MHS Labs Fee Schedule- 2022*

*This is a representation of our current fee schedule. Please contact us to confirm the accurate fee schedule on the date of service.

HTPCS MOD Short Description Long Description Fee
0001U Rbc dna hea 35 ag 11 bld grp Red blood cell typing $1,800.00
0002M Liver dis 10 assays w/ash Molecular pathology test for liver disease, including alcohol liver disease $1,258.50
0002U Onc clrct 3 ur metab alg plp Measurement of substances in urine to predict likelihood of polyps in large $62.50
0003M Liver dis 10 assays w/nash Molecular pathology test for liver disease, including non-alcohol liver disease $1,258.50
0003U Onc ovar 5 prtn ser alg scor Measurement of proteins associated with ovarian cancer in serum $2,375.00
0004M Scoliosis dna alys Molecular pathology test for genetic analysis of curved spine deformity $197.50
0005U Onco prst8 3 gene ur alg Test for detecting genes associated with prostate cancer in urine $1,900.00
0006M Onc hep gene risk classifier Molecular pathology test for genetic analysis of liver tumor (HeproDX) $375.00
0007M Onc gastro 51 gene nomogram Molecular pathology test for genetic analysis of tumors in the digestive system $937.50
0007U Rx test prsmv ur w/def conf Testing for presence of drug in urine $286.08
0008U Hpylori detcj abx rstnc dna Test for detecting Helicobacter pylori genes associated with antibiotic $1,494.78
0009U Onc brst ca erbb2 amp/nonamp Gene analysis of breast tumor tissue $267.50
0010U Nfct ds strn typ whl gen seq Typing of bacterial strain $1,068.15
0011M Onc prst8 ca mrna 12 gen alg Molecular pathology test for genetic analysis of prostate tumor (NeoLAB $1,900.00
0011U Rx mntr lc-ms/ms oral fluid Prescription drug monitoring in oral fluid $286.08
0012M Onc mrna 5 gen rsk urthl ca Molecular pathology test for genetic analysis of bladder tumor (Cxbladder $1,900.00
0012U Germln do gene reargmt detcj Gene analysis for germline disorder $6,289.00
0013M Onc mrna 5 gen recr urthl ca Molecular pathology test for genetic analysis of recurrent bladder tumor $1,900.00
0013U Onc sld org neo gene reargmt Gene analysis of solid organ tumor tissue $6,289.00
0014M Liver ds alys 3 bmrk srm alg Molecular pathology test for risk of serious liver disease within 5 years $440.48
0014U Hem hmtlmf neo gene reargmt DNA test for detecting gene abnormality associated with blood and lymphatic $6,289.00
0015M Adrnl cortcl tum bchm asy 25 Molecular pathology test for genetic analysis of kidney gland tumor (Adrenal $3,263.43
0016M Onc bladder mrna 209 gen alg Molecular pathology test for genetic analysis of bladder tumor (Decipher $8,724.08
0016U Onc hmtlmf neo rna bcr/abl1 RNA test for detecting gene abnormality associated with blood and lymphatic $409.90
0017M Onc dlbcl mrna 20 genes alg mRNA gene expression profiling by fluorescent probe hybridization of 20 genes $6,275.53
0017U Onc hmtlmf neo jak2 mut dna JAK2 mutation test for detecting gene abnormality associated with blood and $229.15
0018M Trnsplj rnl meas cd154+cll Measurement of kidney donor and third-party-induced CD154+T-cytotoxic memory $-
0018U Onc thyr 10 microrna seq alg MicroRNA gene analysis of thyroid nodule tissue $7,505.23
0019U Onc rna tiss predict alg RNA gene analysis of tumor tissue $9,187.50
0021U Onc prst8 detcj 8 autoantb Detection of 8 autoantibodies in prostate tissue $1,900.00
0022U Trgt gen seq dna&rna 1-23 gn DNA and RNA gene analysis for non-small cell lung cancer $4,875.00
0023U Onc aml dna detcj/nondetcj DNA gene analysis for acute myelogenous leukemia $621.28
0024U Glyca nuc mr spectrsc quan Measurement of glycosylated acute phase proteins $85.48
0025U Tenofovir liq chrom ur quan Measurement of tenovir in urine $214.43
0026U Onc thyr dna&mrna 112 genes DNA and microRNA gene analysis of thyroid nodule tissue $9,000.00
0027U Jak2 gene trgt seq alys Gene analysis (Janus kinase 2) of targeted sequence exons 12-15 $304.78
0029U Rx metab advrs trgt seq alys Gene analysis of targeted sequences for adverse drug reactions and drug response $1,855.68
0030U Rx metab warf trgt seq alys Gene analysis of targeted sequences for warfarin drug response $335.33
0031U Cyp1a2 gene Gene analysis (cytochrome P450 family 1, subfamily A, member 2) for common $437.03
0032U Comt gene Gene analysis (catechol-O-methyltransferase) for c.472G>A (rs4680) variant $437.03
0033U Htr2a htr2c genes Gene analysis (5-hydroxytryptamine receptor 2A) for common variants $874.05
0034U Tpmt nudt15 genes Gene analysis (thiopurine S-methyltransferase) for common variants $1,165.43
0035U Neuro csf prion prtn qual Testing for presence of prion protein in cerebrospinal fluid $1,352.48
0036U Xome tum & nml spec seq alys Exome gene analysis for somatic mutation in tumor tissue $11,950.00
0037U Trgt gen seq dna 324 genes DNA gene analysis of 324 genes in solid organ tumor tissue $8,750.00
0038U Vitamin d srm microsamp quan Measurement of vitamin D in serum $74.00
0039U Dna antb 2strand hi avidity Testing for anti-DNA antibody $34.35
0040U Bcr/abl1 gene major bp quan Gene analysis (t(9;22)) for translocation analysis $1,024.75
0041U B brgdrferi antb 5 prtn igm IgM antibody detection test for Borrelia burgdorferi $43.03
0042U B brgdrferi antb 12 prtn igg IgG antibody detection test for Borrelia burgdorferi $43.03
0043U Tbrf b grp antb 4 prtn igm IgM antibody detection test for Tick-Borne Relapsing Fever Borrelia group (IgM) $37.15
0044U Tbrf b grp antb 4 prtn igg IgM antibody detection test for Tick-Borne Relapsing Fever Borrelia group (IgG) $37.15
0045U Onc brst dux carc is 12 gene mRNA gene analysis of 12 genes in breast ductal carcinoma in situ tumor tissue $9,682.50
0046U Flt3 gene itd variants quan Gene analysis (fms-related tyrosine kinase 3) for internal tandem duplication $1,018.58
0047U Onc prst8 mrna 17 gene alg mRNA gene analysis of 17 genes in prostate tumor tissue $9,682.50
0048U Onc sld org neo dna 468 gene DNA gene analysis of 468 genes in solid organ tumor tissue $7,299.00
0049U Npm1 gene analysis quan Gene analysis (nucleophosmin) $1,018.58
0050U Trgt gen seq dna 194 genes DNA gene analysis of targeted sequences in 194 genes for acute myelogenous $7,291.50
0051U Rx mntr lc-ms/ms ur/bld 31 Testing for presence of 31 prescription drugs in urine or blood specimen $484.28
0052U Lpoprtn bld w/5 maj classes Measurement of all five major lipoprotein classes and subclasses in blood $84.65
0053U Onc prst8 ca fish alys 4 gen FISH analysis of 4 genes in prostate needle biopsy specimen $5,075.00
0054U Rx mntr 14+ drugs & sbsts Measurement of 14 or more drug classes in capillary blood $372.40
0055U Card hrt trnspl 96 dna seq DNA gene analysis of 96 target sequences in plasma for heart transplant $8,100.00
0056U Hem aml dna gene reargmt Whole genome sequencing in blood or bone marrow for acute myelogenous leukemia $6,289.00
0058U Onc merkel cll carc srm quan Measurement of antibodies to Merkel cell polyoma virus oncoprotein in serum $807.40
0059U Onc merkel cll carc srm +/- Test for presence of antibodies to Merkel cell polyoma virus oncoprotein in $807.40
0060U Twn zyg gen seq alys chrms2 Gene analysis for identical twins in maternal blood $1,897.63
0061U Tc meas 5 bmrk sfdi m-s alys Spatial frequency domain imaging of skin $62.75
0062U Ai sle igg&igm alys 80 bmrk IgG and IgM analysis of 80 biomarkers of systemic lupus erythematosus in serum $951.80
0063U Neuro autism 32 amines alg Testing for amines associated with autism spectrum disorder in plasma $1,875.00
0064U Antb tp total&rpr ia qual Antibody testing for syphilis $78.33
0065U Syfls tst nontreponemal antb Non-antibody testing for syphilis $45.23
0066U Pamg-1 ia cervico-vag fluid Measurement of placental alpha-micro globulin-1 (PAMG-1) in cervical/vaginal $38.23
0067U Onc brst imhchem prfl 4 bmrk Protein expression profiling of 4 biomarkers of breast cancer in precancerous $4,742.50
0068U Candida species pnl amp prb Detection of Candida species by amplified probe $356.58
0069U Onc clrct microrna mir-31-3p mRNA expression profiling of miR-31-3 in colon tumor tissue $950.00
0070U Cyp2d6 gen com&slct rar vrnt Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) for $1,690.93
0071U Cyp2d6 full gene sequence Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) full $1,500.00
0072U Cyp2d6 gen cyp2d6-2d7 hybrid Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted $1,127.28
0073U Cyp2d6 gen cyp2d7-2d6 hybrid Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted $1,127.28
0074U Cyp2d6 nonduplicated gene Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted $1,127.28
0075U Cyp2d6 5′ gene dup/mlt Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted $1,127.28
0076U Cyp2d6 3′ gene dup/mlt Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) targeted $1,127.28
0077U Ig paraprotein qual bld/ur Detection of Immunoglobulin paraprotein (M-protein) in blood or urine $108.58
0078U Pain mgt opi use gnotyp pnl Gene analysis of 16 genes to evaluate risk of opioid-use disorder $1,127.28
0080U Onc lng 5 clin rsk factr alg Analysis of galectin-3-binding protein and scavenger receptor cysteine-rich $8,800.00
0082U Rx test def 90+ rx/sbsts ur Definitive drug testing for 90 or more drugs in urine $617.30
0083U Onc rspse chemo cntrst tomog Evaluation of response to chemotherapy drugs using motility contrast tomography $418.38
0084U Rbc dna gnotyp 10 bld groups DNA red blood cell antigen typing $1,800.00
0086U Nfct ds bact&fng org id 6+ FISH identification of organisms in blood culture $500.00
0087U Crd hrt trnspl mrna 1283 gen mRNA gene expression profiling of genes in heart transplant biopsy tissue to $7,898.55
0088U Trnsplj kdn algrft rej 1494 mRNA gene expression profiling of genes in kidney transplant tissue to evaluate $7,898.55
0089U Onc mlnma prame & linc00518 Gene expression profiling of melanoma in superficial sample collected by $1,900.00
0090U Onc cutan mlnma mrna 23 gene mRNA gene expression profiling of 23 genes in skin melanoma tissue sample $4,875.00
0092U Onc lng 3 prtn bmrk plsm alg Measurement of 3 protein biomarkers for lung cancer in plasma $6,220.00
0093U Rx mntr 65 com drugs urine Prescription drug monitoring for 65 common drugs in urine $155.35
0094U Genome rapid sequence alys Rapid sequence gene testing $18,955.50
0095U Inflm ee elisa alys alg Test for markers of eosinophilic inflammation of esophagus $1,929.95
0096U Hpv hi risk types male urine Test for detection of high-risk human papillomavirus in male urine $87.73
0101U Hered colon ca do 15 genes Gene sequence analysis panel of 15 genes associated with hereditary colon $4,359.88
0102U Hered brst ca rltd do 17 gen Gene sequence analysis panel of 17 genes associated with hereditary breast $3,259.88
0103U Hered ova ca pnl 24 genes Gene sequence analysis panel of 24 genes associated with hereditary ovarian $4,359.88
0105U Neph ckd mult eclia tum nec Measurement of tumor necrosis factor receptor 1A, receptor superfamily 2 $2,375.00
0106U Gstr emptg 7 timed brth spec Evaluation of gastric emptying by measurement of radiolabeled carbon monoxide $2,186.23
0107U C diff tox ag detcj ia stool Antigen test for detection of Clostridium difficile toxin in stool $40.00
0108U Gi barrett esoph 9 prtn bmrk Computer-assisted digital imaging of esophagus specimen slides to evaluate risk $5,875.00
0109U Id aspergillus dna 4 species DNA test for detection of 4 Aspergillus species $356.58
0110U Rx mntr 1+oral onc rx&sbsts Monitoring of anti-cancer drugs in patient blood, serum, or plasma $67.78
0111U Onc colon ca kras&nras alys Gene analysis (KRAS and NRAS) in prostate tumor tissue $1,705.73
0112U Iadi 16s&18s rrna genes Gene analysis for detection of infectious agent and drug resistance gene $890.33
0113U Onc prst8 pca3&tmprss2-erg Measurement of PCA3 gene in urine and prostate-specific antigen (PSA) in serum $1,900.00
0114U Gi barretts esoph vim&ccna1 Gene analysis (VIM and CCNA1 methylation) in esophageal cells to evaluate $4,845.03
0115U Respir iadna 18 viral&2 bact Respiratory infectious agent detection by nucleic acid (DNA and RNA), 18 viral $688.38
0116U Rx mntr nzm ia 35+oral flu Analysis of 35 or more drugs in mouth fluid to evaluate risk of prescription $617.30
0117U Pain mgmt 11 endogenous anal Analysis of 11 biochemical substances in urine to evaluate likelihood of $2,101.63
0118U Trnsplj don-drv cll-fr dna Measurement of transplant donor cell-free DNA in transplant recipient plasma $6,883.13
0119U Crd ceramides liq chrom plsm Measurement of ceramides for assessment of heart disease risk $209.40
0120U Onc b cll lymphm mrna 58 gen mRNA, gene expression profiling of 58 genes in tissue sample for B-cell $6,275.53
0121U Sc dis vcam-1 whole blood Blood test for sickle cells using VCAM-1 $1,273.00
0122U Sc dis p-selectin whl blood Blood test for sickle cells using P-Selectin $1,315.58
0123U Mchnl fragility rbc prflg Test for fragility of red blood cells $894.08
0129U Hered brst ca rltd do panel Gene analysis of genes associated with hereditary breast cancer and related $3,259.88
0130U Hered colon ca do mrna pnl Targeted mRNA sequence analysis of genes associated with hereditary colon $1,462.25
0131U Hered brst ca rltd do pnl 13 Targeted mRNA sequence analysis of 13 genes associated with hereditary breast $1,775.00
0132U Hered ova ca rltd do pnl 17 Targeted mRNA sequence analysis of 17 genes associated with hereditary ovarian $1,854.10
0133U Hered prst8 ca rltd do 11 Targeted mRNA sequence analysis of 11 genes associated with hereditary prostate $1,725.73
0134U Hered pan ca mrna pnl 18 gen Targeted mRNA sequence analysis of 18 genes associated with hereditary pan $1,870.98
0135U Hered gyn ca mrna pnl 12 gen Targeted mRNA sequence analysis of 12 genes associated with hereditary $1,751.40
0136U Atm mrna seq alys mRNA gene analysis (ataxia telangiectasia mutated) $1,018.58
0137U Palb2 mrna seq alys mRNA gene analysis (partner and localizer of BRCA2) $707.20
0138U Brca1 brca2 mrna seq alys mRNA gene analysis (BRCA1, DNA repair associated and BRCA2, DNA repair $1,170.83
0139U Neuro austm meas 6 c metablt Measurement of 6 central carbon metabolite biomarkers for autism spectrum $1,875.00
0140U Nfct ds fungi dna 15 trgt Amplifed DNA probe detection of fungus in blood culture specimen $391.88
0141U Nfct ds bact&fng gram pos Amplifed DNA probe detection of 20 gram-positive bacterial targets, 4 $391.88
0142U Nfct ds bact&fng gram neg Amplifed DNA probe detection of 20 gram-positive bacterial targets, 6 $391.88
0143U Drug assay 120+ rx/metablt Measurement of 120 or more drugs or metabolites in urine specimen $286.08
0144U Drug assay 160+ rx/metablt Measurement of 160 or more drugs or metabolites in urine specimen $286.08
0145U Drug assay 65+ rx/metablt Measurement of 65 or more drugs or metabolites in urine specimen $286.08
0146U Drug assay 80+ rx/metablt Measurement of 80 or more drugs or metabolites in urine specimen $286.08
0147U Drug assay 85+ rx/metablt Measurement of 85 or more drugs or metabolites in urine specimen $286.08
0148U Drug assay 100+ rx/metablt Measurement of 100 or more drugs or metabolites in urine specimen $286.08
0149U Drug assay 60+ rx/metablt Measurement of 60 or more drugs or metabolites in urine specimen $286.08
0150U Drug assay 120+ rx/metablt Measurement of 120 or more drugs or metabolites in urine specimen $286.08
0152U Nfct ds dna untrgt ngnrj seq Cell-free DNA sequencing of disease-causing organisms in plasma specimen, with $5,315.50
0153U Onc breast mrna 101 genes mRNA gene expression profiling of 101 genes in breast growth tissue specimen $7,898.55
0154U Onc urthl ca rna fgfr3 gene RNA gene analysis for detection of fibroblast growth factor receptor 3 gene $1,205.35
0155U Onc brst ca dna pik3ca gene DNA analysis for detection of PIK3CA gene mutation in breast growth tissue $687.08
0156U Copy number sequence alys Gene analysis copy number sequence analysis $4,350.00
0157U Apc mrna seq alys mRNA gene analysis of APC regulator of WNT signaling pathway $707.20
0158U Mlh1 mrna seq alys mRNA gene analysis of mutL homolog 1 $707.20
0159U Msh2 mrna seq alys mRNA gene analysis of mutS homolog 2 $707.20
0160U Msh6 mrna seq alys mRNA gene analysis of mutS homolog 6 $707.20
0161U Pms2 mrna seq alys mRNA gene analysis of PMS1 homolog 2, mismatch repair system component $707.20
0162U Hered colon ca trgt mrna pnl Targeted mRNA sequence analysis for genes associated with hereditary colon $1,216.35
0163U Onc clrct scr 3 prtn alg Screening test for 3 protein biomarkers of colorectal cancer in serum or plasma $976.88
0164U Gi ibs ia anti-cdtb&vinculin Test for detection of antibodies associated with irritable bowel syndrome in $280.05
0165U Peanut allg asmt epi Test for detection of antigens associated with peanut allergy in blood $1,159.40
0166U Liver ds 10 biochem asy srm Liver disease test panel in serum specimen $1,258.50
0167U Chornc gonadotropin hcg ia Test for detection of human chorionic gonadotropin (pregnancy hormone) in blood $18.80
0168U Ftl aneuploidy dna seq alys DNA analysis for detection of abnormal chromosome number of fetus in maternal $1,897.63
0169U Nudt15&tpmt gene com vrnt Gene analysis (nudix hydrolase 15) and TPMT (thiopurine S-methyltransferase) $1,165.43
0170U Neuro asd rna next gen seq RNA gene sequencing for probability of autism spectrum disorder in saliva $4,387.50
0171U Trgt gen seq alys pnl dna 23 DNA analysis of targeted sequences in 23 genes for detection of abnormalites $3,797.65
0172U Onc sld tum alys brca1 brca2 DNA gene analysis (BRCA1, DNA repair associated and BRCA2, DNA repair $7,575.00
0173U Psyc gen alys panel 14 genes Gene analysis panel for detection of variants in 14 genes associated with $1,165.43
0174U Onc solid tumor 30 prtn trgt Mass spectrometry testing for 30 protein targets in tissue specimen to predict $3,263.43
0175U Psyc gen alys panel 15 genes Gene analysis panel for detection of variants in 15 genes associated with $3,340.23
0176U Cdtb&vinculin igg antb ia Test for detection of IgG antibodies associated with irritable bowel syndrome $160.48
0177U Onc brst ca dna pik3ca 11 DNA gene analysis (phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic $687.08
0178U Peanut allg asmt epi clin rx Test for detection of antigens associated with peanut allergy in blood $1,149.65
0179U Onc nonsm cll lng ca alys 23 Cell-free DNA analysis of targeted sequences in 23 genes for detection of $4,858.03
0180U Abo gnotyp abo 7 exons Red blood cell antigen genotyping, ABO blood group $687.08
0181U Co gnotyp aqp1 exon 1 Red blood cell antigen genotyping, Colton blood group $463.00
0182U Crom gnotyp cd55 exons 1-10 Red blood cell antigen genotyping, CD55 molecule [Cromer blood group] exons 1-10 $753.38
0183U Di gnotyp slc4a1 exon 19 Red blood cell antigen genotyping, solute carrier family 4 member 1 [Diego $463.00
0184U Do gnotyp art4 exon 2 Red blood cell antigen genotyping, ADP-ribosyltransferase 4 [Dombrock blood $463.00
0185U Fut1 gnotyp fut1 exon 4 Red blood cell antigen genotyping, fucosyltransferase 1 [H blood group] exon 4 $463.00
0186U Fut2 gnotyp fut2 exon 2 Red blood cell antigen genotyping, fucosyltransferase 2 [H blood group] exon 2 $463.00
0187U Fy gnotyp ackr1 exons 1-2 Red blood cell antigen genotyping, atypical chemokine receptor 1 [Duffy blood $687.08
0188U Ge gnotyp gypc exons 1-4 Red blood cell antigen genotyping, glycophorin C [Gerbich blood group] exons 1-4 $687.08
0189U Gypa gnotyp ntrns 1 5 exon 2 Red blood cell antigen genotyping, glycophorin A [MNS blood group] introns 1, $687.08
0190U Gypb gnotyp ntrns 1 5 seux 3 Red blood cell antigen genotyping, glycophorin B [MNS blood group] introns 1, $687.08
0191U In gnotyp cd44 exons 2 3 6 Red blood cell antigen genotyping, CD44 molecule [Indian blood group] exons 2, $687.08
0192U Jk gnotyp slc14a1 exon 9 Red blood cell antigen genotyping, solute carrier family 14 member 1 [Kidd $687.08
0193U Jr gnotyp abcg2 exons 2-26 Red blood cell antigen genotyping, ATP binding cassette subfamily G member 2 $707.20
0194U Kel gnotyp kel exon 8 Red blood cell antigen genotyping, Kell metallo-endopeptidase [Kell blood $463.00
0195U Klf1 targeted sequencing Gene analysis (Kruppel-like factor 1) targeted sequence analysis $938.13
0196U Lu gnotyp bcam exon 3 Red blood cell antigen genotyping, basal cell adhesion molecule [Lutheran blood $463.00
0197U Lw gnotyp icam4 exon 1 Red blood cell antigen genotyping, intercellular adhesion molecule 4 $463.00
0198U Rhd&rhce gntyp rhd1-10&rhce5 Red blood cell antigen genotyping, Rh blood group D antigen exons 1-10 and Rh $707.20
0199U Sc gnotyp ermap exons 4 12 Red blood cell antigen genotyping, erythroblast membrane associated protein $687.08
0200U Xk gnotyp xk exons 1-3 Red blood cell antigen genotyping, X-linked Kx blood group exons 1-3 $687.08
0201U Yt gnotyp ache exon 2 Red blood cell antigen genotyping, acetylcholinesterase [Cartwright blood $463.00
0202U Nfct ds 22 trgt sars-cov-2 Test for detection of respiratory disease-causing organisms from back of nose $1,041.95
0203U Ai ibd mrna xprsn prfl 17 mRNA gene expression profiling of 17 genes in whole blood specimen for $1,900.00
0204U Onc thyr mrna xprsn alys 593 mRNA gene analysis of 539 genes in fine needle aspiration thyroid specimen, $7,299.00
0205U Oph amd alys 3 gene variants Gene analysis for detection of variants in 3 genes in cheek swab specimen for $117.50
0206U Neuro alzheimer cell aggregj Cell aggregation testing of cultured skin cells for Alzheimer disease, reported $5,538.50
0207U Neuro alzheimer quan imaging Immunofluorescence testing of cultured skin cells for Alzheimer disease, $1,278.00
0209U Cytog const alys interrog Cytogenomic analysis of whole genome for abnormal chromosomes $1,967.88
