2019 clinical diagnostic laboratory fee schedule80305 $25.20 drug test prsmv dir opt obs 80305...

2019 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2019 American Medical Association.

All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).

HCPCS RATE2019 SHORTDESC

0001U $1,440.00 Rbn dna hea 35 ag 11 bld grp

0002M $1,006.80 Liver dis 10 assays w/ash

0002U $50.00 Onc clrct 3 ur metab alg plp

0003M $1,006.80 Liver dis 10 assays w/nash

0003U $1,900.00 Onc ovar 5 prtn ser alg scor

0004M $158.00 Scoliosis dna alys

0005U $1,520.00 Onco prst8 3 gene ur alg

0006M $300.00 Onc hep gene risk classifier

0006U $493.84 Detc ia meds 120+ analytes

0007M $750.00 Onc gastro 51 gene nomogram

0007U $228.86 Rx test prsmv ur w/def conf

0008U $1,195.82 Hpylori detcj abx rstnc dna

0009M $265.72 Fetal aneuploidy trisom risk

0009U $214.00 Onc brst ca erbb2 amp/nonamp

0010U $854.52 Nfct ds strn typ whl gen seq

0011M $1,520.00 Onc prst8 ca mrna 12 gen alg

0011U $228.86 Rx mntr lc-ms/ms oral fluid

0012M $1,520.00 Onc mrna 5 gen rsk urthl ca

0012U $5,031.20 Germln do gene reargmt detcj

0013M $1,520.00 Onc mrna 5 gen recr urthl ca

0013U $5,031.20 Onc sld org neo gene reargmt

0014U $5,031.20 Hem hmtlmf neo gene reargmt

0016U $364.36 Onc hmtlmf neo rna bcr/abl1

0017U $203.70 Onc hmtlmf neo jak2 mut dna

0018U $0.00 Onc thyr 10 microrna seq alg

0019U $0.00 Onc rna tiss predict alg

0021U $0.00 Onc prst8 detcj 8 autoantb

0022U $0.00 Trgt gen seq dna&rna 23 gene

0023U $0.00 Onc aml dna detcj/nondetcj

0024U $70.12 Glyca nuc mr spectrsc quan

0025U $190.60 Tenofovir liq chrom ur quan

0026U $7,200.00 Onc thyr dna&mrna 112 genes

0027U $301.04 Jak2 gene trgt seq alys

0029U $0.00 Rx metab advrs trgt seq alys

0030U $0.00 Rx metab warf trgt seq alys

0031U $349.62 Cyp1a2 gene

0032U $349.62 Comt gene

0033U $699.24 Htr2a htr2c genes

0034U $932.34 Tpmt nudt15 genes

0035U $0.00 Neuro csf prion prtn qual

0036U $9,560.00 Xome tum & nml spec seq alys


0037U $7,000.00 Trgt gen seq dna 324 genes

0038U $65.78 Vitamin d srm microsamp quan

0039U $30.54 Dna antb 2strand hi avidity

0040U $910.90 Bcr/abl1 gene major bp quan

0041U $0.00 B brgdrferi antb 5 prtn igm

0042U $0.00 B brgdrferi antb 12 prtn igg

0043U $0.00 Tbrf b grp antb 4 prtn igm

0044U $0.00 Tbrf b grp antb 4 prtn igg

0045U $7,746.00 Onc brst dux carc is 12 gene

0046U $331.02 Flt3 gene itd variants quan

0047U $7,746.00 Onc prst8 mrna 17 gene alg

0048U $0.00 Onc sld org neo dna 468 gene

0049U $493.04 Npm1 gene analysis quan

0050U $0.00 Trgt gen seq dna 194 genes

0051U $411.26 Rx mntr lc-ms/ms ur 31 pnl

0052U $67.72 Lpoprtn bld w/5 maj classes

0053U $0.00 Onc prst8 ca fish alys 4 gen

0054U $331.04 Rx mntr 14+ drugs & sbsts

0055U $0.00 Card hrt trnspl 96 dna seq

0056U $0.00 Hem aml dna gene reargmt

0057U $0.00 Onc sld org neo mrna 51 gene

0058U $717.70 Onc merkel cll carc srm quan

0059U $717.70 Onc merkel cll carc srm +/-

0060U $1,518.10 Twn zyg gen seq alys chrms2

0061U $55.70 Tc meas 5 bmrk sfdi m-s alys

36415 $6.00 Routine venipuncture

78267 $22.12 Breath tst attain/anal c-14

78268 $188.82 Breath test analysis c-14

80047 $27.46 Metabolic panel ionized ca

80047 $27.46 Metabolic panel ionized ca

80048 $18.80 Metabolic panel total ca

80048 $18.80 Metabolic panel total ca

80051 $15.58 Electrolyte panel

80051 $15.58 Electrolyte panel

80053 $23.48 Comprehen metabolic panel

80053 $23.48 Comprehen metabolic panel

80055 $106.24 Obstetric panel

80061 $29.76 Lipid panel

80061 $29.76 Lipid panel

80069 $19.30 Renal function panel

80069 $19.30 Renal function panel

80074 $105.86 Acute hepatitis panel

80076 $18.16 Hepatic function panel

80081 $166.36 Obstetric panel

80150 $33.50 Assay of amikacin

80155 $77.14 Drug assay caffeine


80156 $32.36 Assay carbamazepine total

80157 $29.46 Assay carbamazepine free

80158 $40.12 Drug assay cyclosporine

80159 $41.10 Drug assay clozapine

80162 $29.50 Assay of digoxin total

80163 $29.50 Assay of digoxin free

80164 $30.10 Assay dipropylacetic acd tot

80165 $30.10 Dipropylacetic acid free

80168 $36.30 Assay of ethosuximide

80169 $30.52 Drug assay everolimus

80170 $36.40 Assay of gentamicin

80171 $43.34 Drug screen quant gabapentin

80173 $32.36 Assay of haloperidol

80175 $29.46 Drug screen quan lamotrigine

80176 $32.64 Assay of lidocaine

80177 $29.46 Drug scrn quan levetiracetam

80178 $14.70 Assay of lithium

80178 $14.70 Assay of lithium

80180 $40.12 Drug scrn quan mycophenolate

80183 $29.46 Drug scrn quant oxcarbazepin

80184 $30.60 Assay of phenobarbital

80185 $29.46 Assay of phenytoin total

80186 $30.58 Assay of phenytoin free

80188 $36.88 Assay of primidone

80190 $120.00 Assay of procainamide

80192 $37.22 Assay of procainamide

80194 $32.44 Assay of quinidine

80195 $30.52 Assay of sirolimus

80197 $30.52 Assay of tacrolimus

80198 $31.42 Assay of theophylline

80199 $54.22 Drug screen quant tiagabine

80200 $35.84 Assay of tobramycin

80201 $26.48 Assay of topiramate

80202 $30.10 Assay of vancomycin

80203 $29.46 Drug screen quant zonisamide

80299 $37.28 Quantitative assay drug

80305 $25.20 Drug test prsmv dir opt obs

80305 $25.20 Drug test prsmv dir opt obs

80306 $34.28 Drug test prsmv instrmnt

80307 $129.30 Drug test prsmv chem anlyzr

80400 $72.48 Acth stimulation panel



80408 $278.88 Aldosterone suppression eval

80410 $178.62 Calcitonin stimul panel

80412 $1,603.24 Crh stimulation panel


80414 $114.74 Testosterone response

80415 $124.18 Estradiol response panel

80416 $418.64 Renin stimulation panel

80417 $97.76 Renin stimulation panel

80418 $1,287.68 Pituitary evaluation panel

80420 $323.76 Dexamethasone panel

80422 $102.38 Glucagon tolerance panel

80424 $112.22 Glucagon tolerance panel

80426 $329.80 Gonadotropin hormone panel

80428 $148.24 Growth hormone panel

80430 $258.66 Growth hormone panel

80432 $331.22 Insulin suppression panel

80434 $570.06 Insulin tolerance panel

80435 $228.90 Insulin tolerance panel

80436 $202.58 Metyrapone panel

80438 $112.02 Trh stimulation panel

80439 $149.36 Trh stimulation panel

81000 $8.04 Urinalysis nonauto w/scope

81001 $7.04 Urinalysis auto w/scope

81002 $6.96 Urinalysis nonauto w/o scope

81003 $4.98 Urinalysis auto w/o scope

81003 $4.98 Urinalysis auto w/o scope

81005 $4.82 Urinalysis

81007 $59.96 Urine screen for bacteria

81007 $59.96 Urine screen for bacteria

81015 $6.78 Microscopic exam of urine

81020 $9.40 Urinalysis glass test

81025 $17.22 Urine pregnancy test

81050 $7.28 Urinalysis volume measure

81105 $271.60 Hpa-1 genotyping








81120 $386.50 Idh1 common variants

81121 $591.58 Idh2 common variants

81161 $558.00 Dmd dup/delet analysis

81162 $4,055.28 Brca1&2 gen full seq dup/del

