine | |
| 84437 | $8.14 | Assay of neonatal thyroxine | |
| 84439 | $12.92 | Assay of free thyroxine | |
| 84442 | $21.19 | Assay of thyroid activity | |
| 84443 | $24.06 | Assay thyroid stim hormone | |
| 84443 | QW | $24.06 | Assay thyroid stim hormone |
| 84445 | $24.92 | Assay of tsi | |
| 84446 | $20.31 | Assay of vitamin e | |
| 84449 | $21.58 | Assay of transcortin | |
| 84450 | $7.41 | Transferase (AST) (SGOT) | |
| 84450 | QW | $7.41 | Transferase (AST) (SGOT) |
| 84460 | $7.58 | Alanine amino (ALT) (SGPT) | |
| 84460 | QW | $7.58 | Alanine amino (ALT) (SGPT) |
| 84466 | $18.29 | Assay of transferrin | |
| 84478 | $8.24 | Assay of triglycerides | |
| 84478 | QW | $8.24 | Assay of triglycerides |
| 84479 | $9.27 | Assay of thyroid (t3 or t4) | |
| 84480 | $20.31 | Assay, triiodothyronine (t3) | |
| 84481 | $22.52 | Free assay (FT-3) | |
| 84482 | $22.52 | T3 reverse | |
| 84484 | $14.10 | Assay of troponin, quant | |
| 84485 | $10.26 | Assay duodenal fluid trypsin | |
| 84488 | $10.26 | Test feces for trypsin | |
| 84490 | $10.26 | Assay of feces for trypsin | |
| 84510 | $12.53 | Assay of tyrosine | |
| 84512 | $7.77 | Assay of troponin, qual | |
| 84520 | $5.65 | Assay of urea nitrogen | |
| 84520 | QW | $5.65 | Assay of urea nitrogen |
| 84525 | $4.12 | Urea nitrogen semi-quant | |
| 84540 | $6.80 | Assay of urine/urea-n | |
| 84545 | $9.46 | Urea-N clearance test | |
| 84550 | $6.47 | Assay of blood/uric acid | |
| 84550 | QW | $6.47 | Assay of blood/uric acid |
| 84560 | $6.80 | Assay of urine/uric acid | |
| 84577 | $17.87 | Assay of feces/urobilinogen | |
| 84578 | $4.65 | Test urine urobilinogen | |
| 84580 | $10.16 | Assay of urine urobilinogen | |
| 84583 | $7.20 | Assay of urine urobilinogen | |
| 84585 | $22.21 | Assay of urine vma | |
| 84586 | $27.49 | Assay of vip | |
| 84588 | $48.62 | Assay of vasopressin | |
| 84590 | $16.61 | Assay of vitamin a | |
| 84591 | $16.61 | Assay of nos vitamin | |
| 84597 | $10.02 | Assay of vitamin k | |
| 84600 | $23.02 | Assay of volatiles | |
| 84620 | $16.97 | Xylose tolerance test | |
| 84630 | $16.31 | Assay of zinc | |
| 84681 | $27.49 | Assay of c-peptide | |
| 84702 | $21.56 | Chorionic gonadotropin test | |
| 84703 | $10.76 | Chorionic gonadotropin assay | |
| 84703 | QW | $10.76 | Chorionic gonadotropin assay |
| 84704 | $21.56 | Hcg, free betachain test | |
| 84830 | $14.37 | Ovulation tests | |
| 85002 | $6.45 | Bleeding time test | |
| 85004 | $9.27 | Automated diff wbc count | |
| 85007 | $4.93 | Bl smear w/diff wbc count | |
| 85008 | $4.93 | Bl smear w/o diff wbc count | |
| 85009 | $5.33 | Manual diff wbc count b-coat | |
| 85013 | $3.39 | Spun microhematocrit | |
| 85014 | $3.39 | Hematocrit | |
| 85014 | QW | $3.39 | Hematocrit |
| 85018 | $3.39 | Hemoglobin | |
| 85018 | QW | $3.39 | Hemoglobin |
| 85025 | $11.14 | Complete cbc w/auto diff wbc | |
| 85027 | $9.27 | Complete cbc, automated | |
| 85032 | $6.16 | Manual cell count, each | |
| 85041 | $4.31 | Automated rbc count | |
| 85044 | $6.16 | Manual reticulocyte count | |
| 85045 | $5.74 | Automated reticulocyte count | |
| 85046 | $7.99 | Reticyte/hgb concentrate | |
| 85048 | $3.64 | Automated leukocyte count | |
| 85049 | $6.40 | Automated platelet count | |
| 85055 | $6.00 | Reticulated platelet assay | |
| 85130 | $17.03 | Chromogenic substrate assay | |
| 85170 | $5.18 | Blood clot retraction | |
| 85175 | $6.51 | Blood clot lysis time | |
| 85210 | $8.33 | Blood clot factor II test | |
| 85220 | $25.28 | Blood clot factor V test | |
| 85230 | $25.65 | Blood clot factor VII test | |
| 85240 | $25.65 | Blood clot factor VIII test | |
| 85244 | $29.24 | Blood clot factor VIII test | |
| 85245 | $32.87 | Blood clot factor VIII test | |
| 85246 | $32.87 | Blood clot factor VIII test | |
| 85247 | $32.87 | Blood clot factor VIII test | |
| 85250 | $27.27 | Blood clot factor IX test | |
| 85260 | $25.65 | Blood clot factor X test | |