0210U Syphilis tst antb ia quan Measurement of nontreponemal antibodies associated with syphilis $46.58
0211U Onc pan-tum dna&rna gnrj seq Next-generation sequencing of DNA and RNA in tumor tissue specimen with $21,137.50
0212U Rare ds gen dna alys proband Rare diseases genetic testing of complete DNA of first affected person in family $13,688.00
0213U Rare ds gen dna alys ea comp Rare diseases genetic testing of complete DNA of relative of affected person in $6,774.88
0214U Rare ds xom dna alys proband Rare diseases genetic testing of protein coding genes of first affected person $13,061.50
0215U Rare ds xom dna alys ea comp Rare diseases genetic testing of protein coding genes of relative of affected $6,436.63
0216U Neuro inh ataxia dna 12 com DNA analysis of gene sequence of 12 genes for identification and $3,842.55
0217U Neuro inh ataxia dna 51 gene DNA analysis of gene sequence of 51 genes for identification and $5,495.88
0218U Neuro musc dys dmd seq alys DNA analysis of gene sequence for identification and characterization of $5,697.50
0219U Nfct agt hiv gnrj seq alys Gene analysis of human immunodeficiency virus targeted sequence analysis for $1,812.50
0220U Onc brst ca ai assmt 12 feat Image analysis of breast cancer cell specimen with artificial intelligence $1,765.63
0221U Abo gnotyp next gnrj seq abo Red blood cell antigen genotyping, ABO, alpha $687.08
0222U Rhd&rhce gntyp next gnrj seq Red blood cell antigen genotyping, RH proximal promoter, exons 1-10, portions $707.20
0223U Nfct ds 22 trgt sars-cov-2 Test for detection of respiratory disease-causing organisms from back of nose $1,041.95
0224U Antibody sars-cov-2 titer(s) Measurement of antibody to severe acute respiratory syndrome coronavirus 2 $-
0225U Nfct ds dna&rna 21 sarscov2 Test for detection of respiratory disease-causing organisms, 21 target $1,041.95
0226U Svnt sarscov2 elisa plsm srm Surrogate viral neutralization test (sVNT) for detection of antibodies to $-
0227U Rx asy prsmv 30+rx/metablt Presumptive drug testing for 30 or more drugs in urine $155.35
0228U Onc prst8 ma molec prfl alg Detection test by photometric technique for macromolecules in urine to evaluate $-
0229U Bcat1/ikzf1 prmtr mthyln aly Gene analysis (branched chain amino acid transaminase 1 or IKAROS family zinc $480.00
0230U Ar full sequence analysis Gene analysis (androgen receptor), full sequence analysis $753.38
0231U Cacna1a full gene analysis Gene analysis (calcium voltage-gated channel subunit alpha 1A), full gene $2,115.68
0232U Cstb full gene analysis Gene analysis (cystatin B), full gene analysis $687.08
0233U Fxn gene analysis Gene analysis (frataxin) $687.08
0234U Mecp2 full gene analysis Gene analysis (methyl CpG binding protein 2), full gene analysis $1,319.68
0235U Pten full gene analysis Gene analysis (phosphatase and tensin homolog), full gene analysis $1,500.00
0236U Smn1&smn2 full gene analysis Gene analysis (survival of motor neuron 1, telomeric and survival of motor $1,506.75
0237U Car ion chnlpthy gen seq pnl Gene analysis for cardiac ion channelopathies, genomic sequence analysis $1,462.25
0238U Onc lnch syn gen dna seq aly DNA sequence analysis of MLH1, MSH2, MSH6, PMS2, and EPCAM for Lynch syndrome $1,462.25
0239U Trgt gen seq alys pnl 311+ Gene analysis of 311 or more genes associated with solid organ cancer in $8,750.00
0240U Nfct ds vir resp rna 3 trgt Respiratory infectious agent detection by RNA for severe acute respiratory $356.58
0240U QW Nfct ds vir resp rna 3 trgt Respiratory infectious agent detection by RNA for severe acute respiratory $356.58
0241U Nfct ds vir resp rna 4 trgt Respiratory infectious agent detection by RNA for severe acute respiratory $356.58
0241U QW Nfct ds vir resp rna 4 trgt Respiratory infectious agent detection by RNA for severe acute respiratory $356.58
0242U Trgt gen seq alys pnl 55-74 Gene analysis of 55-74 genes associated with solid organ cancer in cell-free $12,500.00
0243U Ob pe biochem assay pgf alg Time-resolved fluorescence immunoassay of placental-growth factor in maternal $161.03
0244U Onc solid orgn dna 257 genes Gene analysis of 257 genes associated with solid organ cancer in tumor tissue $8,750.00
0245U Onc thyr mut alys 10 gen&37 Gene analysis of 10 genes and 37 RNA fusions and expression of 4 mRNA markers, $-
0246U Rbc dna gnotyp 16 bld groups Blood typing for 16 or more blood groups with phenotype prediction of 51 or $1,800.00
0247U Ob prtrm brth ibp4 shbg meas Quantitative measurement of insulin-like growth factor-binding protein 4 and $1,875.00
0248U Onc brn sphrd cll 12 rx pnl Culture of brain cancer cells with 12 drug panel testing for tumor response $-
0249U Onc brst alys 32 phsprtn alg Analysis of 32 phosphoproteins and protein analytes associated with breast $-
0250U Onc sld org neo dna 505 gene Gene analysis of 505 genes associated with solid organ cancer in tumor tissue $7,299.00
0251U Hepcidin-25 elisa serum/plsm ELISA assay for hepacidin-25 in serum or plasma $43.18
0252U Ftl aneuploidy str alys dna Analysis of fetal DNA, short tandem-repeat comparative analysis, for abnormal $-
0253U Rprdtve med rna gen prfl 238 RNA gene expression profiling of 238 genes by next-generation sequencing $-
0254U Reprdtve med alys 24 chrmsm Preimplantation genetic assessment of embryo by gene sequence analysis of 24 $-
0255U Andrology infertility assmt Evaluation of sperm using fluorescence microscopic evaluation of ganglioside $-
0256U Tma/tmao prfl ms/ms ur alg Tandem mass spectroscopy (MS/MS) profile of trimethylamine/trimethylamine $-
0257U Vlcad leuk nzm actv whl bld Evaluation of very long chain acyl-coenzyme A (CoA) dehydrogenase (VLCAD) white $-
0258U Ai psor mrna 50-100 gen alg mRNA gene expression profiling of 50-100 genes in skin surface specimen, $9,187.50
0259U Neph ckd nuc mrs meas gfr Nuclear MR spectroscopy measurement of myo-inositol, valine, and creatinine, $131.78
0260U Rare ds id opt genome mapg Optical genome mapping for detection of abnormalities associated with rare $-
0261U Onc clrct ca img alys w/ai Image analysis with artificial intelligence assessment of 4 cellular and immune $6,283.13
0262U Onc sld tum rt-pcr 7 gen mRNA gene expression profiling of 7 gene pathways in solid organ tumor tissue $-
0263U Neuro asd meas 16 c metblt LC-MS/MS spectroscopy of 16 central carbon metabolites associated with autism $1,875.00
0264U Rare ds id opt genome mapg Detection of abnormalities associated with rare heritable diseases by optical $-
0265U Rar do whl gn&mtcdrl dna als Whole genome and mDNA sequence analysis for detection of abnormalities $-
0266U Unxpl cnst hrtbl do gn xprsn Gene expression profiling by whole transcriptone and next-generation sequencing $-
0267U Rare do id opt gen mapg&seq Optical genome mapping and whole genome sequencing for detection of $-
0268U Hem ahus gen seq alys 15 gen Genomic sequence analysis of 15 genes for detection of abnormalities associated $-
0269U Hem aut dm cgen trmbctpna 14 Genomic sequence analysis of 14 genes for detection of abnormalities associated $-
0270U Hem cgen coagj do 20 genes Genomic sequence analysis of 20 genes for detection of abnormalities associated $-
0271U Hem cgen neutropenia 23 gen Genomic sequence analysis of 23 genes for detection of abnormalities associated $-
0272U Hem genetic bld do 51 genes Comprehensive genomic sequence analysis of 51 genes for detection of $-
0273U Hem gen hyprfibrnlysis 8 gen Genomic sequence analysis of 8 genes for detection of abnormalities associated $-
0274U Hem gen pltlt do 43 genes Genomic sequence analysis of 43 genes for detection of abnormalities associated $-
0275U Hem heprn nduc trmbctpna srm Flow cytometry detection of platelet antibody reactivity in serum for $45.93
0276U Hem inh thrombocytopenia 23 Genomic sequence analysis of 23 genes for detection of abnormalities associated $-
0277U Hem gen pltlt funcj do 31 Genomic sequence analysis of 31 genes for detection of abnormalities associated $-
0278U Hem gen thrombosis 12 genes Genomic sequence analysis of 12 genes for detection of abnormalities associated $-
0279U Hem vw factor&clgn iii bndg ELISA detection of von Willebrand factor (VWF) and collagen III binding in $28.83
0280U Hem vw factor&clgn iv bndg ELISA detection of von Willebrand factor (VWF) and collagen IV binding in $43.18
0281U Hem vwd propeptide ag lvl ELISA measurement of von Willebrand propeptide in plasma specimen, diagnostic $43.18
0282U Rbc dna gntyp 12 bld grp gen Red blood cell antigen genotyping of 12 blood group system genes to predict 44 $1,800.00
0283U Vw factor type 2b eval plsm Radioimmunoassay platelet-binding evaluation of von Willebrand factor (VWF), $46.00
0284U Vw factor type 2n eval plsm ELISA evaluation of von Willebrand factor (VWF), type 2N, factor VIII and VWF $43.18
0285U Onc rsps radj cll fr dna tox Oncology, response to radiation, cell-free dna, quantitative branched chain dna $-
0286U Cep72 nudt15&tpmt gene alys Cep72 (centrosomal protein, 72-kda), nudt15 (nudix hydrolase 15) and tpmt $-
0287U Onc thyr dna&mrna 112 genes Oncology (thyroid), dna and mrna, next-generation sequencing analysis of 112 $-
0288U Onc lung mrna quan pcr 11&3 Oncology (lung), mrna, quantitative pcr analysis of 11 genes (bag1, brca1, $-
0289U Neuro alzheimer mrna 24 gen Neurology (alzheimer disease), mrna, gene expression profiling by rna $-
0290U Pain mgmt mrna gen xprsn 36 Pain management, mrna, gene expression profiling by rna sequencing of 36 genes, $-
0291U Psyc mood do mrna 144 genes Psychiatry (mood disorders), mrna, gene expression profiling by rna sequencing $-
0292U Psyc strs do mrna 72 genes Psychiatry (stress disorders), mrna, gene expression profiling by rna $-
0293U Psyc suicidal idea mrna 54 Psychiatry (suicidal ideation), mrna, gene expression profiling by rna $-
0294U Lngvty&mrtlty rsk mrna 18gen Longevity and mortality risk, mrna, gene expression profiling by rna sequencing $-
0295U Onc brst dux carc 7 proteins Oncology (breast ductal carcinoma in situ), protein expression profiling by $-
0296U Onc orl&/orop ca 20 mlc feat Oncology (oral and/or oropharyngeal cancer), gene expression profiling by rna $-
0297U Onc pan tum whl gen seq dna Oncology (pan tumor), whole genome sequencing of paired malignant and normal $-
0298U Onc pan tum whl trns seq rna Oncology (pan tumor), whole transcriptome sequencing of paired malignant and $-
0299U Onc pan tum whl gen opt mapg Oncology (pan tumor), whole genome optical genome mapping of paired malignant $-
0300U Onc pan tum whl gen seq&opt Oncology (pan tumor), whole genome sequencing and optical genome mapping of $-
0301U Iadna bartonella ddpcr Infectious agent detection by nucleic acid (dna or rna), bartonella henselae $-
0302U Iadna brtnla ddpcr flwg liq Infectious agent detection by nucleic acid (dna or rna), bartonella henselae $-
0303U Hem rbc ads whl bld hypoxic Hematology, red blood cell (rbc) adhesion to endothelial/subendothelial $-
0304U Hem rbc ads whl bld normoxic Hematology, red blood cell (rbc) adhesion to endothelial/subendothelial $-
0305U Hem rbc fnclty&dfrm shr strs Hematology, red blood cell (rbc) functionality and deformity as a function of $-
0306U Onc mrd nxt-gnrj alys 1st Oncology (minimal residual disease [mrd]), next-generation targeted sequencing $-
0307U Onc mrd nxt-gnrj alys sbsq Oncology (minimal residual disease [mrd]), next-generation targeted sequencing $-
0308U Crd cad alys 3 prtn plsm alg Cardiology (coronary artery disease [cad]), analysis of 3 proteins (high $-
0309U Crd cv ds aly 4 prtn plm alg Cardiology (cardiovascular disease), analysis of 4 proteins (nt-probnp, $-
0310U Ped vsclts kd alys 3 bmrks Pediatrics (vasculitis, kawasaki disease [kd]), analysis of 3 biomarkers $-
0311U Nfct ds bct quan antmcrb sc Infectious disease (bacterial), quantitative antimicrobial susceptibility $-
0312U Ai ds sle alys 8 igg autoant Autoimmune diseases (eg, systemic lupus erythematosus [sle]), analysis of 8 igg $-
0313U Onc pncrs dna&mrna seq 74 Oncology (pancreas), dna and mrna next-generation sequencing analysis of 74 $-
0314U Onc cutan mlnma mrna 35 gene Oncology (cutaneous melanoma), mrna gene expression profiling by rt-pcr of 35 $-
0315U Onc cutan sq cll ca mrna 40 Oncology (cutaneous squamous cell carcinoma), mrna gene expression profiling by $-
0316U B brgdrferi lyme ds ospa evl Borrelia burgdorferi (lyme disease), ospa protein evaluation, urine $-
0317U Onc lung ca 4-prb fish assay Oncology (lung cancer), four-probe fish (3q29, 3p22.1, 10q22.3, 10cen) assay, $-
0318U Ped whl gen mthyltn alys 50+ Pediatrics (congenital epigenetic disorders), whole genome methylation analysis $-
0319U Neph rna pretrnspl perph bld Nephrology (renal transplant), rna expression by select transcriptome $-
0320U Neph rna psttrnspl perph bld Nephrology (renal transplant), rna expression by select transcriptome $-
0321U Iadna gu pthgn 20bct&fng org Infectious agent detection by nucleic acid (dna or rna), genitourinary $-
0322U Neuro asd meas 14 acyl carn Neurology (autism spectrum disorder [asd]), quantitative measurements of 14 $-
36415 Routine venipuncture Insertion of needle into vein for collection of blood sample $7.50
78267 Breath tst attain/anal c-14 Nuclear medicine study to acquire exhaled breath samples $27.65
78268 Breath test analysis c-14 Nuclear medicine study to assess exhaled breath samples $236.03
80047 Metabolic panel ionized ca Blood test, basic group of blood chemicals (Calcium, ionized) $34.33
80047 QW Metabolic panel ionized ca Blood test, basic group of blood chemicals (Calcium, ionized) $34.33
80048 Metabolic panel total ca Blood test, basic group of blood chemicals (Calcium, total) $21.15
80048 QW Metabolic panel total ca Blood test, basic group of blood chemicals (Calcium, total) $21.15
80051 Electrolyte panel Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) $17.53
80051 QW Electrolyte panel Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide) $17.53
80053 Comprehen metabolic panel Blood test, comprehensive group of blood chemicals $26.40
80053 QW Comprehen metabolic panel Blood test, comprehensive group of blood chemicals $26.40
80055 Obstetric panel Obstetric blood test panel $119.53
80061 Lipid panel Blood test, lipids (cholesterol and triglycerides) $33.48
80061 QW Lipid panel Blood test, lipids (cholesterol and triglycerides) $33.48
80069 Renal function panel Kidney function blood test panel $21.70
80069 QW Renal function panel Kidney function blood test panel $21.70
80074 Acute hepatitis panel Acute hepatitis panel $119.08
80076 Hepatic function panel Liver function blood test panel $20.43
80081 Obstetric panel Blood test panel for obstetrics ( cbc, differential wbc count, hepatitis b, $187.15
80143 Drug assay acetaminophen Measurement of acetaminophen $46.60
80145 Drug assay adalimumab Measurement of adalimumab $96.43
80150 Assay of amikacin Amikacin (antibiotic) level $37.70
80151 Drug assay amiodarone Measurement of amiodarone $46.60
80155 Drug assay caffeine Caffeine level $96.43
80156 Assay carbamazepine total Carbamazepine level, total $36.43
80157 Assay carbamazepine free Carbamazepine level, free $33.13
80158 Drug assay cyclosporine Cyclosporine level $45.13
80159 Drug assay clozapine Clozapine level $50.38
80161 Asy carbamazepin 10,11-epxid Measurement of carbamazepine-10,11-epoxide $46.60
80162 Assay of digoxin total Digoxin level, total $33.20
80163 Assay of digoxin free Digoxin level, free $33.20
80164 Assay dipropylacetic acd tot Valproic acid level, total $33.85
80165 Dipropylacetic acid free Valproic acid level, free $33.85
80167 Drug assay felbamate Measurement of felbamate $46.60
80168 Assay of ethosuximide Ethosuximide level $40.85
80169 Drug assay everolimus Everolimus level $34.33
80170 Assay of gentamicin Gentamicin (antibiotic) level $40.95
80171 Drug screen quant gabapentin Gabapentin level $54.18
80173 Assay of haloperidol Haloperidol level $39.45
80175 Drug screen quan lamotrigine Lamotrigine level $33.13
80176 Assay of lidocaine Lidocaine level $36.73
80177 Drug scrn quan levetiracetam Levetiracetam level $33.13
80178 Assay of lithium Lithium level $16.53
80178 QW Assay of lithium Lithium level $16.53
80179 Drug assay salicylate Measurement of salicylate $46.60
80180 Drug scrn quan mycophenolate Mycophenolate (mycophenolic acid) level $45.13
80181 Drug assay flecainide Measurement of flecainide $46.60
80183 Drug scrn quant oxcarbazepin Oxcarbazepine level $33.13
80184 Assay of phenobarbital Phenobarbital level $38.25
80185 Assay of phenytoin total Phenytoin level, total $33.13
80186 Assay of phenytoin free Phenytoin level, free $34.40
80187 Drug assay posaconazole Measurement of posaconazole $67.78
80188 Assay of primidone Primidone level $41.48
80189 Drug assay itraconazole Measurement of itraconazole $67.78
80190 Assay of procainamide Procainamide level $150.00
80192 Assay of procainamide Procainamide level, with metabolites $41.88
80193 Drug assay leflunomide Measurement of leflunomide $96.43
80194 Assay of quinidine Quinidine level $36.50
80195 Assay of sirolimus Sirolimus level $34.33
80197 Assay of tacrolimus Tacrolimus level $34.33
80198 Assay of theophylline Theophylline level $35.35
80199 Drug screen quant tiagabine Tiagabine level $67.78
80200 Assay of tobramycin Tobramycin (antibiotic) level $40.33
80201 Assay of topiramate Topiramate level $29.80
80202 Assay of vancomycin Vancomycin (antibiotic) level $33.85
80203 Drug screen quant zonisamide Zonisamide level $33.13
80204 Drug assay methotrexate Measurement of methotrexate $96.43
80210 Drug assay rufinamide Measurement of rufinamide $67.78
80220 Drug asy hydroxychloroquine Measurement of hydroxychloroquine $46.60
80230 Drug assay infliximab Measurement of infliximab $96.43
80235 Drug assay lacosamide Measurement of lacosamide $67.78
80280 Drug assay vedolizumab Measurement of vedolizumab $96.43
80285 Drug assay voriconazole Measurement of voriconazole $67.78
80299 Quantitative assay drug Quantitation of therapeutic drug $46.60
80305 Drug test prsmv dir opt obs Testing for presence of drug, read by direct observation $31.50
80305 QW Drug test prsmv dir opt obs Testing for presence of drug, read by direct observation $31.50
80306 Drug test prsmv instrmnt Testing for presence of drug, read by instrument assisted observation $42.85
80307 Drug test prsmv chem anlyzr Testing for presence of drug, by chemistry analyzers $155.35
80400 Acth stimulation panel Hormonal panel for adrenal gland assessment (adrenal gland insufficiency) $81.55
80402 Acth stimulation panel Hormone panel for adrenal gland assessment (21 hydroxylase deficiency) $217.40
80406 Acth stimulation panel Hormone panel adrenal gland assessment (3 beta-hydroxydehydrogenase deficiency) $195.65
80408 Aldosterone suppression eval Aldosterone suppression evaluation panel $313.75
80410 Calcitonin stimul panel Calcitonin stimulation panel $200.93
80412 Crh stimulation panel Adrenal gland stimulation panel $2,004.05
80414 Testosterone response panel Reproductive hormone panel (testosterone) $129.10
80415 Tot estradiol response panel Reproductive hormone panel (estradiol) $139.73
80416 Renin stimulation panel Renal vein renin (kidney enzyme) stimulation panel $523.30
80417 Renin stimulation panel Peripheral vein renin (kidney enzyme) stimulation panel $109.98
80418 Pituitary evaluation panel Anterior pituitary gland evaluation panel $1,448.70
80420 Dexamethasone panel Dexamethasone (steroid) suppression evaluation panel, 48 hour $404.70
80422 Glucagon tolerance panel Glucagon (hormone) tolerance panel to evaluate for insulinoma (pancreatic tumor) $115.18
80424 Glucagon tolerance panel Glucagon (hormone) tolerance panel to evaluate for pheochromocytoma (adrenal $126.25
80426 Gonadotropin hormone panel Gonadotropin releasing hormone (reproductive hormone) panel $371.03
80428 Growth hormone panel Growth hormone stimulation panel $166.75
80430 Growth hormone panel Growth hormone suppression panel $323.33
80432 Insulin suppression panel Insulin-induced C-peptide (protein) suppression panel $414.03
80434 Insulin tolerance panel Insulin tolerance panel for ACTH (adrenal gland hormone) insufficiency $712.58
80435 Insulin tolerance panel Insulin tolerance panel for growth hormone deficiency $257.50
80436 Metyrapone panel Metyrapone (hormone antibody) panel $227.90
80438 Trh stimulation panel Thyrotropin releasing hormone (TRH) (hypothalamus hormone) stimulation panel, 1 $126.03
80439 Trh stimulation panel Thyrotropin releasing hormone (TRH) (hypothalamus hormone) stimulation panel, 2 $168.03
81000 Urinalysis nonauto w/scope Manual urinalysis test with examination using microscope, non-automated $10.05
81001 Urinalysis auto w/scope Manual urinalysis test with examination using microscope, automated $7.93
81002 Urinalysis nonauto w/o scope Urinalysis, manual test $8.70
81003 Urinalysis auto w/o scope Automated urinalysis test $5.63
81003 QW Urinalysis auto w/o scope Automated urinalysis test $5.63
81005 Urinalysis Analysis of urine, except immunoassays $5.43
81007 Urine screen for bacteria Urinalysis for bacteria $74.95
81007 QW Urine screen for bacteria Urinalysis for bacteria $74.95
81015 Microscopic exam of urine Urinalysis using microscope $7.63
81020 Urinalysis glass test Urinalysis, 2 or 3 glass test $11.75
81025 Urine pregnancy test Urine pregnancy test $21.53
81050 Urinalysis volume measure Urine volume measurement $9.10
81105 Hpa-1 genotyping Gene analysis (Human Platelet Antigen 1) for common variant $305.55
81106 Hpa-2 genotyping Gene analysis (Human Platelet Antigen 2) for common variant $305.55
81107 Hpa-3 genotyping Gene analysis (Human Platelet Antigen 3) for common variant $305.55
81108 Hpa-4 genotyping Gene analysis (Human Platelet Antigen 4) for common variant $305.55