81163 $936.00 Brca1&2 gene full seq alys

81164 $1,168.46 Brca1&2 gen ful dup/del alys

81165 $565.76 Brca1 gene full seq alys

81166 $602.70 Brca1 gene full dup/del alys

81167 $565.76 Brca2 gene full dup/del alys


81170 $600.00 Abl1 gene

81171 $274.00 Aff2 gene detc abnor alleles

81172 $549.66 Aff2 gene charac alleles

81173 $602.70 Ar gene full gene sequence

81174 $370.40 Ar gene known famil variant

81175 $1,353.00 Asxl1 full gene sequence

81176 $537.54 Asxl1 gene target seq alys

81177 $274.00 Atn1 gene detc abnor alleles

81178 $274.00 Atxn1 gene detc abnor allele




81182 $274.00 Atxn8os gen detc abnor allel

81183 $274.00 Atxn10 gene detc abnor allel

81184 $274.00 Cacna1a gen detc abnor allel

81185 $1,692.54 Cacna1a gene full gene seq

81186 $370.40 Cacna1a gen known famil vrnt

81187 $274.00 Cnbp gene detc abnor allele

81188 $274.00 Cstb gene detc abnor allele

81189 $549.66 Cstb gene full gene sequence

81190 $370.40 Cstb gene known famil vrnt

81200 $94.50 Aspa gene

81201 $1,560.00 Apc gene full sequence

81202 $560.00 Apc gene known fam variants

81203 $400.00 Apc gene dup/delet variants

81204 $274.00 Ar gene charac alleles

81205 $189.98 Bckdhb gene

81206 $364.36 Bcr/abl1 gene major bp

81207 $321.86 Bcr/abl1 gene minor bp

81208 $429.24 Bcr/abl1 gene other bp

81209 $78.62 Blm gene

81210 $350.80 Braf gene

81212 $880.00 Brca1&2 185&5385&6174 vrnt

81215 $750.50 Brca1 gene known famil vrnt

81216 $370.24 Brca2 gene full seq alys

81217 $750.50 Brca2 gene known famil vrnt

81218 $537.54 Cebpa gene full sequence

81219 $270.28 Calr gene com variants

81220 $1,113.20 Cftr gene com variants

81221 $194.44 Cftr gene known fam variants

81222 $870.14 Cftr gene dup/delet variants

81223 $998.00 Cftr gene full sequence

81224 $337.50 Cftr gene intron poly t

81225 $582.72 Cyp2c19 gene com variants

81226 $901.82 Cyp2d6 gene com variants

81227 $349.62 Cyp2c9 gene com variants


81228 $1,800.00 Cytogen micrarray copy nmbr

81229 $2,320.00 Cytogen m array copy no&snp

81230 $349.62 Cyp3a4 gene common variants

81231 $349.62 Cyp3a5 gene common variants

81232 $349.62 Dpyd gene common variants

81233 $350.80 Btk gene common variants

81234 $274.00 Dmpk gene detc abnor allele

81235 $649.16 Egfr gene com variants

81236 $565.76 Ezh2 gene full gene sequence

81237 $350.80 Ezh2 gene common variants

81238 $1,200.00 F9 full gene sequence

81239 $549.66 Dmpk gene charac alleles

81240 $131.38 F2 gene

81241 $146.74 F5 gene

81242 $73.24 Fancc gene

81243 $114.08 Fmr1 gene detection

81244 $89.78 Fmr1 gene charac alleles

81245 $331.02 Flt3 gene

81246 $166.00 Flt3 gene analysis

81247 $349.62 G6pd gene alys cmn variant

81248 $750.50 G6pd known familial variant

81249 $1,200.00 G6pd full gene sequence

81250 $116.98 G6pc gene

81251 $94.50 Gba gene

81252 $202.24 Gjb2 gene full sequence

81253 $123.04 Gjb2 gene known fam variants

81254 $70.00 Gjb6 gene com variants

81255 $102.90 Hexa gene

81256 $145.24 Hfe gene

81257 $204.52 Hba1/hba2 gene

81258 $750.50 Hba1/hba2 gene fam vrnt

81259 $1,200.00 Hba1/hba2 full gene sequence

81260 $78.62 Ikbkap gene

81261 $439.98 Igh gene rearrange amp meth

81262 $137.10 Igh gene rearrang dir probe

81263 $654.48 Igh vari regional mutation

81264 $345.46 Igk rearrangeabn clonal pop

81265 $477.88 Str markers specimen anal

81266 $609.62 Str markers spec anal addl

81267 $461.02 Chimerism anal no cell selec

81268 $579.52 Chimerism anal w/cell select

81269 $404.80 Hba1/hba2 gene dup/del vrnts

81270 $203.70 Jak2 gene

81271 $274.00 Htt gene detc abnor alleles

81272 $659.02 Kit gene targeted seq analys

81273 $249.74 Kit gene analys d816 variant


81274 $549.66 Htt gene charac alleles

81275 $386.50 Kras gene variants exon 2

81276 $386.50 Kras gene addl variants

81283 $146.74 Ifnl3 gene

81284 $274.00 Fxn gene detc abnor alleles

81285 $549.66 Fxn gene charac alleles

81286 $549.66 Fxn gene full gene sequence

81287 $249.28 Mgmt gene prmtr mthyltn alys

81288 $384.64 Mlh1 gene

81289 $370.40 Fxn gene known famil variant

81290 $78.62 Mcoln1 gene

81291 $130.68 Mthfr gene

81292 $1,350.80 Mlh1 gene full seq

81293 $662.00 Mlh1 gene known variants

81294 $404.80 Mlh1 gene dup/delete variant

81295 $763.40 Msh2 gene full seq

81296 $675.46 Msh2 gene known variants

81297 $426.60 Msh2 gene dup/delete variant

81298 $1,283.70 Msh6 gene full seq

81299 $616.00 Msh6 gene known variants

81300 $476.00 Msh6 gene dup/delete variant

81301 $697.12 Microsatellite instability

81302 $1,055.74 Mecp2 gene full seq

81303 $240.00 Mecp2 gene known variant

81304 $300.00 Mecp2 gene dup/delet variant

81305 $350.80 Myd88 gene p.leu265pro vrnt

81306 $582.72 Nudt15 gene common variants

81310 $493.04 Npm1 gene

81311 $591.58 Nras gene variants exon 2&3

81312 $274.00 Pabpn1 gene detc abnor allel

81313 $510.10 Pca3/klk3 antigen

81314 $659.02 Pdgfra gene

81315 $460.70 Pml/raralpha com breakpoints

81316 $460.70 Pml/raralpha 1 breakpoint

81317 $1,353.00 Pms2 gene full seq analysis

81318 $662.00 Pms2 known familial variants

81319 $407.00 Pms2 gene dup/delet variants

81320 $582.72 Plcg2 gene common variants

81321 $1,200.00 Pten gene full sequence

81322 $95.12 Pten gene known fam variant

81323 $600.00 Pten gene dup/delet variant

81324 $1,516.72 Pmp22 gene dup/delet

81325 $1,539.16 Pmp22 gene full sequence

81326 $95.12 Pmp22 gene known fam variant

81327 $384.00 Sept9 gen prmtr mthyltn alys

81328 $349.62 Slco1b1 gene com variants


81329 $274.00 Smn1 gene dos/deletion alys

81330 $94.00 Smpd1 gene common variants

81331 $102.14 Snrpn/ube3a gene

81332 $97.00 Serpina1 gene

81333 $274.00 Tgfbi gene common variants

81334 $659.02 Runx1 gene targeted seq alys

81335 $349.62 Tpmt gene com variants

81336 $602.70 Smn1 gene full gene sequence

81337 $370.40 Smn1 gen nown famil seq vrnt

81340 $464.26 Trb@ gene rearrange amplify

81341 $110.20 Trb@ gene rearrange dirprobe

81342 $447.76 Trg gene rearrangement anal

81343 $274.00 Ppp2r2b gen detc abnor allel

81344 $274.00 Tbp gene detc abnor alleles

81345 $370.40 Tert gene targeted seq alys

81346 $349.62 Tyms gene com variants

81350 $468.00 Ugt1a1 gene

81355 $176.40 Vkorc1 gene

81361 $349.62 Hbb gene com variants

81362 $750.50 Hbb gene known fam variant

81363 $404.80 Hbb gene dup/del variants

81364 $649.16 Hbb full gene sequence

81370 $893.60 Hla i & ii typing lr

81371 $809.04 Hla i & ii type verify lr

81372 $807.18 Hla i typing complete lr

81373 $254.86 Hla i typing 1 locus lr

81374 $161.66 Hla i typing 1 antigen lr

81375 $490.54 Hla ii typing ag equiv lr

81376 $271.60 Hla ii typing 1 locus lr

81377 $204.02 Hla ii type 1 ag equiv lr

81378 $767.92 Hla i & ii typing hr

81379 $745.30 Hla i typing complete hr

81380 $393.88 Hla i typing 1 locus hr

