36415 Routine venipuncture |
36415 |
$29.00 |
$29.00 |
36430 Blood transfusion service |
36430 |
$755.50 |
$755.50 |
80047 Metabolic panel ionized ca |
80047 |
$273.00 |
$273.00 |
80048 Basic Metabolic Panel |
80048 |
$43.01 |
$43.01 |
80051 Electrolyte panel |
80051 |
$43.01 |
$43.01 |
80053 Comprehensive Metabolic Panel |
80053 |
$75.28 |
$75.28 |
80061 Lipids Blood Test |
80061 |
$130.00 |
$130.00 |
80069 Kidney Function Panel |
80069 |
$58.07 |
$58.07 |
80074 Acute hepatitis panel |
80074 |
$315.08 |
$315.08 |
80074 Acute Hepatits Panel |
80074 |
$315.08 |
$315.08 |
80076 Liver Function Blood Panel |
80076 |
$48.39 |
$48.39 |
80081 Obstetric Blood Panel With HIV |
80081 |
$767.30 |
$767.30 |
80197 Assay of tacrolimus |
80197 |
$91.41 |
$91.41 |
80202 Assay of vancomycin |
80202 |
$90.33 |
$90.33 |
80307 Drug test prsmv chem anlyzr |
80307 |
$55.00 |
$433.50 |
81000 Urinalysis, Manual, Microscope Exam |
81000 |
$16.50 |
$16.50 |
81001 Urinalysis, Manual, Microscope Exam |
81001 |
$36.50 |
$36.50 |
81002 Urinalysis, Automated |
81002 |
$26.50 |
$26.50 |
81003 Urinalysis, Automated |
81003 |
$29.50 |
$29.50 |
82040 Assay of serum albumin |
82040 |
$29.50 |
$29.50 |
82043 Microalbumin quantitative |
82043 |
$86.50 |
$86.50 |
82140 Assay of ammonia |
82140 |
$91.00 |
$91.00 |
82150 Assay of amylase |
82150 |
$93.50 |
$93.50 |
82247 Bilirubin total |
82247 |
$29.50 |
$62.00 |
82248 Bilirubin direct |
82248 |
$29.50 |
$29.50 |
82261 Assay of biotinidase |
82261 |
$56.00 |
$56.00 |
82306 Vitamin d 25 hydroxy |
82306 |
$196.79 |
$196.79 |
82310 Assay of calcium |
82310 |
$29.50 |
$29.50 |
82330 Assay of calcium |
82330 |
$70.50 |
$70.50 |
82378 Carcinoembryonic antigen |
82378 |
$125.82 |
$125.82 |
82533 Total cortisol |
82533 |
$108.62 |
$108.62 |
82550 Assay of ck (cpk) |
82550 |
$91.00 |
$91.00 |
82565 Assay of creatinine |
82565 |
$29.50 |
$29.50 |
82570 Assay of urine creatinine |
82570 |
$67.50 |
$67.50 |
82607 Vitamin b-12 |
82607 |
$100.01 |
$100.01 |
82728 Assay of ferritin |
82728 |
$146.50 |
$146.50 |
82746 Assay of folic acid serum |
82746 |
$97.86 |
$97.86 |
82760 Assay of galactose |
82760 |
$57.50 |
$57.50 |
82776 Galactose transferase test |
82776 |
$79.00 |
$79.00 |
82784 Assay iga/igd/igg/igm each |
82784 |
$61.29 |
$61.29 |
82803 Blood gases any combination |
82803 |
$105.00 |
$212.50 |
82945 Glucose other fluid |
82945 |
$26.50 |
$26.50 |
82947 Assay glucose blood quant |
82947 |
$26.50 |
$62.00 |
82948 Reagent strip/blood glucose |
82948 |
$26.50 |
$26.50 |
83010 Assay of haptoglobin quant |
83010 |
$61.83 |
$83.88 |
83020 Hemoglobin electrophoresis |
83020 |
$84.95 |
$84.95 |
83036 Glycosylated hemoglobin test |
83036 |
$67.50 |
$67.50 |
83498 Assay of progesterone 17-d |
83498 |
$72.50 |
$168.00 |
83516 Immunoassay nonantibody |
83516 |
$79.57 |
$256.00 |
83540 Assay of iron |
83540 |
$93.50 |
$222.00 |
83550 Iron binding test |
83550 |
$118.00 |
$118.00 |
83605 Assay of lactic acid |
83605 |
$125.00 |
$125.00 |
83615 Lactate (ld) (ldh) enzyme |
83615 |
$36.50 |
$36.50 |
83690 Assay of lipase |
83690 |
$91.00 |
$91.00 |
83735 Assay of magnesium |
83735 |
$87.50 |
$87.50 |
83789 Mass spectrometry qual/quan |
83789 |
$109.69 |
$556.50 |
83880 Assay of natriuretic peptide |
83880 |
$152.50 |
$152.50 |
83883 Assay nephelometry not spec |
83883 |
$53.00 |
$125.50 |
83930 Assay of blood osmolality |
83930 |
$67.50 |
$67.50 |
83935 Assay of urine osmolality |
83935 |
$67.50 |
$79.00 |
83970 Assay of parathormone |
