CodeMap® 




2017 ICD-10 Diagnosis Code Set Loaded     


4/3/2017 NCD Edits Loaded     


2017 Lab Fee Schedule     


2017-B DME Fee Schedule     


2017-A PEN Fee Schedule-no changes for Q2/2017     


2017 April ASC Fee Schedule Updated     


April 2017 ASP Drug Pricing Updated     


Q2 2017 CCI Edits Loaded     


Q2 2017 MUE Edits Loaded     


LCD Database Current Through 05/15/2017     

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Laboratory Fee Schedule

2017
2016

Physician Fee Schedule

2017
2016

OPPS Fee Schedule

2017
2016

ASC Fee Schedule

2017
2016

APC Codes

2017
2016

ASP Drug Pricing Files




2016 Laboratory Fee Schedule
Selected Fee Schedule:
Procedure
Short Descriptor
2016 Lab Fee
Schedule
0006M
New for 2016
Onc hep gene risk classifier
$0.00
0007M
New for 2016
Onc gastro 51 gene nomogram
$0.00
0008M
New for 2016
Onc breast risk score
$3419.42
0009M
New for 2016
Fetal aneuploidy trisom risk
$0.00
36415
Routine venipuncture
$3.00
78267
Breath tst attain/anal c-14
$10.71
78268
Breath test analysis c-14
$91.75
80047
Metabolic panel ionized ca
$11.52
80048
Metabolic panel total ca
$11.52
80051
Electrolyte panel
$9.55
80053
Comprehen metabolic panel
$14.39
80055
New for 2016
Obstetric panel
$65.12
80061
Lipid panel
$18.24
80069
Renal function panel
$11.83
80074
Acute hepatitis panel
$64.89
80076
Hepatic function panel
$11.13
80081
New for 2016
Obstetric panel
$101.97
80150
Assay of amikacin
$15.45
80155
Drug assay caffeine
$19.27
80156
Assay carbamazepine total
$19.84
80157
Assay carbamazepine free
$18.06
80158
Drug assay cyclosporine
$24.59
80159
Drug assay clozapine
$16.33
80162
Assay of digoxin total
$18.09
80163
Assay of digoxin free
$18.09
80164
Assay dipropylacetic acd tot
$18.46
80165
Dipropylacetic acid free
$18.46
80168
Assay of ethosuximide
$22.26
80169
Drug assay everolimus
$18.71
80170
Assay of gentamicin
$22.32
80171
Drug screen quant gabapentin
$18.06
80173
Assay of haloperidol
$19.84
80175
Drug screen quan lamotrigine
$18.06
80176
Assay of lidocaine
$20.01
80177
Drug scrn quan levetiracetam
$18.06
80178
Assay of lithium
$9.01
80180
Drug scrn quan mycophenolate
$24.59
80183
Drug scrn quant oxcarbazepin
$18.06
80184
Assay of phenobarbital
$15.60
80185
Assay of phenytoin total
$18.06
80186
Assay of phenytoin free
$18.75
80188
Assay of primidone
$22.61
80190
Assay of procainamide
$22.82
80192
Assay of procainamide
$22.82
80194
Assay of quinidine
$19.89
80195
Assay of sirolimus
$18.71
80197
Assay of tacrolimus
$18.71
80198
Assay of theophylline
$19.27
80199
Drug screen quant tiagabine
$24.60
80200
Assay of tobramycin
$15.45
80201
Assay of topiramate
$16.24
80202
Assay of vancomycin
$18.46
80203
Drug screen quant zonisamide
$18.06
80299
Quantitative assay drug
$18.66
80400
Acth stimulation panel
$44.43
80402
Acth stimulation panel
$118.45
80406
Acth stimulation panel
$106.60
80408
Aldosterone suppression eval
$170.95
80410
Calcitonin stimul panel
$109.44
80412
Crh stimulation panel
$449.02
80414
Testosterone response
$70.34
80415
Estradiol response panel
$30.89
80416
Renin stimulation panel
$179.76
80417
Renin stimulation panel
$59.92
80418
Pituitary evaluation panel
$787.54
80420
Dexamethasone panel
$98.14
80422
Glucagon tolerance panel
$62.76
80424
Glucagon tolerance panel
$68.79
80426
Gonadotropin hormone panel
$202.16
80428
Growth hormone panel
$88.87
80430
Growth hormone panel
$104.91
80432
Insulin suppression panel
$184.03
80434
Insulin tolerance panel
$137.82
80435
Insulin tolerance panel
$137.82
80436
Metyrapone panel
$91.86
80438
Trh stimulation panel
$68.67
80439
Trh stimulation panel
$91.56
81000
Urinalysis nonauto w/scope
$4.32
81001
Urinalysis auto w/scope
$4.32
81002
Urinalysis nonauto w/o scope
$3.48
81003
Urinalysis auto w/o scope
$3.06
81005
Urinalysis
$2.95
81007
Urine screen for bacteria
$3.49
81015
Microscopic exam of urine
$4.15
81020
Urinalysis glass test
$3.87
81025
Urine pregnancy test
$8.61
81050
Urinalysis volume measure
$4.09
81161
Dmd dup/delet analysis
$140.14
81162
New for 2016
Brca1&2 seq & full dup/del
$2485.86
81170
New for 2016
Abl1 gene
$329.51
81206
Bcr/abl1 gene major bp
$223.35
81207
Bcr/abl1 gene minor bp
$197.30
81208
Bcr/abl1 gene other bp
$219.10
81210
Braf gene
$178.98
81211
Brca1&2 seq & com dup/del
$2180.22
81212
Brca1&2 185&5385&6174 var
$176.44
81213
Brca1&2 uncom dup/del var
$581.84
81214
Brca1 full seq & com dup/del
$1435.97
81215