| 85270 | $25.65 | Blood clot factor XI test | |
| 85280 | $27.71 | Blood clot factor XII test | |
| 85290 | $23.41 | Blood clot factor XIII test | |
| 85291 | $12.74 | Blood clot factor XIII test | |
| 85292 | $7.47 | Blood clot factor assay | |
| 85293 | $7.47 | Blood clot factor assay | |
| 85300 | $8.33 | Antithrombin III test | |
| 85301 | $15.49 | Antithrombin III test | |
| 85302 | $17.22 | Blood clot inhibitor antigen | |
| 85303 | $19.81 | Blood clot inhibitor test | |
| 85305 | $16.61 | Blood clot inhibitor assay | |
| 85306 | $21.95 | Blood clot inhibitor test | |
| 85307 | $21.95 | Assay activated protein c | |
| 85335 | $18.44 | Factor inhibitor test | |
| 85337 | $14.93 | Thrombomodulin | |
| 85345 | $6.16 | Coagulation time | |
| 85347 | $6.10 | Coagulation time | |
| 85348 | $5.34 | Coagulation time | |
| 85360 | $11.45 | Euglobulin lysis | |
| 85362 | $9.86 | Fibrin degradation products | |
| 85366 | $12.34 | Fibrinogen test | |
| 85370 | $15.21 | Fibrinogen test | |
| 85378 | $10.21 | Fibrin degrade, semiquant | |
| 85379 | $14.57 | Fibrin degradation, quant | |
| 85380 | $14.57 | Fibrin degradation, vte | |
| 85384 | $12.17 | Fibrinogen | |
| 85385 | $12.17 | Fibrinogen | |
| 85390 | $6.80 | Fibrinolysins screen | |
| 85397 | $32.87 | Clotting funct activity | |
| 85400 | $12.67 | Fibrinolytic plasmin | |
| 85410 | $11.05 | Fibrinolytic antiplasmin | |
| 85415 | $13.59 | Fibrinolytic plasminogen | |
| 85420 | $9.36 | Fibrinolytic plasminogen | |
| 85421 | $14.59 | Fibrinolytic plasminogen | |
| 85441 | $6.02 | Heinz bodies, direct | |
| 85445 | $9.76 | Heinz bodies, induced | |
| 85460 | $11.09 | Hemoglobin, fetal | |
| 85461 | $9.50 | Hemoglobin, fetal | |
| 85475 | $12.71 | Hemolysin | |
| 85520 | $13.59 | Heparin assay | |
| 85525 | $13.59 | Heparin neutralization | |
| 85530 | $13.59 | Heparin-protamine tolerance | |
| 85536 | $9.27 | Iron stain peripheral blood | |
| 85540 | $12.32 | Wbc alkaline phosphatase | |
| 85547 | $12.32 | RBC mechanical fragility | |
| 85549 | $26.87 | Muramidase | |
| 85555 | $9.58 | RBC osmotic fragility | |
| 85557 | $19.13 | RBC osmotic fragility | |
| 85576 | $30.77 | Blood platelet aggregation | |
| 85576 | QW | $30.77 | Blood platelet aggregation |
| 85597 | $25.75 | Platelet neutralization | |
| 85610 | $5.62 | Prothrombin time | |
| 85610 | QW | $5.62 | Prothrombin time |
| 85611 | $5.64 | Prothrombin test | |
| 85612 | $13.70 | Viper venom prothrombin time | |
| 85613 | $13.70 | Russell viper venom, diluted | |
| 85635 | $14.10 | Reptilase test | |
| 85651 | $5.08 | Rbc sed rate, nonautomated | |
| 85652 | $3.87 | Rbc sed rate, automated | |
| 85660 | $7.90 | RBC sickle cell test | |
| 85670 | $8.27 | Thrombin time, plasma | |
| 85675 | $6.66 | Thrombin time, titer | |
| 85705 | $11.45 | Thromboplastin inhibition | |
| 85730 | $8.60 | Thromboplastin time, partial | |
| 85732 | $9.27 | Thromboplastin time, partial | |
| 85810 | $16.72 | Blood viscosity examination | |
| 86000 | $10.00 | Agglutinins, febrile | |
| 86001 | $7.47 | Allergen specific igg | |
| 86003 | $7.47 | Allergen specific IgE | |
| 86005 | $11.42 | Allergen specific IgE | |
| 86021 | $21.56 | WBC antibody identification | |
| 86022 | $26.31 | Platelet antibodies | |
| 86023 | $17.84 | Immunoglobulin assay | |
| 86038 | $17.32 | Antinuclear antibodies | |
| 86039 | $15.99 | Antinuclear antibodies (ANA) | |
| 86060 | $10.46 | Antistreptolysin o, titer | |
| 86063 | $8.27 | Antistreptolysin o, screen | |
| 86140 | $7.41 | C-reactive protein | |
| 86141 | $18.54 | C-reactive protein, hs | |
| 86146 | $23.70 | Glycoprotein antibody | |
| 86147 | $23.70 | Cardiolipin antibody | |
| 86148 | $23.01 | Phospholipid antibody | |
| 86155 | $22.89 | Chemotaxis assay | |
| 86156 | $9.60 | Cold agglutinin, screen | |
| 86157 | $11.55 | Cold agglutinin, titer | |
| 86160 | $17.20 | Complement, antigen | |
| 86161 | $17.20 | Complement/function activity | |