83970 |
$205.00 |
$205.00 |
84030 Assay of blood pku |
84030 |
$30.00 |
$168.00 |
84075 Assay alkaline phosphatase |
84075 |
$34.50 |
$34.50 |
84100 Assay of phosphorus |
84100 |
$29.50 |
$29.50 |
84132 Assay of serum potassium |
84132 |
$29.50 |
$29.50 |
84134 Assay of prealbumin |
84134 |
$133.00 |
$133.00 |
84145 Procalcitonin (pct) |
84145 |
$305.50 |
$305.50 |
84153 PSA (Prostate Specific Antigen) |
84153 |
$174.00 |
$174.00 |
84154 PSA (Prostate Specific Antigen) |
84154 |
$122.59 |
$122.59 |
84155 Assay of protein serum |
84155 |
$29.50 |
$29.50 |
84156 Assay of protein urine |
84156 |
$29.50 |
$29.50 |
84157 Assay of protein other |
84157 |
$29.50 |
$29.50 |
84165 Protein e-phoresis serum |
84165 |
$70.98 |
$70.98 |
84295 Assay of serum sodium |
84295 |
$29.50 |
$29.50 |
84300 Assay of urine sodium |
84300 |
$58.50 |
$58.50 |
84403 Assay of total testosterone |
84403 |
$153.00 |
$184.00 |
84436 Assay of total thyroxine |
84436 |
$66.00 |
$68.50 |
84439 Assay of free thyroxine |
84439 |
$53.77 |
$53.77 |
84443 Thyroid Simulating Hormone (TSH) Blood Test |
84443 |
$56.00 |
$125.00 |
84450 Transferase (ast) (sgot) |
84450 |
$34.50 |
$62.00 |
84460 Alanine amino (alt) (sgpt) |
84460 |
$34.50 |
$62.00 |
84478 Assay of triglycerides |
84478 |
$29.50 |
$68.50 |
84484 Assay of troponin quant |
84484 |
$58.07 |
$58.07 |
84520 Assay of urea nitrogen |
84520 |
$26.50 |
$26.50 |
84550 Assay of blood/uric acid |
84550 |
$29.50 |
$29.50 |
84702 Chorionic gonadotropin test |
84702 |
$75.50 |
$171.50 |
84703 Chorionic gonadotropin assay |
84703 |
$93.50 |
$93.50 |
85014 Hematocrit |
85014 |
$29.00 |
$29.00 |
85018 Hemoglobin |
85018 |
$23.00 |
$23.00 |
85025 Complete Blood Count (CBC), With Differential, Automated |
85025 |
$48.39 |
$48.39 |
85027 Complete Blood Count (CBC), Automated |
85027 |
$51.00 |
$59.50 |
85046 Reticyte/hgb concentrate |
85046 |
$65.50 |
$65.50 |
85049 Automated platelet count |
85049 |
$51.00 |
$51.00 |
85347 Coagulation time activated |
85347 |
$51.00 |
$79.00 |
85379 Fibrin degradation quant |
85379 |
$105.00 |
$105.00 |
85384 Fibrinogen activity |
85384 |
$54.00 |
$81.00 |
85390 Fibrinolysins screen i&r |
85390 |
$43.00 |
$71.00 |
85525 Heparin neutralization |
85525 |
$68.50 |
$68.50 |
85576 Blood platelet aggregation |
85576 |
$90.50 |
$188.00 |
85610 Clotting Time Blood Test |
85610 |
$51.00 |
$82.50 |
85651 Rbc sed rate nonautomated |
85651 |
$45.50 |
$45.50 |
85670 Thrombin time plasma |
85670 |
$82.50 |
$82.50 |
85730 Coagulation Assessment Blood Test |
85730 |
$78.00 |
$82.50 |
86003 Allergen specific ige |
86003 |
$28.00 |
$28.00 |
86038 Antinuclear antibodies |
86038 |
$80.65 |
$80.65 |
86140 C-reactive protein |
86140 |
$68.50 |
$68.50 |
86160 Complement antigen |
86160 |
$79.57 |
$79.57 |
86235 Nuclear antigen antibody |
86235 |
$90.50 |
$153.00 |
86255 Fluorescent antibody screen |
86255 |
$38.18 |
$79.57 |
86300 Immunoassay tumor ca 15-3 |
86300 |
$107.00 |
$131.00 |
86317 Immunoassay infectious agent |
86317 |
$24.00 |
$72.56 |
86334 Immunofix e-phoresis serum |
86334 |
$178.50 |
$178.50 |
86360 T cell absolute count/ratio |
86360 |
$301.00 |
$301.00 |
86430 Rheumatoid factor test qual |
86430 |
$72.00 |
$72.00 |
86480 Tb test cell immun measure |
86480 |
$207.00 |
$207.00 |
86592 Syphilis test non-trep qual |
86592 |
$67.50 |
$67.50 |
86618 Lyme disease antibody |
86618 |
$112.91 |
$112.91 |
86704 Hep b core antibody total |
86704 |
$79.57 |
$79.57 |
86706 Hep b surface antibody |
86706 |