Brca1 gene known fam variant
$93.10
81217
Brca2 gene known fam variant
$93.10
81218
New for 2016
Cebpa gene full sequence
$329.51
81219
New for 2016
Calr gene com variants
$165.68
81225
Cyp2c19 gene com variants
$291.36
81226
Cyp2d6 gene com variants
$450.91
81227
Cyp2c9 gene com variants
$174.81
81235
Egfr gene com variants
$329.51
81240
F2 gene
$67.03
81241
F5 gene
$83.24
81245
Flt3 gene
$165.68
81246
Flt3 gene analysis
$83.04
81256
Hfe gene
$89.04
81261
Igh gene rearrange amp meth
$269.70
81262
Igh gene rearrang dir probe
$59.46
81263
Igh vari regional mutation
$401.19
81264
Igk rearrangeabn clonal pop
$203.41
81265
Str markers specimen anal
$292.94
81267
Chimerism anal no cell selec
$282.60
81268
Chimerism anal w/cell select
$355.24
81270
Jak2 gene
$124.87
81272
New for 2016
Kit gene targeted seq analys
$329.51
81273
New for 2016
Kit gene analys d816 variant
$124.87
81275
Kras gene variants exon 2
$197.19
81276
New for 2016
Kras gene addl variants
$197.19
81287
Mgmt gene methylation anal
$83.09
81288
Mlh1 gene
$159.64
81291
Mthfr gene
$59.46
81292
Mlh1 gene full seq
$645.26
81293
Mlh1 gene known variants
$258.67
81294
Mlh1 gene dup/delete variant
$190.39
81295
Msh2 gene full seq
$151.48
81296
Msh2 gene known variants
$129.34
81297
Msh2 gene dup/delete variant
$151.48
81298
Msh6 gene full seq
$287.40
81299
Msh6 gene known variants
$161.00
81300
Msh6 gene dup/delete variant
$161.44
81301
Microsatellite instability
$394.44
81310
Npm1 gene
$246.77
81311
New for 2016
Nras gene variants exon 2&3
$295.79
81313
Pca3/klk3 antigen
$260.26
81314
New for 2016
Pdgfra gene
$329.51
81315
Pml/raralpha com breakpoints
$282.40
81316
Pml/raralpha 1 breakpoint
$430.74
81317
Pms2 gene full seq analysis
$780.12
81318
Pms2 known familial variants
$184.33
81319
Pms2 gene dup/delet variants
$221.33
81321
Pten gene full sequence
$599.80
81322
Pten gene known fam variant
$58.31
81323
Pten gene dup/delet variant
$87.47
81332
Serpina1 gene
$59.46
81340
Trb@ gene rearrange amplify
$284.59
81341
Trb@ gene rearrange dirprobe
$67.55
81342
Trg gene rearrangement anal
$274.48
81370
Hla i & ii typing lr
$547.78
81371
Hla i & ii type verify lr
$327.87
81372
Hla i typing complete lr
$300.91
81373
Hla i typing 1 locus lr
$151.70
81374
Hla i typing 1 antigen lr
$99.10
81375
Hla ii typing ag equiv lr
$300.70
81376
Hla ii typing 1 locus lr
$166.49
81377
Hla ii type 1 ag equiv lr
$125.06
81378
Hla i & ii typing hr
$470.73
81379
Hla i typing complete hr
$456.86
81380
Hla i typing 1 locus hr
$241.45
81381
Hla i typing 1 allele hr
$128.84
81382
Hla ii typing 1 loc hr
$168.48
81383
Hla ii typing 1 allele hr
$148.66
81410
Aortic dysfunction/dilation
$0.00
81411
Aortic dysfunction/dilation
$0.00
81412
New for 2016
Ashkenazi jewish assoc dis
$0.00
81415
Exome sequence analysis
$0.00
81416
Exome sequence analysis
$0.00
81417
Exome re-evaluation
$0.00
81420
Fetal chrmoml aneuploidy
$0.00
81425
Genome sequence analysis
$0.00
81426
Genome sequence analysis
$0.00
81427
Genome re-evaluation
$0.00
81430
Hearing loss sequence analys
$0.00
81431
Hearing loss dup/del analys
$0.00
81432
New for 2016
Hrdtry brst ca-rlatd dsordrs
$0.00
81433
New for 2016
Hrdtry brst ca-rlatd dsordrs
$0.00
81434
New for 2016
Hereditary retinal disorders
$0.00
81435
Hereditary colon ca dsordrs
$796.75
81436
Hereditary colon ca dsordrs
$796.75
81437
New for 2016
Heredtry nurondcrn tum dsrdr
$0.00
81438
New for 2016
Heredtry nurondcrn tum dsrdr
$0.00
81440
Mitochondrial gene
$0.00
81442
New for 2016
Noonan spectrum disorders
$0.00
81445
Targeted genomic seq analys
$597.91
81450
Targeted genomic seq analys
$648.40
81455
Targeted genomic seq analys
$0.00
81460
Whole mitochondrial genome
$0.00
81465
Whole mitochondrial genome
$0.00
81470
X-linked intellectual dblt
$0.00
81471
X-linked intellectual dblt
$0.00
81490
New for 2016
Autoimmune rheumatoid arthr
$0.00
81493
New for 2016
Cor artery disease mrna
$0.00
81519
New for 2016
Oncology breast mrna
$3419.42
81525
New for 2016
Oncology colon mrna
$0.00
81528
New for 2016
Oncology colorectal scr
$508.87
81535
New for 2016
Oncology gynecologic
$579.46
81536
New for 2016
Oncology gynecologic
$158.14
81538
New for 2016
Oncology lung
$0.00
81540
New for 2016
Oncology tum unknown origin
$0.00
81545
New for 2016
Oncology thyroid
$0.00
81595
New for 2016
Cardiology hrt trnspl mrna
$0.00
82009
Test for acetone/ketones
$6.16
82010
Acetone assay
$11.13
82013
Acetylcholinesterase assay
$15.21