| 86162 | $29.10 | Complement, total (CH50) | |
| 86171 | $14.35 | Complement fixation, each | |
| 86185 | $12.81 | Counterimmunoelectrophoresis | |
| 86200 | $18.54 | Ccp antibody | |
| 86215 | $18.98 | Deoxyribonuclease, antibody | |
| 86225 | $19.68 | DNA antibody | |
| 86226 | $17.35 | DNA antibody, single strand | |
| 86235 | $25.69 | Nuclear antigen antibody | |
| 86243 | $29.39 | Fc receptor | |
| 86255 | $17.26 | Fluorescent antibody, screen | |
| 86256 | $17.26 | Fluorescent antibody, titer | |
| 86277 | $22.54 | Growth hormone antibody | |
| 86280 | $11.73 | Hemagglutination inhibition | |
| 86294 | $28.10 | Immunoassay, tumor, qual | |
| 86294 | QW | $28.10 | Immunoassay, tumor, qual |
| 86300 | $29.21 | Immunoassay, tumor, ca 15-3 | |
| 86301 | $29.21 | Immunoassay, tumor, ca 19-9 | |
| 86304 | $29.21 | Immunoassay, tumor, ca 125 | |
| 86305 | $29.21 | Human epididymis protein 4 | |
| 86308 | $7.41 | Heterophile antibodies | |
| 86308 | QW | $7.41 | Heterophile antibodies |
| 86309 | $9.27 | Heterophile antibodies | |
| 86310 | $10.56 | Heterophile antibodies | |
| 86316 | $29.21 | Immunoassay, tumor other | |
| 86317 | $21.47 | Immunoassay,infectious agent | |
| 86318 | $18.54 | Immunoassay,infectious agent | |
| 86318 | QW | $18.54 | Immunoassay,infectious agent |
| 86320 | $32.10 | Serum immunoelectrophoresis | |
| 86325 | $32.03 | Other immunoelectrophoresis | |
| 86327 | $32.50 | Immunoelectrophoresis assay | |
| 86329 | $20.11 | Immunodiffusion | |
| 86331 | $17.17 | Immunodiffusion ouchterlony | |
| 86332 | $34.91 | Immune complex assay | |
| 86334 | $32.00 | Immunofix e-phoresis, serum | |
| 86335 | $42.04 | Immunfix e-phorsis/urine/csf | |
| 86336 | $22.32 | Inhibin A | |
| 86337 | $30.67 | Insulin antibodies | |
| 86340 | $21.59 | Intrinsic factor antibody | |
| 86341 | $28.34 | Islet cell antibody | |
| 86343 | $17.85 | Leukocyte histamine release | |
| 86344 | $11.44 | Leukocyte phagocytosis | |
| 86352 | $97.30 | Cell function assay w/stim | |
| 86353 | $70.22 | Lymphocyte transformation | |
| 86355 | $54.03 | B cells, total count | |
| 86356 | $6.00 | Mononuclear cell antigen | |
| 86357 | $54.03 | Nk cells, total count | |
| 86359 | $54.03 | T cells, total count | |
| 86360 | $10.02 | T cell, absolute count/ratio | |
| 86361 | $6.00 | T cell, absolute count | |
| 86367 | $54.03 | Stem cells, total count | |
| 86376 | $20.84 | Microsomal antibody | |
| 86378 | $28.20 | Migration inhibitory factor | |
| 86382 | $24.22 | Neutralization test, viral | |
| 86384 | $16.31 | Nitroblue tetrazolium dye | |
| 86403 | $14.60 | Particle agglutination test | |
| 86406 | $15.24 | Particle agglutination test | |
| 86430 | $8.13 | Rheumatoid factor test | |
| 86431 | $8.13 | Rheumatoid factor, quant | |
| 86480 | $88.77 | Tb test, cell immun measure | |
| 86590 | $12.53 | Streptokinase, antibody | |
| 86592 | $6.11 | Syphilis test non-trep qual | |
| 86593 | $6.30 | Syphilis test non-trep quant | |
| 86602 | $8.31 | Antinomyces antibody | |
| 86603 | $18.43 | Adenovirus antibody | |
| 86606 | $21.56 | Aspergillus antibody | |
| 86609 | $18.46 | Bacterium antibody | |
| 86611 | $8.31 | Bartonella antibody | |
| 86612 | $18.49 | Blastomyces antibody | |
| 86615 | $18.89 | Bordetella antibody | |
| 86617 | $22.19 | Lyme disease antibody | |
| 86618 | $21.58 | Lyme disease antibody | |
| 86618 | QW | $21.58 | Lyme disease antibody |
| 86619 | $19.17 | Borrelia antibody | |
| 86622 | $12.79 | Brucella antibody | |
| 86625 | $18.80 | Campylobacter antibody | |
| 86628 | $11.60 | Candida antibody | |
| 86631 | $16.94 | Chlamydia antibody | |
| 86632 | $18.18 | Chlamydia igm antibody | |
| 86635 | $16.43 | Coccidioides antibody | |
| 86638 | $17.37 | Q fever antibody | |
| 86641 | $16.26 | Cryptococcus antibody | |
| 86644 | $20.62 | CMV antibody | |
| 86645 | $24.12 | CMV antibody, IgM | |
| 86648 | $21.79 | Diphtheria antibody | |
| 86651 | $18.89 | Encephalitis antibody | |