81109 Hpa-5 genotyping Gene analysis (Human Platelet Antigen 5) for common variant $305.55
81110 Hpa-6 genotyping Gene analysis (Human Platelet Antigen 6) for common variant $305.55
81111 Hpa-9 genotyping Gene analysis (Human Platelet Antigen 9) for common variant $305.55
81112 Hpa-15 genotyping Gene analysis (Human Platelet Antigen 15) for common variant $305.55
81120 Idh1 common variants Gene analysis (isocitrate dehydrogenase 1 [NADP+], soluble) for common variants $483.13
81121 Idh2 common variants Gene analysis (isocitrate dehydrogenase 2 [NADP+], mitochondrial) for common $739.48
81161 Dmd dup/delet analysis Gene analysis (dystrophin) $697.50
81162 Brca1&2 gen full seq dup/del Gene analysis (breast cancer 1 and 2) of full sequence and analysis for $4,562.20
81163 Brca1&2 gene full seq alys Gene analysis (breast cancer 1 and 2) of full sequence $1,170.00
81164 Brca1&2 gen ful dup/del alys Gene analysis (breast cancer 1 and 2) for duplication or deletion variants $1,460.58
81165 Brca1 gene full seq alys Gene analysis (breast cancer 1) of full sequence $707.20
81166 Brca1 gene full dup/del alys Gene analysis (breast cancer 1) for duplication or deletion variants $753.38
81167 Brca2 gene full dup/del alys Gene analysis (breast cancer 2) for duplication or deletion variants $707.20
81168 Ccnd1/igh translocation alys Gene analysis (CCND1/IGH (t(11;14))) translocation analysis $518.28
81170 Abl1 gene Gene analysis (ABL proto-oncogene 1, non-receptor tyrosine kinase) $750.00
81171 Aff2 gene detc abnor alleles Gene analysis (fragile X mental retardation 2) for abnormal alleles $342.50
81172 Aff2 gene charac alleles Gene analysis (fragile X mental retardation 2) for characterization of alleles $687.08
81173 Ar gene full gene sequence Gene analysis (androgen receptor) of full sequence $753.38
81174 Ar gene known famil variant Gene analysis (androgen receptor) for known familial variant $463.00
81175 Asxl1 full gene sequence Gene analysis (additional sex combs like 1, transcriptional regulator) full $1,691.25
81176 Asxl1 gene target seq alys Gene analysis (additional sex combs like 1, transcriptional regulator) targeted $604.75
81177 Atn1 gene detc abnor alleles Gene analysis (atropin 1) for abnormal alleles $342.50
81178 Atxn1 gene detc abnor allele Gene analysis (ataxin 1) for abnormal alleles $342.50
81179 Atxn2 gene detc abnor allele Gene analysis (ataxin 2) for abnormal alleles $342.50
81180 Atxn3 gene detc abnor allele Gene analysis (ataxin 3) for abnormal alleles $342.50
81181 Atxn7 gene detc abnor allele Gene analysis (ataxin 7) for abnormal alleles $342.50
81182 Atxn8os gen detc abnor allel Gene analysis (ataxin 8 opposite strand [non-protein coding]) for abnormal $342.50
81183 Atxn10 gene detc abnor allel Gene analysis (ataxin 10) for abnormal alleles $342.50
81184 Cacna1a gen detc abnor allel Gene analysis (calcium voltage-gated channel subunit alpha1 A) for abnormal $342.50
81185 Cacna1a gene full gene seq Gene analysis (calcium voltage-gated channel subunit alpha1 A) of full sequence $2,115.68
81186 Cacna1a gen known famil vrnt Gene analysis (calcium voltage-gated channel subunit alpha1 A) for known $463.00
81187 Cnbp gene detc abnor allele Gene analysis (CCH-type zinc finger nucleic acid binding protein) for abnormal $342.50
81188 Cstb gene detc abnor allele Gene analysis (cystatin B) for abnormal alleles $342.50
81189 Cstb gene full gene sequence Gene analysis (cystatin B) of full sequence $687.08
81190 Cstb gene known famil vrnt Gene analysis (cystatin B) for known familial variants $463.00
81191 Ntrk1 translocation analysis Gene analysis (neurotrophic receptor tyrosine kinase 1) translocation analysis $518.28
81192 Ntrk2 translocation analysis Gene analysis (neurotrophic receptor tyrosine kinase 2) translocation analysis $518.28
81193 Ntrk3 translocation analysis Gene analysis (neurotrophic receptor tyrosine kinase 3) translocation analysis $518.28
81194 Ntrk translocation analysis Gene analysis (neurotrophic receptor tyrosine kinase 1, 2, and 3) translocation $1,295.70
81200 Aspa gene Gene analysis (aspartoacylase) $118.13
81201 Apc gene full sequence Gene analysis (adenomatous polyposis coli), full gene sequence $1,950.00
81202 Apc gene known fam variants Gene analysis (adenomatous polyposis coli), known familial variants $700.00
81203 Apc gene dup/delet variants Gene analysis (adenomatous polyposis coli), duplication or deletion variants $500.00
81204 Ar gene charac alleles Gene analysis (androgen receptor) for characterization of alleles $342.50
81205 Bckdhb gene Gene analysis (branched-chain keto acid dehydrogenase E1, beta polypeptide) $237.48
81206 Bcr/abl1 gene major bp Translocation analysis (BCR/ABL1) major breakpoint $409.90
81207 Bcr/abl1 gene minor bp Translocation analysis (BCR/ABL1) minor breakpoint $362.10
81208 Bcr/abl1 gene other bp Translocation analysis (BCR/ABL1) other breakpoint $536.55
81209 Blm gene Gene analysis (Bloom syndrome, RecQ helicase-like) $98.28
81210 Braf gene Gene analysis (v-raf murine sarcoma viral oncogene homolog B1) $438.50
81212 Brca1&2 185&5385&6174 vrnt Gene analysis (breast cancer 1 and 2) for 185delAG, 5385insC, 6174delT variants $1,100.00
81215 Brca1 gene known famil vrnt Gene analysis (breast cancer 1) for known familial variant $938.13
81216 Brca2 gene full seq alys Gene analysis (breast cancer 2) of full sequence $462.80
81217 Brca2 gene known famil vrnt Gene analysis (breast cancer 2) for known familial variant $938.13
81218 Cebpa gene full sequence Gene analysis (ccaat/enhancer binding protein [c/ebp], alpha) full gene sequence $604.75
81219 Calr gene com variants Gene analysis (calreticulin), common variants $304.08
81220 Cftr gene com variants Gene analysis (cystic fibrosis transmembrane conductance regular) common $1,391.50
81221 Cftr gene known fam variants Gene analysis (cystic fibrosis transmembrane conductance regular) known $243.05
81222 Cftr gene dup/delet variants Gene analysis (cystic fibrosis transmembrane conductance regular) duplication $1,087.68
81223 Cftr gene full sequence Gene analysis (cystic fibrosis transmembrane conductance regular) full gene $1,247.50
81224 Cftr gene intron poly t Gene analysis (cystic fibrosis transmembrane conductance regular) intron 8 $421.88
81225 Cyp2c19 gene com variants Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 19) common $728.40
81226 Cyp2d6 gene com variants Gene analysis (cytochrome P450, family 2, subfamily D, polypeptide 6) common $1,127.28
81227 Cyp2c9 gene com variants Gene analysis (cytochrome P450, family 2, subfamily C, polypeptide 9) common $437.03
81228 Cytog alys chrml abnr cgh Genome-wide microarray analysis for copy number variants $2,250.00
81229 Cytog alys chrml abnr snpcgh Genome-wide microarray analysis for copy number and single nucleotide $2,900.00
81230 Cyp3a4 gene common variants Gene analysis (cytochrome P450 family 3 subfamily A member 4) for common variant $437.03
81231 Cyp3a5 gene common variants Gene analysis (cytochrome P450 family 3 subfamily A member 5) for common variant $437.03
81232 Dpyd gene common variants Gene analysis (dihydropyrimidine dehydrogenase) for common variant $437.03
81233 Btk gene common variants Gene analysis (Bruton’s tyrosine kinase) for common variants $438.50
81234 Dmpk gene detc abnor allele Gene analysis (DM1 protein kinase) for abnormal alleles $342.50
81235 Egfr gene com variants Gene analysis (epidermal growth factor receptor), common variants $811.45
81236 Ezh2 gene full gene sequence Gene analysis (enhancer of zeste 2 polycomb repressive complex 2 subunit) of $707.20
81237 Ezh2 gene common variants Gene analysis (enhancer of zeste 2 polycomb repressive complex 2 subunit) for $438.50
81238 F9 full gene sequence Gene analysis (coagulation factor IX) full sequence analysis $1,500.00
81239 Dmpk gene charac alleles Gene analysis (DM1 protein kinase) for characterization of alleles $687.08
81240 F2 gene Gene analysis (prothrombin, coagulation factor II) A variant $164.23
81241 F5 gene Gene analysis (coagulation factor V) Leiden variant $183.43
81242 Fancc gene Gene analysis (Fanconi anemia, complementation group C) common variant $91.55
81243 Fmr1 gene detection Gene analysis (fragile X mental retardation) abnormal alleles $142.60
81244 Fmr1 gene charac alleles Gene analysis (fragile X mental retardation 1) for characterization of alleles $112.23
81245 Flt3 gene Gene analysis (fms-related tyrosine kinase 3) internal tandem duplication $413.78
81246 Flt3 gene analysis Test for detecting genes associated with blood cancer $207.50
81247 G6pd gene alys cmn variant Gene analysis (glucose-6-phosphate dehydrogenase) for common variant $437.03
81248 G6pd known familial variant Gene analysis (glucose-6-phosphate dehydrogenase) for known familial variant $938.13
81249 G6pd full gene sequence Gene analysis (glucose-6-phosphate dehydrogenase) full sequence analysis $1,500.00
81250 G6pc gene Gene analysis (glucose-6-phosphatase, catalytic subunit) common variants $146.23
81251 Gba gene Gene analysis (glucosidase, beta, acid) common variants $118.13
81252 Gjb2 gene full sequence Gene analysis (gap junction protein, beta 2, 26kda, connexin 26), full gene $252.80
81253 Gjb2 gene known fam variants Gene analysis (gap junction protein, beta 2, 26kda, connexin 26), known $153.80
81254 Gjb6 gene com variants Gene analysis (gap junction protein, beta 6, 30kda, connexin 30), common $87.50
81255 Hexa gene Gene analysis (hexosaminidase A) common variants $128.63
81256 Hfe gene Gene analysis (hemochromatosis) common variants $163.40
81257 Hba1/hba2 gene Gene analysis (alpha globin 1 and alpha globin 2) for common deletions or $255.65
81258 Hba1/hba2 gene fam vrnt Gene analysis (alpha globin 1 and alpha globin 2) for known familial variant $938.13
81259 Hba1/hba2 full gene sequence Gene analysis (alpha globin 1 and alpha globin 2) full sequence analysis $1,500.00
81260 Ikbkap gene Gene analysis (inhibitor of kappa light polypeptide gene enhancer in B-cells, $98.28
81261 Igh gene rearrange amp meth Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect $494.98
81262 Igh gene rearrang dir probe Gene rearrangement analysis (immunoglobulin heavy chain locus) to detect $171.38
81263 Igh vari regional mutation Gene rearrangement analysis (immunoglobulin heavy chain locus), variable region $736.30
81264 Igk rearrangeabn clonal pop Gene rearrangement analysis (immunoglobulin kappa light chain locus) to detect $431.83
81265 Str markers specimen anal Comparative analysis using Short Tandem Repeat (STR) markers of patient and $582.68
81266 Str markers spec anal addl Comparative analysis using Short Tandem Repeat (STR) markers of patient and $762.03
81267 Chimerism anal no cell selec Chimerism analysis post transplantation, without cell selection $518.65
81268 Chimerism anal w/cell select Chimerism analysis post transplantation, with cell selection $651.98
81269 Hba1/hba2 gene dup/del vrnts Gene analysis (alpha globin 1 and alpha globin 2) for duplication/deletion $506.00
81270 Jak2 gene Gene analysis (Janus kinase 2) variant $229.15
81271 Htt gene detc abnor alleles Gene analysis (Huntingtin) for abnormal alleles $342.50
81272 Kit gene targeted seq analys Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), $823.78
81273 Kit gene analys d816 variant Gene analysis (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog), $312.18
81274 Htt gene charac alleles Gene analysis (Huntingtin) for characterization of alleles $687.08
81275 Kras gene variants exon 2 Gene analysis (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) variants in codons $483.13
81276 Kras gene addl variants Gene analysis (Kirsten rat sarcoma viral oncogene homolog), additional variants $483.13
81277 Cytogenomic neo microra alys Cancer cytogenomic array gene analysis $2,900.00
81278 [email protected]/bcl2 translocation alys Gene analysis ([email protected]/BCL2 (t(14;18)) translocation analysis $518.28
81279 Jak2 gene trgt sequence alys Gene analysis (Janus kinase 2) targeted sequence analysis $463.00
81283 Ifnl3 gene Gene analysis (interferon, lambda 3) for rs12979860 variant $183.43
81284 Fxn gene detc abnor alleles Gene analysis (frataxin) for abnormal alleles $342.50
81285 Fxn gene charac alleles Gene analysis (frataxin) for characterization of alleles $687.08
81286 Fxn gene full gene sequence Gene analysis (frataxin) of full sequence $687.08
81287 Mgmt gene prmtr mthyltn alys Gene analysis (O-6-methylguanine-DNA methyltransferase) for promoter methylation $311.60
81288 Mlh1 gene Test for detecting genes associated with colon cancer, promoter methylation $480.80
81289 Fxn gene known famil variant Gene analysis (frataxin) for known familial variants $463.00
81290 Mcoln1 gene Gene analysis (mucolipin 1) common variants $98.28
81291 Mthfr gene Gene analysis (5, 10-methylenetetrahydrofolate reductase) common variants $163.35
81292 Mlh1 gene full seq Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) full sequence $1,688.50
81293 Mlh1 gene known variants Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) known $827.50
81294 Mlh1 gene dup/delete variant Gene analysis (mutL homolog 1, colon cancer, nonpolyposis type 2) duplication $506.00
81295 Msh2 gene full seq Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) full sequence $954.25
81296 Msh2 gene known variants Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) known $844.33
81297 Msh2 gene dup/delete variant Gene analysis (mutS homolog 2, colon cancer, nonpolyposis type 1) duplication $533.25
81298 Msh6 gene full seq Gene analysis (mutS homolog 6 [E coli]) full sequence analysis $1,604.63
81299 Msh6 gene known variants Gene analysis (mutS homolog 6 [E coli]) known familial variants $770.00
81300 Msh6 gene dup/delete variant Gene analysis (mutS homolog 6 [E coli]) duplication or deletion variants $595.00
81301 Microsatellite instability Microsatellite instability analysis $871.40
81302 Mecp2 gene full seq Gene analysis (methyl CpG binding protein 2) full sequence analysis $1,319.68
81303 Mecp2 gene known variant Gene analysis (methyl CpG binding protein 2) known familial variant $300.00
81304 Mecp2 gene dup/delet variant Gene analysis (methyl CpG binding protein 2) duplication or deletion variants $375.00
81305 Myd88 gene p.leu265pro vrnt Gene analysis (myeloid differentiation primary response 88) for p.Leu265Pro $438.50
81306 Nudt15 gene common variants Gene analysis (nudix hydrolase 15) for common variants $728.40
81307 Palb2 gene full gene seq Gene analysis (partner and localizer of BRCA2) full sequence analysis $1,691.25
81308 Palb2 gene known famil vrnt Gene analysis (partner and localizer of BRCA2) for detection of known familial $753.38
81309 Pik3ca gene trgt seq alys Gene analysis (partner and localizer of BRCA2) targeted sequence analysis $687.08
81310 Npm1 gene Gene analysis (nucleophosmin) exon 12 variants $616.30
81311 Nras gene variants exon 2&3 Gene analysis for cancer (neuroblastoma) $739.48
81312 Pabpn1 gene detc abnor allel Gene analysis (poly[A] binding protein nuclear 1) for abnormal alleles $342.50
81313 Pca3/klk3 antigen Test for detecting genes associated with prostate cancer $637.63
81314 Pdgfra gene Gene analysis ((platelet-derived growth factor receptor, alpha polypeptide) $823.78
81315 Pml/raralpha com breakpoints Translocation analysis (PML-RARA regulated adaptor molecule 1) common breakpoint $518.28
81316 Pml/raralpha 1 breakpoint Translocation analysis (PML-RARA regulated adaptor molecule 1) single breakpoint $518.28
81317 Pms2 gene full seq analysis Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) full $1,691.25
81318 Pms2 known familial variants Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) known $827.50
81319 Pms2 gene dup/delet variants Gene analysis (postmeiotic segregation increased 2 [S cerevisiae]) duplication $508.75
81320 Plcg2 gene common variants Gene analysis (phospholipase C gamma 2) for common variants $728.40
81321 Pten gene full sequence Gene analysis (phosphatase and tensin homolog), full sequence analysis $1,500.00
81322 Pten gene known fam variant Gene analysis (phosphatase and tensin homolog), known familial variant $116.50
81323 Pten gene dup/delet variant Gene analysis (phosphatase and tensin homolog), duplication or deletion variant $750.00
81324 Pmp22 gene dup/delet Gene analysis (peripheral myelin protein 22), duplication or deletion analysis $1,895.90
81325 Pmp22 gene full sequence Gene analysis (peripheral myelin protein 22), full sequence analysis $1,923.95
81326 Pmp22 gene known fam variant Gene analysis (peripheral myelin protein 22), known familial variant $116.50
81327 Sept9 gen prmtr mthyltn alys Gene analysis (Septin9) for promoter methylation $480.00
81328 Slco1b1 gene com variants Gene analysis (solute carrier organic anion transporter family, member 1B1) for $437.03
81329 Smn1 gene dos/deletion alys Gene analysis (survival of motor neuron 1, telomeric) for dosage/deletion $342.50
81330 Smpd1 gene common variants Gene analysis (sphingomyelin phosphodiesterase 1, acid lysosomal) common $117.50
81331 Snrpn/ube3a gene Methylation analysis (small nuclear ribonucleoprotein polypeptide N and $127.68
81332 Serpina1 gene Gene analysis (serpin peptidase inhibitor, clade A, alpha-1 antiproteinase, $109.13
81333 Tgfbi gene common variants Gene analysis (transforming growth factor beta-induced) for common variants $342.50
81334 Runx1 gene targeted seq alys Gene analysis (runt related transcription factor 1) targeted sequence analysis $823.78
81335 Tpmt gene com variants Gene analysis (thiopurine S-methyltransferase) for common variant $437.03
81336 Smn1 gene full gene sequence Gene analysis (survival of motor neuron 1, telomeric) of full sequence $753.38
81337 Smn1 gen nown famil seq vrnt Gene analysis (survival of motor neuron 1, telomeric) for known familial $463.00
81338 Mpl gene common variants Gene analysis (MPL proto-oncogene, thrombopoietin receptor) for detection of $375.83
81339 Mpl gene seq alys exon 10 Gene analysis (MPL proto-oncogene, thrombopoietin receptor) sequence analysis $463.00
81340 [email protected] gene rearrange amplify Gene analysis (T cell antigen receptor beta) amplification methodology $522.30
81341 [email protected] gene rearrange dirprobe Gene rearrangement analysis detection abnormal clonal population (T cell $123.98
81342 Trg gene rearrangement anal Gene rearrangement analysis detection abnormal clonal population (T cell $503.75
81343 Ppp2r2b gen detc abnor allel Gene analysis (protein phosphatase 2 regulatory subunit Bbeta) for abnormal $342.50
81344 Tbp gene detc abnor alleles Gene analysis (TATA box binding protein) for abnormal alleles $342.50
81345 Tert gene targeted seq alys Gene analysis (telomerase reverse transcriptase) targeted sequence analysis $463.00
81346 Tyms gene com variants Gene analysis (thymidylate synthetase) for common variant $437.03
81347 Sf3b1 gene common variants Gene analysis (splicing factor [3b] subunit B1) for detection of common variants $483.13
81348 Srsf2 gene common variants Gene analysis (serine and arginine-rich splicing factor 2) for detection of $438.50
81349 Cytog alys chrml abnr lw-ps Genome-wide microarray analysis for copy number and loss-of-heterozygosity $-
81350 Ugt1a1 gene common variants Gene analysis (UDP glucuronosyltransferase 1 family, polypeptide A1) for $585.00
81351 Tp53 gene full gene sequence Gene analysis (tumor protein 53) full sequence analysis $1,604.63
81352 Tp53 gene trgt sequence alys Gene analysis (tumor protein 53) targeted sequence analysis $823.78
81353 Tp53 gene known famil vrnt Gene analysis (tumor protein 53) targeted sequence analysis for detection of $770.00
81355 Vkorc1 gene Gene analysis (vitamin K epoxide reductase complex subunit 1) common variants $220.50
81357 U2af1 gene common variants Gene analysis (U2 small nuclear RNA auxiliary factor 1) for detection of common $483.13
81360 Zrsr2 gene common variants Gene analysis (zinc finger CCCH-type, RNA binding motif and $483.13
81361 Hbb gene com variants Gene analysis (hemoglobin, subunit beta) for common variant $437.03
81362 Hbb gene known fam variant Gene analysis (hemoglobin, subunit beta) for known familial variant $938.13
81363 Hbb gene dup/del variants Gene analysis (hemoglobin, subunit beta) for duplication/deletion variant $506.00
81364 Hbb full gene sequence Gene analysis (hemoglobin, subunit beta) full sequence analysis $811.45
81370 Hla i & ii typing lr HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1 $1,005.30
81371 Hla i & ii type verify lr HLA class I and II typing, low resolution HLA-A, -B, and -DRB1 $1,011.30
81372 Hla i typing complete lr HLA class I typing low resolution $1,008.98
81373 Hla i typing 1 locus lr HLA class I typing low resolution one locus $318.58
81374 Hla i typing 1 antigen lr HLA class I typing, low resolution one antigen equivalent $185.83
81375 Hla ii typing ag equiv lr HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1 $551.85
81376 Hla ii typing 1 locus lr HLA class II typing low resolution one locus $305.55
81377 Hla ii type 1 ag equiv lr HLA class II typing low resolution one antigen equivalent $236.85
81378 Hla i & ii typing hr HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1 $863.93
81379 Hla i typing complete hr HLA Class I typing high resolution $838.45
81380 Hla i typing 1 locus hr HLA class I typing high resolution one locus $443.13
81381 Hla i typing 1 allele hr HLA class I typing high resolution one allele or allele group $424.75
81382 Hla ii typing 1 loc hr HLA class II typing high resolution one locus $309.20
81383 Hla ii typing 1 allele hr HLA class II typing high resolution one allele or allele group $272.83