81381 $339.80 Hla i typing 1 allele hr

81382 $274.84 Hla ii typing 1 loc hr

81383 $242.52 Hla ii typing 1 allele hr

81400 $127.92 Mopath procedure level 1







81407 $1,692.54 Mopath procedure level 8

81408 $4,000.00 Mopath procedure level 9

81410 $1,008.00 Aortic dysfunction/dilation


81411 $2,700.38 Aortic dysfunction/dilation

81412 $4,897.12 Ashkenazi jewish assoc dis

81413 $1,299.78 Car ion chnnlpath inc 10 gns

81414 $1,299.78 Car ion chnnlpath inc 2 gns

81415 $9,560.00 Exome sequence analysis

81416 $24,000.00 Exome sequence analysis

81417 $640.00 Exome re-evaluation

81420 $1,518.10 Fetal chrmoml aneuploidy

81422 $1,518.10 Fetal chrmoml microdeltj

81425 $10,062.40 Genome sequence analysis

81426 $5,419.90 Genome sequence analysis

81427 $4,675.30 Genome re-evaluation

81430 $3,250.00 Hearing loss sequence analys

81431 $1,359.14 Hearing loss dup/del analys

81432 $1,509.00 Hrdtry brst ca-rlatd dsordrs

81433 $975.40 Hrdtry brst ca-rlatd dsordrs

81434 $1,195.82 Hereditary retinal disorders

81435 $1,299.78 Hereditary colon ca dsordrs

81436 $1,299.78 Hereditary colon ca dsordrs

81437 $975.40 Heredtry nurondcrn tum dsrdr

81438 $975.40 Heredtry nurondcrn tum dsrdr

81439 $1,299.78 Hrdtry cardmypy gene panel

81440 $6,648.00 Mitochondrial gene

81442 $4,287.20 Noonan spectrum disorders

81443 $4,897.12 Genetic tstg severe inh cond

81445 $1,195.82 Targeted genomic seq analys

81448 $1,299.78 Hrdtry perph neurphy panel



81460 $2,574.00 Whole mitochondrial genome

81465 $1,872.00 Whole mitochondrial genome

81470 $1,828.00 X-linked intellectual dblt

81471 $1,828.00 X-linked intellectual dblt

81490 $1,681.30 Autoimmune rheumatoid arthr

81493 $2,100.00 Cor artery disease mrna

81500 $521.00 Onco (ovar) two proteins

81503 $1,794.00 Onco (ovar) five proteins

81504 $1,040.00 Oncology tissue of origin

81506 $149.34 Endo assay seven anal

81507 $1,590.00 Fetal aneuploidy trisom risk

81508 $108.60 Ftl cgen abnor two proteins

81509 $2,974.74 Ftl cgen abnor 3 proteins

81510 $111.08 Ftl cgen abnor three anal

81511 $307.00 Ftl cgen abnor four anal

81512 $139.04 Ftl cgen abnor five anal

81518 $7,746.00 Onc brst mrna 11 genes


81519 $7,746.00 Oncology breast mrna

81520 $5,578.24 Onc breast mrna 58 genes

81521 $7,746.00 Onc breast mrna 70 genes

81525 $6,232.00 Oncology colon mrna

81528 $1,017.74 Oncology colorectal scr

81535 $1,158.92 Oncology gynecologic

81536 $355.12 Oncology gynecologic

81538 $5,742.00 Oncology lung

81539 $1,520.00 Oncology prostate prob score

81540 $7,500.00 Oncology tum unknown origin

81541 $7,746.00 Onc prostate mrna 46 genes

81545 $7,200.00 Oncology thyroid

81551 $4,060.00 Onc prostate 3 genes

81595 $6,480.00 Cardiology hrt trnspl mrna

81596 $144.38 Nfct ds chrnc hcv 6 assays

82009 $10.04 Test for acetone/ketones

82010 $18.16 Acetone assay

82010 $18.16 Acetone assay

82013 $24.82 Acetylcholinesterase assay

82016 $32.98 Acylcarnitines qual

82017 $37.48 Acylcarnitines quant

82024 $85.82 Assay of acth

82030 $57.34 Assay of adp & amp

82040 $11.00 Assay of serum albumin

82040 $11.00 Assay of serum albumin

82042 $15.56 Other source albumin quan ea

82042 $15.56 Other source albumin quan ea

82043 $12.84 Ur albumin quantitative

82043 $12.84 Ur albumin quantitative

82044 $12.46 Ur albumin semiquantitative

82044 $12.46 Ur albumin semiquantitative

82045 $75.42 Albumin ischemia modified

82075 $60.00 Assay of breath ethanol

82085 $21.58 Assay of aldolase

82088 $90.56 Assay of aldosterone

82103 $29.86 Alpha-1-antitrypsin total

82104 $32.14 Alpha-1-antitrypsin pheno

82105 $37.28 Alpha-fetoprotein serum

82106 $37.28 Alpha-fetoprotein amniotic

82107 $143.14 Alpha-fetoprotein l3

82108 $56.62 Assay of aluminum

82120 $11.98 Amines vaginal fluid qual

82120 $11.98 Amines vaginal fluid qual

82127 $30.82 Amino acid single qual

82128 $30.82 Amino acids mult qual

82131 $45.96 Amino acids single quant


82135 $36.56 Assay aminolevulinic acid

82136 $39.22 Amino acids quant 2-5

82139 $37.48 Amino acids quan 6 or more

82140 $32.38 Assay of ammonia

82143 $18.70 Amniotic fluid scan

82150 $14.40 Assay of amylase

82150 $14.40 Assay of amylase

82154 $64.08 Androstanediol glucuronide

82157 $65.06 Assay of androstenedione

82160 $55.56 Assay of androsterone

82163 $45.60 Assay of angiotensin ii

82164 $32.44 Angiotensin i enzyme test

82172 $42.18 Assay of apolipoprotein

82175 $42.16 Assay of arsenic

82180 $21.96 Assay of ascorbic acid

82190 $33.12 Atomic absorption

82232 $35.94 Assay of beta-2 protein

82239 $38.06 Bile acids total

82240 $59.06 Bile acids cholylglycine

82247 $11.14 Bilirubin total

82247 $11.14 Bilirubin total

82248 $11.14 Bilirubin direct

82252 $10.12 Fecal bilirubin test

82261 $37.48 Assay of biotinidase

82270 $8.76 Occult blood feces

82271 $10.64 Occult blood other sources

82271 $10.64 Occult blood other sources

82272 $8.46 Occult bld feces 1-3 tests

82274 $35.34 Assay test for blood fecal

82274 $35.34 Assay test for blood fecal

82286 $11.46 Assay of bradykinin

82300 $51.44 Assay of cadmium

82306 $65.78 Vitamin d 25 hydroxy

82308 $59.54 Assay of calcitonin

82310 $11.46 Assay of calcium




82331 $26.68 Calcium infusion test

82340 $13.40 Assay of calcium in urine

82355 $25.72 Calculus analysis qual

82360 $28.60 Calculus assay quant

82365 $28.66 Calculus spectroscopy

82370 $27.84 X-ray assay calculus

82373 $40.12 Assay c-d transfer measure

82374 $10.86 Assay blood carbon dioxide


82374 $10.86 Assay blood carbon dioxide

82375 $27.38 Assay carboxyhb quant

82376 $28.14 Assay carboxyhb qual

82378 $42.14 Carcinoembryonic antigen

82379 $37.48 Assay of carnitine

82380 $20.50 Assay of carotene

82382 $54.60 Assay urine catecholamines

82383 $58.16 Assay blood catecholamines

82384 $56.12 Assay three catecholamines

82387 $40.12 Assay of cathepsin-d

82390 $23.86 Assay of ceruloplasmin

82397 $31.38 Chemiluminescent assay

82415 $28.16 Assay of chloramphenicol

82435 $10.22 Assay of blood chloride

82435 $10.22 Assay of blood chloride

82436 $11.50 Assay of urine chloride

82438 $10.86 Assay other fluid chlorides

82441 $13.34 Test for chlorohydrocarbons

82465 $9.68 Assay bld/serum cholesterol

82465 $9.68 Assay bld/serum cholesterol

82480 $17.50 Assay serum cholinesterase

82482 $19.62 Assay rbc cholinesterase

82485 $45.90 Assay chondroitin sulfate

82495 $45.06 Assay of chromium

82507 $61.78 Assay of citrate

82523 $41.52 Collagen crosslinks

82523 $41.52 Collagen crosslinks

82525 $27.58 Assay of copper

82528 $50.04 Assay of corticosterone

82530 $37.14 Cortisol free

82533 $36.22 Total cortisol

82540 $10.30 Assay of creatine

82542 $48.18 Col chromotography qual/quan

82550 $14.46 Assay of ck (cpk)

82550 $14.46 Assay of ck (cpk)