| 86652 | $18.89 | Encephalitis antibody | |
| 86653 | $18.89 | Encephalitis antibody | |
| 86654 | $18.89 | Encephalitis antibody | |
| 86658 | $18.66 | Enterovirus antibody | |
| 86663 | $18.80 | Epstein-barr antibody | |
| 86664 | $21.91 | Epstein-barr antibody | |
| 86665 | $25.98 | Epstein-barr antibody | |
| 86666 | $8.31 | Ehrlichia antibody | |
| 86668 | $14.90 | Francisella tularensis | |
| 86671 | $17.56 | Fungus antibody | |
| 86674 | $20.13 | Giardia lamblia antibody | |
| 86677 | $20.79 | Helicobacter pylori | |
| 86682 | $18.63 | Helminth antibody | |
| 86684 | $22.70 | Hemophilus influenza | |
| 86687 | $12.02 | Htlv-i antibody | |
| 86688 | $20.07 | Htlv-ii antibody | |
| 86689 | $27.72 | HTLV/HIV confirmatory test | |
| 86692 | $24.58 | Hepatitis, delta agent | |
| 86694 | $20.62 | Herpes simplex test | |
| 86695 | $18.89 | Herpes simplex test | |
| 86696 | $27.72 | Herpes simplex type 2 | |
| 86698 | $17.91 | Histoplasma | |
| 86701 | $12.72 | HIV-1 | |
| 86701 | QW | $12.72 | HIV-1 |
| 86702 | $19.37 | HIV-2 | |
| 86703 | $19.65 | HIV-1/HIV-2, single assay | |
| 86703 | QW | $19.65 | HIV-1/HIV-2, single assay |
| 86704 | $17.26 | Hep b core antibody, total | |
| 86705 | $16.86 | Hep b core antibody, igm | |
| 86706 | $15.38 | Hep b surface antibody | |
| 86707 | $16.57 | Hep be antibody | |
| 86708 | $17.75 | Hep a antibody, total | |
| 86709 | $16.12 | Hep a antibody, igm | |
| 86710 | $19.42 | Influenza virus antibody | |
| 86713 | $21.92 | Legionella antibody | |
| 86717 | $17.55 | Leishmania antibody | |
| 86720 | $18.89 | Leptospira antibody | |
| 86723 | $18.89 | Listeria monocytogenes ab | |
| 86727 | $18.43 | Lymph choriomeningitis ab | |
| 86729 | $17.12 | Lympho venereum antibody | |
| 86732 | $18.89 | Mucormycosis antibody | |
| 86735 | $18.69 | Mumps antibody | |
| 86738 | $18.97 | Mycoplasma antibody | |
| 86741 | $18.89 | Neisseria meningitidis | |
| 86744 | $18.89 | Nocardia antibody | |
| 86747 | $21.53 | Parvovirus antibody | |
| 86750 | $13.33 | Malaria antibody | |
| 86753 | $17.75 | Protozoa antibody nos | |
| 86756 | $18.46 | Respiratory virus antibody | |
| 86757 | $27.72 | Rickettsia antibody | |
| 86759 | $18.89 | Rotavirus antibody | |
| 86762 | $20.62 | Rubella antibody | |
| 86765 | $18.46 | Rubeola antibody | |
| 86768 | $16.67 | Salmonella antibody | |
| 86771 | $18.79 | Shigella antibody | |
| 86774 | $21.19 | Tetanus antibody | |
| 86777 | $20.62 | Toxoplasma antibody | |
| 86778 | $20.63 | Toxoplasma antibody, igm | |
| 86780 | $18.97 | Treponema pallidum | |
| 86784 | $11.60 | Trichinella antibody | |
| 86787 | $18.46 | Varicella-zoster antibody | |
| 86788 | $24.12 | West nile virus ab, igm | |
| 86789 | $20.62 | West nile virus antibody | |
| 86790 | $18.46 | Virus antibody nos | |
| 86793 | $18.79 | Yersinia antibody | |
| 86800 | $22.78 | Thyroglobulin antibody | |
| 86803 | $20.44 | Hepatitis c ab test | |
| 86804 | $22.19 | Hep c ab test, confirm | |
| 86805 | $74.89 | Lymphocytotoxicity assay | |
| 86806 | $68.16 | Lymphocytotoxicity assay | |
| 86807 | $56.68 | Cytotoxic antibody screening | |
| 86808 | $42.51 | Cytotoxic antibody screening | |
| 86812 | $36.96 | HLA typing, A, B, or C | |
| 86813 | $83.06 | HLA typing, A, B, or C | |
| 86816 | $39.90 | HLA typing, DR/DQ | |
| 86817 | $92.22 | HLA typing, DR/DQ | |
| 86821 | $80.87 | Lymphocyte culture, mixed | |
| 86822 | $52.36 | Lymphocyte culture, primed | |
| 86825 | $18.00 | Hla x-match, non-cytotoxic | |
| 86826 | $6.00 | Hla x-match, non-cyt add-on | |
| 86880 | $7.70 | Coombs test, direct | |
| 86885 | $8.20 | Coombs test, indirect, qual | |
| 86886 | $7.41 | Coombs test, indirect, titer | |
| 86900 | $4.27 | Blood typing, ABO | |
| 86901 | $4.27 | Blood typing, Rh (D) | |
| 86903 | $8.67 | Blood typing, antigen screen | |
| 86904 | $13.62 | Blood typing, patient serum | |
| 86905 | $5.48 | Blood typing, RBC antigens | |
| 86906 | $11.10 | Blood typing, Rh phenotype | |