81400 Mopath procedure level 1 Molecular pathology procedure level 1 $159.90
81401 Mopath procedure level 2 Molecular pathology procedure level 2 $342.50
81402 Mopath procedure level 3 Molecular pathology procedure level 3 $375.83
81403 Mopath procedure level 4 Molecular pathology procedure level 4 $463.00
81404 Mopath procedure level 5 Molecular pathology procedure level 5 $687.08
81405 Mopath procedure level 6 Molecular pathology procedure level 6 genetic analysis $753.38
81406 Mopath procedure level 7 Molecular pathology procedure level 7 $707.20
81407 Mopath procedure level 8 Molecular pathology procedure level 8 $2,115.68
81408 Mopath procedure level 9 Molecular pathology procedure level 9 $5,000.00
81410 Aortic dysfunction/dilation Test for detecting genes associated with heart disease, genomic sequence $1,260.00
81411 Aortic dysfunction/dilation Test for detecting genes associated with heart disease, duplication/deletion $3,375.48
81412 Ashkenazi jewish assoc dis Test for detecting genes for disorders related to Ashkenazi Jews, genomic $6,121.40
81413 Car ion chnnlpath inc 10 gns Test for detecting genes associated with heart disease, genomic sequence $1,462.25
81414 Car ion chnnlpath inc 2 gns Test for detecting genes associated with heart disease, duplication/deletion $1,462.25
81415 Exome sequence analysis Test for detecting exome, sequence analysis $11,950.00
81416 Exome sequence analysis Test for detecting exome, sequence analysis, each comparator exome $30,000.00
81417 Exome re-evaluation Reevaluation test of previously obtained exome sequence $800.00
81419 Epilepsy gen seq alys panel Gene analysis panel for evaluation of genes associated with epilepsy $6,121.40
81420 Fetal chrmoml aneuploidy Test for detecting genes associated with fetal disease, aneuploidy genomic $1,897.63
81422 Fetal chrmoml microdeltj Test for detecting genes associated with fetal disease, microdeletion(s) $1,897.63
81425 Genome sequence analysis Test for detecting genes associated with disease, genome sequence analysis $12,578.00
81426 Genome sequence analysis Test for detecting genes associated with disease, genome sequence analysis, $6,774.88
81427 Genome re-evaluation Reevaluation test of previously obtained genome sequence $5,844.13
81430 Hearing loss sequence analys Test for detecting genes causing hearing loss genomic sequence analysis panel, $4,062.50
81431 Hearing loss dup/del analys Test for detecting genes causing hearing loss, duplication/deletion analysis $1,698.93
81432 Hrdtry brst ca-rlatd dsordrs Test for detecting genes associated with inherited breast cancer-related $1,697.63
81433 Hrdtry brst ca-rlatd dsordrs Gene analysis (breast and related cancers), duplication or deletion variants $1,097.33
81434 Hereditary retinal disorders Gene analysis (retinal disorders), genomic sequence $1,494.78
81435 Hereditary colon ca dsordrs Test for detecting genes associated with colon cancer, genomic sequence $1,462.25
81436 Hereditary colon ca dsordrs Test for detecting genes associated with colon cancer, duplication/deletion $1,462.25
81437 Heredtry nurondcrn tum dsrdr Gene analysis (neuroendocrine tumors), genomic sequence $1,097.33
81438 Heredtry nurondcrn tum dsrdr Gene analysis (neuroendocrine tumors), duplication and deletion variants $1,097.33
81439 Hrdtry cardmypy gene panel Test for detecting genes associated with inherited disease of heart muscle $1,462.25
81440 Mitochondrial gene Test for detecting genes $8,310.00
81442 Noonan spectrum disorders Gene analysis (noonan syndrome) genomic sequence analysis $5,359.00
81443 Genetic tstg severe inh cond Genomic sequence analysis panel for severe inherited conditions with sequencing $6,121.40
81445 Targeted genomic seq analys Test for detecting genes associated with cancer of body organ $1,494.78
81448 Hrdtry perph neurphy panel Gene analysis panel for hereditary disorders of the peripheral nervous system $1,462.25
81450 Targeted genomic seq analys Test for detecting genes associated with blood related cancer $1,898.83
81455 Targeted genomic seq analys Test for detecting genes associated with cancer $7,299.00
81460 Whole mitochondrial genome Test for detecting genes associated with disease, genomic sequence, must $3,217.50
81465 Whole mitochondrial genome Test for detecting genes associated with disease, whole mitochondrial genome $2,340.00
81470 X-linked intellectual dblt Test for detecting genes associated with intellectual disability, genomic $2,285.00
81471 X-linked intellectual dblt Test for detecting genes associated with intellectual disability, $2,285.00
81490 Autoimmune rheumatoid arthr Test for detecting genes associated with rheumatoid arthritis using immunoassay $2,101.63
81493 Cor artery disease mrna Test for detecting genes associated with heart vessels diseases $2,625.00
81500 Onco (ovar) two proteins Genetic profiling on oncology biopsy of ovarian lesions, assays of two proteins $651.25
81503 Onco (ovar) five proteins Genetic profiling on oncology biopsy of ovarian lesions, assays of five proteins $2,242.50
81504 Oncology tissue of origin Genetic profiling on oncology biopsy lesions $1,300.00
81506 Endo assay seven anal Endocrinology (type 2 diabetes), biochemical assays of seven analytes (glucose, $172.30
81507 Fetal aneuploidy trisom risk DNA analysis using maternal plasma $1,987.50
81508 Ftl cgen abnor two proteins Fetal congenital abnormalities, biochemical assays of two proteins (papp-a, hcg $135.75
81509 Ftl cgen abnor 3 proteins Fetal congenital abnormalities, biochemical assays of three proteins (papp-a, $3,718.43
81510 Ftl cgen abnor three anal Fetal congenital abnormalities, biochemical assays of three analytes (afp, ue3, $138.85
81511 Ftl cgen abnor four anal Fetal congenital abnormalities, biochemical assays of four analytes (afp, ue3, $383.75
81512 Ftl cgen abnor five anal Fetal congenital abnormalities, biochemical assays of five analytes (afp, ue3, $173.80
81513 Nfct ds bv rna vag flu alg Measurement of RNA of bacteria in vaginal fluid specimen $356.58
81514 Nfct ds bv&vaginitis dna alg Measurement of DNA of bacteria in vaginal fluid specimen $657.48
81518 Onc brst mrna 11 genes mRNA gene analysis of 11 genes in breast tumor tissue $9,682.50
81519 Oncology breast mrna Test for detecting genes associated with breast cancer $9,682.50
81520 Onc breast mrna 58 genes Gene analysis of breast tumor tissue, profiling by hybrid capture of 58 genes $6,275.53
81521 Onc breast mrna 70 genes Gene analysis of breast tumor tissue, profiling of 70 content genes and 465 $9,682.50
81522 Onc breast mrna 12 genes mRNA gene expression analysis of 12 genes in breast tumor tissue $9,682.50
81523 Onc brst mrna 70 cnt 31 gene Next-generation sequencing of breast cancer profiling 70 content genes and 31 $9,682.50
81525 Oncology colon mrna Gene analysis (colon related cancer) $7,790.00
81528 Oncology colorectal scr Gene analysis (colorectal cancer) $1,272.18
81529 Onc cutan mlnma mrna 31 gene mRNA gene analysis of 31 genes in skin melanoma tissue specimen $17,982.50
81535 Oncology gynecologic Culture of live tumor cells and chemotherapy drug response by staining, first $1,448.65
81536 Oncology gynecologic Culture of live tumor cells and chemotherapy drug response by staining, each $443.90
81538 Oncology lung Testing of lung tumor cells for prediction of survival $7,177.50
81539 Oncology prostate prob score Measurement of proteins associated with prostate cancer $1,900.00
81540 Oncology tum unknown origin Gene analysis (cancer) $9,375.00
81541 Onc prostate mrna 46 genes Gene analysis of prostate tumor tissue, profiling by real-time RT-PCR of 46 $9,682.50
81542 Onc prostate mrna 22 cnt gen mRNA gene expression analysis of 22 genes in prostate tumor tissue $9,682.50
81546 Onc thyr mrna 10,196 gen alg mRNA gene analysis of 10,196 genes in fine needle aspiration thyroid specimen, $9,000.00
81551 Onc prostate 3 genes Gene analysis of prostate tumor tissue, profiling by real-time PCR of 3 genes $5,075.00
81552 Onc uveal mlnma mrna 15 gene mRNA gene expression analysis of 15 genes in eye melanoma o tissue or fine $19,440.00
81554 Pulm ds ipf mrna 190 gen alg mRNA gene analysis of 190 genes associated with lung disease (idiopathic $13,750.00
81560 Trnsplj pd lvr&bwl cd154+cll Measurement of donor and third-party memory cells for transplantation medicine $-
81595 Cardiology hrt trnspl mrna Test for detecting genes associated with heart diseases $8,100.00
81596 Nfct ds chrnc hcv 6 assays Biochemical assays for evaluation of chronic Hepatitis C virus infection $180.48
82009 Test for acetone/ketones Ketone bodies analysis, qualitative $11.30
82010 Acetone assay Ketone bodies analysis, quantitative $20.43
82010 QW Acetone assay Ketone bodies analysis, quantitative $20.43
82013 Acetylcholinesterase assay Acetylcholinesterase (enzyme) level $30.73
82016 Acylcarnitines qual Chemical analysis for genetic disorder $41.23
82017 Acylcarnitines quant Chemical test for genetic disorder $42.18
82024 Assay of acth Adrenocorticotropic hormone (ACTH) level $96.55
82030 Assay of adp & amp Adenosine, 5-monophosphate, cyclic (cyclic AMP) level $64.50
82040 Assay of serum albumin Albumin (protein) level $12.38
82040 QW Assay of serum albumin Albumin (protein) level $12.38
82042 Other source albumin quan ea Cerebrospinal fluid, or amniotic fluid albumin (protein) level $19.45
82042 QW Other source albumin quan ea Cerebrospinal fluid, or amniotic fluid albumin (protein) level $19.45
82043 Ur albumin quantitative Urine microalbumin (protein) level $14.45
82043 QW Ur albumin quantitative Urine microalbumin (protein) level $14.45
82044 Ur albumin semiquantitative Urine microalbumin (protein) analysis $15.58
82044 QW Ur albumin semiquantitative Urine microalbumin (protein) analysis $15.58
82045 Albumin ischemia modified Albumin (protein) level related to restricted heart blood flow $84.85
82075 Assay of breath ethanol Measurement of alcohol level in breath specimen $75.00
82077 Assay spec xcp ur&breath ia Measurement of alcohol level in specimen other than breath or urine $43.18
82085 Assay of aldolase Aldolase (enzyme) level $24.28
82088 Assay of aldosterone Aldosterone hormone level $101.88
82103 Alpha-1-antitrypsin total Alpha-1-antitrypsin (protein) blood test, total $33.60
82104 Alpha-1-antitrypsin pheno Alpha-1-antitrypsin (protein) blood test, phenotype $36.15
82105 Alpha-fetoprotein serum Alpha-fetoprotein (AFP) level, serum $41.93
82106 Alpha-fetoprotein amniotic Alpha-fetoprotein (AFP) level, amniotic fluid $42.50
82107 Alpha-fetoprotein l3 Alpha-fetoprotein (AFP) analysis $161.03
82108 Assay of aluminum Aluminum level $63.70
82120 Amines vaginal fluid qual Vaginal fluid chemical analysis for bacteria $14.98
82120 QW Amines vaginal fluid qual Vaginal fluid chemical analysis for bacteria $14.98
82127 Amino acid single qual Amino acid analysis, qualitative, each specimen $35.45
82128 Amino acids mult qual Amino acid analysis, multiple amino acids, qualitative, each specimen $34.68
82131 Amino acids single quant Amino acid analysis, quantitative, each specimen $57.45
82135 Assay aminolevulinic acid Aminolevulinic acid (protein) level $41.13
82136 Amino acids quant 2-5 Amino acid level, 2 to 5 amino acids, quantitative, each specimen $49.03
82139 Amino acids quan 6 or more Amino acid level, 6 or more amino acids, quantitative, each specimen $42.18
82140 Assay of ammonia Ammonia level $36.43
82143 Amniotic fluid scan Amniotic fluid scan $23.38
82150 Assay of amylase Amylase (enzyme) level $16.20
82150 QW Assay of amylase Amylase (enzyme) level $16.20
82154 Androstanediol glucuronide Androstanediol glucuronide (hormone) level $72.08
82157 Assay of androstenedione Androstenedione (hormone) level $73.20
82160 Assay of androsterone Androsterone (hormone) level $63.88
82163 Assay of angiotensin ii Angiotensin ll (protein) level $51.30
82164 Angiotensin i enzyme test Angiotensin l – converting enzyme (ACE) level $36.50
82172 Assay of apolipoprotein Apolipoprotein level $52.73
82175 Assay of arsenic Arsenic level $47.43
82180 Assay of ascorbic acid Ascorbic acid (Vitamin C) level, blood $24.73
82190 Atomic absorption Measurement of substance using spectroscopy (light) $39.75
82232 Assay of beta-2 protein Beta-2 microglobulin (protein) level $40.45
82239 Bile acids total Bile acids level, total $42.80
82240 Bile acids cholylglycine Bile acids level, cholylglycine $66.45
82247 Bilirubin total Bilirubin level, total $12.55
82247 QW Bilirubin total Bilirubin level, total $12.55
82248 Bilirubin direct Bilirubin level, direct $12.55
82252 Fecal bilirubin test Stool analysis for bilirubin $11.40
82261 Assay of biotinidase Biotinidase (enzyme) level $42.18
82270 Occult blood feces Stool analysis for blood to screen for colon tumors $10.95
82271 Occult blood other sources Specimen analysis for blood $13.30
82271 QW Occult blood other sources Specimen analysis for blood $13.30
82272 Occult bld feces 1-3 tests Stool analysis for blood, by peroxidase activity $10.58
82274 Assay test for blood fecal Stool analysis for blood, by fecal hemoglobin determination by immunoassay $39.80
82274 QW Assay test for blood fecal Stool analysis for blood, by fecal hemoglobin determination by immunoassay $39.80
82286 Assay of bradykinin Bradykinin (protein) level $12.90
82300 Assay of cadmium Cadmium level $59.10
82306 Vitamin d 25 hydroxy Vitamin D-3 level $74.00
82308 Assay of calcitonin Calcitonin (hormone) level $66.98
82310 Assay of calcium Calcium level, total $12.90
82310 QW Assay of calcium Calcium level, total $12.90
82330 Assay of calcium Calcium level, ionized $34.20
82330 QW Assay of calcium Calcium level, ionized $34.20
82331 Calcium infusion test Calcium level, after calcium infusion test $33.35
82340 Assay of calcium in urine Urine calcium level $15.08
82355 Calculus analysis qual Analysis of stone $28.95
82360 Calculus assay quant Chemical analysis of stone $32.18
82365 Calculus spectroscopy Infrared analysis of stone $32.25
82370 X-ray assay calculus X-ray analysis of stone $31.30
82373 Assay c-d transfer measure Carbohydrate deficient transferrin (protein) level $45.15
82374 Assay blood carbon dioxide Carbon dioxide (bicarbonate) level $12.20
82374 QW Assay blood carbon dioxide Carbon dioxide (bicarbonate) level $12.20
82375 Assay carboxyhb quant Carboxyhemoglobin (protein) level $30.80
82376 Assay carboxyhb qual Carboxyhemoglobin (protein) analysis $35.18
82378 Carcinoembryonic antigen Carcinoembryonic antigen (CEA) protein level $47.40
82379 Assay of carnitine Carnitine level $42.18
82380 Assay of carotene Carotene level $23.05
82382 Assay urine catecholamines Catecholamines (organic nitrogen) urine level $68.25
82383 Assay blood catecholamines Catecholamines organic nitrogen blood level $72.70
82384 Assay three catecholamines Catecholamines (organic nitrogen) level $63.13
82387 Assay of cathepsin-d Cathepsin-D (enzyme) level $45.15
82390 Assay of ceruloplasmin Ceruloplasmin (protein) level $26.85
82397 Chemiluminescent assay Analysis using chemiluminescent technique (light and chemical )reaction $35.30
82415 Assay of chloramphenicol Chloramphenicol level $31.68
82435 Assay of blood chloride Blood chloride level $11.50
82435 QW Assay of blood chloride Blood chloride level $11.50
82436 Assay of urine chloride Urine chloride level $14.38
82438 Assay other fluid chlorides Chloride level $12.50
82441 Test for chlorohydrocarbons Screening test for chlorinated hydrocarbons $15.03
82465 Assay bld/serum cholesterol Cholesterol level $10.88
82465 QW Assay bld/serum cholesterol Cholesterol level $10.88
82480 Assay serum cholinesterase Cholinesterase (enzyme) level, to test for exposure to chemical or liver disease $19.68
82482 Assay rbc cholinesterase Cholinesterase (enzyme) level $24.53
82485 Assay chondroitin sulfate Chondroitin B sulfate (protein) level $51.63
82495 Assay of chromium Chromium level to test for poisoning or deficiency $50.70
82507 Assay of citrate Citrate level $69.50
82523 Collagen crosslinks Collagen cross links test, (urine test to evaluate bone health) $46.70
82523 QW Collagen crosslinks Collagen cross links test, (urine test to evaluate bone health) $46.70
82525 Assay of copper Copper level $31.03
82528 Assay of corticosterone Corticosterone (hormone) level $56.30
82530 Cortisol free Cortisol (hormone) measurement, free $41.78
82533 Total cortisol Cortisol (hormone) measurement, total $40.75
82540 Assay of creatine Creatine measurement $11.60
82542 Col chromotography qual/quan Chemical analysis using chromatography technique $60.23
82550 Assay of ck (cpk) Creatine kinase (cardiac enzyme) level, total $16.28
82550 QW Assay of ck (cpk) Creatine kinase (cardiac enzyme) level, total $16.28
82552 Assay of cpk in blood Creatine kinase (cardiac enzyme) level, isoenzymes $33.48
82553 Creatine mb fraction Creatine kinase (cardiac enzyme) level, MB fraction only $28.88
82554 Creatine isoforms Creatine kinase (cardiac enzyme) level, isoforms $29.68
82565 Assay of creatinine Blood creatinine level $12.80
82565 QW Assay of creatinine Blood creatinine level $12.80
82570 Assay of urine creatinine Creatinine level to test for kidney function or muscle injury $12.95
82570 QW Assay of urine creatinine Creatinine level to test for kidney function or muscle injury $12.95
82575 Creatinine clearance test Creatinine clearance measurement to test for kidney function $23.65
82585 Assay of cryofibrinogen Cryofibrinogen (protein) level $35.35
82595 Assay of cryoglobulin Cryoglobulin (protein) measurement $16.18
82600 Assay of cyanide Cyanide measurement $48.50
82607 Vitamin b-12 Cyanocobalamin (vitamin B-12) level $37.70
82608 B-12 binding capacity Cyanocobalamin (vitamin B-12) level, unsaturated binding capacity $35.80
82610 Cystatin c Cystatin C (enzyme inhibitor) level $46.30
82615 Test for urine cystines Cystine and homocystine (amino acids) analysis $23.88
82626 Dehydroepiandrosterone Dehydroepiandrosterone (DHEA) hormone level $63.18
82627 Dehydroepiandrosterone Dehydroepiandrosterone (DHEA-S) hormone level $55.58
82633 Desoxycorticosterone Desoxycorticosterone, 11 (hormone) level $77.45
82634 Deoxycortisol Deoxycortisol, 11 (hormone) level $73.20
82638 Assay of dibucaine number Dibucaine number (enzyme) measurement $30.63
82642 Dihydrotestosterone Measurement of dihydrotestosterone $73.20
82652 Vit d 1 25-dihydroxy Dihydroxyvitamin D, 1, 25 level $96.25
82653 El-1 fecal quantitative Measurement of pancreatic elastase (enzyme) in stool $57.43
82656 El-1 fecal qual/semiq Detection of pancreatic elastase (enzyme) in stool $28.83
82657 Enzyme cell activity Enzyme activity measurement, nonradioactive substrate $55.43
82658 Enzyme cell activity ra Enzyme activity measurement, radioactive substrate $110.08
82664 Electrophoretic test Electrophoresis, laboratory testing technique $153.75
82668 Assay of erythropoietin Erythropoietin (protein) level $46.98
82670 Assay of total estradiol Measurement of total estradiol (hormone) $69.85
82671 Assay of estrogens Estrogen analysis, fractionated $80.75
82672 Assay of estrogen Estrogen analysis, total $54.25
82677 Assay of estriol Estriol (hormone) level $60.45
82679 Assay of estrone Estrone (hormone) level $62.38
82679 QW Assay of estrone Estrone (hormone) level $62.38
82681 Assay dir meas fr estradiol Direct measurement of free estradiol (hormone) $69.85
82693 Assay of ethylene glycol Ethylene glycol (antifreeze) measurement $37.25
82696 Assay of etiocholanolone Etiocholanolone (testosterone byproduct) level $65.60
82705 Fats/lipids feces qual Stool fat or lipids analysis, qualitative $12.75
82710 Fats/lipids feces quant Stool fat or lipids analysis, quantitative $42.00
82715 Assay of fecal fat Stool fat differential measurement, quantitative $57.43
82725 Assay of blood fatty acids Fatty acids measurement $46.93
82726 Long chain fatty acids Very long chain fatty acids level $49.38
82728 Assay of ferritin Ferritin (blood protein) level $34.08
82731 Assay of fetal fibronectin Fetal fibronectin (protein) analysis $161.03
82735 Assay of fluoride Fluoride level $46.35
82746 Assay of folic acid serum Folic acid level, serum $36.75
82747 Assay of folic acid rbc Folic acid level, RBC $44.13
82757 Assay of semen fructose Semen fructose (carbohydrate) level $43.35
82759 Assay of rbc galactokinase Galactokinase (enzyme) level $53.70
82760 Assay of galactose Galactose (carbohydrate) level $28.00
82775 Assay galactose transferase Galactose-1-phosphate uridyl transferase (enzyme) level $52.68
82776 Galactose transferase test Galactose-1-phosphate uridyl transferase screening test $29.35
82777 Galectin-3 Galectin-3 level $110.63
82784 Assay iga/igd/igg/igm each Gammaglobulin (immune system protein) measurement $23.25
82785 Assay of ige IgE (immune system protein) level $41.15
82787 Igg 1 2 3 or 4 each Gammaglobulin (immune system protein) measurement, immunoglobulin subclasses $20.05
82800 Blood ph Blood pH level $27.50
82803 Blood gases any combination Blood gases measurement $65.18
82805 Blood gases w/o2 saturation Blood gases measurement, with O2 saturation $196.93
82810 Blood gases o2 sat only Blood gas, oxygen saturation measurement $24.43
82820 Hemoglobin-oxygen affinity Hemoglobin-oxygen affinity measurement $33.35
82930 Gastric analy w/ph ea spec Gastric acid analysis $16.78
82938 Gastrin test Gastrin (GI tract hormone) level, after secretin stimulation $44.23
82941 Assay of gastrin Gastrin (GI tract hormone) level $44.08
82943 Assay of glucagon Glucagon (pancreatic hormone) level $35.73
82945 Glucose other fluid Glucose (sugar) level on body fluid $9.83
82946 Glucagon tolerance test Glucagon (pancreatic hormone) tolerance test $44.43