82552 $29.76 Assay of cpk in blood

82553 $25.66 Creatine mb fraction

82554 $26.38 Creatine isoforms

82565 $11.38 Assay of creatinine

82565 $11.38 Assay of creatinine

82570 $11.50 Assay of urine creatinine

82570 $11.50 Assay of urine creatinine

82575 $21.02 Creatinine clearance test

82585 $28.28 Assay of cryofibrinogen

82595 $14.36 Assay of cryoglobulin

82600 $43.10 Assay of cyanide


82607 $33.50 Vitamin b-12

82608 $31.82 B-12 binding capacity

82610 $37.04 Cystatin c

82615 $19.10 Test for urine cystines

82626 $56.16 Dehydroepiandrosterone

82627 $49.42 Dehydroepiandrosterone

82633 $68.86 Desoxycorticosterone

82634 $65.06 Deoxycortisol

82638 $27.22 Assay of dibucaine number

82642 $65.06 Dihydrotestosterone

82652 $85.56 Vit d 1 25-dihydroxy

82656 $25.62 Pancreatic elastase fecal

82657 $44.34 Enzyme cell activity

82658 $88.06 Enzyme cell activity ra

82664 $123.00 Electrophoretic test

82668 $41.76 Assay of erythropoietin

82670 $62.08 Assay of estradiol

82671 $71.78 Assay of estrogens

82672 $48.22 Assay of estrogen

82677 $53.74 Assay of estriol

82679 $55.46 Assay of estrone

82679 $55.46 Assay of estrone

82693 $33.12 Assay of ethylene glycol

82696 $52.48 Assay of etiocholanolone

82705 $11.32 Fats/lipids feces qual

82710 $37.34 Fats/lipids feces quant

82715 $45.94 Assay of fecal fat

82725 $37.54 Assay of blood fatty acids

82726 $40.12 Long chain fatty acids

82728 $30.30 Assay of ferritin

82731 $143.14 Assay of fetal fibronectin

82735 $41.20 Assay of fluoride

82746 $32.68 Assay of folic acid serum

82747 $38.50 Assay of folic acid rbc

82757 $38.52 Assay of semen fructose

82759 $47.74 Assay of rbc galactokinase

82760 $24.88 Assay of galactose

82775 $46.82 Assay galactose transferase

82776 $23.48 Galactose transferase test

82777 $88.50 Galectin-3

82784 $20.68 Assay iga/igd/igg/igm each

82785 $36.58 Assay of ige

82787 $17.82 Igg 1 2 3 or 4 each

82800 $22.00 Blood ph

82803 $52.14 Blood gases any combination

82805 $157.54 Blood gases w/o2 saturation


82810 $19.54 Blood gases o2 sat only

82820 $26.68 Hemoglobin-oxygen affinity

82930 $13.42 Gastric analy w/ph ea spec

82938 $39.32 Gastrin test

82941 $39.18 Assay of gastrin

82943 $31.76 Assay of glucagon

82945 $8.74 Glucose other fluid

82946 $35.54 Glucagon tolerance test

82947 $8.74 Assay glucose blood quant

82947 $8.74 Assay glucose blood quant

82948 $10.08 Reagent strip/blood glucose

82950 $10.54 Glucose test

82950 $10.54 Glucose test

82951 $28.60 Glucose tolerance test (gtt)

82951 $28.60 Glucose tolerance test (gtt)

82952 $8.72 Gtt-added samples

82952 $8.72 Gtt-added samples

82955 $21.54 Assay of g6pd enzyme

82960 $13.44 Test for g6pd enzyme

82962 $6.56 Glucose blood test

82963 $47.74 Assay of glucosidase

82965 $26.30 Assay of gdh enzyme

82977 $16.00 Assay of ggt

82977 $16.00 Assay of ggt

82978 $31.68 Assay of glutathione

82979 $20.98 Assay rbc glutathione

82985 $33.52 Assay of glycated protein

82985 $33.52 Assay of glycated protein

83001 $41.30 Assay of gonadotropin (fsh)

83001 $41.30 Assay of gonadotropin (fsh)

83002 $41.14 Assay of gonadotropin (lh)

83002 $41.14 Assay of gonadotropin (lh)

83003 $37.04 Assay growth hormone (hgh)

83006 $151.20 Growth stimulation gene 2

83009 $149.68 H pylori (c-13) blood

83010 $27.94 Assay of haptoglobin quant

83012 $53.78 Assay of haptoglobins

83013 $149.68 H pylori (c-13) breath

83014 $17.46 H pylori drug admin

83015 $41.88 Heavy metal qual any anal

83018 $48.82 Heavy metal quant each nes

83020 $28.60 Hemoglobin electrophoresis

83021 $40.12 Hemoglobin chromotography

83026 $8.02 Hemoglobin copper sulfate

83030 $21.48 Fetal hemoglobin chemical

83033 $16.00 Fetal hemoglobin assay qual


83036 $21.58 Glycosylated hemoglobin test

83036 $21.58 Glycosylated hemoglobin test

83037 $21.58 Glycosylated hb home device

83037 $21.58 Glycosylated hb home device

83045 $12.98 Blood methemoglobin test

83050 $16.40 Blood methemoglobin assay

83051 $16.24 Assay of plasma hemoglobin

83060 $18.38 Blood sulfhemoglobin assay

83065 $18.00 Assay of hemoglobin heat

83068 $18.94 Hemoglobin stability screen

83069 $8.78 Assay of urine hemoglobin

83070 $10.54 Assay of hemosiderin qual

83080 $37.48 Assay of b hexosaminidase

83088 $65.62 Assay of histamine

83090 $37.48 Assay of homocystine

83150 $44.82 Assay of homovanillic acid

83491 $38.94 Assay of corticosteroids 17

83497 $28.66 Assay of 5-hiaa

83498 $60.38 Assay of progesterone 17-d

83500 $50.34 Assay free hydroxyproline

83505 $54.02 Assay total hydroxyproline

83516 $25.62 Immunoassay nonantibody

83516 $25.62 Immunoassay nonantibody

83518 $19.28 Immunoassay dipstick

83518 $19.28 Immunoassay dipstick

83519 $36.80 Ria nonantibody

83520 $34.54 Immunoassay quant nos nonab

83520 $34.54 Immunoassay quant nos nonab

83525 $25.40 Assay of insulin

83527 $28.78 Assay of insulin

83528 $39.64 Assay of intrinsic factor

83540 $14.38 Assay of iron

83550 $19.42 Iron binding test

83570 $19.66 Assay of idh enzyme

83582 $31.50 Assay of ketogenic steroids

83586 $28.44 Assay 17- ketosteroids

83593 $58.44 Fractionation ketosteroids

83605 $23.74 Assay of lactic acid

83605 $23.74 Assay of lactic acid

83615 $13.42 Lactate (ld) (ldh) enzyme

83625 $28.44 Assay of ldh enzymes

83630 $43.62 Lactoferrin fecal (qual)

83631 $43.62 Lactoferrin fecal (quant)

83632 $44.94 Placental lactogen

83633 $22.50 Test urine for lactose

83655 $26.90 Assay of lead


83655 $26.90 Assay of lead

83661 $48.86 L/s ratio fetal lung

83662 $42.02 Foam stability fetal lung

83663 $42.02 Fluoro polarize fetal lung

83664 $42.02 Lamellar bdy fetal lung

83670 $20.36 Assay of lap enzyme

83690 $15.30 Assay of lipase

83695 $28.78 Assay of lipoprotein(a)

83698 $92.62 Assay lipoprotein pla2

83700 $25.02 Lipopro bld electrophoretic

83701 $67.72 Lipoprotein bld hr fraction

83704 $70.12 Lipoprotein bld quan part

83718 $18.20 Assay of lipoprotein

83718 $18.20 Assay of lipoprotein

83719 $25.86 Assay of blood lipoprotein



83722 $70.12 Lipoprtn dir meas sd ldl chl

83727 $38.20 Assay of lrh hormone

83735 $14.88 Assay of magnesium

83775 $16.38 Assay malate dehydrogenase

83785 $54.66 Assay of manganese

83789 $48.22 Mass spectrometry qual/quan

83825 $36.12 Assay of mercury

83835 $37.64 Assay of metanephrines

83857 $23.86 Assay of methemalbumin

83861 $44.96 Microfluid analy tears

83861 $44.96 Microfluid analy tears

83864 $57.00 Mucopolysaccharides

83872 $13.02 Assay synovial fluid mucin

83873 $38.24 Assay of csf protein

83874 $28.70 Assay of myoglobin

83876 $101.72 Assay myeloperoxidase

83880 $78.52 Assay of natriuretic peptide

83880 $78.52 Assay of natriuretic peptide

83883 $30.22 Assay nephelometry not spec

83885 $54.46 Assay of nickel

83915 $24.78 Assay of nucleotidase

83916 $54.78 Oligoclonal bands

83918 $47.20 Organic acids total quant

83919 $36.56 Organic acids qual each

83921 $42.42 Organic acid single quant

83930 $14.70 Assay of blood osmolality

83935 $15.14 Assay of urine osmolality

83937 $66.32 Assay of osteocalcin

83945 $28.90 Assay of oxalate


83950 $143.14 Oncoprotein her-2/neu

83951 $143.14 Oncoprotein dcp

83970 $91.72 Assay of parathormone

83986 $7.96 Assay ph body fluid nos

83986 $7.96 Assay ph body fluid nos

83987 $7.96 Exhaled breath condensate

83993 $43.62 Assay for calprotectin fecal

84030 $12.22 Assay of blood pku

84035 $8.14 Assay of phenylketones

84060 $16.42 Assay acid phosphatase

84066 $21.46 Assay prostate phosphatase

84075 $11.50 Assay alkaline phosphatase



84080 $32.86 Assay alkaline phosphatases

84081 $36.70 Assay phosphatidylglycerol

84085 $20.98 Assay of rbc pg6d enzyme

84087 $22.94 Assay phosphohexose enzymes

84100 $10.54 Assay of phosphorus

84105 $11.56 Assay of urine phosphorus

84106 $11.64 Test for porphobilinogen

84110 $18.76 Assay of porphobilinogen

84112 $196.22 Eval amniotic fluid protein

84119 $26.72 Test urine for porphyrins

84120 $32.70 Assay of urine porphyrins

84126 $78.22 Assay of feces porphyrins

84132 $10.22 Assay of serum potassium

84132 $10.22 Assay of serum potassium

84133 $9.58 Assay of urine potassium

84134 $32.42 Assay of prealbumin

84135 $42.54 Assay of pregnanediol

84138 $42.10 Assay of pregnanetriol

84140 $45.94 Assay of pregnenolone

84143 $50.68 Assay of 17-hydroxypregneno

84144 $46.36 Assay of progesterone

84145 $59.54 Procalcitonin (pct)