| 86940 | $11.74 | Hemolysins/agglutinins, auto | |
| 86941 | $13.61 | Hemolysins/agglutinins | |
| 87001 | $18.93 | Small animal inoculation | |
| 87003 | $24.11 | Small animal inoculation | |
| 87015 | $9.57 | Specimen concentration | |
| 87040 | $14.79 | Blood culture for bacteria | |
| 87045 | $13.51 | Feces culture, bacteria | |
| 87046 | $13.51 | Stool cultr, bacteria, each | |
| 87070 | $12.34 | Culture, bacteria, other | |
| 87071 | $13.51 | Culture bacteri aerobic othr | |
| 87073 | $13.51 | Culture bacteria anaerobic | |
| 87075 | $13.55 | Cultr bacteria, except blood | |
| 87076 | $11.57 | Culture anaerobe ident, each | |
| 87077 | $11.57 | Culture aerobic identify | |
| 87077 | QW | $11.57 | Culture aerobic identify |
| 87081 | $9.50 | Culture screen only | |
| 87084 | $12.34 | Culture of specimen by kit | |
| 87086 | $11.57 | Urine culture/colony count | |
| 87088 | $11.60 | Urine bacteria culture | |
| 87101 | $11.05 | Skin fungi culture | |
| 87102 | $12.03 | Fungus isolation culture | |
| 87103 | $12.92 | Blood fungus culture | |
| 87106 | $14.79 | Fungi identification, yeast | |
| 87107 | $14.79 | Fungi identification, mold | |
| 87109 | $22.04 | Mycoplasma | |
| 87110 | $24.33 | Chlamydia culture | |
| 87116 | $15.48 | Mycobacteria culture | |
| 87118 | $15.67 | Mycobacteric identification | |
| 87140 | $7.98 | Culture type immunofluoresc | |
| 87143 | $17.95 | Culture typing, glc/hplc | |
| 87147 | $7.41 | Culture type, immunologic | |
| 87149 | $18.24 | Dna/rna direct probe | |
| 87150 | $42.69 | Dna/rna, amplified probe | |
| 87152 | $7.49 | Culture type pulse field gel | |
| 87153 | $165.22 | Dna/rna sequencing | |
| 87158 | $7.49 | Culture typing, added method | |
| 87164 | $15.38 | Dark field examination | |
| 87166 | $16.18 | Dark field examination | |
| 87168 | $6.11 | Macroscopic exam arthropod | |
| 87169 | $6.11 | Macroscopic exam parasite | |
| 87172 | $6.11 | Pinworm exam | |
| 87176 | $8.43 | Tissue homogenization, cultr | |
| 87177 | $12.74 | Ova and parasites smears | |
| 87181 | $1.20 | Microbe susceptible, diffuse | |
| 87184 | $9.88 | Microbe susceptible, disk | |
| 87185 | $1.20 | Microbe susceptible, enzyme | |
| 87186 | $12.38 | Microbe susceptible, mic | |
| 87187 | $14.84 | Microbe susceptible, mlc | |
| 87188 | $8.33 | Microbe suscept, macrobroth | |
| 87190 | $8.10 | Microbe suscept, mycobacteri | |
| 87197 | $21.52 | Bactericidal level, serum | |
| 87205 | $6.11 | Smear, gram stain | |
| 87206 | $7.70 | Smear, fluorescent/acid stai | |
| 87207 | $8.58 | Smear, special stain | |
| 87209 | $25.74 | Smear, complex stain | |
| 87210 | $6.11 | Smear, wet mount, saline/ink | |
| 87210 | QW | $6.11 | Smear, wet mount, saline/ink |
| 87220 | $6.11 | Tissue exam for fungi | |
| 87230 | $28.28 | Assay, toxin or antitoxin | |
| 87250 | $28.01 | Virus inoculate, eggs/animal | |
| 87252 | $37.33 | Virus inoculation, tissue | |
| 87253 | $28.93 | Virus inoculate tissue, addl | |
| 87254 | $28.01 | Virus inoculation, shell via | |
| 87255 | $48.50 | Genet virus isolate, hsv | |
| 87260 | $17.18 | Adenovirus ag, if | |
| 87265 | $17.18 | Pertussis ag, if | |
| 87267 | $17.18 | Enterovirus antibody, dfa | |
| 87269 | $17.18 | Giardia ag, if | |
| 87270 | $17.18 | Chlamydia trachomatis ag, if | |
| 87271 | $17.18 | Cytomegalovirus dfa | |
| 87272 | $17.18 | Cryptosporidium ag, if | |
| 87273 | $17.18 | Herpes simplex 2, ag, if | |
| 87274 | $17.18 | Herpes simplex 1, ag, if | |
| 87275 | $17.18 | Influenza b, ag, if | |
| 87276 | $17.18 | Influenza a, ag, if | |
| 87277 | $17.18 | Legionella micdadei, ag, if | |
| 87278 | $17.18 | Legion pneumophilia ag, if | |
| 87279 | $17.18 | Parainfluenza, ag, if | |
| 87280 | $17.18 | Respiratory syncytial ag, if | |
| 87281 | $17.18 | Pneumocystis carinii, ag, if | |
| 87283 | $17.18 | Rubeola, ag, if | |
| 87285 | $17.18 | Treponema pallidum, ag, if | |
| 87290 | $17.18 | Varicella zoster, ag, if | |