82947 Assay glucose blood quant Blood glucose (sugar) level $9.83
82947 QW Assay glucose blood quant Blood glucose (sugar) level $9.83
82948 Reagent strip/blood glucose Blood glucose (sugar) measurement using reagent strip $12.60
82950 Glucose test Blood glucose (sugar) level after receiving dose of glucose $11.88
82950 QW Glucose test Blood glucose (sugar) level after receiving dose of glucose $11.88
82951 Glucose tolerance test (gtt) Blood glucose (sugar) tolerance test, 3 specimens $32.18
82951 QW Glucose tolerance test (gtt) Blood glucose (sugar) tolerance test, 3 specimens $32.18
82952 Gtt-added samples Blood glucose (sugar) tolerance test, each additional beyond 3 specimens $9.80
82952 QW Gtt-added samples Blood glucose (sugar) tolerance test, each additional beyond 3 specimens $9.80
82955 Assay of g6pd enzyme G6PD (enzyme) level $24.25
82960 Test for g6pd enzyme G6PD (enzyme) screening test $15.13
82962 Glucose blood test Blood glucose (sugar) test performed by hand-held instrument $8.20
82963 Assay of glucosidase Glucosidase (sugar enzyme) measurement $53.70
82965 Assay of gdh enzyme Glutamate dehydrogenase (enzyme) measurement $32.88
82977 Assay of ggt Glutamyltransferase (liver enzyme) level $18.00
82977 QW Assay of ggt Glutamyltransferase (liver enzyme) level $18.00
82978 Assay of glutathione Glutathione (protein) level $38.63
82979 Assay rbc glutathione Glutathione reductase (enzyme) level $23.60
82985 Assay of glycated protein Glycated protein level $41.90
82985 QW Assay of glycated protein Glycated protein level $41.90
83001 Assay of gonadotropin (fsh) Gonadotropin, follicle stimulating (reproductive hormone) level $46.45
83001 QW Assay of gonadotropin (fsh) Gonadotropin, follicle stimulating (reproductive hormone) level $46.45
83002 Assay of gonadotropin (lh) Gonadotropin, luteinizing (reproductive hormone) level $46.30
83002 QW Assay of gonadotropin (lh) Gonadotropin, luteinizing (reproductive hormone) level $46.30
83003 Assay growth hormone (hgh) Human growth hormone level $41.68
83006 Growth stimulation gene 2 Test for detecting genes associated with growth stimulation $189.00
83009 H pylori (c-13) blood Blood test analysis for helicobacter pylori $168.40
83010 Assay of haptoglobin quant Haptoglobin (serum protein) level $31.45
83012 Assay of haptoglobins Haptoglobin (serum protein) measurement $67.23
83013 H pylori (c-13) breath Breath test analysis for helicobacter pylori $168.40
83014 H pylori drug admin Administration of drug for helicobacter pylori $19.65
83015 Heavy metal qual any anal Heavy metal screening test $52.35
83018 Heavy metal quant each nes Heavy metal level $54.90
83020 Hemoglobin electrophoresis Hemoglobin analysis and measurement, electrophoresis $32.18
83021 Hemoglobin chromotography Hemoglobin analysis and measurement, chromatography $45.15
83026 Hemoglobin copper sulfate Hemoglobin level $10.03
83030 Fetal hemoglobin chemical Fetal hemoglobin level $26.85
83033 Fetal hemoglobin assay qual Fetal hemoglobin analysis $20.00
83036 Glycosylated hemoglobin test Hemoglobin A1C level $24.28
83036 QW Glycosylated hemoglobin test Hemoglobin A1C level $24.28
83037 Glycosylated hb home device Hemoglobin A1C level, by device for home use $24.28
83037 QW Glycosylated hb home device Hemoglobin A1C level, by device for home use $24.28
83045 Blood methemoglobin test Methemoglobin (hemoglobin) analysis, qualitative $16.23
83050 Blood methemoglobin assay Methemoglobin (hemoglobin) analysis, quantitative $20.50
83051 Assay of plasma hemoglobin Plasma hemoglobin level $18.28
83060 Blood sulfhemoglobin assay Sulfhemoglobin (hemoglobin) level $22.00
83065 Assay of hemoglobin heat Thermolabile (heat sensitive) hemoglobin level $22.50
83068 Hemoglobin stability screen Screening test for unstable hemoglobin $23.68
83069 Assay of urine hemoglobin Urine hemoglobin level $9.88
83070 Assay of hemosiderin qual Hemosiderin (hemoglobin breakdown product) analysis $11.88
83080 Assay of b hexosaminidase b-Hexosaminidase (enzyme) level $42.18
83088 Assay of histamine Histamine (immune system substance) level $73.83
83090 Assay of homocystine Homocysteine (amino acid) level $44.80
83150 Assay of homovanillic acid Homovanillic acid (organic acid) level $56.03
83491 Assay of corticosteroids 17 Hydroxycorticosteroids, 17 (adrenal gland hormone) level $44.75
83497 Assay of 5-hiaa Hydroxyindolacetic acid (product of metabolism) level $32.25
83498 Assay of progesterone 17-d Hydroxyprogesterone, 17-D (synthetic hormone) level $67.93
83500 Assay free hydroxyproline Hydroxyproline (amino acid) measurement, free $56.63
83505 Assay total hydroxyproline Hydroxyproline (amino acid) measurement, total $60.75
83516 Immunoassay nonantibody Analysis of substance using immunoassay technique, multiple step method $28.83
83516 QW Immunoassay nonantibody Analysis of substance using immunoassay technique, multiple step method $28.83
83518 Immunoassay dipstick Analysis of substance using immunoassay technique, single step method $24.10
83518 QW Immunoassay dipstick Analysis of substance using immunoassay technique, single step method $24.10
83519 Ria nonantibody Measurement of substance using immunoassay technique, by radioimmunoassay $46.00
83520 Immunoassay quant nos nonab Measurement of substance using immunoassay technique $43.18
83520 QW Immunoassay quant nos nonab Measurement of substance using immunoassay technique $43.18
83521 Ig light chains free each Measurement of immunoglobulin light chains $43.18
83525 Assay of insulin Insulin measurement, total $28.58
83527 Assay of insulin Insulin measurement, free $32.38
83528 Assay of intrinsic factor Intrinsic factor (stomach protein) level $49.55
83529 Asay of interleukin-6 (il-6) Measurement of interleukin-6 $43.18
83540 Assay of iron Iron level $16.18
83550 Iron binding test Iron binding capacity $21.85
83570 Assay of idh enzyme Isocitric dehydrogenase (enzyme) level $22.13
83582 Assay of ketogenic steroids Ketogenic steroids (hormone) measurement $38.68
83586 Assay 17- ketosteroids Ketosteroids, 17 (hormone) measurement, total $32.00
83593 Fractionation ketosteroids Ketosteroids, 17 (hormone) measurement, fractionation $71.25
83605 Assay of lactic acid Lactic acid level $28.93
83605 QW Assay of lactic acid Lactic acid level $28.93
83615 Lactate (ld) (ldh) enzyme Lactate dehydrogenase (enzyme) level $15.10
83625 Assay of ldh enzymes Lactate dehydrogenase (enzyme) measurement $31.98
83630 Lactoferrin fecal (qual) Stool lactoferrin (immune system protein) analysis $49.25
83631 Lactoferrin fecal (quant) Stool lactoferrin (immune system protein) level $49.08
83632 Placental lactogen Human placental lactogen (placental hormone) level $50.55
83633 Test urine for lactose Urine lactose (carbohydrate) analysis $28.13
83655 Assay of lead Lead level $30.28
83655 QW Assay of lead Lead level $30.28
83661 L/s ratio fetal lung Fetal lung maturity assessment, lecithin sphingomyelin (L/S) ratio $54.98
83662 Foam stability fetal lung Fetal lung maturity assessment, foam stability test $47.28
83663 Fluoro polarize fetal lung Fetal lung maturity assessment, fluorescence polarization $47.28
83664 Lamellar bdy fetal lung Fetal lung maturity assessment, lamellar body density $48.30
83670 Assay of lap enzyme Leucine aminopeptidase (enzyme) level $24.53
83690 Assay of lipase Lipase (fat enzyme) level $17.23
83695 Assay of lipoprotein(a) Lipoprotein (A) level $35.80
83698 Assay lipoprotein pla2 Lipoprotein-associated phospholipase A2 (enzyme) level $115.78
83700 Lipopro bld electrophoretic Lipoprotein level, electrophoretic separation and quantitation $28.15
83701 Lipoprotein bld hr fraction Lipoprotein measurement $84.65
83704 Lipoprotein bld quan part Lipoprotein level, quantitation of lipoprotein particle number(s) $85.48
83718 Assay of lipoprotein HDL cholesterol level $20.48
83718 QW Assay of lipoprotein HDL cholesterol level $20.48
83719 Assay of blood lipoprotein VLDL cholesterol level $31.88
83721 Assay of blood lipoprotein LDL cholesterol level $26.25
83721 QW Assay of blood lipoprotein LDL cholesterol level $26.25
83722 Lipoprtn dir meas sd ldl chl Measurement of small dense low density lipoprotein cholesterol $85.48
83727 Assay of lrh hormone Luteinizing releasing factor (reproductive hormone) level $42.98
83735 Assay of magnesium Magnesium level $16.75
83775 Assay malate dehydrogenase Malate dehydrogenase (enzyme) level $18.43
83785 Assay of manganese Manganese (heavy metal) level $66.63
83789 Mass spectrometry qual/quan Mass spectrometry (laboratory testing method) $60.28
83825 Assay of mercury Mercury level $40.65
83835 Assay of metanephrines Metanephrines level $42.35
83857 Assay of methemalbumin Methemalbumin (protein) level $26.85
83861 Microfluid analy tears Microfluid analysis of tears $56.20
83861 QW Microfluid analy tears Microfluid analysis of tears $56.20
83864 Mucopolysaccharides Mucopolysaccharides (protein) level $71.25
83872 Assay synovial fluid mucin Joint fluid diagnostic test $14.65
83873 Assay of csf protein Myelin basic protein (nerve protein) level, spinal fluid $43.00
83874 Assay of myoglobin Myoglobin (muscle protein) level $32.30
83876 Assay myeloperoxidase Myeloperoxidase (white blood cell enzyme) measurement $127.15
83880 Assay of natriuretic peptide Natriuretic peptide (heart and blood vessel protein) level $98.15
83880 QW Assay of natriuretic peptide Natriuretic peptide (heart and blood vessel protein) level $98.15
83883 Assay nephelometry not spec Nephelometry, test method using light $34.00
83885 Assay of nickel Nickel level $61.28
83915 Assay of nucleotidase Nucleotidase 5′ (enzyme) level $27.88
83916 Oligoclonal bands Measurement of immune substance (oligoclonal bands) $68.48
83918 Organic acids total quant Organic acids level $59.00
83919 Organic acids qual each Organic acids analysis $41.13
83921 Organic acid single quant Organic acid level $53.03
83930 Assay of blood osmolality Blood osmolality (concentration) measurement $16.53
83935 Assay of urine osmolality Urine osmolality (concentration) measurement $17.05
83937 Assay of osteocalcin Osteocalcin (bone protein) level $74.63
83945 Assay of oxalate Oxalate level $36.13
83950 Oncoprotein her-2/neu HER-2 oncoprotein (cancer related gene) measurement $161.03
83951 Oncoprotein dcp Oncoprotein (cancer related gene) measurement $161.03
83970 Assay of parathormone Parathormone (parathyroid hormone) level $103.20
83986 Assay ph body fluid nos Body fluid pH level $8.95
83986 QW Assay ph body fluid nos Body fluid pH level $8.95
83987 Exhaled breath condensate pH exhaled breath $8.95
83993 Assay for calprotectin fecal Stool calprotectin (protein) level $49.08
84030 Assay of blood pku Phenylalanine, PKU (amino acid) level $13.75
84035 Assay of phenylketones Phenylketones (ketone) analysis $9.95
84060 Assay acid phosphatase Phosphatase (enzyme) measurement, acid, total $19.10
84066 Assay prostate phosphatase Phosphatase, prostatic (prostate enzyme) level $24.15
84075 Assay alkaline phosphatase Phosphatase (enzyme) level, alkaline $12.95
84075 QW Assay alkaline phosphatase Phosphatase (enzyme) level, alkaline $12.95
84078 Assay alkaline phosphatase Phosphatase (enzyme) level, alkaline, heat stable $20.65
84080 Assay alkaline phosphatases Phosphatase (enzyme) measurement, alkaline, isoenzymes $36.95
84081 Assay phosphatidylglycerol Phosphatidylglycerol (amniotic fluid organic acid) level $41.30
84085 Assay of rbc pg6d enzyme Phosphogluconate, 6, dehydrogenase (enzyme) level $23.60
84087 Assay phosphohexose enzymes Phosphohexose isomerase (enzyme) level $26.83
84100 Assay of phosphorus Phosphate level $11.85
84105 Assay of urine phosphorus Urine phosphate level $14.45
84106 Test for porphobilinogen Urine porphobilinogen (metabolism substance) analysis $14.55
84110 Assay of porphobilinogen Urine porphobilinogen (metabolism substance) level $21.10
84112 Eval amniotic fluid protein Cervicovaginal secretion of placenta protein $245.28
84119 Test urine for porphyrins Urine porphyrins (metabolism substance) analysis $33.40
84120 Assay of urine porphyrins Urine porphyrins (metabolism substance) measurement $36.78
84126 Assay of feces porphyrins Stool porphyrins (metabolism substance) level $97.78
84132 Assay of serum potassium Blood potassium level $11.90
84132 QW Assay of serum potassium Blood potassium level $11.90
84133 Assay of urine potassium Urine potassium level $11.83
84134 Assay of prealbumin Prealbumin (protein) level $36.48
84135 Assay of pregnanediol Pregnanediol (reproductive hormone) level $53.18
84138 Assay of pregnanetriol Pregnanetriol (reproductive hormone) level $52.63
84140 Assay of pregnenolone Pregnenolone (reproductive hormone) level $51.68
84143 Assay of 17-hydroxypregneno 17-hydroxypregnenolone (hormone) level $57.03
84144 Assay of progesterone Progesterone (reproductive hormone) level $52.15
84145 Procalcitonin (pct) Procalcitonin (hormone) level $68.05
84146 Assay of prolactin Prolactin (milk producing hormone) level $48.45
84150 Assay of prostaglandin Prostaglandin (hormone) level $104.43
84152 Assay of psa complexed PSA (prostate specific antigen) measurement, complexed $45.98
84153 Assay of psa total PSA (prostate specific antigen) measurement, total $45.98
84154 Assay of psa free PSA (prostate specific antigen) measurement, free $45.98
84155 Assay of protein serum Total protein level, blood $9.18
84155 QW Assay of protein serum Total protein level, blood $9.18
84156 Assay of protein urine Total protein level, urine $9.18
84157 Assay of protein other Total protein level, body fluid $10.00
84157 QW Assay of protein other Total protein level, body fluid $10.00
84160 Assay of protein any source Total protein level $14.03
84163 Pappa serum Pregnancy-associated plasma protein-A level $37.63
84165 Protein e-phoresis serum Protein measurement, serum $26.85
84166 Protein e-phoresis/urine/csf Protein measurement, body fluid $44.58
84181 Western blot test Protein measurement $42.58
84182 Protein western blot test Protein measurement, immunological probe for band identification $73.03
84202 Assay rbc protoporphyrin Protoporphyrin (metabolism substance) level $35.88
84203 Test rbc protoporphyrin Protoporphyrin (metabolism substance) screening test $24.35
84206 Assay of proinsulin Proinsulin (pancreatic hormone) level $66.73
84207 Assay of vitamin b-6 Vitamin B-6 level $70.25
84210 Assay of pyruvate Pyruvate (organic acid) level $36.20
84220 Assay of pyruvate kinase Pyruvate kinase (enzyme) level $23.60
84228 Assay of quinine Quinine (drug) level $29.08
84233 Assay of estrogen Estrogen receptor analysis $219.70
84234 Assay of progesterone Progesterone (reproductive hormone) receptor analysis $162.20
84235 Assay of endocrine hormone Hormone receptor analysis $178.08
84238 Assay nonendocrine receptor Chemical receptor analysis $91.43
84244 Assay of renin Renin (kidney enzyme) level $54.98
84252 Assay of vitamin b-2 Vitamin B-2 (riboflavin) level $50.60
84255 Assay of selenium Selenium (vitamin) level $63.83
84260 Assay of serotonin Serotonin (hormone) level $77.45
84270 Assay of sex hormone globul Sex hormone binding globulin (protein) level $54.33
84275 Assay of sialic acid Sialic acid (organic acid) level $33.60
84285 Assay of silica Silica (silicon) level $63.03
84295 Assay of serum sodium Blood sodium level $12.03
84295 QW Assay of serum sodium Blood sodium level $12.03
84300 Assay of urine sodium Urine sodium level $12.65
84302 Assay of sweat sodium Sodium level $12.15
84305 Assay of somatomedin Somatomedin (growth factor) level $53.15
84307 Assay of somatostatin Somatostatin (growth hormone inhibitor) level $45.70
84311 Spectrophotometry Chemical analysis using spectrophotometry (light) $20.25
84315 Body fluid specific gravity Specific gravity (liquid weight) measurement $8.20
84375 Chromatogram assay sugars Carbohydrate (sugar) analysis $97.50
84376 Sugars single qual Carbohydrate analysis, single qualitative $13.75
84377 Sugars multiple qual Carbohydrate analysis, multiple qualitative $13.75
84378 Sugars single quant Carbohydrate analysis, single quantitative $28.83
84379 Sugars multiple quant Carbohydrate analysis, multiple quantitative $28.83
84392 Assay of urine sulfate Urine sulfate (acid) level $13.73
84402 Assay of free testosterone Testosterone (hormone) level, free $63.68
84403 Assay of total testosterone Testosterone (hormone) level, total $64.53
84410 Testosterone bioavailable Testosterone level $128.20
84425 Assay of vitamin b-1 Vitamin B-1 (thiamine) level $53.08
84430 Assay of thiocyanate Thiocyanate (organic sulfur substance) level $29.08
84431 Thromboxane urine Urine analysis for thromboxane (lipid) $87.78
84432 Assay of thyroglobulin Thyroglobulin (thyroid related hormone) level $40.15
84436 Assay of total thyroxine Thyroxine (thyroid chemical), total $17.18
84437 Assay of neonatal thyroxine Thyroxine (thyroid chemical), requiring elution $16.18
84439 Assay of free thyroxine Thyroxine (thyroid chemical), free $22.55
84442 Assay of thyroid activity Thyroxine binding globulin (thyroid related protein) level $36.95
84443 Assay thyroid stim hormone Blood test, thyroid stimulating hormone (TSH) $42.00
84443 QW Assay thyroid stim hormone Blood test, thyroid stimulating hormone (TSH) $42.00
84445 Assay of tsi globulin Thyroid stimulating immune globulins (thyroid related protein) level $127.15
84446 Assay of vitamin e Vitamin E level $35.45
84449 Assay of transcortin Transcortin (cortisol binding protein) level $45.00
84450 Transferase (ast) (sgot) Liver enzyme (SGOT), level $12.95
84450 QW Transferase (ast) (sgot) Liver enzyme (SGOT), level $12.95
84460 Alanine amino (alt) (sgpt) Liver enzyme (SGPT), level $13.25
84460 QW Alanine amino (alt) (sgpt) Liver enzyme (SGPT), level $13.25
84466 Assay of transferrin Transferrin (iron binding protein) level $31.90
84478 Assay of triglycerides Triglycerides level $14.35
84478 QW Assay of triglycerides Triglycerides level $14.35
84479 Assay of thyroid (t3 or t4) Thyroid hormone evaluation $16.18
84480 Assay triiodothyronine (t3) Thyroid hormone, T3 measurement, total $35.45
84481 Free assay (ft-3) Thyroid hormone, T3 measurement, free $42.35
84482 T3 reverse Thyroid hormone, T3 measurement, reverse $39.40
84484 Assay of troponin quant Troponin (protein) analysis, quantitative $31.18
84485 Assay duodenal fluid trypsin Trypsin (pancreatic enzyme) measurement, intestinal fluid $18.00
84488 Test feces for trypsin Trypsin (pancreatic enzyme) analysis, stool $18.25
84490 Assay of feces for trypsin Stool trypsin (pancreatic enzyme) analysis, 24-hour collection $24.83
84510 Assay of tyrosine Tyrosine (amino acid) level $26.58
84512 Assay of troponin qual Troponin (protein) analysis, qualitative $25.23
84520 Assay of urea nitrogen Urea nitrogen level to assess kidney function, quantitative $9.88
84520 QW Assay of urea nitrogen Urea nitrogen level to assess kidney function, quantitative $9.88
84525 Urea nitrogen semi-quant Urea nitrogen level to assess kidney function, semiquantitative $12.83
84540 Assay of urine/urea-n Urea nitrogen level to assess kidney function, urine $13.90
84545 Urea-n clearance test Urea nitrogen level to assess kidney function, clearance $18.00
84550 Assay of blood/uric acid Uric acid level, blood $11.30
84550 QW Assay of blood/uric acid Uric acid level, blood $11.30
84560 Assay of urine/uric acid Uric acid level $12.70
84577 Assay of feces/urobilinogen Urobilinogen (metabolism substance) level, stool $42.00
84578 Test urine urobilinogen Urobilinogen (metabolism substance) analysis, urine $11.18
84580 Assay of urine urobilinogen Urobilinogen (metabolism substance) level, urine $23.88
84583 Assay of urine urobilinogen Urobilinogen (metabolism substance) measurement, urine $15.13
84585 Assay of urine vma Urine vanillylmandelic acid $38.75
84586 Assay of vip Vasoactive intestinal peptide (intestinal hormone) level $88.33
84588 Assay of vasopressin ADH (antidiuretic hormone) level $84.85
84590 Assay of vitamin a Vitamin A level $29.03
84591 Assay of nos vitamin Vitamin measurement $42.65
84597 Assay of vitamin k Vitamin K level $34.30
84600 Assay of volatiles Volatile chemical measurement $42.78
84620 Xylose tolerance test Xylose (carbohydrate) absorption test of blood and/or urine $32.28
84630 Assay of zinc Zinc level $28.48
84681 Assay of c-peptide C-peptide (protein) level $52.03
84702 Chorionic gonadotropin test Gonadotropin, chorionic (reproductive hormone) level $37.63
84703 Chorionic gonadotropin assay Gonadotropin (reproductive hormone) analysis $18.80
84703 QW Chorionic gonadotropin assay Gonadotropin (reproductive hormone) analysis $18.80
84704 Hcg free betachain test Gonadotropin, chorionic (reproductive hormone) measurement $38.23
84830 Ovulation tests Ovulation tests $31.75
85002 Bleeding time test Bleeding time $12.05
85004 Automated diff wbc count White blood cell count $16.18
85007 Bl smear w/diff wbc count Microscopic examination for white blood cells with manual cell count $9.50
85008 Bl smear w/o diff wbc count Microscopic examination for white blood cells $8.58
85009 Manual diff wbc count b-coat Manual white blood cell count and evaluation $12.68
85013 Spun microhematocrit Red blood cell hemoglobin concentration $17.50
85014 Hematocrit Red blood cell concentration measurement $5.93
85014 QW Hematocrit Red blood cell concentration measurement $5.93
85018 Hemoglobin Blood count, hemoglobin $5.93
85018 QW Hemoglobin Blood count, hemoglobin $5.93
85025 Complete cbc w/auto diff wbc Complete blood cell count (red cells, white blood cell, platelets), automated $19.43
85025 QW Complete cbc w/auto diff wbc Complete blood cell count (red cells, white blood cell, platelets), automated $19.43