84146 $43.06 Assay of prolactin

84150 $83.54 Assay of prostaglandin

84152 $40.88 Assay of psa complexed

84153 $40.88 Assay of psa total

84154 $40.88 Assay of psa free

84155 $8.14 Assay of protein serum

84155 $8.14 Assay of protein serum

84156 $8.14 Assay of protein urine

84157 $8.14 Assay of protein other

84157 $8.14 Assay of protein other


84160 $11.50 Assay of protein any source

84163 $33.46 Pappa serum

84165 $23.86 Protein e-phoresis serum

84166 $39.62 Protein e-phoresis/urine/csf

84181 $37.84 Western blot test

84182 $58.42 Protein western blot test

84202 $31.88 Assay rbc protoporphyrin

84203 $19.48 Test rbc protoporphyrin

84206 $53.38 Assay of proinsulin

84207 $62.44 Assay of vitamin b-6

84210 $28.96 Assay of pyruvate

84220 $20.98 Assay of pyruvate kinase

84228 $25.86 Assay of quinine

84233 $175.76 Assay of estrogen

84234 $144.18 Assay of progesterone

84235 $142.46 Assay of endocrine hormone

84238 $81.26 Assay nonendocrine receptor

84244 $48.88 Assay of renin


84255 $56.74 Assay of selenium

84260 $68.86 Assay of serotonin

84270 $48.30 Assay of sex hormone globul

84275 $29.86 Assay of sialic acid

84285 $52.30 Assay of silica

84295 $10.70 Assay of serum sodium

84295 $10.70 Assay of serum sodium

84300 $10.80 Assay of urine sodium

84302 $10.80 Assay of sweat sodium

84305 $47.26 Assay of somatomedin

84307 $40.62 Assay of somatostatin

84311 $16.20 Spectrophotometry

84315 $6.56 Body fluid specific gravity

84375 $78.00 Chromatogram assay sugars

84376 $12.22 Sugars single qual

84377 $12.22 Sugars multiple qual

84378 $25.62 Sugars single quant

84379 $25.62 Sugars multiple quant

84392 $10.98 Assay of urine sulfate

84402 $56.60 Assay of free testosterone

84403 $57.36 Assay of total testosterone

84410 $113.96 Testosterone bioavailable


84430 $25.86 Assay of thiocyanate

84431 $70.22 Thromboxane urine

84432 $35.68 Assay of thyroglobulin

84436 $15.26 Assay of total thyroxine


84437 $14.36 Assay of neonatal thyroxine

84439 $20.04 Assay of free thyroxine

84442 $32.86 Assay of thyroid activity

84443 $37.34 Assay thyroid stim hormone

84443 $37.34 Assay thyroid stim hormone

84445 $113.02 Assay of tsi globulin

84446 $31.50 Assay of vitamin e

84449 $40.00 Assay of transcortin

84450 $11.50 Transferase (ast) (sgot)

84450 $11.50 Transferase (ast) (sgot)

84460 $11.78 Alanine amino (alt) (sgpt)

84460 $11.78 Alanine amino (alt) (sgpt)

84466 $28.36 Assay of transferrin

84478 $12.76 Assay of triglycerides

84478 $12.76 Assay of triglycerides

84479 $14.36 Assay of thyroid (t3 or t4)

84480 $31.50 Assay triiodothyronine (t3)

84481 $37.64 Free assay (ft-3)