82016
Acylcarnitines qual
$18.89
82017
Acylcarnitines quant
$22.97
82024
Assay of acth
$52.61
82030
Assay of adp & amp
$30.88
82040
Assay of serum albumin
$6.74
82042
Assay of urine albumin
$7.05
82043
Microalbumin quantitative
$7.87
82044
Microalbumin semiquant
$6.23
82045
Albumin ischemia modified
$38.63
82075
Assay of breath ethanol
$13.54
82085
Assay of aldolase
$13.22
82088
Assay of aldosterone
$55.51
82103
Alpha-1-antitrypsin total
$18.30
82104
Alpha-1-antitrypsin pheno
$19.70
82105
Alpha-fetoprotein serum
$22.85
82106
Alpha-fetoprotein amniotic
$22.85
82107
Alpha-fetoprotein l3
$63.76
82108
Assay of aluminum
$34.71
82120
Amines vaginal fluid qual
$5.13
82127
Amino acid single qual
$18.89
82128
Amino acids mult qual
$18.89
82131
Amino acids single quant
$22.98
82135
Assay aminolevulinic acid
$19.77
82136
Amino acids quant 2-5
$22.97
82139
Amino acids quan 6 or more
$22.97
82140
Assay of ammonia
$19.85
82143
Amniotic fluid scan
$9.35
82150
Assay of amylase
$8.83
82154
Androstanediol glucuronide
$39.28
82157
Assay of androstenedione
$39.88
82160
Assay of androsterone
$34.06
82163
Assay of angiotensin ii
$27.96
82164
Angiotensin i enzyme test
$19.89
82172
Assay of apolipoprotein
$21.11
82175
Assay of arsenic
$25.84
82180
Assay of ascorbic acid
$7.90
82190
Atomic absorption
$20.31
82232
Assay of beta-2 protein
$22.04
82239
Bile acids total
$23.33
82240
Bile acids cholylglycine
$19.30
82247
Bilirubin total
$6.83
82248
Bilirubin direct
$6.83
82252
Fecal bilirubin test
$6.20
82261
Assay of biotinidase
$22.97
82270
Occult blood feces
$4.43
82271
Occult blood other sources
$4.43
82272
Occult bld feces 1-3 tests
$4.43
82274
Assay test for blood fecal
$21.67
82286
Assay of bradykinin
$9.38
82300
Assay of cadmium
$31.52
82306
Vitamin d 25 hydroxy
$40.33
82308
Assay of calcitonin
$36.49
82310
Assay of calcium
$7.03
82330
Assay of calcium
$18.63
82331
Calcium infusion test
$7.05
82340
Assay of calcium in urine
$8.21
82355
Calculus analysis qual
$15.77
82360
Calculus assay quant
$14.22
82365
Calculus spectroscopy
$14.50
82370
X-ray assay calculus
$14.50
82373
Assay c-d transfer measure
$24.60
82374
Assay blood carbon dioxide
$6.66
82375
Assay carboxyhb quant
$7.90
82376
Assay carboxyhb qual
$7.77
82378
Carcinoembryonic antigen
$25.84
82379
Assay of carnitine
$22.97
82380
Assay of carotene
$12.57
82382
Assay urine catecholamines
$23.42
82383
Assay blood catecholamines
$34.14
82384
Assay three catecholamines
$34.40
82387
Assay of cathepsin-d
$28.35
82390
Assay of ceruloplasmin
$14.63
82397
Chemiluminescent assay
$19.24
82415
Assay of chloramphenicol
$17.26
82435
Assay of blood chloride
$6.26
82436
Assay of urine chloride
$6.85
82438
Assay other fluid chlorides
$6.66
82441
Test for chlorohydrocarbons
$8.18
82465
Assay bld/serum cholesterol
$5.92
82480
Assay serum cholinesterase
$10.73
82482
Assay rbc cholinesterase
$10.46
82485
Assay chondroitin sulfate
$28.13
82495
Assay of chromium
$27.63
82507
Assay of citrate
$17.43
82523
Collagen crosslinks
$25.46
82525
Assay of copper
$16.41
82528
Assay of corticosterone
$30.67
82530
Cortisol free
$22.76
82533
Total cortisol
$22.21
82540
Assay of creatine
$6.32
82542
Col chromotography qual/quan
$24.60
82550
Assay of ck (cpk)
$8.87
82552
Assay of cpk in blood
$18.25
82553
Creatine mb fraction
$15.73
82554
Creatine isoforms
$16.17
82565
Assay of creatinine
$6.98
82570
Assay of urine creatinine
$7.05
82575
Creatinine clearance test
$12.88
82585
Assay of cryofibrinogen
$11.69
82595
Assay of cryoglobulin
$8.81
82600
Assay of cyanide
$26.43
82607
Vitamin b-12
$20.54
82608
B-12 binding capacity
$19.51
82610
Cystatin c
$18.52
82615
Test for urine cystines
$11.12
82626
Dehydroepiandrosterone
$34.42
82627
Dehydroepiandrosterone
$30.29
82633
Desoxycorticosterone
$37.65
82634
Deoxycortisol
$23.71
82638
Assay of dibucaine number
$16.68
82652
Vit d 1 25-dihydroxy
$52.44
82656
Pancreatic elastase fecal
$15.71
82657
Enzyme cell activity
$24.60
82658
Enzyme cell activity ra
$24.60
82664
Electrophoretic test
$37.65
82668
Assay of erythropoietin
$25.60
82670
Assay of estradiol
$15.45
82671
Assay of estrogens
$34.83
82672
Assay of estrogen
$29.56
82677
Assay of estriol
$15.17
82679
Assay of estrone
$15.22
82693
Assay of ethylene glycol
$20.29
82696
Assay of etiocholanolone
$20.38
82705
Fats/lipids feces qual
$3.87
82710
Fats/lipids feces quant
$4.74
82715
Assay of fecal fat
$4.85
82725
Assay of blood fatty acids
$18.13