| 87299 | $17.18 | Antibody detection, nos, if | |
| 87300 | $17.18 | Ag detection, polyval, if | |
| 87301 | $17.18 | Adenovirus ag, eia | |
| 87305 | $17.18 | Aspergillus ag, eia | |
| 87320 | $17.18 | Chylmd trach ag, eia | |
| 87324 | $17.18 | Clostridium ag, eia | |
| 87327 | $17.18 | Cryptococcus neoform ag, eia | |
| 87328 | $17.18 | Cryptosporidium ag, eia | |
| 87329 | $17.18 | Giardia ag, eia | |
| 87332 | $17.18 | Cytomegalovirus ag, eia | |
| 87335 | $17.18 | E coli 0157 ag, eia | |
| 87336 | $17.18 | Entamoeb hist dispr, ag, eia | |
| 87337 | $17.18 | Entamoeb hist group, ag, eia | |
| 87338 | $17.62 | Hpylori, stool, eia | |
| 87339 | $17.18 | H pylori ag, eia | |
| 87340 | $14.79 | Hepatitis b surface ag, eia | |
| 87341 | $14.79 | Hepatitis b surface, ag, eia | |
| 87350 | $16.51 | Hepatitis be ag, eia | |
| 87380 | $23.52 | Hepatitis delta ag, eia | |
| 87385 | $17.18 | Histoplasma capsul ag, eia | |
| 87390 | $16.00 | Hiv-1 ag, eia | |
| 87391 | $16.00 | Hiv-2 ag, eia | |
| 87400 | $17.18 | Influenza a/b, ag, eia | |
| 87420 | $17.18 | Resp syncytial ag, eia | |
| 87425 | $17.18 | Rotavirus ag, eia | |
| 87427 | $17.18 | Shiga-like toxin ag, eia | |
| 87430 | $17.18 | Strep a ag, eia | |
| 87449 | $17.18 | Ag detect nos, eia, mult | |
| 87449 | QW | $17.18 | Ag detect nos, eia, mult |
| 87450 | $13.73 | Ag detect nos, eia, single | |
| 87451 | $13.73 | Ag detect polyval, eia, mult | |
| 87470 | $18.24 | Bartonella, dna, dir probe | |
| 87471 | $42.69 | Bartonella, dna, amp probe | |
| 87472 | $61.35 | Bartonella, dna, quant | |
| 87475 | $18.24 | Lyme dis, dna, dir probe | |
| 87476 | $42.69 | Lyme dis, dna, amp probe | |
| 87477 | $61.35 | Lyme dis, dna, quant | |
| 87480 | $18.24 | Candida, dna, dir probe | |
| 87481 | $42.69 | Candida, dna, amp probe | |
| 87482 | $59.79 | Candida, dna, quant | |
| 87485 | $18.24 | Chylmd pneum, dna, dir probe | |
| 87486 | $42.69 | Chylmd pneum, dna, amp probe | |
| 87487 | $61.35 | Chylmd pneum, dna, quant | |
| 87490 | $18.24 | Chylmd trach, dna, dir probe | |
| 87491 | $42.69 | Chylmd trach, dna, amp probe | |
| 87492 | $50.07 | Chylmd trach, dna, quant | |
| 87493 | $42.69 | C diff amplified probe | |
| 87495 | $18.24 | Cytomeg, dna, dir probe | |
| 87496 | $42.69 | Cytomeg, dna, amp probe | |
| 87497 | $61.35 | Cytomeg, dna, quant | |
| 87498 | $42.69 | Enterovirus, dna, amp probe | |
| 87500 | $42.69 | Vanomycin, dna, amp probe | |
| 87510 | $18.24 | Gardner vag, dna, dir probe | |
| 87511 | $42.69 | Gardner vag, dna, amp probe | |
| 87512 | $59.79 | Gardner vag, dna, quant | |
| 87515 | $18.24 | Hepatitis b, dna, dir probe | |
| 87516 | $42.69 | Hepatitis b, dna, amp probe | |
| 87517 | $61.35 | Hepatitis b, dna, quant | |
| 87520 | $18.24 | Hepatitis c, rna, dir probe | |
| 87521 | $42.69 | Hepatitis c, rna, amp probe | |
| 87522 | $61.35 | Hepatitis c, rna, quant | |
| 87525 | $18.24 | Hepatitis g, dna, dir probe | |
| 87526 | $42.69 | Hepatitis g, dna, amp probe | |
| 87527 | $59.79 | Hepatitis g, dna, quant | |
| 87528 | $18.24 | Hsv, dna, dir probe | |
| 87529 | $42.69 | Hsv, dna, amp probe | |
| 87530 | $61.35 | Hsv, dna, quant | |
| 87531 | $18.24 | Hhv-6, dna, dir probe | |
| 87532 | $42.69 | Hhv-6, dna, amp probe | |
| 87533 | $59.79 | Hhv-6, dna, quant | |
| 87534 | $18.24 | Hiv-1, dna, dir probe | |
| 87535 | $42.69 | Hiv-1, dna, amp probe | |
| 87536 | $100.94 | Hiv-1, dna, quant | |
| 87537 | $18.24 | Hiv-2, dna, dir probe | |
| 87538 | $42.69 | Hiv-2, dna, amp probe | |
| 87539 | $61.35 | Hiv-2, dna, quant | |
| 87540 | $18.24 | Legion pneumo, dna, dir prob | |
| 87541 | $42.69 | Legion pneumo, dna, amp prob | |
| 87542 | $59.79 | Legion pneumo, dna, quant | |
| 87550 | $18.24 | Mycobacteria, dna, dir probe | |
| 87551 | $42.69 | Mycobacteria, dna, amp probe | |
| 87552 | $61.35 | Mycobacteria, dna, quant | |
| 87555 | $18.24 | M.tuberculo, dna, dir probe | |
| 87556 | $42.69 | M.tuberculo, dna, amp probe | |