84482 $35.02 T3 reverse

84484 $24.94 Assay of troponin quant

84485 $16.00 Assay duodenal fluid trypsin

84488 $16.22 Test feces for trypsin

84490 $19.86 Assay of feces for trypsin

84510 $23.12 Assay of tyrosine

84512 $20.18 Assay of troponin qual

84520 $8.78 Assay of urea nitrogen

84520 $8.78 Assay of urea nitrogen

84525 $10.26 Urea nitrogen semi-quant

84540 $11.12 Assay of urine/urea-n

84545 $14.70 Urea-n clearance test

84550 $10.04 Assay of blood/uric acid

84550 $10.04 Assay of blood/uric acid

84560 $10.54 Assay of urine/uric acid

84577 $37.34 Assay of feces/urobilinogen

84578 $8.94 Test urine urobilinogen

84580 $19.10 Assay of urine urobilinogen

84583 $12.10 Assay of urine urobilinogen

84585 $34.44 Assay of urine vma

84586 $78.52 Assay of vip

84588 $75.42 Assay of vasopressin

84590 $25.80 Assay of vitamin a

84591 $34.12 Assay of nos vitamin

84597 $30.48 Assay of vitamin k

84600 $35.74 Assay of volatiles

84620 $26.32 Xylose tolerance test

84630 $25.30 Assay of zinc


84681 $46.26 Assay of c-peptide

84702 $33.46 Chorionic gonadotropin test

84703 $16.72 Chorionic gonadotropin assay

84703 $16.72 Chorionic gonadotropin assay

84704 $33.46 Hcg free betachain test

84830 $25.40 Ovulation tests

85002 $10.02 Bleeding time test

85004 $14.36 Automated diff wbc count

85007 $7.64 Bl smear w/diff wbc count

85008 $7.64 Bl smear w/o diff wbc count

85009 $10.14 Manual diff wbc count b-coat

85013 $14.00 Spun microhematocrit

85014 $5.26 Hematocrit

85014 $5.26 Hematocrit

85018 $5.26 Hemoglobin

85018 $5.26 Hemoglobin

85025 $17.26 Complete cbc w/auto diff wbc

85025 $17.26 Complete cbc w/auto diff wbc

85027 $14.36 Complete cbc automated

85032 $9.58 Manual cell count each

85041 $6.70 Automated rbc count

85044 $9.58 Manual reticulocyte count

85045 $8.88 Automated reticulocyte count

85046 $12.38 Reticyte/hgb concentrate

85048 $5.64 Automated leukocyte count

85049 $9.94 Automated platelet count

85055 $71.48 Reticulated platelet assay

85130 $26.42 Chromogenic substrate assay

85170 $32.60 Blood clot retraction

85175 $40.74 Blood clot lysis time

85210 $28.86 Clot factor ii prothrom spec

85220 $39.22 Blooc clot factor v test

85230 $39.78 Clot factor vii proconvertin

85240 $39.78 Clot factor viii ahg 1 stage

85244 $45.38 Clot factor viii reltd antgn

85245 $50.98 Clot factor viii vw ristoctn

85246 $50.98 Clot factor viii vw antigen

85247 $50.98 Clot factor viii multimetric

85250 $42.32 Clot factor ix ptc/chrstmas

85260 $39.78 Clot factor x stuart-power

85270 $39.78 Clot factor xi pta

85280 $43.00 Clot factor xii hageman

85290 $36.30 Clot factor xiii fibrin stab

85291 $19.76 Clot factor xiii fibrin scrn

85292 $42.08 Clot factor fletcher fact

85293 $42.08 Clot factor wght kininogen


85300 $26.34 Antithrombin iii activity

85301 $24.02 Antithrombin iii antigen

85302 $26.70 Clot inhibit prot c antigen

85303 $30.74 Clot inhibit prot c activity

85305 $25.80 Clot inhibit prot s total

85306 $34.06 Clot inhibit prot s free

85307 $34.06 Assay activated protein c

85335 $28.60 Factor inhibitor test

85337 $34.54 Thrombomodulin

85345 $9.58 Coagulation time lee & white

85347 $9.46 Coagulation time activated

85348 $8.98 Coagulation time otr method

85360 $18.68 Euglobulin lysis

85362 $15.30 Fibrin degradation products

85366 $160.92 Fibrinogen test

85370 $25.24 Fibrinogen test

85378 $19.44 Fibrin degrade semiquant

85379 $22.62 Fibrin degradation quant

85380 $22.62 Fibrin degradj d-dimer

85384 $19.44 Fibrinogen activity

85385 $28.92 Fibrinogen antigen

85390 $30.96 Fibrinolysins screen i&r

85397 $61.72 Clotting funct activity

85400 $17.12 Fibrinolytic plasmin

85410 $17.12 Fibrinolytic antiplasmin

85415 $38.20 Fibrinolytic plasminogen



85441 $9.34 Heinz bodies direct

85445 $15.14 Heinz bodies induced

85460 $17.18 Hemoglobin fetal

85461 $18.72 Hemoglobin fetal

85475 $19.72 Hemolysin acid

85520 $29.10 Heparin assay

85525 $26.30 Heparin neutralization

85530 $29.10 Heparin-protamine tolerance

85536 $14.36 Iron stain peripheral blood

85540 $19.12 Wbc alkaline phosphatase

85547 $19.12 Rbc mechanical fragility

85549 $41.66 Muramidase

85555 $14.94 Rbc osmotic fragility

85557 $29.68 Rbc osmotic fragility

85576 $49.82 Blood platelet aggregation

85576 $49.82 Blood platelet aggregation

85597 $39.94 Phospholipid pltlt neutraliz

85598 $39.94 Hexagnal phosph pltlt neutrl


85610 $8.74 Prothrombin time

85610 $8.74 Prothrombin time

85611 $8.76 Prothrombin test

85612 $34.98 Viper venom prothrombin time

85613 $21.28 Russell viper venom diluted

85635 $21.88 Reptilase test

85651 $8.54 Rbc sed rate nonautomated

85652 $6.00 Rbc sed rate automated

85660 $12.24 Rbc sickle cell test

85670 $12.82 Thrombin time plasma

85675 $15.22 Thrombin time titer

85705 $21.40 Thromboplastin inhibition

85730 $13.34 Thromboplastin time partial

85732 $14.36 Thromboplastin time partial

85810 $25.94 Blood viscosity examination

86000 $15.52 Agglutinins febrile antigen

86001 $15.64 Allergen specific igg

86003 $11.60 Allg spec ige crude xtrc ea

86005 $17.70 Allg spec ige multiallg scr

86008 $39.86 Allg spec ige recomb ea

86021 $33.46 Wbc antibody identification

86022 $40.82 Platelet antibodies

86023 $27.68 Immunoglobulin assay

86038 $26.86 Antinuclear antibodies

86039 $24.80 Antinuclear antibodies (ana)

86060 $16.22 Antistreptolysin o titer

86063 $12.82 Antistreptolysin o screen

86140 $11.50 C-reactive protein

86141 $28.78 C-reactive protein hs

86146 $56.56 Beta-2 glycoprotein antibody

86147 $56.56 Cardiolipin antibody ea ig

86148 $35.70 Anti-phospholipid antibody

86152 $546.00 Cell enumeration & id

86155 $35.52 Chemotaxis assay

86156 $16.14 Cold agglutinin screen

86157 $17.92 Cold agglutinin titer

86160 $26.66 Complement antigen

86161 $26.66 Complement/function activity

86162 $45.16 Complement total (ch50)

86171 $22.24 Complement fixation each

86200 $28.78 Ccp antibody

86215 $29.44 Deoxyribonuclease antibody

86225 $30.54 Dna antibody native

86226 $26.90 Dna antibody single strand

86235 $39.86 Nuclear antigen antibody

86255 $26.78 Fluorescent antibody screen


86256 $26.78 Fluorescent antibody titer

86277 $34.98 Growth hormone antibody

86280 $18.20 Hemagglutination inhibition

86294 $51.14 Immunoassay tumor qual

86294 $51.14 Immunoassay tumor qual

86300 $46.26 Immunoassay tumor ca 15-3

86301 $46.26 Immunoassay tumor ca 19-9

86304 $46.26 Immunoassay tumor ca 125

86305 $46.26 Human epididymis protein 4

86308 $11.50 Heterophile antibody screen

86308 $11.50 Heterophile antibody screen

86309 $14.36 Heterophile antibody titer

86310 $16.38 Heterophile antibody absrbj

86316 $46.26 Immunoassay tumor other

86317 $33.30 Immunoassay infectious agent



86320 $59.84 Serum immunoelectrophoresis

86325 $49.70 Other immunoelectrophoresis

86327 $59.84 Immunoelectrophoresis assay

86329 $31.22 Immunodiffusion nes

86331 $26.62 Immunodiffusion ouchterlony

86332 $54.16 Immune complex assay

86334 $49.66 Immunofix e-phoresis serum

86335 $65.22 Immunfix e-phorsis/urine/csf

86336 $34.64 Inhibin a

86337 $47.58 Insulin antibodies

86340 $33.50 Intrinsic factor antibody

86341 $47.14 Islet cell antibody

86343 $27.68 Leukocyte histamine release

86344 $20.78 Leukocyte phagocytosis

86352 $301.92 Cell function assay w/stim

86353 $108.94 Lymphocyte transformation

86355 $83.84 B cells total count

86356 $59.50 Mononuclear cell antigen

86357 $83.84 Nk cells total count

86359 $83.84 T cells total count

86360 $104.40 T cell absolute count/ratio

86361 $59.50 T cell absolute count

86367 $155.56 Stem cells total count

86376 $32.34 Microsomal antibody each

86382 $37.58 Neutralization test viral

86384 $27.22 Nitroblue tetrazolium dye

86386 $43.56 Nuclear matrix protein 22

86386 $43.56 Nuclear matrix protein 22

86403 $23.08 Particle agglut antbdy scrn


86406 $23.64 Particle agglut antbdy titr

86430 $12.60 Rheumatoid factor test qual

86431 $12.60 Rheumatoid factor quant

86480 $137.74 Tb test cell immun measure

86481 $200.00 Tb ag response t-cell susp

86590 $25.32 Streptokinase antibody

86592 $9.50 Syphilis test non-trep qual

86593 $9.78 Syphilis test non-trep quant

86602 $22.62 Antinomyces antibody

86603 $28.60 Adenovirus antibody

86606 $33.46 Aspergillus antibody

86609 $28.62 Bacterium antibody

86611 $22.62 Bartonella antibody

86612 $28.68 Blastomyces antibody

86615 $29.30 Bordetella antibody

86617 $34.42 Lyme disease antibody



86619 $29.72 Borrelia antibody

86622 $19.84 Brucella antibody

86625 $29.16 Campylobacter antibody

86628 $26.68 Candida antibody

86631 $26.28 Chlamydia antibody

86632 $28.18 Chlamydia igm antibody

86635 $25.50 Coccidioides antibody

86638 $26.94 Q fever antibody

86641 $32.02 Cryptococcus antibody

86644 $31.98 Cmv antibody

86645 $37.44 Cmv antibody igm

86648 $33.80 Diphtheria antibody

86651 $29.30 Encephalitis californ antbdy

86652 $29.30 Encephaltis east eqne anbdy

86653 $29.30 Encephaltis st louis antbody

86654 $29.30 Encephaltis west eqne antbdy

86658 $28.94 Enterovirus antibody

86663 $29.16 Epstein-barr antibody

86664 $33.98 Epstein-barr nuclear antigen

86665 $40.32 Epstein-barr capsid vca

86666 $22.62 Ehrlichia antibody

86668 $28.32 Francisella tularensis

86671 $27.24 Fungus nes antibody

86674 $32.70 Giardia lamblia antibody

86677 $33.70 Helicobacter pylori antibody

86682 $28.90 Helminth antibody

86684 $35.20 Hemophilus influenza antibdy

86687 $18.64 Htlv-i antibody


86688 $31.12 Htlv-ii antibody

86689 $43.02 Htlv/hiv confirmj antibody

86692 $38.14 Hepatitis delta agent antbdy

86694 $31.98 Herpes simplex nes antbdy

86695 $29.30 Herpes simplex type 1 test

86696 $43.02 Herpes simplex type 2 test

86698 $27.76 Histoplasma antibody

86701 $19.74 Hiv-1antibody

86701 $19.74 Hiv-1antibody

86702 $30.04 Hiv-2 antibody

86703 $30.46 Hiv-1/hiv-2 1 result antbdy

86704 $26.78 Hep b core antibody total

86705 $26.16 Hep b core antibody igm

86706 $23.86 Hep b surface antibody

86707 $25.70 Hepatitis be antibody

86708 $27.52 Hepatitis a antibody

86709 $25.02 Hepatitis a igm antibody

86710 $30.12 Influenza virus antibody

86711 $33.78 John cunningham antibody

86713 $34.00 Legionella antibody

86717 $27.22 Leishmania antibody

86720 $32.40 Leptospira antibody

86723 $29.30 Listeria monocytogenes

86727 $28.60 Lymph choriomeningitis ab

86732 $30.00 Mucormycosis antibody

86735 $29.00 Mumps antibody

86738 $29.42 Mycoplasma antibody

86741 $29.30 Neisseria meningitidis

86744 $31.98 Nocardia antibody

86747 $33.40 Parvovirus antibody

86750 $29.30 Malaria antibody

86753 $27.52 Protozoa antibody nos

86756 $31.78 Respiratory virus antibody

86757 $43.02 Rickettsia antibody

86759 $36.46 Rotavirus antibody

86762 $31.98 Rubella antibody

86765 $28.62 Rubeola antibody

86768 $29.30 Salmonella antibody

86771 $48.96 Shigella antibody

86774 $32.88 Tetanus antibody

86777 $31.98 Toxoplasma antibody

86778 $32.02 Toxoplasma antibody igm

86780 $29.42 Treponema pallidum

86780 $29.42 Treponema pallidum

86784 $27.92 Trichinella antibody

86787 $28.62 Varicella-zoster antibody


86788 $37.44 West nile virus ab igm

86789 $31.98 West nile virus antibody

86790 $28.62 Virus antibody nos

86793 $29.30 Yersinia antibody

86794 $37.44 Zika virus igm antibody

86800 $35.34 Thyroglobulin antibody

86803 $31.70 Hepatitis c ab test

86803 $31.70 Hepatitis c ab test

86804 $34.42 Hep c ab test confirm

86805 $379.02 Lymphocytotoxicity assay

86806 $105.76 Lymphocytotoxicity assay

86807 $157.30 Cytotoxic antibody screening

86808 $65.96 Cytotoxic antibody screening

86812 $57.34 Hla typing a b or c

86813 $128.88 Hla typing a b or c

86816 $61.90 Hla typing dr/dq

86817 $212.28 Hla typing dr/dq

86821 $81.24 Lymphocyte culture mixed

86825 $218.98 Hla x-math non-cytotoxic

86826 $73.06 Hla x-match noncytotoxc addl

86828 $128.38 Hla class i&ii antibody qual

86829 $128.38 Hla class i/ii antibody qual

86830 $191.04 Hla class i phenotype qual

86831 $163.76 Hla class ii phenotype qual

86832 $647.50 Hla class i high defin qual

86833 $651.60 Hla class ii high defin qual

86834 $794.58 Hla class i semiquant panel

86835 $717.70 Hla class ii semiquant panel

86850 $19.54 Rbc antibody screen

86880 $11.98 Coombs test direct

86885 $12.72 Coombs test indirect qual

86886 $11.50 Coombs test indirect titer

86900 $6.64 Blood typing serologic abo

86901 $6.64 Blood typing serologic rh(d)