82726
Long chain fatty acids
$24.60
82728
Assay of ferritin
$18.57
82731
Assay of fetal fibronectin
$63.76
82735
Assay of fluoride
$25.25
82746
Assay of folic acid serum
$20.03
82747
Assay of folic acid rbc
$23.59
82757
Assay of semen fructose
$23.62
82759
Assay of rbc galactokinase
$29.27
82760
Assay of galactose
$15.25
82775
Assay galactose transferase
$24.15
82776
Galactose transferase test
$7.90
82777
Galectin-3
$29.96
82784
Assay iga/igd/igg/igm each
$12.67
82785
Assay of ige
$22.43
82787
Igg 1 2 3 or 4 each
$10.92
82800
Blood ph
$8.30
82803
Blood gases any combination
$16.45
82805
Blood gases w/o2 saturation
$38.58
82810
Blood gases o2 sat only
$11.89
82820
Hemoglobin-oxygen affinity
$13.61
82930
Gastric analy w/ph ea spec
$7.42
82938
Gastrin test
$24.10
82941
Assay of gastrin
$24.02
82943
Assay of glucagon
$10.62
82945
Glucose other fluid
$5.35
82946
Glucagon tolerance test
$20.54
82947
Assay glucose blood quant
$5.35
82948
Reagent strip/blood glucose
$4.32
82950
Glucose test
$6.47
82951
Glucose tolerance test (gtt)
$17.53
82952
Gtt-added samples
$5.34
82955
Assay of g6pd enzyme
$13.21
82960
Test for g6pd enzyme
$8.24
82962
Glucose blood test
$3.19
82963
Assay of glucosidase
$24.15
82965
Assay of gdh enzyme
$10.52
82977
Assay of ggt
$9.81
82978
Assay of glutathione
$19.42
82979
Assay rbc glutathione
$9.38
82985
Assay of glycated protein
$20.54
83001
Assay of gonadotropin (fsh)
$25.31
83002
Assay of gonadotropin (lh)
$25.22
83003
Assay growth hormone (hgh)
$22.21
83006
Growth stimulation gene 2
$29.96
83009
H pylori (c-13) blood
$91.75
83010
Assay of haptoglobin quant
$17.13
83012
Assay of haptoglobins
$22.21
83013
H pylori (c-13) breath
$91.75
83014
H pylori drug admin
$10.71
83015
Heavy metal qual any anal
$25.65
83018
Heavy metal quant each nes
$29.92
83020
Hemoglobin electrophoresis
$13.46
83021
Hemoglobin chromotography
$24.60
83026
Hemoglobin copper sulfate
$3.22
83030
Fetal hemoglobin chemical
$4.85
83033
Fetal hemoglobin assay qual
$8.12
83036
Glycosylated hemoglobin test
$13.22
83037
Glycosylated hb home device
$13.22
83045
Blood methemoglobin test
$6.75
83050
Blood methemoglobin assay
$4.79
83051
Assay of plasma hemoglobin
$4.85
83060
Blood sulfhemoglobin assay
$4.85
83065
Assay of hemoglobin heat
$4.85
83068
Hemoglobin stability screen
$4.85
83069
Assay of urine hemoglobin
$2.35
83070
Assay of hemosiderin qual
$4.74
83080
Assay of b hexosaminidase
$22.97
83088
Assay of histamine
$40.23
83090
Assay of homocystine
$22.98
83150
Assay of homovanillic acid
$26.36
83491
Assay of corticosteroids 17
$23.87
83497
Assay of 5-hiaa
$17.56
83498
Assay of progesterone 17-d
$37.01
83499
Assay of progesterone 20-
$34.34
83500
Assay free hydroxyproline
$30.85
83505
Assay total hydroxyproline
$33.12
83516
Immunoassay nonantibody
$15.71
83518
Immunoassay dipstick
$11.54
83519
Ria nonantibody
$18.40
83520
Immunoassay quant nos nonab
$17.63
83525
Assay of insulin
$15.57
83527
Assay of insulin
$17.64
83528
Assay of intrinsic factor
$21.67
83540
Assay of iron
$8.82
83550
Iron binding test
$11.91
83570
Assay of idh enzyme
$12.05
83582
Assay of ketogenic steroids
$19.16
83586
Assay 17- ketosteroids
$17.44
83593
Fractionation ketosteroids
$35.82
83605
Assay of lactic acid
$14.55
83615
Lactate (ld) (ldh) enzyme
$8.22
83625
Assay of ldh enzymes
$15.66
83630
Lactoferrin fecal (qual)
$26.74
83631
Lactoferrin fecal (quant)
$26.74
83632
Placental lactogen
$27.54
83633
Test urine for lactose
$7.49
83655
Assay of lead
$16.49
83661
L/s ratio fetal lung
$29.95
83662
Foam stability fetal lung
$25.76
83663
Fluoro polarize fetal lung
$25.76
83664
Lamellar bdy fetal lung
$25.76
83670
Assay of lap enzyme
$12.48
83690
Assay of lipase
$9.38
83695
Assay of lipoprotein(a)
$17.63
83698
Assay lipoprotein pla2
$38.63
83700
Lipopro bld electrophoretic
$15.33
83701
Lipoprotein bld hr fraction
$33.82
83704
Lipoprotein bld quan part
$42.98
83718
Assay of lipoprotein
$11.16
83719
Assay of blood lipoprotein
$15.85
83721
Assay of blood lipoprotein
$13.00
83727
Assay of lrh hormone
$23.42
83735
Assay of magnesium
$9.12
83775
Assay malate dehydrogenase
$10.04
83785
Assay of manganese
$33.51
83789
Mass spectrometry qual/quan
$24.60
83825
Assay of mercury
$22.14
83835
Assay of metanephrines
$23.07
83857
Assay of methemalbumin
$14.63
83861
Microfluid analy tears
$22.50
83864
Mucopolysaccharides
$27.13
83872
Assay synovial fluid mucin
$7.98
83873
Assay of csf protein
$22.21
83874
