| 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 |
|
Igh@/bcl2 translocation alys |
Gene analysis (IGH@/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 |
|
Trb@ gene rearrange amplify |
Gene analysis (T cell antigen receptor beta) amplification methodology |
$522.30 |
| 81341 |
|
Trb@ 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 |