86902 $12.70 Blood type antigen donor ea

86904 $32.68 Blood typing patient serum

86905 $8.50 Blood typing rbc antigens

86906 $17.22 Bld typing serologic rh phnt

86940 $18.22 Hemolysins/agglutinins auto

86941 $26.90 Hemolysins/agglutinins

87003 $37.42 Small animal inoculation

87015 $14.84 Specimen infect agnt concntj

87040 $22.94 Blood culture for bacteria

87045 $20.98 Feces culture aerobic bact

87046 $20.98 Stool cultr aerobic bact ea

87070 $19.14 Culture othr specimn aerobic


87071 $20.98 Culture aerobic quant other

87073 $20.98 Culture bacteria anaerobic

87075 $21.04 Cultr bacteria except blood

87076 $17.94 Culture anaerobe ident each

87077 $17.94 Culture aerobic identify

87077 $17.94 Culture aerobic identify

87081 $14.72 Culture screen only

87084 $54.14 Culture of specimen by kit

87086 $17.94 Urine culture/colony count

87088 $17.98 Urine bacteria culture

87101 $17.12 Skin fungi culture

87102 $18.68 Fungus isolation culture

87103 $40.92 Blood fungus culture

87106 $22.94 Fungi identification yeast

87107 $22.94 Fungi identification mold

87109 $34.20 Mycoplasma

87110 $43.54 Chlamydia culture

87116 $24.00 Mycobacteria culture

87118 $29.22 Mycobacteric identification

87140 $12.38 Culture type immunofluoresc

87143 $27.84 Culture typing glc/hplc

87147 $11.50 Culture type immunologic

87149 $44.56 Dna/rna direct probe

87150 $77.98 Dna/rna amplified probe

87152 $15.48 Culture type pulse field gel

87153 $256.34 Dna/rna sequencing

87158 $15.48 Culture typing added method

87164 $23.86 Dark field examination

87166 $25.12 Dark field examination

87168 $9.50 Macroscopic exam arthropod

87169 $9.50 Macroscopic exam parasite

87172 $9.50 Pinworm exam

87176 $13.08 Tissue homogenization cultr

87177 $19.78 Ova and parasites smears

87181 $10.54 Microbe susceptible diffuse

87184 $15.32 Microbe susceptible disk

87185 $10.54 Microbe susceptible enzyme

87186 $19.22 Microbe susceptible mic

87187 $80.34 Microbe susceptible mlc

87188 $14.76 Microbe suscept macrobroth

87190 $14.62 Microbe suscept mycobacteri

87197 $33.38 Bactericidal level serum

87205 $9.50 Smear gram stain

87206 $11.98 Smear fluorescent/acid stai

87207 $13.32 Smear special stain

87209 $39.94 Smear complex stain


87210 $11.64 Smear wet mount saline/ink

87210 $11.64 Smear wet mount saline/ink

87220 $9.50 Tissue exam for fungi

87230 $43.86 Assay toxin or antitoxin

87250 $43.46 Virus inoculate eggs/animal

87252 $57.94 Virus inoculation tissue

87253 $44.90 Virus inoculate tissue addl

87254 $43.46 Virus inoculation shell via

87255 $75.24 Genet virus isolate hsv

87260 $28.86 Adenovirus ag if

87265 $26.64 Pertussis ag if

87267 $26.84 Enterovirus antibody dfa

87269 $27.22 Giardia ag if

87270 $26.64 Chlamydia trachomatis ag if

87271 $26.84 Cytomegalovirus dfa

87272 $26.64 Cryptosporidium ag if

87273 $26.64 Herpes simplex 2 ag if

87274 $26.64 Herpes simplex 1 ag if

87275 $26.64 Influenza b ag if

87276 $32.14 Influenza a ag if

87278 $31.20 Legion pneumophilia ag if

87279 $32.86 Parainfluenza ag if

87280 $26.84 Respiratory syncytial ag if

87281 $26.64 Pneumocystis carinii ag if

87283 $121.60 Rubeola ag if

87285 $26.64 Treponema pallidum ag if

87290 $26.84 Varicella zoster ag if

87299 $32.20 Antibody detection nos if

87300 $26.64 Ag detection polyval if

87301 $26.64 Adenovirus ag ia

87305 $26.64 Aspergillus ag ia

87320 $30.00 Chylmd trach ag ia

87324 $26.64 Clostridium ag ia

87327 $26.84 Cryptococcus neoform ag ia

87328 $27.64 Cryptosporidium ag ia

87329 $26.64 Giardia ag ia

87332 $26.64 Cytomegalovirus ag ia

87335 $26.64 E coli 0157 ag ia

87336 $32.00 Entamoeb hist dispr ag ia

87337 $26.64 Entamoeb hist group ag ia

87338 $31.96 Hpylori stool ia

87338 $31.96 Hpylori stool ia

87339 $32.00 H pylori ag ia

87340 $22.96 Hepatitis b surface ag ia

87341 $22.96 Hepatitis b surface ag ia

87350 $25.62 Hepatitis be ag ia


87380 $36.72 Hepatitis delta ag ia

87385 $26.64 Histoplasma capsul ag ia

87389 $53.50 Hiv-1 ag w/hiv-1 & hiv-2 ab

87389 $53.50 Hiv-1 ag w/hiv-1 & hiv-2 ab

87390 $48.12 Hiv-1 ag ia

87391 $43.80 Hiv-2 ag ia

87400 $28.26 Influenza a/b ag ia

87420 $27.82 Resp syncytial ag ia

87425 $26.64 Rotavirus ag ia

87427 $26.64 Shiga-like toxin ag ia

87430 $33.62 Strep a ag ia

87449 $26.64 Ag detect nos ia mult

87449 $26.64 Ag detect nos ia mult

87450 $21.32 Ag detect nos ia single

87451 $21.32 Ag detect polyval ia mult

87471 $77.98 Bartonella dna amp probe

87472 $95.20 Bartonella dna quant

87475 $44.56 Lyme dis dna dir probe

87476 $77.98 Lyme dis dna amp probe

87480 $44.56 Candida dna dir probe

87481 $77.98 Candida dna amp probe

87482 $111.48 Candida dna quant

87483 $926.18 Cns dna amp probe type 12-25

87485 $44.56 Chylmd pneum dna dir probe

87486 $77.98 Chylmd pneum dna amp probe

87487 $95.20 Chylmd pneum dna quant

87490 $45.50 Chylmd trach dna dir probe

87491 $77.98 Chylmd trach dna amp probe

87492 $106.94 Chylmd trach dna quant

87493 $77.98 C diff amplified probe

87495 $60.06 Cytomeg dna dir probe

87496 $77.98 Cytomeg dna amp probe

87497 $95.20 Cytomeg dna quant

87498 $77.98 Enterovirus probe&revrs trns

87500 $77.98 Vanomycin dna amp probe

87501 $114.04 Influenza dna amp prob 1+

87502 $191.60 Influenza dna amp probe

87502 $191.60 Influenza dna amp probe

87503 $58.44 Influenza dna amp prob addl

87505 $285.08 Nfct agent detection gi

87506 $525.98 Iadna-dna/rna probe tq 6-11

87507 $926.18 Iadna-dna/rna probe tq 12-25

87510 $44.56 Gardner vag dna dir probe

87511 $77.98 Gardner vag dna amp probe

87512 $92.80 Gardner vag dna quant

87516 $77.98 Hepatitis b dna amp probe


87517 $95.20 Hepatitis b dna quant

87520 $62.44 Hepatitis c rna dir probe

87521 $77.98 Hepatitis c probe&rvrs trnsc

87522 $95.20 Hepatitis c revrs trnscrpj

87525 $59.60 Hepatitis g dna dir probe

87526 $78.52 Hepatitis g dna amp probe

87527 $92.80 Hepatitis g dna quant

87528 $44.56 Hsv dna dir probe

87529 $77.98 Hsv dna amp probe

87530 $95.20 Hsv dna quant

87531 $116.00 Hhv-6 dna dir probe

87532 $77.98 Hhv-6 dna amp probe

87533 $92.80 Hhv-6 dna quant

87534 $44.56 Hiv-1 dna dir probe

87535 $77.98 Hiv-1 probe&reverse trnscrpj

87536 $189.10 Hiv-1 quant&revrse trnscrpj

87537 $44.56 Hiv-2 dna dir probe

87538 $77.98 Hiv-2 probe&revrse trnscripj

87539 $117.24 Hiv-2 quant&revrse trnscripj

87540 $44.56 Legion pneumo dna dir prob

87541 $77.98 Legion pneumo dna amp prob

87542 $92.80 Legion pneumo dna quant

87550 $44.56 Mycobacteria dna dir probe