Assay of myoglobin
$17.59
83876
Assay myeloperoxidase
$38.63
83880
Assay of natriuretic peptide
$38.63
83883
Assay nephelometry not spec
$18.52
83885
Assay of nickel
$14.50
83915
Assay of nucleotidase
$15.19
83916
Oligoclonal bands
$27.39
83918
Organic acids total quant
$22.41
83919
Organic acids qual each
$22.41
83921
Organic acid single quant
$22.41
83930
Assay of blood osmolality
$8.74
83935
Assay of urine osmolality
$9.29
83937
Assay of osteocalcin
$40.66
83945
Assay of oxalate
$17.53
83950
Oncoprotein her-2/neu
$63.76
83951
Oncoprotein dcp
$63.76
83970
Assay of parathormone
$56.23
83986
Assay ph body fluid nos
$4.88
83987
Exhaled breath condensate
$20.15
83992
Assay for phencyclidine
$20.02
83993
Assay for calprotectin fecal
$26.74
84030
Assay of blood pku
$7.49
84035
Assay of phenylketones
$4.99
84060
Assay acid phosphatase
$10.06
84061
Phosphatase forensic exam
$10.77
84066
Assay prostate phosphatase
$13.16
84075
Assay alkaline phosphatase
$7.05
84078
Assay alkaline phosphatase
$9.95
84080
Assay alkaline phosphatases
$20.14
84081
Assay phosphatidylglycerol
$22.50
84085
Assay of rbc pg6d enzyme
$9.18
84087
Assay phosphohexose enzymes
$13.54
84100
Assay of phosphorus
$6.46
84105
Assay of urine phosphorus
$7.05
84106
Test for porphobilinogen
$5.83
84110
Assay of porphobilinogen
$11.50
84112
Eval amniotic fluid protein
$63.76
84119
Test urine for porphyrins
$11.74
84120
Assay of urine porphyrins
$20.04
84126
Assay of feces porphyrins
$34.70
84132
Assay of serum potassium
$6.26
84133
Assay of urine potassium
$5.86
84134
Assay of prealbumin
$19.87
84135
Assay of pregnanediol
$17.87
84138
Assay of pregnanetriol
$25.79
84140
Assay of pregnenolone
$28.16
84143
Assay of 17-hydroxypregneno
$31.08
84144
Assay of progesterone
$28.42
84145
Procalcitonin (pct)
$36.49
84146
Assay of prolactin
$26.40
84150
Assay of prostaglandin
$14.50
84152
Assay of psa complexed
$25.06
84153
Assay of psa total
$25.06
84154
Assay of psa free
$25.06
84155
Assay of protein serum
$5.00
84156
Assay of protein urine
$5.00
84157
Assay of protein other
$5.00
84160
Assay of protein any source
$7.05
84163
Pappa serum
$20.51
84165
Protein e-phoresis serum
$14.63
84166
Protein e-phoresis/urine/csf
$24.29
84181
Western blot test
$23.20
84182
Protein western blot test
$24.52
84202
Assay rbc protoporphyrin
$19.54
84203
Test rbc protoporphyrin
$11.73
84206
Assay of proinsulin
$24.26
84207
Assay of vitamin b-6
$38.27
84210
Assay of pyruvate
$14.79
84220
Assay of pyruvate kinase
$12.86
84228
Assay of quinine
$15.85
84233
Assay of estrogen
$63.76
84234
Assay of progesterone
$55.43
84235
Assay of endocrine hormone
$50.21
84238
Assay nonendocrine receptor
$49.82
84244
Assay of renin
$29.96
84252
Assay of vitamin b-2
$27.57
84255
Assay of selenium
$34.78
84260
Assay of serotonin
$7.90
84270
Assay of sex hormone globul
$29.61
84275
Assay of sialic acid
$18.30
84285
Assay of silica
$11.55
84295
Assay of serum sodium
$6.56
84300
Assay of urine sodium
$6.63
84302
Assay of sweat sodium
$6.63
84305
Assay of somatomedin
$28.96
84307
Assay of somatostatin
$24.90
84311
Spectrophotometry
$9.52
84315
Body fluid specific gravity
$3.42
84375
Chromatogram assay sugars
$26.71
84376
Sugars single qual
$7.49
84377
Sugars multiple qual
$7.49
84378
Sugars single quant
$15.70
84379
Sugars multiple quant
$15.70
84392
Assay of urine sulfate
$6.47
84402
Assay of free testosterone
$34.69
84403
Assay of total testosterone
$35.17
84425
Assay of vitamin b-1
$28.92
84430
Assay of thiocyanate
$15.85
84431
Thromboxane urine
$22.89
84432
Assay of thyroglobulin
$21.88
84436
Assay of total thyroxine
$9.35
84437
Assay of neonatal thyroxine
$8.81
84439
Assay of free thyroxine
$12.28
84442
Assay of thyroid activity
$20.14
84443
Assay thyroid stim hormone
$22.89
84445
Assay of tsi globulin
$69.27
84446
Assay of vitamin e
$19.31
84449
Assay of transcortin
$24.52
84450
Transferase (ast) (sgot)
$7.05
84460
Alanine amino (alt) (sgpt)
$7.22
84466
Assay of transferrin
$17.39
84478
Assay of triglycerides
$7.83
84479
Assay of thyroid (t3 or t4)
$8.81
84480
Assay triiodothyronine (t3)
$15.04
84481
Free assay (ft-3)
$15.45
84482
T3 reverse
$21.47
84484
Assay of troponin quant
$13.40
84485
Assay duodenal fluid trypsin
$10.23
84488
Test feces for trypsin
$9.95
84490
Assay of feces for trypsin
$8.74
84510
Assay of tyrosine
$14.17
84512
Assay of troponin qual
$10.49
84520
Assay of urea nitrogen
$5.38
84525
Urea nitrogen semi-quant