85027 Complete cbc automated Complete blood cell count (red cells, white blood cell, platelets), automated $16.18
85032 Manual cell count each Manual blood cell count $10.78
85041 Automated rbc count Red blood cell count, automated test $7.55
85044 Manual reticulocyte count Red blood count, manual test $10.78
85045 Automated reticulocyte count Red blood count, automated test $9.98
85046 Reticyte/hgb concentrate Red blood count automated, with additional calculations $13.93
85048 Automated leukocyte count Automated white blood cell count $6.35
85049 Automated platelet count Platelet count, automated test $11.20
85055 Reticulated platelet assay Reticulated (young) platelet measurement $89.35
85130 Chromogenic substrate assay Assessment of blood clotting function $29.73
85170 Blood clot retraction Blood clot evaluation, (retraction time) $40.75
85175 Blood clot lysis time Blood clot evaluation, (clot dissolving time) $50.93
85210 Clot factor ii prothrom spec Clotting factor II prothrombin, measurement $32.45
85220 Blooc clot factor v test Clotting factor V (AcG or proaccelerin) measurement $44.13
85230 Clot factor vii proconvertin Clotting factor VII (proconvertin, stable factor) $44.75
85240 Clot factor viii ahg 1 stage Clotting factor VIII (AHG) measurement $44.75
85244 Clot factor viii reltd antgn Clotting factor VIII related antigen measurement $51.05
85245 Clot factor viii vw ristoctn Clotting factor VIII (VW factor) measurement $57.35
85246 Clot factor viii vw antigen Clotting factor VIII (VW factor) antigen $57.35
85247 Clot factor viii multimetric Clotting factor VIII (von Willebrand factor) measurement $57.35
85250 Clot factor ix ptc/chrstmas Clotting factor IX (PTC or Christmas) measurement $47.60
85260 Clot factor x stuart-power Clotting factor X (Stuart-Prower) measurement $44.75
85270 Clot factor xi pta Clotting factor XI (PTA) measurement $44.75
85280 Clot factor xii hageman Clotting factor XII (Hageman) measurement $48.38
85290 Clot factor xiii fibrin stab Clotting factor XIII (fibrin stabilizing) measurement $40.85
85291 Clot factor xiii fibrin scrn Clotting factor XIII (fibrin stabilizing) screening test $22.78
85292 Clot factor fletcher fact Fletcher factor (clotting factor) measurement $47.33
85293 Clot factor wght kininogen Fitzgerald factor (clotting factor) measurement $47.33
85300 Antithrombin iii activity Antithrombin III antigen (clotting inhibitor) activity $29.63
85301 Antithrombin iii antigen Antithrombin III antigen (clotting inhibitor) level $27.03
85302 Clot inhibit prot c antigen Protein C, (clotting inhibitor) activity $30.03
85303 Clot inhibit prot c activity Protein C antigen (clotting inhibitor) measurement $34.60
85305 Clot inhibit prot s total Protein S (clotting inhibitor) level $29.03
85306 Clot inhibit prot s free Protein S (clotting inhibitor) measurement $38.30
85307 Assay activated protein c Activated protein resistance assay $38.30
85335 Factor inhibitor test Clotting factor inhibitor test $32.18
85337 Thrombomodulin Thrombomodulin (coagulation protein) measurement $43.18
85345 Coagulation time lee & white Coagulation time measurement, Lee and White $11.73
85347 Coagulation time activated Coagulation time measurement, activated $10.70
85348 Coagulation time otr method Coagulation time measurement, other methods $11.23
85360 Euglobulin lysis Euglobulin lysis (clot dissolving) measurement $21.03
85362 Fibrin degradation products Coagulation function analysis, agglutination slide, semiquantitative $17.23
85366 Fibrinogen test Coagulation function measurement, paracoagulation $201.15
85370 Fibrinogen test Coagulation function measurement, quantitative $31.08
85378 Fibrin degrade semiquant Coagulation function measurement, qualitative or semiquantitative $24.30
85379 Fibrin degradation quant Coagulation function measurement, D-dimer; quantitative $25.45
85380 Fibrin degradj d-dimer Coagulation function measurement, ultrasensitive, qualitative or $25.45
85384 Fibrinogen activity Fibrinogen (factor 1) activity measurement $24.30
85385 Fibrinogen antigen Fibrinogen (factor 1) antigen detection $36.15
85390 Fibrinolysins screen i&r Coagulation function screening test with interpretation and report $38.70
85397 Clotting funct activity Measurement of blood coagulation and fibrinolysis (clot dissolving) function $77.15
85400 Fibrinolytic plasmin Plasmin (fibrinolytic factor) measurement $19.28
85410 Fibrinolytic antiplasmin Alpha-2 antiplasmin (factor inhibitor) measurement $19.28
85415 Fibrinolytic plasminogen Plasminogen activator (fibrinolytic factor) measurement $42.98
85420 Fibrinolytic plasminogen Plasminogen (fibrinolytic factor) measurement $16.33
85421 Fibrinolytic plasminogen Plasminogen antigenic (factor inhibitor) measurement $25.45
85441 Heinz bodies direct Evaluation of red blood cell defect (Heinz bodies), direct $10.50
85445 Heinz bodies induced Evaluation of red blood cell defect (Heinz bodies), induced $17.05
85460 Hemoglobin fetal Fetal hemoglobin or red blood cells measurement for assessment of $19.33
85461 Hemoglobin fetal Fetal hemoglobin or red blood cells measurement for assessment of $23.40
85475 Hemolysin acid Measurement of hemolysin (red blood cell destructive substance) $22.18
85520 Heparin assay Heparin assay $32.73
85525 Heparin neutralization Heparin neutralization test $29.60
85530 Heparin-protamine tolerance Heparin therapy assessment $32.73
85536 Iron stain peripheral blood Blood smear for iron $17.20
85540 Wbc alkaline phosphatase White blood cell alkaline phosphatase (enzyme) measurement with cell count $21.50
85547 Rbc mechanical fragility Red blood cell fragility measurement $21.50
85549 Muramidase White blood cell enzyme activity measurement $46.88
85555 Rbc osmotic fragility Red blood cell fragility measurement, unincubated $18.68
85557 Rbc osmotic fragility Red blood cell fragility measurement, incubated $33.40
85576 Blood platelet aggregation Platelet aggregation function test $62.28
85576 QW Blood platelet aggregation Platelet aggregation function test $62.28
85597 Phospholipid pltlt neutraliz Platelet function test $44.95
85598 Hexagnal phosph pltlt neutrl Phospholipid test $44.95
85610 Prothrombin time Blood test, clotting time $10.73
85610 QW Prothrombin time Blood test, clotting time $10.73
85611 Prothrombin test Blood test, clotting time, substitution $9.85
85612 Viper venom prothrombin time Clotting factor X assessment test, undiluted $43.73
85613 Russell viper venom diluted Clotting factor X assessment test, diluted $23.95
85635 Reptilase test Blood coagulation screening test $24.63
85651 Rbc sed rate nonautomated Red blood cell sedimentation rate, to detect inflammation, non-automated $10.68
85652 Rbc sed rate automated Red blood cell sedimentation rate, to detect inflammation, automated $6.75
85660 Rbc sickle cell test Red blood cell sickling measurement $13.78
85670 Thrombin time plasma Thrombin time, fibrinogen screening test, plasma $14.43
85675 Thrombin time titer Thrombin time, fibrinogen screening test, titer $17.13
85705 Thromboplastin inhibition Thromboplastin inhibition (circulating anticoagulant) measurement $24.08
85730 Thromboplastin time partial Coagulation assessment blood test, plasma or whole blood $15.03
85732 Thromboplastin time partial Coagulation assessment blood test, substitution, plasma fractions $16.18
85810 Blood viscosity examination Blood viscosity measurement $29.18
86000 Agglutinins febrile antigen Measurement of antibody to infectious organism $17.45
86001 Allergen specific igg Measurement of antibody (IgG) to allergic substance, each allergen $19.55
86003 Allg spec ige crude xtrc ea Measurement of antibody (IgE) to allergic substance, crude allergen extract, $13.05
86005 Allg spec ige multiallg scr Measurement of antibody (IgE) to allergic substance, multiallergen screen $19.93
86008 Allg spec ige recomb ea Measurement of antibody (IgE) to allergic substance, recombinant or purified $44.83
86015 Actin antibody each Measurement of Actin (smooth muscle) antibody $28.83
86021 Wbc antibody identification Antibody identification test for white blood cell antibodies $37.63
86022 Platelet antibodies Antibody identification test, platelet antibodies $45.93
86023 Immunoglobulin assay Antibody identification test, platelet associated immunoglobulin assay $31.15
86036 Anca screen each antibody Screening test for antineutrophil cytoplasmic antibody $30.13
86037 Anca titer each antibody Antineutrophil cytoplasmic antibody titer $30.13
86038 Antinuclear antibodies Screening test for autoimmune disorder $30.23
86039 Antinuclear antibodies (ana) Measurement of antibody for assessment of autoimmune disorder, titer $27.90
86051 Aquaporin-4 antb elisa ELISA detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody $28.83
86052 Aquaporin-4 antb cba each Cell-based immunofluorescence (CBA) detection of aquaporin-4 (neuromyelitis $30.13
86053 Aqaprn-4 antb flo cytmtry ea Flow cytometry detection of aquaporin-4 (neuromyelitis optica [NMO]) antibody $30.13
86060 Antistreptolysin o titer Measurement for Strep antibody (strep throat) $18.25
86063 Antistreptolysin o screen Screening test for Strep antibody (strep throat) $14.43
86140 C-reactive protein Measurement C-reactive protein for detection of infection or inflammation $12.95
86141 C-reactive protein hs Measurement C-reactive protein for detection of infection or inflammation, high $32.38
86146 Beta-2 glycoprotein antibody Beta 2 glycoprotein 1 antibody (autoantibody) measurement $63.63
86147 Cardiolipin antibody ea ig Cardiolipin antibody (tissue antibody) measurement $63.63
86148 Anti-phospholipid antibody Phospholipid antibody (autoimmune antibody) measurement $40.18
86152 Cell enumeration & id Cell enumeration using immunologic selection and identification in fluid $626.95
86155 Chemotaxis assay Measurement of white blood cell function $39.98
86156 Cold agglutinin screen Measurement of cold agglutinin (protein) to screen for infection or disease $20.18
86157 Cold agglutinin titer Measurement of cold agglutinin (protein) to detect infection or disease $20.15
86160 Complement antigen Measurement of complement (immune system proteins), antigen, $30.00
86161 Complement/function activity Measurement of complement function (immune system proteins) $30.00
86162 Complement total (ch50) Measurement of complement (immune system proteins), total hemolytic $50.80
86171 Complement fixation each Measurement of complement fixation tests (immune system proteins) $25.03
86200 Ccp antibody Measurement of antibody for rheumatoid arthritis assessment $32.38
86215 Deoxyribonuclease antibody Measurement of DNA antibody $33.13
86225 Dna antibody native Measurement of DNA antibody, native or double stranded $34.35
86226 Dna antibody single strand Measurement of DNA antibody, single stranded $30.28
86231 Ema each ig class Detection of endomysial antibody (EMA) $30.23
86235 Nuclear antigen antibody Measurement of antibody for assessment of autoimmune disorder, any method $44.83
86255 Fluorescent antibody screen Screening test for antibody to noninfectious agent $30.13
86256 Fluorescent antibody titer Measurement of antibody to noninfectious agent $30.13
86258 Dgp antibody each ig class Detection of gliadin (deamidated) (DGP) antibody $28.83
86277 Growth hormone antibody Measurement of growth hormone antibody $39.35
86280 Hemagglutination inhibition Measurement of immune system protein $20.48
86294 Immunoassay tumor qual Immunologic analysis for detection of tumor antigen, qualitative or $63.93
86294 QW Immunoassay tumor qual Immunologic analysis for detection of tumor antigen, qualitative or $63.93
86300 Immunoassay tumor ca 15-3 Immunologic analysis for detection of tumor antigen, quantitative; CA 15-3 $52.03
86301 Immunoassay tumor ca 19-9 Immunologic analysis for detection of tumor antigen, quantitative; CA 19-9 $52.03
86304 Immunoassay tumor ca 125 Immunologic analysis for detection of tumor antigen, quantitative; CA 125 $52.03
86305 Human epididymis protein 4 Analysis of female reproductive genetic marker $52.03
86308 Heterophile antibody screen Screening test for mononucleosis (mono) $12.95
86308 QW Heterophile antibody screen Screening test for mononucleosis (mono) $12.95
86309 Heterophile antibody titer Mononucleosis antibody level, titer $16.18
86310 Heterophile antibody absrbj Mononucleosis antibody level, titers after absorption $18.43
86316 Immunoassay tumor other Analysis for detection of tumor marker $52.03
86317 Immunoassay infectious agent Detection of infectious agent antibody, quantitative $37.48
86318 Ia infectious agent antibody Test for detection of infectious agent antibody, qualitative or semiquantitative $45.23
86318 QW Ia infectious agent antibody Test for detection of infectious agent antibody, qualitative or semiquantitative $45.23
86320 Serum immunoelectrophoresis Immunologic analysis technique on serum $74.80
86325 Other immunoelectrophoresis Immunologic analysis technique on body fluid $57.83
86327 Immunoelectrophoresis assay Immunologic analysis technique, crossed $74.80
86328 Ia nfct ab sarscov2 covid19 Test for detection of severe acute respiratory syndrome coronavirus 2 $113.20
86328 QW Ia nfct ab sarscov2 covid19 Test for detection of severe acute respiratory syndrome coronavirus 2 $113.20
86329 Immunodiffusion nes Immunologic analysis technique, unspecified $35.13
86331 Immunodiffusion ouchterlony Immunologic analysis for detection of antigen or antibody $29.95
86332 Immune complex assay Immune complex measurement $60.93
86334 Immunofix e-phoresis serum Immunologic analysis technique on serum (immunofixation) $55.85
86335 Immunfix e-phorsis/urine/csf Immunologic analysis technique on body fluid, other fluids with concentration $73.38
86336 Inhibin a Inhibin A (reproductive organ hormone) measurement $38.98
86337 Insulin antibodies Insulin antibody measurement $53.53
86340 Intrinsic factor antibody Intrinsic factor (stomach protein) antibody measurement $37.70
86341 Islet cell antibody Islet cell (pancreas) antibody measurement $58.93
86343 Leukocyte histamine release White blood cell histamine (immune system chemical) release test $31.15
86344 Leukocyte phagocytosis White blood cell function measurement $25.98
86352 Cell function assay w/stim Analysis of cell function and analysis for genetic marker $339.65
86353 Lymphocyte transformation White blood cell function measurement, mitogen or antigen induced blastogenesis $122.58
86355 B cells total count Total cell count for B cells (white blood cells) $94.33
86356 Mononuclear cell antigen White blood cell antigen measurement $66.95
86357 Nk cells total count Total cell count for natural killer cells (white blood cell) $94.33
86359 T cells total count T cells count, total $94.33
86360 T cell absolute count/ratio T cell count and ratio, including ratio $117.45
86361 T cell absolute count T cell count and ratio $66.95
86362 Mog-igg1 antb cba each Cell-based immunofluorescence (CBA) detection of myelin oligodendrocyte $30.13
86363 Mog-igg1 antb flo cytmtry ea Flow cytometry detection of myelin oligodendrocyte glycoprotein (MOG-IgG1) $30.13
86364 Tiss trnsgltmnase ea ig clas Measurement of tissue transglutaminase $28.83
86367 Stem cells total count Stem cells count, total $194.45
86376 Microsomal antibody each Microsomal antibodies (autoantibody) measurement $36.38
86381 Mitochondrial antibody each Measurement of mitochondrial antibody $63.63
86382 Neutralization test viral Viral neutralization test to detect viral antibody level $42.28
86384 Nitroblue tetrazolium dye Nitroblue tetrazolium dye test to measure white blood cell function $34.03
86386 Nuclear matrix protein 22 Protein test for diagnosis and monitoring of bladder cancer $54.45
86386 QW Nuclear matrix protein 22 Protein test for diagnosis and monitoring of bladder cancer $54.45
86403 Particle agglut antbdy scrn Screening test for presence of antibody $28.85
86406 Particle agglut antbdy titr Antibody level measurement $26.60
86408 Neutrlzg antb sarscov2 scr Screening test for detection of severe acute respiratory syndrome coronavirus 2 $-
86409 Neutrlzg antb sarscov2 titer Measurement of neutralizing antibody to severe acute respiratory syndrome $-
86413 Sars-cov-2 antb quantitative Quantitative measurement of severe acute respiratory syndrome coronavirus 2 $-
86430 Rheumatoid factor test qual Rheumatoid factor analysis $15.35
86431 Rheumatoid factor quant Rheumatoid factor level $14.18
86480 Tb test cell immun measure Tuberculosis test, gamma interferon $154.95
86481 Tb ag response t-cell susp Tuberculosis test, enumeration of T-cells $250.00
86590 Streptokinase antibody Measurement of antibody to streptokinase (enzyme) $31.65
86592 Syphilis test non-trep qual Syphilis detection test $10.68
86593 Syphilis test non-trep quant Syphilis test $11.00
86596 Voltage-gtd ca chnl antb ea Measurement of voltage-gated calcium channel antibody $46.00
86602 Antinomyces antibody Analysis for antibody to actinomyces (bacteria) $25.45
86603 Adenovirus antibody Analysis for antibody to adenovirus (respiratory virus) $32.18
86606 Aspergillus antibody Analysis for antibody to aspergillus (fungus) $37.63
86609 Bacterium antibody Analysis for antibody bacteria $32.20
86611 Bartonella antibody Analysis for antibody to Bartonella (bacteria) $25.45
86612 Blastomyces antibody Analysis for antibody to blastomyces (fungus) $32.25
86615 Bordetella antibody Analysis for antibody bordetella (respiratory bacteria) $32.98
86617 Lyme disease antibody Confirmation test for antibody to Borrelia burgdorferi (Lyme disease bacteria) $38.73
86618 Lyme disease antibody Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) $42.58
86618 QW Lyme disease antibody Analysis for antibody Borrelia burgdorferi (Lyme disease bacteria) $42.58
86619 Borrelia antibody Analysis for antibody to Borrelia (relapsing fever bacteria) $33.45
86622 Brucella antibody Analysis for antibody to Brucella (bacteria) $22.33
86625 Campylobacter antibody Analysis for antibody to Campylobacter (intestinal bacteria) $32.80
86628 Candida antibody Analysis for antibody to Candida (yeast) $30.03
86631 Chlamydia antibody Analysis for antibody to Chlamydia (bacteria) $29.55
86632 Chlamydia igm antibody Analysis for antibody (Igm) to Chlamydia (bacteria) $31.70
86635 Coccidioides antibody Analysis for antibody to Coccidioides (bacteria) $28.68
86638 Q fever antibody Analysis for antibody to Coxiella burnetii (Q fever bacteria) $30.30
86641 Cryptococcus antibody Analysis for antibody to Cryptococcus (yeast) $36.03
86644 Cmv antibody Analysis for antibody to Cytomegalovirus (CMV) $35.98
86645 Cmv antibody igm Analysis for antibody (IgM) to Cytomegalovirus (CMV) $42.13
86648 Diphtheria antibody Analysis for antibody to Diphtheria (bacteria) $38.03
86651 Encephalitis californ antbdy Analysis for antibody to La crosse (California) virus (encephalitis causing $32.98
86652 Encephaltis east eqne anbdy Analysis for antibody to Eastern equine virus (viral encephalitis) $32.98
86653 Encephaltis st louis antbody Analysis for antibody to St. Louis virus (viral encephalitis) $32.98
86654 Encephaltis west eqne antbdy Analysis for antibody to Western equine virus (viral encephalitis) $32.98
86658 Enterovirus antibody Analysis for antibody to Enterovirus (gastrointestinal virus) $32.58
86663 Epstein-barr antibody Analysis for antibody to Epstein-Barr virus (mononucleosis virus), early antigen $32.80
86664 Epstein-barr nuclear antigen Analysis for antibody to Epstein-Barr virus (mononucleosis virus), nuclear $38.23
86665 Epstein-barr capsid vca Analysis for antibody to Epstein-Barr virus (mononucleosis virus), viral capsid $45.35
86666 Ehrlichia antibody Analysis for antibody to Ehrlichia (bacteria transmitted by ticks) $25.45
86668 Francisella tularensis Analysis for antibody to Francisella tularensis (bacteria transmitted by $35.40
86671 Fungus nes antibody Analysis for antibody to fungus $30.63
86674 Giardia lamblia antibody Analysis for antibody to Giardia lamblia (intestinal parasite) $36.80
86677 Helicobacter pylori antibody Analysis for antibody to Helicobacter pylori (gastrointestinal bacteria) $42.13
86682 Helminth antibody Analysis for antibody to helminth (intestinal worm) $32.53
86684 Hemophilus influenza antibdy Analysis for antibody to Haemophilus influenza (respiratory bacteria) $39.60
86687 Htlv-i antibody Analysis for antibody to Human T-cell lymphotropic virus, type 1 (HTLV-1) $22.73
86688 Htlv-ii antibody Analysis for antibody to Human T-cell lymphotropic virus, type 2 (HTLV-2) $35.00
86689 Htlv/hiv confirmj antibody Confirmation test for antibody to Human T-cell lymphotropic virus (HTLV) or HIV $48.38
86692 Hepatitis delta agent antbdy Analysis for antibody to Hepatitis D virus $42.90
86694 Herpes simplex nes antbdy Analysis for antibody to Herpes simplex virus $35.98
86695 Herpes simplex type 1 test Analysis for antibody to Herpes simplex virus, type 1 $32.98
86696 Herpes simplex type 2 test Analysis for antibody to Herpes simplex virus, type 2 $48.38
86698 Histoplasma antibody Analysis for antibody to histoplasma (fungus) $34.48
86701 Hiv-1antibody Analysis for antibody to HIV -1 virus $22.23
86701 QW Hiv-1antibody Analysis for antibody to HIV -1 virus $22.23
86702 Hiv-2 antibody Analysis for antibody to HIV-2 virus $33.80
86703 Hiv-1/hiv-2 1 result antbdy Analysis for antibody to HIV-1 and HIV-2 virus $34.28
86704 Hep b core antibody total Hepatitis B core antibody measurement $30.13
86705 Hep b core antibody igm Hepatitis B core antibody (IgM) measurement $29.43
86706 Hep b surface antibody Hepatitis B surface antibody measurement $26.85
86707 Hepatitis be antibody Hepatitis Be antibody measurement $28.93
86708 Hepatitis a antibody Measurement of Hepatitis A antibody $30.98