$115.50 |
$115.50 |
86762 Rubella antibody |
86762 |
$159.50 |
$159.50 |
86787 Varicella-zoster antibody |
86787 |
$167.50 |
$167.50 |
86803 Hepatitis c ab test |
86803 |
$133.00 |
$133.00 |
86850 Rbc antibody screen |
86850 |
$25.80 |
$25.80 |
86870 Rbc antibody identification |
86870 |
$319.00 |
$319.00 |
86880 Coombs test direct |
86880 |
$99.00 |
$99.00 |
86900 Blood typing serologic abo |
86900 |
$54.00 |
$54.00 |
86901 Blood typing serologic rh(d) |
86901 |
$54.00 |
$54.00 |
86902 Blood type antigen donor ea |
86902 |
$82.50 |
$82.50 |
86920 Compatibility test spin |
86920 |
$165.50 |
$245.00 |
86922 Compatibility test antiglob |
86922 |
$178.00 |
$178.00 |
87015 Specimen infect agnt concntj |
87015 |
$51.00 |
$51.00 |
87040 Blood culture for bacteria |
87040 |
$68.82 |
$68.82 |
87070 Culture othr specimn aerobic |
87070 |
$40.87 |
$57.00 |
87075 Cultr bacteria except blood |
87075 |
$62.37 |
$62.37 |
87077 Culture aerobic identify |
87077 |
$107.00 |
$132.00 |
87086 Urine culture/colony count |
87086 |
$94.00 |
$94.00 |
87088 Urine bacteria culture |
87088 |
$40.50 |
$40.50 |
87102 Fungus isolation culture |
87102 |
$55.92 |
$55.92 |
87116 Mycobacteria culture |
87116 |
$72.05 |
$72.05 |
87149 Dna/rna direct probe |
87149 |
$90.00 |
$90.00 |
87176 Tissue homogenization cultr |
87176 |
$36.50 |
$36.50 |
87186 Microbe susceptible mic |
87186 |
$90.00 |
$188.00 |
87205 Smear gram stain |
87205 |
$59.00 |
$59.00 |
87206 Smear fluorescent/acid stai |
87206 |
$59.00 |
$82.50 |
87340 Hepatitis b surface ag ia |
87340 |
$118.00 |
$118.00 |
87389 Hiv-1 ag w/hiv-1 & hiv-2 ab |
87389 |
$189.50 |
$189.50 |
87449 Ag detect nos ia mult |
87449 |
$94.00 |
$270.00 |
87480 Candida dna dir probe |
87480 |
$78.00 |
$78.00 |
87491 Chylmd trach dna amp probe |
87491 |
$245.50 |
$245.50 |
87493 C diff amplified probe |
87493 |
$233.35 |
$233.35 |
87506 Iadna-dna/rna probe tq 6-11 |
87506 |
$524.00 |
$524.00 |
87510 Gardner vag dna dir probe |
87510 |
$78.00 |
$78.00 |
87522 Hepatitis c revrs trnscrpj |
87522 |
$188.19 |
$188.19 |
87536 Hiv-1 quant&revrse trnscrpj |
87536 |
$555.50 |
$555.50 |
87591 N.gonorrhoeae dna amp prob |
87591 |
$245.50 |
$245.50 |
87624 Hpv high-risk types |
87624 |
$296.50 |
$296.50 |
87631 Resp virus 3-5 targets |
87631 |
$674.50 |
$674.50 |
87641 Mr-staph dna amp probe |
87641 |
$204.00 |
$204.00 |
87660 Trichomonas vagin dir probe |
87660 |
$78.00 |
$78.00 |
88112 Cytopath cell enhance tech |
88112 |
$81.00 |
$81.00 |
88173 Cytopath eval fna report |
88173 |
$178.00 |
$178.00 |
88185 Flowcytometry/tc add-on |
88185 |
$115.50 |
$115.50 |
88304 Tissue exam by pathologist |
88304 |
$127.50 |
$877.50 |
88305 Tissue exam by pathologist |
88305 |
$138.50 |
|
88307 Tissue exam by pathologist |
88307 |
$435.00 |
|
88311 Decalcify tissue |
88311 |
$29.50 |
$29.50 |
88312 Special stains group 1 |
88312 |
$178.00 |
$178.00 |
88313 Special stains group 2 |
88313 |
$64.00 |
$294.00 |
88331 Path consult intraop 1 bloc |
88331 |
$232.50 |
$232.50 |
88341 Immunohisto antb addl slide |
88341 |
$295.50 |
$295.50 |
88342 Immunohisto antb 1st stain |
88342 |
$295.50 |
$295.50 |
88360 Tumor immunohistochem/manual |
88360 |
$295.50 |
$523.00 |
89050 Body fluid cell count |
89050 |
$65.50 |
$105.00 |
G0103 Psa screening |
G0103 |
$174.00 |
$174.00 |
G0123 Screen cerv/vag thin layer |
G0123 |
$131.00 |
$131.00 |
G0475 Hiv combination assay |
G0475 |
$189.50 |
$189.50 |
G0480 Drug test prsmv chem anlyzr |
G0480 |
$75.00 |
$518.50 |