$5.13
84540
Assay of urine/urea-n
$6.47
84545
Urea-n clearance test
$6.31
84550
Assay of blood/uric acid
$6.16
84560
Assay of urine/uric acid
$6.47
84577
Assay of feces/urobilinogen
$17.00
84578
Test urine urobilinogen
$4.43
84580
Assay of urine urobilinogen
$6.31
84583
Assay of urine urobilinogen
$6.85
84585
Assay of urine vma
$21.11
84586
Assay of vip
$48.13
84588
Assay of vasopressin
$38.63
84590
Assay of vitamin a
$15.81
84591
Assay of nos vitamin
$15.81
84597
Assay of vitamin k
$15.45
84600
Assay of volatiles
$21.68
84620
Xylose tolerance test
$11.86
84630
Assay of zinc
$15.41
84681
Assay of c-peptide
$28.35
84702
Chorionic gonadotropin test
$20.51
84703
Chorionic gonadotropin assay
$10.24
84704
Hcg free betachain test
$20.51
84830
Ovulation tests
$13.66
85002
Bleeding time test
$6.14
85004
Automated diff wbc count
$8.81
85007
Bl smear w/diff wbc count
$4.68
85008
Bl smear w/o diff wbc count
$4.68
85009
Manual diff wbc count b-coat
$4.74
85013
Spun microhematocrit
$3.23
85014
Hematocrit
$3.23
85018
Hemoglobin
$3.23
85025
Complete cbc w/auto diff wbc
$10.59
85027
Complete cbc automated
$8.81
85032
Manual cell count each
$5.86
85041
Automated rbc count
$3.58
85044
Manual reticulocyte count
$5.86
85045
Automated reticulocyte count
$5.45
85046
Reticyte/hgb concentrate
$7.59
85048
Automated leukocyte count
$3.46
85049
Automated platelet count
$6.10
85055
Reticulated platelet assay
$18.41
85130
Chromogenic substrate assay
$16.20
85170
Blood clot retraction
$4.93
85175
Blood clot lysis time
$6.20
85210
Clot factor ii prothrom spec
$17.69
85220
Blooc clot factor v test
$24.04
85230
Clot factor vii proconvertin
$24.39
85240
Clot factor viii ahg 1 stage
$24.39
85244
Clot factor viii reltd antgn
$27.82
85245
Clot factor viii vw ristoctn
$19.30
85246
Clot factor viii vw antigen
$19.30
85247
Clot factor viii multimetric
$19.30
85250
Clot factor ix ptc/chrstmas
$25.94
85260
Clot factor x stuart-power
$24.39
85270
Clot factor xi pta
$24.39
85280
Clot factor xii hageman
$26.36
85290
Clot factor xiii fibrin stab
$22.26
85291
Clot factor xiii fibrin scrn
$12.12
85292
Clot factor fletcher fact
$25.80
85293
Clot factor wght kininogen
$25.80
85300
Antithrombin iii activity
$16.15
85301
Antithrombin iii antigen
$14.73
85302
Clot inhibit prot c antigen
$16.37
85303
Clot inhibit prot c activity
$18.84
85305
Clot inhibit prot s total
$15.81
85306
Clot inhibit prot s free
$20.88
85307
Assay activated protein c
$20.88
85335
Factor inhibitor test
$17.53
85337
Thrombomodulin
$14.20
85345
Coagulation time lee & white
$4.72
85347
Coagulation time activated
$4.85
85348
Coagulation time otr method
$5.08
85360
Euglobulin lysis
$11.45
85362
Fibrin degradation products
$9.38
85366
Fibrinogen test
$9.65
85370
Fibrinogen test
$15.47
85378
Fibrin degrade semiquant
$9.72
85379
Fibrin degradation quant
$13.87
85380
Fibrin degradj d-dimer
$13.87
85384
Fibrinogen activity
$11.57
85385
Fibrinogen antigen
$11.57
85390
Fibrinolysins screen i&r
$3.87
85397
Clotting funct activity
$19.30
85400
Fibrinolytic plasmin
$12.05
85410
Fibrinolytic antiplasmin
$10.50
85415
Fibrinolytic plasminogen
$23.42
85420
Fibrinolytic plasminogen
$8.90
85421
Fibrinolytic plasminogen
$13.88
85441
Heinz bodies direct
$5.73
85445
Heinz bodies induced
$9.29
85460
Hemoglobin fetal
$4.85
85461
Hemoglobin fetal
$9.04
85475
Hemolysin acid
$12.09
85520
Heparin assay
$17.83
85525
Heparin neutralization
$16.13
85530
Heparin-protamine tolerance
$19.30
85536
Iron stain peripheral blood
$8.81
85540
Wbc alkaline phosphatase
$11.72
85547
Rbc mechanical fragility
$3.58
85549
Muramidase
$25.54
85555
Rbc osmotic fragility
$9.10
85557
Rbc osmotic fragility
$7.77
85576
Blood platelet aggregation
$29.27
85597
Phospholipid pltlt neutraliz
$24.49
85598
Hexagnal phosph pltlt neutrl
$24.49
85610
Prothrombin time
$5.36
85611
Prothrombin test
$5.37
85612
Viper venom prothrombin time
$13.05
85613
Russell viper venom diluted
$13.05
85635
Reptilase test
$5.79
85651
Rbc sed rate nonautomated
$4.83
85652
Rbc sed rate automated
$3.68
85660
Rbc sickle cell test
$7.51
85670
Thrombin time plasma
$7.86
85675
Thrombin time titer
$9.32
85705
Thromboplastin inhibition
$13.11
85730
Thromboplastin time partial
$8.18
85732
Thromboplastin time partial
$8.81
85810
Blood viscosity examination
$15.90
86000
Agglutinins febrile antigen
$9.51
86001
Allergen specific igg
$7.11
86003
Allergen specific ige
$7.11
86005
Allergen specific ige