86709 Hepatitis a igm antibody Measurement of Hepatitis A antibody (IgM) $28.15
86710 Influenza virus antibody Analysis for antibody to Influenza virus $33.88
86711 John cunningham antibody Analysis for antibody to john cunningham virus $42.23
86713 Legionella antibody Analysis for antibody to Legionella (waterborne bacteria) $38.25
86717 Leishmania antibody Analysis for antibody to Leishmania (parasite) $30.63
86720 Leptospira antibody Analysis for antibody to Leptospira $40.50
86723 Listeria monocytogenes Analysis for antibody to Listeria monocytogenes (bacteria) $32.98
86727 Lymph choriomeningitis ab Analysis for antibody to lymphocytic choriomeningitis virus (viral meningitis) $32.18
86732 Mucormycosis antibody Analysis for antibody to mucormycosis (fungus) $37.50
86735 Mumps antibody Analysis for antibody to mumps virus $32.63
86738 Mycoplasma antibody Analysis for antibody to Mycoplasma (bacteria) $33.10
86741 Neisseria meningitidis Analysis for antibody to Neisseria meningitidis (bacterial meningitis) $32.98
86744 Nocardia antibody Analysis for antibody to Nocardia (bacteria) $39.98
86747 Parvovirus antibody Analysis for antibody to parvovirus $37.58
86750 Malaria antibody Analysis for antibody to Plasmodium (malaria parasite) $32.98
86753 Protozoa antibody nos Analysis for antibody to protozoa (parasite) $30.98
86756 Respiratory virus antibody Analysis for antibody to respiratory syncytial virus (RSV) $39.73
86757 Rickettsia antibody Analysis for antibody to Rickettsia (bacteria) $48.38
86759 Rotavirus antibody Analysis for antibody to Rotavirus (intestinal virus) $45.58
86762 Rubella antibody Analysis for antibody to Rubella (German measles virus) $35.98
86765 Rubeola antibody Analysis for antibody to Rubeola (measles virus) $32.20
86768 Salmonella antibody Analysis for antibody to Salmonella (intestinal bacteria) $32.98
86769 Sars-cov-2 covid-19 antibody Measure of severe acute respiratory syndrome coronavirus 2 (Covid-19) antibody $105.33
86771 Shigella antibody Analysis for antibody to Shigella (intestinal bacteria) $61.20
86774 Tetanus antibody Analysis for antibody to tetanus bacteria (Clostridium tetanus) $37.00
86777 Toxoplasma antibody Analysis for antibody to Toxoplasma (parasite) $35.98
86778 Toxoplasma antibody igm Analysis for antibody (IgM) to Toxoplasma (parasite) $36.03
86780 Treponema pallidum Analysis for antibody, Treponema pallidum $33.10
86780 QW Treponema pallidum Analysis for antibody, Treponema pallidum $33.10
86784 Trichinella antibody Analysis for antibody to Trichinella (worm parasite) $31.40
86787 Varicella-zoster antibody Analysis for antibody to varicella-zoster virus (chicken pox) $32.20
86788 West nile virus ab igm Analysis for antibody (IgM) to West Nile virus $42.13
86789 West nile virus antibody Analysis for antibody to West Nile virus $35.98
86790 Virus antibody nos Analysis for antibody to virus $32.20
86793 Yersinia antibody Analysis for antibody to Yersinia (bacteria) $32.98
86794 Zika virus igm antibody Analysis for antibody to Zika virus $42.13
86800 Thyroglobulin antibody Thyroglobulin (thyroid protein) antibody measurement $39.78
86803 Hepatitis c ab test Hepatitis C antibody measurement $35.68
86803 QW Hepatitis c ab test Hepatitis C antibody measurement $35.68
86804 Hep c ab test confirm Confirmation test for Hepatitis C antibody $38.73
86805 Lymphocytotoxicity assay Immunologic analysis for autoimmune disease, with titration $473.78
86806 Lymphocytotoxicity assay Immunologic analysis for autoimmune disease, without titration $118.98
86807 Cytotoxic antibody screening Transplant antibody measurement, standard method $196.63
86808 Cytotoxic antibody screening Transplant antibody measurement, quick method $74.20
86812 Hla typing a b or c Immunologic analysis for autoimmune disease, A, B, or C, single antigen $64.53
86813 Hla typing a b or c Immunologic analysis for autoimmune disease, A, B, or C, multiple antigens $145.00
86816 Hla typing dr/dq Immunologic analysis for autoimmune disease, DR/DQ, single antigen $75.43
86817 Hla typing dr/dq Immunologic analysis for autoimmune disease, DR/DQ, multiple antigens $265.35
86821 Lymphocyte culture mixed Immunologic analysis for autoimmune disease, lymphocyte culture, mixed $91.40
86825 Hla x-math non-cytotoxic Immunologic analysis for organ transplant, first serum sample or dilution $273.73
86826 Hla x-match noncytotoxc addl Immunologic analysis for organ transplant, each additional serum sample or $91.33
86828 Hla class i&ii antibody qual Assessment of antibodies to Class I and Class II human leukocyte antigens (HLA) $160.48
86829 Hla class i/ii antibody qual Assessment of antibodies to Class I or Class II human leukocyte antigens (HLA) $160.48
86830 Hla class i phenotype qual Assessment of antibody to human leukocyte antigens (HLA) with antibody $238.80
86831 Hla class ii phenotype qual Assessment of antibody to human leukocyte antigens (HLA) with antibody $204.70
86832 Hla class i high defin qual Assessment of antibody to human leukocyte antigens (HLA) with high definition $809.38
86833 Hla class ii high defin qual Assessment of antibody to human leukocyte antigens (HLA) with high definition $814.50
86834 Hla class i semiquant panel Assessment of antibody to human leukocyte antigens (HLA), HLA class I $893.90
86835 Hla class ii semiquant panel Assessment of antibody to human leukocyte antigens (HLA) with solid phase $807.40
86850 Rbc antibody screen Screening test for red blood cell antibodies $24.43
86880 Coombs test direct Red blood cell antibody detection test, direct $13.48
86885 Coombs test indirect qual Red blood cell antibody detection test, indirect $14.30
86886 Coombs test indirect titer Red blood cell antibody level $12.95
86900 Blood typing serologic abo Blood group typing (ABO) $7.48
86901 Blood typing serologic rh(d) Blood typing for Rh (D) antigen $7.48
86902 Blood type antigen donor ea Screening test for compatible blood unit, using reagent serum $15.88
86904 Blood typing patient serum Screening test for compatible blood unit, using patient serum $40.85
86905 Blood typing rbc antigens Blood typing for red blood cell antigens $9.58
86906 Bld typing serologic rh phnt Blood typing Rh phenotyping $19.38
86940 Hemolysins/agglutinins auto Red blood cell antibody screening test $21.93
86941 Hemolysins/agglutinins Red blood cell antibody measurement $30.28
87003 Small animal inoculation Animal inoculation, small animal with observation and dissection $42.10
87015 Specimen infect agnt concntj Concentration of specimen for infectious agents $16.70
87040 Blood culture for bacteria Bacterial blood culture $25.80
87045 Feces culture aerobic bact Stool culture $23.60
87046 Stool cultr aerobic bact ea Stool culture, additional pathogens $23.60
87070 Culture othr specimn aerobic Bacterial culture, any other source except urine, blood or stool, aerobic $21.55
87071 Culture aerobic quant other Bacterial culture and colony count $24.73
87073 Culture bacteria anaerobic Bacterial culture and colony count for anaerobic bacteria $24.15
87075 Cultr bacteria except blood Bacterial culture, any source, except blood, anaerobic $23.68
87076 Culture anaerobe ident each Bacterial culture for anaerobic isolates $20.20
87077 Culture aerobic identify Bacterial culture for aerobic isolates $20.20
87077 QW Culture aerobic identify Bacterial culture for aerobic isolates $20.20
87081 Culture screen only Screening test for pathogenic organisms $16.58
87084 Culture of specimen by kit Screening test for pathogenic organisms with colony count $67.68
87086 Urine culture/colony count Bacterial colony count, urine $20.18
87088 Urine bacteria culture Bacterial urine culture $20.23
87101 Skin fungi culture Fungal culture (mold or yeast) of skin, hair, or nail $19.28
87102 Fungus isolation culture Fungal culture (mold or yeast) $21.03
87103 Blood fungus culture Fungal blood culture (mold or yeast) $51.15
87106 Fungi identification yeast Fungal culture, yeast $25.80
87107 Fungi identification mold Culture for identification of yeast $25.80
87109 Mycoplasma Mycoplasma culture $38.48
87110 Chlamydia culture Culture for chlamydia $49.00
87116 Mycobacteria culture Culture for acid-fast bacilli $27.00
87118 Mycobacteric identification Identification of mycobacteria (TB or TB like organism) $36.53
87140 Culture type immunofluoresc Identification of organisms by immunologic analysis, immunofluorescent method $13.93
87143 Culture typing glc/hplc Identification of organism using chromatography $31.30
87147 Culture type immunologic Identification of organisms by immunologic analysis, other than $12.95
87149 Dna/rna direct probe Identification of organisms by genetic analysis, direct probe technique $50.13
87150 Dna/rna amplified probe Identification of organisms by genetic analysis, amplified probe technique $87.73
87152 Culture type pulse field gel Identification of organism by pulse field gel typing $19.35
87153 Dna/rna sequencing Identification of organisms by nucleic acid sequencing method $288.40
87154 Cul typ id bld pthgn 6+ trgt Amplifed nucleic acid probe typing of disease agent in blood culture specimen $545.15
87158 Culture typing added method Microbial identification $19.35
87164 Dark field examination Dark field microscopic examination for organism, includes specimen collection $26.85
87166 Dark field examination Dark field microscopic examination for organism, without collection $28.25
87168 Macroscopic exam arthropod Macroscopic examination (visual inspection) of insect $10.68
87169 Macroscopic exam parasite Macroscopic examination (visual inspection) of parasite $10.78
87172 Pinworm exam Pinworm test $10.68
87176 Tissue homogenization cultr Tissue preparation for culture $14.70
87177 Ova and parasites smears Smear for parasites $22.25
87181 Microbe susceptible diffuse Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), agar $11.88
87184 Microbe susceptible disk Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral) $18.70
87185 Microbe susceptible enzyme Detection of antimicrobial drug (antibiotic, antifungal, antiviral) $11.88
87186 Microbe susceptible mic Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), $21.63
87187 Microbe susceptible mlc Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), $100.43
87188 Microbe suscept macrobroth Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), $16.60
87190 Microbe suscept mycobacteri Antimicrobial study, mycobacteria (TB organism family) $18.28
87197 Bactericidal level serum Evaluation of antibiotic therapy $37.55
87205 Smear gram stain Special Gram or Giemsa stain for microorganism $10.68
87206 Smear fluorescent/acid stai Special fluorescent and/or acid fast stain for microorganism $13.48
87207 Smear special stain Special stain for inclusion bodies or parasites $14.98
87209 Smear complex stain Special stain for parasites $44.95
87210 Smear wet mount saline/ink Smear for infectious agents $14.55
87210 QW Smear wet mount saline/ink Smear for infectious agents $14.55
87220 Tissue exam for fungi Tissue fungi or parasites $10.68
87230 Assay toxin or antitoxin Microbial toxin or antitoxin assay $49.35
87250 Virus inoculate eggs/animal Inoculation of embryonated eggs, or small animal for virus isolation $48.90
87252 Virus inoculation tissue Tissue culture inoculation for virus isolation $65.18
87253 Virus inoculate tissue addl Tissue culture for virus isolation $50.50
87254 Virus inoculation shell via Virus isolation, centrifuge enhanced $48.90
87255 Genet virus isolate hsv Virus isolation $84.65
87260 Adenovirus ag if Detection test for adenovirus (virus) $36.08
87265 Pertussis ag if Detection test for bordetella pertussis or parapertussis (respiratory bacteria) $29.95
87267 Enterovirus antibody dfa Detection test for enterovirus (intestinal virus), direct fluorescent antibody $33.55
87269 Giardia ag if Detection test by immunofluorescent technique for giardia (intestinal parasite) $34.03
87270 Chlamydia trachomatis ag if Detection test by immunofluorescent technique for chlamydia $29.95
87271 Cytomegalovirus dfa Detection test by immunofluorescent technique for cytomegalovirus (CMV) $33.55
87272 Cryptosporidium ag if Detection test by immunofluorescent technique for cryptosporidium (parasite) $29.95
87273 Herpes simplex 2 ag if Detection test by immunofluorescent technique for herpes simplex virus type 2 $29.95
87274 Herpes simplex 1 ag if Detection test by immunofluorescent technique for herpes simplex virus type 1 $29.95
87275 Influenza b ag if Detection test by immunofluorescent technique for influenza B virus $30.63
87276 Influenza a ag if Detection test by immunofluorescent technique for influenza A virus $40.18
87278 Legion pneumophilia ag if Detection test by immunofluorescent technique for legionella pneumophila (water $39.00
87279 Parainfluenza ag if Detection test by immunofluorescent technique for parainfluenza virus $41.08
87280 Respiratory syncytial ag if Detection test by immunofluorescent technique for respiratory syncytial virus $33.55
87281 Pneumocystis carinii ag if Detection test by immunofluorescent technique for pneumocystis carinii $29.95
87283 Rubeola ag if Detection test by immunofluorescent technique for rubeola (measles virus) $152.00
87285 Treponema pallidum ag if Detection test by immunofluorescent technique for treponema pallidum (syphilis $30.45
87290 Varicella zoster ag if Detection test by immunofluorescent technique for varicella (chicken pox) $33.55
87299 Antibody detection nos if Detection test by immunofluorescent technique for organism $40.25
87300 Ag detection polyval if Detection test by immunofluorescent technique for multiple organisms $29.95
87301 Adenovirus ag ia Detection test by immunoassay technique for adenovirus enteric types 40/41 $29.95
87305 Aspergillus ag ia Detection test by immunoassay technique for aspergillus (fungus) $29.95
87320 Chlmyd trach ag ia Detection test by immunoassay technique for Chlamydia trachomatis $37.50
87324 Clostridium ag ia Detection test by immunoassay technique for clostridium difficile toxins (stool $29.95
87327 Cryptococcus neoform ag ia Detection test by immunoassay technique, multistep method, for Cryptococcus $33.55
87328 Cryptosporidium ag ia Detection test by immunoassay technique for cryptosporidium (parasite) $34.55
87329 Giardia ag ia Detection test by immunoassay technique for giardia (intestinal parasite) $29.95
87332 Cytomegalovirus ag ia Detection test by immunoassay technique for cytomegalovirus $29.95
87335 E coli 0157 ag ia Detection test by immunoassay technique for Escherichia coli 0157 (E. coli) $31.65
87336 Entamoeb hist dispr ag ia Detection test by immunoassay technique for entamoeba histolytica dispar group $40.00
87337 Entamoeb hist group ag ia Detection test by immunoassay technique for entamoeba histolytica group $29.95
87338 Hpylori stool ag ia Detection test by immunoassay technique for Helicobacter pylori (GI tract $35.95
87338 QW Hpylori stool ag ia Detection test by immunoassay technique for Helicobacter pylori (GI tract $35.95
87339 H pylori ag ia Detection test by immunoassay technique for helicobacter pylori (GI tract $40.00
87340 Hepatitis b surface ag ia Detection test by immunoassay technique for Hepatitis B surface antigen $25.83
87341 Hep b surface ag neutrlzj ia Detection test by immunoassay technique for Hepatitis B surface antigen $25.83
87350 Hepatitis be ag ia Detection test by immunoassay technique for Hepatitis Be surface antigen $28.83
87380 Hepatitis delta agent ag ia Detection test by immunoassay technique for Hepatitis D $45.90
87385 Histoplasma capsul ag ia Detection test by immunoassay technique for histoplasma capsulatum (parasite) $33.13
87389 Hiv-1 ag w/hiv-1&-2 ab ag ia Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 $60.20
87389 QW Hiv-1 ag w/hiv-1&-2 ab ag ia Detection test by immunoassay technique for HIV-1 antigen and HIV-1 and HIV-2 $60.20
87390 Hiv-1 ag ia Detection test by immunoassay technique for HIV-1 antigen $60.15
87391 Hiv-2 ag ia Detection test by immunoassay technique for HIV-2 antigen $54.75
87400 Influenza a/b each ag ia Detection test by immunoassay technique for influenza virus $35.33
87400 QW Influenza a/b each ag ia Detection test by immunoassay technique for influenza virus $35.33
87420 Resp syncytial virus ag ia Detection test by immunoassay technique for respiratory syncytial virus (RSV) $34.78
87420 QW Resp syncytial virus ag ia Detection test by immunoassay technique for respiratory syncytial virus (RSV) $34.78
87425 Rotavirus ag ia Detection test by immunoassay technique for Rotavirus $29.95
87426 Sarscov coronavirus ag ia Detection test by immunoassay technique for severe acute respiratory syndrome $-
87426 QW Sarscov coronavirus ag ia Detection test by immunoassay technique for severe acute respiratory syndrome $-
87427 Shiga-like toxin ag ia Detection test by immunoassay technique for Shiga-like toxin (bacterial toxin) $29.95
87428 Sarscov & inf vir a&b ag ia Detection test by immunoassay technique for severe acute respiratory syndrome $77.35
87428 QW Sarscov & inf vir a&b ag ia Detection test by immunoassay technique for severe acute respiratory syndrome $77.35
87430 Strep a ag ia Detection test by immunoassay technique for Streptococcus, group A (strep) $42.03
87430 QW Strep a ag ia Detection test by immunoassay technique for Streptococcus, group A (strep) $42.03
87449 Nos each organism ag ia Detection test by immunoassay technique for other organism $29.95
87449 QW Nos each organism ag ia Detection test by immunoassay technique for other organism $29.95
87451 Polyvalent mult org ea ag ia Detection test by immunoassay technique for multiple organisms, each polyvalent $26.28
87471 Bartonella dna amp probe Detection by nucleic acid Bartonella henselae and Bartonella quintana $87.73
87472 Bartonella dna quant Detection by nucleic acid Bartonella henselae and Bartonella quintana $107.10
87475 Lyme dis dna dir probe Detection by nucleic acid for borrelia burgdorferi (bacteria), direct probe $50.13
87476 Lyme dis dna amp probe Detection by nucleic acid for borrelia burgdorferi (bacteria), amplified probe $87.73
87480 Candida dna dir probe Detection test for candida species (yeast), direct probe technique $50.13
87481 Candida dna amp probe Detection test for candida species (yeast), amplified probe technique $87.73
87482 Candida dna quant Detection test for candida species (yeast), quantification $139.35
87483 Cns dna amp probe type 12-25 Test for detecting nucleic acid of organism causing infection of central $1,041.95
87485 Chlmyd pneum dna dir probe Detection test by nucleic acid for chlamydia pneumoniae, direct probe technique $50.13
87486 Chlmyd pneum dna amp probe Detection test by nucleic acid for Chlamydia pneumoniae, amplified probe $87.73
87487 Chlmyd pneum dna quant Detection test by nucleic acid for chlamydia pneumoniae, quantification $107.10
87490 Chlmyd trach dna dir probe Detection test by nucleic acid for chlamydia, direct probe technique $56.88
87491 Chlmyd trach dna amp probe Detection test by nucleic acid for chlamydia trachomatis, amplified probe $87.73
87492 Chlmyd trach dna quant Detection test by nucleic acid for chlamydia trachomatis, quantification $133.68
87493 C diff amplified probe Detection test by nucleic acid for clostridium difficile, amplified probe $93.18
87495 Cytomeg dna dir probe Detection test by nucleic acid for cytomegalovirus (CMV), direct probe technique $75.08
87496 Cytomeg dna amp probe Detection test by nucleic acid for Cytomegalovirus (CMV), amplified probe $87.73
87497 Cytomeg dna quant Detection test by nucleic acid for cytomegalovirus, quantification $107.10
87498 Enterovirus probe&revrs trns Detection test by nucleic acid for enterovirus (intestinal virus), amplified $87.73
87500 Vanomycin dna amp probe Detection test by nucleic acid for Vancomycin resistance strep (VRE), amplified $87.73
87501 Influenza dna amp prob 1+ Detection test by nucleic acid for influenza virus, each type or subtype $128.28
87502 Influenza dna amp probe Detection test by nucleic acid for multiple types influenza virus $239.50
87502 QW Influenza dna amp probe Detection test by nucleic acid for multiple types influenza virus $239.50
87503 Influenza dna amp prob addl Detection test by nucleic acid for multiple types influenza virus, each $73.05
87505 Nfct agent detection gi Detection test by nucleic acid for digestive tract pathogen, multiple types or $320.73
87506 Iadna-dna/rna probe tq 6-11 Detection test by nucleic acid for digestive tract pathogen, multiple types or $657.48
87507 Iadna-dna/rna probe tq 12-25 Detection test by nucleic acid for digestive tract pathogen, multiple types or $1,041.95
87510 Gardner vag dna dir probe Detection test for gardnerella vaginalis (bacteria), direct probe technique $50.13
87511 Gardner vag dna amp probe Detection test for gardnerella vaginalis (bacteria), amplified probe technique $87.73
87512 Gardner vag dna quant Detection test for gardnerella vaginalis (bacteria), quantification $104.40
87516 Hepatitis b dna amp probe Detection test by nucleic acid for Hepatitis B virus, amplified probe technique $87.73
87517 Hepatitis b dna quant Detection test by nucleic acid for Hepatitis B virus, quantification $107.10
87520 Hepatitis c rna dir probe Detection test by nucleic acid for Hepatitis C virus, direct probe technique $78.05
87521 Hepatitis c probe&rvrs trnsc Detection test by nucleic acid for Hepatitis C virus, amplified probe technique $87.73
87522 Hepatitis c revrs trnscrpj Detection test by nucleic acid for Hepatitis C virus, quantification $107.10
87525 Hepatitis g dna dir probe Detection test by nucleic acid for Hepatitis G virus, direct probe technique $74.50