| 87557 | $61.35 | M.tuberculo, dna, quant | |
| 87560 | $18.24 | M.avium-intra, dna, dir prob | |
| 87561 | $42.69 | M.avium-intra, dna, amp prob | |
| 87562 | $61.35 | M.avium-intra, dna, quant | |
| 87580 | $18.24 | M.pneumon, dna, dir probe | |
| 87581 | $42.69 | M.pneumon, dna, amp probe | |
| 87582 | $59.79 | M.pneumon, dna, quant | |
| 87590 | $18.24 | N.gonorrhoeae, dna, dir prob | |
| 87591 | $42.69 | N.gonorrhoeae, dna, amp prob | |
| 87592 | $61.35 | N.gonorrhoeae, dna, quant | |
| 87620 | $18.24 | Hpv, dna, dir probe | |
| 87621 | $42.69 | Hpv, dna, amp probe | |
| 87622 | $59.79 | Hpv, dna, quant | |
| 87640 | $42.69 | Staph a, dna, amp probe | |
| 87641 | $42.69 | Mr-staph, dna, amp probe | |
| 87650 | $18.24 | Strep a, dna, dir probe | |
| 87651 | $42.69 | Strep a, dna, amp probe | |
| 87652 | $59.79 | Strep a, dna, quant | |
| 87653 | $42.69 | Strep b, dna, amp probe | |
| 87660 | $18.24 | Trichomonas vagin, dir probe | |
| 87797 | $18.24 | Detect agent nos, dna, dir | |
| 87798 | $42.69 | Detect agent nos, dna, amp | |
| 87799 | $61.35 | Detect agent nos, dna, quant | |
| 87800 | $36.47 | Detect agnt mult, dna, direc | |
| 87801 | $85.40 | Detect agnt mult, dna, ampli | |
| 87802 | $17.18 | Strep b assay w/optic | |
| 87803 | $17.18 | Clostridium toxin a w/optic | |
| 87804 | $17.18 | Influenza assay w/optic | |
| 87804 | QW | $17.18 | Influenza assay w/optic |
| 87807 | $17.18 | Rsv assay w/optic | |
| 87807 | QW | $17.18 | Rsv assay w/optic |
| 87808 | $17.18 | Trichomonas assay w/optic | |
| 87808 | QW | $17.18 | Trichomonas assay w/optic |
| 87809 | $17.18 | Adenovirus assay w/optic | |
| 87810 | $17.18 | Chylmd trach assay w/optic | |
| 87850 | $17.18 | N. gonorrhoeae assay w/optic | |
| 87880 | $17.18 | Strep a assay w/optic | |
| 87880 | QW | $17.18 | Strep a assay w/optic |
| 87899 | $17.18 | Agent nos assay w/optic | |
| 87899 | QW | $17.18 | Agent nos assay w/optic |
| 87900 | $186.69 | Phenotype, infect agent drug | |
| 87901 | $368.73 | Genotype, dna, hiv reverse t | |
| 87902 | $368.73 | Genotype, dna, hepatitis C | |
| 87903 | $699.88 | Phenotype, dna hiv w/culture | |
| 87904 | $37.33 | Phenotype, dna hiv w/clt add | |
| 87905 | $13.52 | Sialidase enzyme assay | |
| 87905 | QW | $13.52 | Sialidase enzyme assay |
| 88130 | $21.56 | Sex chromatin identification | |
| 88140 | $11.45 | Sex chromatin identification | |
| 88142 | $28.92 | Cytopath, c/v, thin layer | |
| 88143 | $28.92 | Cytopath c/v thin layer redo | |
| 88147 | $15.13 | Cytopath, c/v, automated | |
| 88148 | $15.13 | Cytopath, c/v, auto rescreen | |
| 88150 | $15.13 | Cytopath, c/v, manual | |
| 88152 | $15.13 | Cytopath, c/v, auto redo | |
| 88153 | $15.13 | Cytopath, c/v, redo | |
| 88154 | $15.13 | Cytopath, c/v, select | |
| 88155 | $8.58 | Cytopath, c/v, index add-on | |
| 88164 | $15.13 | Cytopath tbs, c/v, manual | |
| 88165 | $15.13 | Cytopath tbs, c/v, redo | |
| 88166 | $15.13 | Cytopath tbs, c/v, auto redo | |
| 88167 | $15.13 | Cytopath tbs, c/v, select | |
| 88174 | $30.13 | Cytopath, c/v auto, in fluid | |
| 88175 | $35.57 | Cytopath c/v auto fluid redo | |
| 88230 | $166.86 | Tissue culture, lymphocyte | |
| 88233 | $201.57 | Tissue culture, skin/biopsy | |
| 88235 | $210.91 | Tissue culture, placenta | |
| 88237 | $180.91 | Tissue culture, bone marrow | |
| 88239 | $211.30 | Tissue culture, tumor | |
| 88240 | $14.47 | Cell cryopreserve/storage | |
| 88241 | $14.47 | Frozen cell preparation | |
| 88245 | $195.01 | Chromosome analysis, 20-25 | |
| 88248 | $248.04 | Chromosome analysis, 50-100 | |
| 88249 | $248.04 | Chromosome analysis, 100 | |
| 88261 | $253.14 | Chromosome analysis, 5 | |
| 88262 | $178.53 | Chromosome analysis, 15-20 | |
| 88263 | $195.01 | Chromosome analysis, 45 | |
| 88264 | $178.53 | Chromosome analysis, 20-25 | |
| 88267 | $257.48 | Chromosome analys, placenta | |
| 88269 | $195.01 | Chromosome analys, amniotic | |