87551 $96.48 Mycobacteria dna amp probe

87552 $95.20 Mycobacteria dna quant

87555 $53.76 M.tuberculo dna dir probe

87556 $83.36 M.tuberculo dna amp probe

87557 $95.20 M.tuberculo dna quant

87560 $54.58 M.avium-intra dna dir prob

87561 $77.98 M.avium-intra dna amp prob

87562 $95.20 M.avium-intra dna quant

87580 $44.56 M.pneumon dna dir probe

87581 $77.98 M.pneumon dna amp probe

87582 $605.24 M.pneumon dna quant

87590 $53.76 N.gonorrhoeae dna dir prob

87591 $77.98 N.gonorrhoeae dna amp prob

87592 $95.20 N.gonorrhoeae dna quant

87623 $77.98 Hpv low-risk types

87624 $77.98 Hpv high-risk types

87625 $81.10 Hpv types 16 & 18 only

87631 $285.26 Resp virus 3-5 targets





87634 $155.98 Rsv dna/rna amp probe


87634 $155.98 Rsv dna/rna amp probe

87640 $77.98 Staph a dna amp probe

87641 $77.98 Mr-staph dna amp probe

87650 $44.56 Strep a dna dir probe

87650 $44.56 Strep a dna dir probe

87651 $77.98 Strep a dna amp probe

87651 $77.98 Strep a dna amp probe

87652 $92.80 Strep a dna quant

87653 $77.98 Strep b dna amp probe

87660 $44.56 Trichomonas vagin dir probe

87661 $77.98 Trichomonas vaginalis amplif

87662 $114.04 Zika virus dna/rna amp probe

87797 $60.06 Detect agent nos dna dir

87798 $77.98 Detect agent nos dna amp

87799 $95.20 Detect agent nos dna quant

87800 $89.14 Detect agnt mult dna direc

87801 $155.98 Detect agnt mult dna ampli

87801 $155.98 Detect agnt mult dna ampli

87802 $26.64 Strep b assay w/optic

87803 $32.00 Clostridium toxin a w/optic

87804 $33.10 Influenza assay w/optic

87804 $33.10 Influenza assay w/optic

87806 $65.54 Hiv antigen w/hiv antibodies

87806 $65.54 Hiv antigen w/hiv antibodies

87807 $26.64 Rsv assay w/optic

87807 $26.64 Rsv assay w/optic

87808 $30.58 Trichomonas assay w/optic

87808 $30.58 Trichomonas assay w/optic

87809 $43.52 Adenovirus assay w/optic

87809 $43.52 Adenovirus assay w/optic

87810 $70.58 Chylmd trach assay w/optic

87850 $49.12 N. gonorrhoeae assay w/optic

87880 $33.06 Strep a assay w/optic

87880 $33.06 Strep a assay w/optic

87899 $32.14 Agent nos assay w/optic

87899 $32.14 Agent nos assay w/optic

87900 $289.66 Phenotype infect agent drug

87901 $572.10 Genotype dna hiv reverse t

87902 $572.10 Genotype dna/rna hep c

87903 $1,085.90 Phenotype dna hiv w/culture

87904 $57.94 Phenotype dna hiv w/clt add

87905 $27.16 Sialidase enzyme assay

87905 $27.16 Sialidase enzyme assay

87906 $286.06 Genotype dna/rna hiv

87910 $572.10 Genotype cytomegalovirus

87912 $572.10 Genotype dna hepatitis b


88130 $39.94 Sex chromatin identification

88140 $17.76 Sex chromatin identification

88142 $45.02 Cytopath c/v thin layer

88143 $46.08 Cytopath c/v thin layer redo

88147 $101.12 Cytopath c/v automated

88148 $33.76 Cytopath c/v auto rescreen

88150 $29.98 Cytopath c/v manual

88152 $55.28 Cytopath c/v auto redo

88153 $48.06 Cytopath c/v redo

88155 $29.30 Cytopath c/v index add-on

88164 $29.98 Cytopath tbs c/v manual

88165 $84.44 Cytopath tbs c/v redo

88166 $29.98 Cytopath tbs c/v auto redo

88167 $29.98 Cytopath tbs c/v select

88174 $50.74 Cytopath c/v auto in fluid

88175 $58.88 Cytopath c/v auto fluid redo

88230 $258.88 Tissue culture lymphocyte

88233 $312.72 Tissue culture skin/biopsy

88235 $327.26 Tissue culture placenta

88237 $287.50 Tissue culture bone marrow

88239 $327.82 Tissue culture tumor

88240 $26.14 Cell cryopreserve/storage

88241 $24.18 Frozen cell preparation

88245 $384.84 Chromosome analysis 20-25


88249 $384.84 Chromosome analysis 100





88267 $399.50 Chromosome analys placenta

88269 $369.62 Chromosome analys amniotic

88271 $47.60 Cytogenetics dna probe

88272 $81.40 Cytogenetics 3-5

88273 $71.40 Cytogenetics 10-30

88274 $84.76 Cytogenetics 25-99

88275 $102.38 Cytogenetics 100-300

88280 $66.94 Chromosome karyotype study

88283 $152.44 Chromosome banding study

88285 $53.82 Chromosome count additional

88289 $76.52 Chromosome study additional

88371 $49.40 Protein western blot tissue

88372 $52.44 Protein analysis w/probe

88720 $11.14 Bilirubin total transcut

88738 $11.14 Hgb quant transcutaneous

88740 $18.74 Transcutaneous carboxyhb


88741 $18.74 Transcutaneous methb

89050 $10.50 Body fluid cell count

89051 $12.24 Body fluid cell count

89055 $9.50 Leukocyte assessment fecal

89060 $15.90 Exam synovial fluid crystals

89125 $11.76 Specimen fat stain

89160 $9.70 Exam feces for meat fibers

89190 $11.58 Nasal smear for eosinophils

89300 $19.84 Semen analysis w/huhner

89300 $19.84 Semen analysis w/huhner

89310 $19.14 Semen analysis w/count

89320 $26.78 Semen anal vol/count/mot

89321 $26.78 Semen anal sperm detection

89321 $26.78 Semen anal sperm detection

89322 $34.44 Semen anal strict criteria

89325 $23.72 Sperm antibody test

89329 $43.52 Sperm evaluation test

89330 $21.98 Evaluation cervical mucus

89331 $43.52 Retrograde ejaculation anal

G0027 $14.46 Semen analysis

G0103 $40.88 Psa screening

G0123 $45.02 Screen cerv/vag thin layer

G0143 $54.10 Scr c/v cyto,thinlayer,rescr



G0147 $29.98 Scr c/v cyto, automated sys

G0148 $63.88 Scr c/v cyto, autosys, rescr

G0306 $17.26 Cbc/diffwbc w/o platelet

G0307 $14.36 Cbc without platelet

G0328 $36.10 Fecal blood scrn immunoassay

G0328 $36.10 Fecal blood scrn immunoassay

G0432 $39.14 Eia hiv-1/hiv-2 screen

G0433 $36.58 Elisa hiv-1/hiv-2 screen

G0433 $36.58 Elisa hiv-1/hiv-2 screen

G0435 $26.64 Oral hiv-1/hiv-2 screen

G0471 $10.00 Ven blood coll snf/hha

G0472 $92.70 Hep c screen high risk/other

G0472 $92.70 Hep c screen high risk/other

G0475 $53.50 Hiv combination assay

G0475 $53.50 Hiv combination assay

G0476 $77.98 Hpv combo assay ca screen

G0480 $228.86 Drug test def 1-7 classes



G0483 $493.84 Drug test def 22+ classes

G0499 $62.82 Hepb screen high risk indiv


G0659 $129.30 Drug test def simple all cl

G9143 $268.26 Warfarin respon genetic test

P2028 $11.00 Cephalin floculation test

P2029 $11.00 Congo red blood test

P2031 $11.00 Hair analysis

P2033 $11.00 Blood thymol turbidity

P2038 $11.00 Blood mucoprotein

P3000 $29.98 Screen pap by tech w md supv

P9612 $6.00 Catheterize for urine spec

P9615 $6.00 Urine specimen collect mult

Q0111 $29.98 Wet mounts/ w preparations

Q0112 $11.66 Potassium hydroxide preps

Q0113 $9.50 Pinworm examinations

Q0114 $19.48 Fern test

Q0115 $50.00 Post-coital mucous exam

2019 clinical diagnostic laboratory fee schedule80305 $25.20 drug test prsmv dir opt obs 80305...

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