87526 Hepatitis g dna amp probe Detection test by nucleic acid for Hepatitis G virus, amplified probe technique $98.15
87527 Hepatitis g dna quant Detection test by nucleic acid for Hepatitis G virus, quantification $104.40
87528 Hsv dna dir probe Detection test by nucleic acid for herpes simplex virus, direct probe technique $50.13
87529 Hsv dna amp probe Detection test by nucleic acid for herpes simplex virus, amplified probe $87.73
87530 Hsv dna quant Detection test by nucleic acid for herpes simplex virus, quantification $107.10
87531 Hhv-6 dna dir probe Detection test by nucleic acid for herpes virus-6, direct probe technique $145.00
87532 Hhv-6 dna amp probe Detection test by nucleic acid for herpes virus-6, amplified probe technique $87.73
87533 Hhv-6 dna quant Detection test by nucleic acid for herpes virus-6, quantification $104.40
87534 Hiv-1 dna dir probe Detection test by nucleic acid for HIV-1 virus, direct probe technique $54.80
87535 Hiv-1 probe&reverse trnscrpj Detection test by nucleic acid for HIV-1 virus, amplified probe technique $87.73
87536 Hiv-1 quant&revrse trnscrpj Detection test by nucleic acid for HIV-1 virus, quantification $212.75
87537 Hiv-2 dna dir probe Detection test by nucleic acid for HIV-2 virus, direct probe technique $54.80
87538 Hiv-2 probe&revrse trnscripj Detection test by nucleic acid for HIV-2 virus, amplified probe technique $87.73
87539 Hiv-2 quant&revrse trnscripj Detection test by nucleic acid for HIV-2 virus, quantification $146.55
87540 Legion pneumo dna dir prob Detection test by nucleic acid for legionella pneumophila (water borne $50.13
87541 Legion pneumo dna amp prob Detection test by nucleic acid for legionella pneumophila (water borne $87.73
87542 Legion pneumo dna quant Detection test by nucleic acid for legionella pneumophila (water borne $104.40
87550 Mycobacteria dna dir probe Detection test by nucleic acid for Mycobacteria species (bacteria), direct $50.13
87551 Mycobacteria dna amp probe Detection test by nucleic acid for Mycobacteria species (bacteria), amplified $120.60
87552 Mycobacteria dna quant Detection test by nucleic acid for Mycobacteria species (bacteria), $107.10
87555 M.tuberculo dna dir probe Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), $67.20
87556 M.tuberculo dna amp probe Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), $104.20
87557 M.tuberculo dna quant Detection test by nucleic acid for Mycobacteria tuberculosis (TB bacteria), $107.10
87560 M.avium-intra dna dir prob Detection test by nucleic acid for Mycobacteria avium-intracellulare $68.23
87561 M.avium-intra dna amp prob Detection test by nucleic acid for Mycobacteria avium-intracellulare $87.73
87562 M.avium-intra dna quant Detection test by nucleic acid for Mycobacteria avium-intracellulare $107.10
87563 M. genitalium amp probe Detection of Mycoplasma genitalium by DNA or RNA probe $87.73
87580 M.pneumon dna dir probe Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), direct $50.13
87581 M.pneumon dna amp probe Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), amplified $87.73
87582 M.pneumon dna quant Detection test by nucleic acid for Mycoplasma pneumoniae (bacteria), $756.55
87590 N.gonorrhoeae dna dir prob Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae $67.20
87591 N.gonorrhoeae dna amp prob Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae $87.73
87592 N.gonorrhoeae dna quant Detection test by nucleic acid for Neisseria gonorrhoeae (gonorrhoeae $107.10
87623 Hpv low-risk types Detection test by nucleic acid for human papillomavirus (hpv), low-risk types $87.73
87624 Hpv high-risk types Detection test by nucleic acid for human papillomavirus (hpv), high-risk types $87.73
87625 Hpv types 16 & 18 only Detection test by nucleic acid for human papillomavirus (hpv), types 16 and 18 $101.38
87631 Resp virus 3-5 targets Detection test by nucleic acid for multiple types of respiratory virus, $356.58
87631 QW Resp virus 3-5 targets Detection test by nucleic acid for multiple types of respiratory virus, $356.58
87632 Resp virus 6-11 targets Detection test by nucleic acid for multiple types of respiratory virus, $545.15
87633 Resp virus 12-25 targets Detection test by nucleic acid for multiple types of respiratory virus, $1,041.95
87633 QW Resp virus 12-25 targets Detection test by nucleic acid for multiple types of respiratory virus, $1,041.95
87634 Rsv dna/rna amp probe Detection test by nucleic acid for respiratory syncytial virus, amplified probe $175.50
87634 QW Rsv dna/rna amp probe Detection test by nucleic acid for respiratory syncytial virus, amplified probe $175.50
87635 Sars-cov-2 covid-19 amp prb Amplifed DNA or RNA probe detection of severe acute respiratory syndrome $128.28
87635 QW Sars-cov-2 covid-19 amp prb Amplifed DNA or RNA probe detection of severe acute respiratory syndrome $128.28
87636 Sarscov2 & inf a&b amp prb Detection test by multiplex amplified probe technique for severe acute $356.58
87636 QW Sarscov2 & inf a&b amp prb Detection test by multiplex amplified probe technique for severe acute $356.58
87637 Sarscov2&inf a&b&rsv amp prb Detection test by multiplex amplified probe technique for severe acute $356.58
87637 QW Sarscov2&inf a&b&rsv amp prb Detection test by multiplex amplified probe technique for severe acute $356.58
87640 Staph a dna amp probe Detection test by nucleic acid for Staphylococcus aureus (bacteria), amplified $87.73
87641 Mr-staph dna amp probe Detection test by nucleic acid for Staphylococcus aureus, methicillin resistant $87.73
87650 Strep a dna dir probe Detection test by nucleic acid for Strep (Streptococcus, group A), direct probe $50.13
87650 QW Strep a dna dir probe Detection test by nucleic acid for Strep (Streptococcus, group A), direct probe $50.13
87651 Strep a dna amp probe Detection test by nucleic acid for Strep (Streptococcus, group A), amplified $87.73
87651 QW Strep a dna amp probe Detection test by nucleic acid for Strep (Streptococcus, group A), amplified $87.73
87652 Strep a dna quant Detection test by nucleic acid for Strep (Streptococcus, group A), $104.40
87653 Strep b dna amp probe Detection test by nucleic acid for Strep (Streptococcus, group B), amplified $87.73
87660 Trichomonas vagin dir probe Detection test by nucleic acid for Trichomonas vaginalis (genital parasite), $50.13
87661 Trichomonas vaginalis amplif Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, $87.73
87662 Zika virus dna/rna amp probe Detection test by nucleic acid for Zika virus, amplified probe technique $128.28
87797 Detect agent nos dna dir Detection test by nucleic acid for organism, direct probe technique $75.08
87798 Detect agent nos dna amp Detection test by nucleic acid for organism, amplified probe technique $87.73
87799 Detect agent nos dna quant Detection test by nucleic acid for organism, quantification $107.10
87800 Detect agnt mult dna direc Detection test by nucleic acid for multiple organisms, direct probe(s) technique $109.18
87801 Detect agnt mult dna ampli Detection test by nucleic acid for multiple organisms, amplified probe(s) $175.50
87801 QW Detect agnt mult dna ampli Detection test by nucleic acid for multiple organisms, amplified probe(s) $175.50
87802 Strep b assay w/optic Detection test by immunoassay with direct visual observation for Streptococcus, $31.83
87803 Clostridium toxin a w/optic Detection test by immunoassay with direct visual observation for Clostridium $40.00
87804 Influenza assay w/optic Detection test by immunoassay with direct visual observation for influenza virus $41.38
87804 QW Influenza assay w/optic Detection test by immunoassay with direct visual observation for influenza virus $41.38
87806 Hiv ag w/hiv1&2 antb w/optic Detection test by immunoassay with direct visual observation for HIV-1 antigen, $81.93
87806 QW Hiv ag w/hiv1&2 antb w/optic Detection test by immunoassay with direct visual observation for HIV-1 antigen, $81.93
87807 Rsv assay w/optic Detection test by immunoassay with direct visual observation for respiratory $32.75
87807 QW Rsv assay w/optic Detection test by immunoassay with direct visual observation for respiratory $32.75
87808 Trichomonas assay w/optic Detection test by immunoassay with direct visual observation for Trichomonas $38.23
87808 QW Trichomonas assay w/optic Detection test by immunoassay with direct visual observation for Trichomonas $38.23
87809 Adenovirus assay w/optic Detection test by immunoassay with direct visual observation for adenovirus $54.40
87809 QW Adenovirus assay w/optic Detection test by immunoassay with direct visual observation for adenovirus $54.40
87810 Chlmyd trach assay w/optic Detection test by immunoassay with direct visual observation for Chlamydia $88.23
87811 Sars-cov-2 covid19 w/optic Detection test by immunoassay with direct visual observation for severe acute $-
87811 QW Sars-cov-2 covid19 w/optic Detection test by immunoassay with direct visual observation for severe acute $-
87850 N. gonorrhoeae assay w/optic Detection test by immunoassay with direct visual observation for Neisseria $61.40
87880 Strep a assay w/optic Detection test by immunoassay with direct visual observation for Streptococcus, $41.33
87880 QW Strep a assay w/optic Detection test by immunoassay with direct visual observation for Streptococcus, $41.33
87899 Agent nos assay w/optic Detection test by immunoassay with direct visual observation for other organism $40.18
87899 QW Agent nos assay w/optic Detection test by immunoassay with direct visual observation for other organism $40.18
87900 Phenotype infect agent drug Infectious agent drug susceptibility analysis $325.88
87901 Genotype dna hiv reverse t Analysis test by nucleic acid for HIV-1 virus $643.63
87902 Genotype dna/rna hep c Analysis test by nucleic acid for Hepatitis C virus $643.63
87903 Phenotype dna hiv w/culture Analysis test by nucleic acid for HIV-1 virus, first through 10 drugs tested $1,221.65
87904 Phenotype dna hiv w/clt add Analysis test by nucleic acid for HIV-1 virus, each additional drug tested $65.18
87905 Sialidase enzyme assay Infectious agent enzymatic activity to detect organism $30.55
87905 QW Sialidase enzyme assay Infectious agent enzymatic activity to detect organism $30.55
87906 Genotype dna/rna hiv Analysis test by nucleic acid for HIV-1 virus, other region $321.83
87910 Genotype cytomegalovirus Analysis test by nucleic acid for cytomegalovirus, cytomegalovirus $643.63
87912 Genotype dna hepatitis b Analysis test by nucleic acid for hepatitis b virus $643.63
88130 Sex chromatin identification Sex identification, Barr bodies $44.95
88140 Sex chromatin identification Sex identification, peripheral blood smear $19.98
88142 Cytopath c/v thin layer Pap test, manual screening $50.65
88143 Cytopath c/v thin layer redo Pap test, manual screening and rescreening $57.60
88147 Cytopath c/v automated Pap test (Pap smear), automated system $126.40
88148 Cytopath c/v auto rescreen Pap test (Pap smear), automated system with manual rescreening $40.00
88150 Cytopath c/v manual Pap test, slides, manual screening $39.80
88152 Cytopath c/v auto redo Pap test, slides, automated system with computer-assisted rescreening $69.10
88153 Cytopath c/v redo Pap test, slides, manual screening and rescreening $60.08
88155 Cytopath c/v index add-on Pap test, slides, definitive hormonal evaluation $36.63
88164 Cytopath tbs c/v manual Pap test, slides, manual screening (the Bethesda System) $39.80
88165 Cytopath tbs c/v redo Pap test, slides, manual screening and rescreening (the Bethesda System) $105.55
88166 Cytopath tbs c/v auto redo Pap test, slides, manual screening and computer-assisted rescreening (the $39.80
88167 Cytopath tbs c/v select Pap test, slides, manual screening and computer-assisted rescreening using cell $39.80
88174 Cytopath c/v auto in fluid Pap test, automated thin layer preparation; automated system $63.43
88175 Cytopath c/v auto fluid redo Pap test, automated thin layer preparation; automated system and manual $66.53
88230 Tissue culture lymphocyte Tissue culture to identify white blood cell disorders $291.23
88233 Tissue culture skin/biopsy Tissue culture to identify skin disorders $351.83
88235 Tissue culture placenta Tissue culture for disorders of amniotic fluid or placenta cells $375.75
88237 Tissue culture bone marrow Tissue culture for tumor disorders of bone marrow and blood cells $359.38
88239 Tissue culture tumor Tissue culture for tumor disorders $368.80
88240 Cell cryopreserve/storage Cryopreservation, freezing and storage of cells $32.68
88241 Frozen cell preparation Thawing and expansion of frozen cells $30.23
88245 Chromosome analysis 20-25 Chromosome analysis for genetic defects, baseline Sister Chromatid Exchange $432.93
88248 Chromosome analysis 50-100 Chromosome analysis for genetic defects, baseline breakage, score 50-100 cells, $432.93
88249 Chromosome analysis 100 Chromosome analysis for genetic defects, score 100 cells, clastogen stress $432.93
88261 Chromosome analysis 5 Chromosome analysis for genetic defects, count 5 cells $660.85
88262 Chromosome analysis 15-20 Chromosome analysis for genetic defects, count 15-20 cells $313.73
88263 Chromosome analysis 45 Chromosome analysis for genetic defects, count 45 cells for mosaicism $375.73
88264 Chromosome analysis 20-25 Chromosome analysis for genetic defects, analyze 20-25 cells $361.53
88267 Chromosome analys placenta Chromosome analysis of amniotic fluid or placenta for genetic defects $471.43
88269 Chromosome analys amniotic Chromosome analysis of amniotic fluid for genetic defects $434.15
88271 Cytogenetics dna probe DNA testing for genetic defects $53.55
88272 Cytogenetics 3-5 Chromosome analysis for genetic defects, analyze 3-5 cells $101.75
88273 Cytogenetics 10-30 Chromosome analysis for genetic defects, analyze 10-30 cells $87.03
88274 Cytogenetics 25-99 Chromosome analysis for genetic defects, analyze 25-99 cells $105.95
88275 Cytogenetics 100-300 Chromosome analysis for genetic defects, analyze 100-300 cells $127.98
88280 Chromosome karyotype study Chromosome analysis for genetic defects, additional karyotypes, each study $83.68
88283 Chromosome banding study Chromosome analysis for genetic defects, additional specialized banding $171.50
88285 Chromosome count additional Chromosome analysis for genetic defects, additional cells counted, each study $67.28
88289 Chromosome study additional Chromosome analysis for genetic defects, additional high resolution study $86.08
88371 Protein western blot tissue Protein analysis of tissue with interpretation and report $55.58
88372 Protein analysis w/probe Protein analysis of tissue by western blot, with interpretation and report $65.55
88720 Bilirubin total transcut Measurement of bilirubin $12.55
88738 Hgb quant transcutaneous Hemoglobin measurement $12.55
88740 Transcutaneous carboxyhb Hemoglobin measurement, per day $23.43
88741 Transcutaneous methb Hemoglobin measurement, per day, methemoglobin $23.43
89050 Body fluid cell count Body fluid cell count $11.80
89051 Body fluid cell count Body fluid cell count with cell identification $14.00
89055 Leukocyte assessment fecal White blood cell measure, stool specimen $10.68
89060 Exam synovial fluid crystals Crystal identification from tissue or body fluid $18.33
89125 Specimen fat stain Fat stain of stool, urine, or respiratory secretions $14.70
89160 Exam feces for meat fibers Examination of stool for meat fibers $12.13
89190 Nasal smear for eosinophils Nasal smear for eosinophils (allergy related white blood cells) $14.48
89300 Semen analysis w/huhner Semen analysis presence and/or motility of sperm $24.60
89300 QW Semen analysis w/huhner Semen analysis presence and/or motility of sperm $24.60
89310 Semen analysis w/count Semen analysis motility and count $21.53
89320 Semen anal vol/count/mot Semen evaluation volume, sperm count, motility and analysis $30.78
89321 Semen anal sperm detection Semen analysis for sperm presence $30.13
89321 QW Semen anal sperm detection Semen analysis for sperm presence $30.13
89322 Semen anal strict criteria Semen evaluation, volume, sperm count, motility, and analysis $38.75
89325 Sperm antibody test Sperm antibody measurement $26.68
89329 Sperm evaluation test Sperm evaluation, hamster penetration test $48.98
89330 Evaluation cervical mucus Sperm evaluation, cervical mucus penetration test $25.95
89331 Retrograde ejaculation anal Sperm evaluation, for reverse ejaculation, urine specimen $48.98
G0027 Semen analysis Semen analysis; presence and/or motility of sperm excluding huhner $16.25
G0103 Psa screening Prostate cancer screening; prostate specific antigen test (psa) $48.28
G0123 Screen cerv/vag thin layer Screening cytopathology, cervical or vaginal (any reporting system), collected $50.65
G0143 Scr c/v cyto,thinlayer,rescr Screening cytopathology, cervical or vaginal (any reporting system), collected $67.63
G0144 Scr c/v cyto,thinlayer,rescr Screening cytopathology, cervical or vaginal (any reporting system), collected $109.93
G0145 Scr c/v cyto,thinlayer,rescr Screening cytopathology, cervical or vaginal (any reporting system), collected $66.23
G0147 Scr c/v cyto, automated sys Screening cytopathology smears, cervical or vaginal, performed by automated $39.80
G0148 Scr c/v cyto, autosys, rescr Screening cytopathology smears, cervical or vaginal, performed by automated $79.85
G0306 Cbc/diffwbc w/o platelet Complete cbc, automated (hgb, hct, rbc, wbc, without platelet count) and $19.43
G0307 Cbc without platelet Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count) $16.18
G0327 Colon ca scrn;bld-bsd biomrk Colorectal cancer screening; blood-based biomarker $-
G0328 Fecal blood scrn immunoassay Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 $45.13
G0328 QW Fecal blood scrn immunoassay Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 $45.13
G0432 Eia hiv-1/hiv-2 screen Infectious agent antibody detection by enzyme immunoassay (eia) technique, $48.93
G0433 Elisa hiv-1/hiv-2 screen Infectious agent antibody detection by enzyme-linked immunosorbent assay $45.73
G0433 QW Elisa hiv-1/hiv-2 screen Infectious agent antibody detection by enzyme-linked immunosorbent assay $45.73
G0435 Oral hiv-1/hiv-2 screen Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, $29.95
G0471 Ven blood coll snf/hha Collection of venous blood by venipuncture or urine sample by catheterization $12.50
G0472 Hep c screen high risk/other Hepatitis c antibody screening, for individual at high risk and other covered $115.88
G0472 QW Hep c screen high risk/other Hepatitis c antibody screening, for individual at high risk and other covered $115.88
G0475 Hiv combination assay Hiv antigen/antibody, combination assay, screening $60.20
G0475 QW Hiv combination assay Hiv antigen/antibody, combination assay, screening $60.20
G0476 Hpv combo assay ca screen Infectious agent detection by nucleic acid (dna or rna); human papillomavirus $87.73
G0480 Drug test def 1-7 classes Drug test(s), definitive, utilizing (1) drug identification methods able to $286.08
G0481 Drug test def 8-14 classes Drug test(s), definitive, utilizing (1) drug identification methods able to $391.48
G0482 Drug test def 15-21 classes Drug test(s), definitive, utilizing (1) drug identification methods able to $496.85
G0483 Drug test def 22+ classes Drug test(s), definitive, utilizing (1) drug identification methods able to $617.30
G0499 Hepb screen high risk indiv Hepatitis b screening in non-pregnant, high risk individual includes hepatitis $70.68
G0659 Drug test def simple all cl Drug test(s), definitive, utilizing drug identification methods able to $155.35
G2023 Specimen collect covid-19 Specimen collection for severe acute respiratory syndrome coronavirus 2 $58.65
G2024 Spec coll snf/lab covid-19 Specimen collection for severe acute respiratory syndrome coronavirus 2 $63.65
G9143 Warfarin respon genetic test Warfarin responsiveness testing by genetic technique using any method, any $301.80
P2028 Cephalin floculation test Cephalin floculation, blood $12.38
P2029 Congo red blood test Congo red, blood $12.38
P2031 Hair analysis Hair analysis (excluding arsenic) $12.38
P2033 Blood thymol turbidity Thymol turbidity, blood $12.38
P2038 Blood mucoprotein Mucoprotein, blood (seromucoid) (medical necessity procedure) $12.38
P3000 Screen pap by tech w md supv Screening papanicolaou smear, cervical or vaginal, up to three smears, by $39.80
P9612 Catheterize for urine spec Catheterization for collection of specimen, single patient, all places of $7.50
P9615 Urine specimen collect mult Catheterization for collection of specimen(s) (multiple patients) $7.50
Q0111 Wet mounts/ w preparations Wet mounts, including preparations of vaginal, cervical or skin specimens $39.80
Q0112 Potassium hydroxide preps All potassium hydroxide (koh) preparations $14.58
Q0113 Pinworm examinations Pinworm examinations $10.68
Q0114 Fern test Fern test $24.35
Q0115 Post-coital mucous exam Post-coital direct, qualitative examinations of vaginal or cervical mucous $62.50
U0001 2019-ncov diagnostic p Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel $89.80
U0002 Covid-19 lab test non-cdc 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple $128.28
U0002 QW Covid-19 lab test non-cdc 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple $128.28
U0003 Cov-19 amp prb hgh thruput Infectious agent detection by nucleic acid (dna or rna); severe acute $187.50
U0004 Cov-19 test non-cdc hgh thru 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple $187.50
U0005 Infec agen detec ampli probe Infectious agent detection by nucleic acid (dna or rna); severe acute $62.50