| 88271 | $20.73 | Cytogenetics, dna probe | |
| 88272 | $36.28 | Cytogenetics, 3-5 | |
| 88273 | $46.02 | Cytogenetics, 10-30 | |
| 88274 | $49.86 | Cytogenetics, 25-99 | |
| 88275 | $57.52 | Cytogenetics, 100-300 | |
| 88280 | $35.95 | Chromosome karyotype study | |
| 88283 | $98.25 | Chromosome banding study | |
| 88285 | $27.21 | Chromosome count, additional | |
| 88289 | $41.58 | Chromosome study, additional | |
| 88371 | $31.83 | Protein, western blot tissue | |
| 88372 | $32.58 | Protein analysis w/probe | |
| 88720 | $7.19 | Bilirubin total transcut | |
| 88738 | $7.19 | Hgb quant transcutaneous | |
| 88740 | $7.19 | Transcutaneous carboxyhb | |
| 88741 | $7.19 | Transcutaneous methb | |
| 89050 | $6.77 | Body fluid cell count | |
| 89051 | $7.89 | Body fluid cell count | |
| 89055 | $6.11 | Leukocyte assessment, fecal | |
| 89060 | $10.24 | Exam,synovial fluid crystals | |
| 89125 | $6.19 | Specimen fat stain | |
| 89160 | $5.28 | Exam feces for meat fibers | |
| 89190 | $6.80 | Nasal smear for eosinophils | |
| 89225 | $4.78 | Starch granules, feces | |
| 89235 | $7.88 | Water load test | |
| 89300 | $12.77 | Semen analysis w/huhner | |
| 89300 | QW | $12.77 | Semen analysis w/huhner |
| 89310 | $12.33 | Semen analysis w/count | |
| 89320 | $17.26 | Semen anal vol/count/mot | |
| 89321 | $17.26 | Semen anal, sperm detection | |
| 89321 | QW | $17.26 | Semen anal, sperm detection |
| 89322 | $22.20 | Semen anal, strict criteria | |
| 89325 | $15.29 | Sperm antibody test | |
| 89329 | $30.03 | Sperm evaluation test | |
| 89330 | $14.18 | Evaluation, cervical mucus | |
| 89331 | $28.06 | Retrograde ejaculation anal | |
| ATP02 | $7.46 | Auto.Test Pane Pricing Code, 1-2 Tests | |
| ATP03 | $9.52 | Auto.Test Pane Pricing Code, 3 Tests | |
| ATP04 | $10.05 | Auto.Test Pane Pricing Code, 4 Tests | |
| ATP05 | $11.20 | Auto.Test Pane Pricing Code, 5 Tests | |
| ATP06 | $11.24 | Auto.Test Pane Pricing Code, 6 Tests | |
| ATP07 | $11.70 | Auto.Test Pane Pricing Code, 7 Tests | |
| ATP08 | $12.12 | Auto.Test Pane Pricing Code, 8 Tests | |
| ATP09 | $12.43 | Auto.Test Pane Pricing Code, 9 Tests | |
| ATP10 | $12.43 | Auto.Test Pane Pricing Code, 10 Tests | |
| ATP11 | $12.65 | Auto.Test Pane Pricing Code, 11 Tests | |
| ATP12 | $12.94 | Auto.Test Pane Pricing Code, 12 Tests | |
| ATP16 | $15.14 | Auto Test Panel Pricing Code 13-16 Test | |
| ATP18 | $15.24 | Auto Test Panel Pricing Code, 17-18 Test | |
| ATP19 | $15.84 | Auto Test Panel Pricing Code, 19 Tests | |
| ATP20 | $16.35 | Auto Test Panel Pricing Code, 20 Tests | |
| ATP21 | $16.86 | Auto Test Panel Pricing Code, 21 Tests | |
| ATP22 | $17.38 | Auto.Test Panel Pricing Code, 22+ Tests | |
| ATP23 | $17.38 | ||
| G0027 | $9.32 | Semen analysis | |
| G0103 | $26.34 | PSA screening | |
| G0123 | $28.92 | Screen cerv/vag thin layer | |
| G0143 | $28.92 | Scr c/v cyto,thinlayer,rescr | |
| G0144 | $30.13 | Scr c/v cyto,thinlayer,rescr | |
| G0145 | $35.57 | Scr c/v cyto,thinlayer,rescr | |
| G0147 | $15.13 | Scr c/v cyto, automated sys | |
| G0148 | $15.13 | Scr c/v cyto, autosys, rescr | |
| G0306 | $11.14 | CBC/diffwbc w/o platelet | |
| G0307 | $9.27 | CBC without platelet | |
| G0328 | $22.78 | Fecal blood scrn immunoassay | |
| G0328 | QW | $22.78 | Fecal blood scrn immunoassay |
| G0430 | $20.83 | Drug screen multi class | |
| G0431 | $19.72 | Drug screen single class | |
| P2038 | $7.20 | Blood mucoprotein | |
| P3000 | $15.13 | Screen pap by tech w md supv | |
| P9612 | $3.00 | Catheterize for urine spec | |
| P9615 | $3.00 | Urine specimen collect mult | |
| Q0111 | $6.11 | Wet mounts/ w preparations | |
| Q0112 | $6.11 | Potassium hydroxide preps | |
| Q0113 | $7.75 | Pinworm examinations | |
| Q0114 | $10.24 | Fern test | |
| Q0115 | $14.18 | Post-coital mucous exam | |
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Covenant Health Care LLC. All Rights Reserved
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