$10.86
86021
Wbc antibody identification
$20.51
86022
Platelet antibodies
$19.87
86023
Immunoglobulin assay
$16.97
86038
Antinuclear antibodies
$16.47
86039
Antinuclear antibodies (ana)
$15.20
86060
Antistreptolysin o titer
$9.95
86063
Antistreptolysin o screen
$7.86
86140
C-reactive protein
$7.05
86141
C-reactive protein hs
$17.63
86146
Beta-2 glycoprotein antibody
$34.66
86147
Cardiolipin antibody ea ig
$34.66
86148
Anti-phospholipid antibody
$21.89
86152
Cell enumeration & id
$334.70
86155
Chemotaxis assay
$21.78
86156
Cold agglutinin screen
$9.12
86157
Cold agglutinin titer
$10.98
86160
Complement antigen
$16.35
86161
Complement/function activity
$16.35
86162
Complement total (ch50)
$27.68
86171
Complement fixation each
$13.64
86185
Counterimmunoelectrophoresis
$12.19
86200
Ccp antibody
$17.63
86215
Deoxyribonuclease antibody
$18.05
86225
Dna antibody native
$18.71
86226
Dna antibody single strand
$16.49
86235
Nuclear antigen antibody
$24.15
86243
Fc receptor
$27.95
86255
Fluorescent antibody screen
$16.41
86256
Fluorescent antibody titer
$16.41
86277
Growth hormone antibody
$21.44
86280
Hemagglutination inhibition
$11.16
86294
Immunoassay tumor qual
$21.69
86300
Immunoassay tumor ca 15-3
$28.35
86301
Immunoassay tumor ca 19-9
$28.35
86304
Immunoassay tumor ca 125
$28.35
86305
Human epididymis protein 4
$28.35
86308
Heterophile antibody screen
$7.05
86309
Heterophile antibody titer
$8.81
86310
Heterophile antibody absrbj
$10.04
86316
Immunoassay tumor other
$28.35
86317
Immunoassay infectious agent
$20.42
86318
Immunoassay infectious agent
$17.63
86320
Serum immunoelectrophoresis
$30.53
86325
Other immunoelectrophoresis
$30.47
86327
Immunoelectrophoresis assay
$22.21
86329
Immunodiffusion nes
$19.13
86331
Immunodiffusion ouchterlony
$16.32
86332
Immune complex assay
$33.20
86334
Immunofix e-phoresis serum
$30.44
86335
Immunfix e-phorsis/urine/csf
$39.97
86336
Inhibin a
$21.23
86337
Insulin antibodies
$29.16
86340
Intrinsic factor antibody
$20.54
86341
Islet cell antibody
$26.95
86343
Leukocyte histamine release
$16.98
86344
Leukocyte phagocytosis
$10.88
86352
Cell function assay w/stim
$185.07
86353
Lymphocyte transformation
$66.79
86355
B cells total count
$51.39
86356
Mononuclear cell antigen
$18.41
86357
Nk cells total count
$51.39
86359
T cells total count
$51.39
86360
T cell absolute count/ratio
$64.01
86361
T cell absolute count
$18.41
86367
Stem cells total count
$51.39
86376
Microsomal antibody each
$19.82
86378
Migration inhibitory factor
$26.83
86382
Neutralization test viral
$23.04
86384
Nitroblue tetrazolium dye
$15.51
86386
Nuclear matrix protein 22
$21.76
86403
Particle agglut antbdy scrn
$6.79
86406
Particle agglut antbdy titr
$14.49
86430
Rheumatoid factor test qual
$7.73
86431
Rheumatoid factor quant
$7.73
86480
Tb test cell immun measure
$84.43
86481
Tb ag response t-cell susp
$102.07
86590
Streptokinase antibody
$15.04
86592
Syphilis test non-trep qual
$5.82
86593
Syphilis test non-trep quant
$5.99
86602
Antinomyces antibody
$13.87
86603
Adenovirus antibody
$17.52
86606
Aspergillus antibody
$20.51
86609
Bacterium antibody
$17.55
86611
Bartonella antibody
$13.87
86612
Blastomyces antibody
$17.58
86615
Bordetella antibody
$17.97
86617
Lyme disease antibody
$21.10
86618
Lyme disease antibody
$23.20
86619
Borrelia antibody
$18.22
86622
Brucella antibody
$12.17
86625
Campylobacter antibody
$17.87
86628
Candida antibody
$16.35
86631
Chlamydia antibody
$16.11
86632
Chlamydia igm antibody
$17.28
86635
Coccidioides antibody
$15.63
86638
Q fever antibody
$16.51
86641
Cryptococcus antibody
$19.63
86644
Cmv antibody
$19.61
86645
Cmv antibody igm
$22.95
86648
Diphtheria antibody
$20.72
86651
Encephalitis californ antbdy
$17.97
86652
Encephaltis east eqne anbdy
$17.97
86653
Encephaltis st louis antbody
$17.97
86654
Encephaltis west eqne antbdy
$17.97
86658
Enterovirus antibody
$17.75
86663
Epstein-barr antibody
$17.87
86664
Epstein-barr nuclear antigen
$20.84
86665
Epstein-barr capsid vca
$24.72
86666
Ehrlichia antibody
$13.87
86668
Francisella tularensis
$14.17
86671
Fungus nes antibody
$16.69
86674
Giardia lamblia antibody
$20.05
86677
Helicobacter pylori antibody
$19.77
86682
Helminth antibody
$17.72
86684
Hemophilus influenza antibdy
$21.58
86687
Htlv-i antibody
$11.43
86688
Htlv-ii antibody
$19.08
86689
Htlv/hiv confirmj antibody
$26.37
86692
Hepatitis delta agent antbdy
$23.38
86694
Herpes simplex nes antbdy
$19.61
86695
Herpes simplex type 1 test
$17.97
86696
Herpes simplex type 2 test
$26.37
86698
Histoplasma antibody
$17.02
86701
Hiv-1antibody
$12.11
86702
Hiv-2 antibody
$18.41
86703
Hiv-1/hiv-2 1 result antbdy
$18.67
86704
Hep b core antibody total
$16.41
86705
Hep b core antibody igm
$16.04
86706
Hep b surface antibody
$14.63
86707
Hepatitis be antibody
$15.76
86708
Hepatitis a antibody
$16.87
86709
Hepatitis a igm antibody
$15.33
86710
Influenza virus antibody
$18.46
86711
John cunningham antibody
$19.61
86713
Legionella antibody
$20.85
86717
Leishmania antibody
$16.68
86720
Leptospira antibody
$17.97
86723
Listeria monocytogenes
$17.97
86727
Lymph choriomeningitis ab
$17.52
86729
Lympho venereum antibody
$16.27
86732
Mucormycosis antibody
$17.97
86735
Mumps antibody
$17.77
86738
Mycoplasma antibody
$18.04
86741
Neisseria meningitidis
$17.97
86744
Nocardia antibody
$17.97
86747
Parvovirus antibody
$20.48
86750
Malaria antibody
$17.97
86753
Protozoa antibody nos
$16.87
86756
Respiratory virus antibody
$17.55
86757
Rickettsia antibody
$26.37
86759
Rotavirus antibody
$17.97
86762
Rubella antibody
$19.61
86765
Rubeola antibody
$17.55
86768
Salmonella antibody
$17.97
86771
Shigella antibody
$17.97
86774
Tetanus antibody
$20.16
86777
Toxoplasma antibody
$19.61
86778
Toxoplasma antibody igm
$19.62
86780
Treponema pallidum
$18.03
86784
Trichinella antibody
$17.11
86787
Varicella-zoster antibody
$17.55
86788
West nile virus ab igm
$22.95
86789
West nile virus antibody
$19.61
86790
Virus antibody nos
$17.55
86793
Yersinia antibody
$17.97
86800
Thyroglobulin antibody
$21.67
86803
Hepatitis c ab test
$19.44
86804
Hep c ab test confirm
$21.10
86805
Lymphocytotoxicity assay
$71.23
86806
Lymphocytotoxicity assay
$64.83
86807
Cytotoxic antibody screening
$53.91
86808
Cytotoxic antibody screening
$40.43
86812
Hla typing a b or c
$35.16
86813
Hla typing a b or c
$76.28
86816
Hla typing dr/dq
$31.87
86817
Hla typing dr/dq
$76.28
86821
Lymphocyte culture mixed
$76.91
86822
Lymphocyte culture primed
$49.80
86825
Hla x-math non-cytotoxic
$55.24
86826
Hla x-match noncytotoxc addl
$18.41
86828
Hla class i&ii antibody qual
$53.91
86829
Hla class i/ii antibody qual
$40.43
86830
Hla class i phenotype qual
$109.98
86831
Hla class ii phenotype qual
$94.27
86832
Hla class i high defin qual
$172.83
86833
Hla class ii high defin qual
$157.12
86834
Hla class i semiquant panel
$487.07
86835
Hla class ii semiquant panel
$439.93
86850
New for 2016
Rbc antibody screen
$5.21
86880
Coombs test direct
$7.33
86885
Coombs test indirect qual
$7.80
86886
Coombs test indirect titer
$7.05
86900
Blood typing serologic abo
$4.07
86901
Blood typing serologic rh(d)
$4.07
86902
Blood type antigen donor ea
$5.21
86904
Blood typing patient serum
$12.96
86905
Blood typing rbc antigens
$5.21
86906
Bld typing serologic rh phnt
$10.55
86940
Hemolysins/agglutinins auto
$11.17
86941
Hemolysins/agglutinins
$16.49
87003
Small animal inoculation
$22.93
87015
Specimen infect agnt concntj
$9.09
87040
Blood culture for bacteria
$14.07
87045
Feces culture aerobic bact
$12.86
87046
Stool cultr aerobic bact ea
$12.86
87070
Culture othr specimn aerobic
$11.74
87071
Culture aerobic quant other
$12.86
87073
Culture bacteria anaerobic
$12.86
87075
Cultr bacteria except blood
$12.90
87076
Culture anaerobe ident each
$5.79
87077
Culture aerobic identify
$5.79
87081
Culture screen only
$9.03
87084
Culture of specimen by kit
$6.79
87086
Urine culture/colony count
$11.00
87088
Urine bacteria culture
$11.03
87101
Skin fungi culture
$10.50
87102
Fungus isolation culture
$11.45
87103
Blood fungus culture
$12.28
87106
Fungi identification yeast
$14.07
87107
Fungi identification mold
$14.07
87109
Mycoplasma
$20.96
87110
Chlamydia culture
$26.69
87116
Mycobacteria culture
$14.71
87118
Mycobacteric identification
$14.91
87140
Culture type immunofluoresc
$7.59
87143
Culture typing glc/hplc
$17.06
87147
Culture type immunologic
$7.05
87149
Dna/rna direct probe
$27.32
87150
Dna/rna amplified probe
$47.80
87152
Culture type pulse field gel
$7.13
87153
Dna/rna sequencing
$157.14
87158
Culture typing added method
$7.13
87164
Dark field examination
$14.63
87166
Dark field examination
$15.38
87168
Macroscopic exam arthropod
$5.82
87169
Macroscopic exam parasite
$5.82
87172
Pinworm exam
$5.82
87176
Tissue homogenization cultr
$8.01
87177
Ova and parasites smears
$11.86
87181
Microbe susceptible diffuse
$6.47
87184
Microbe susceptible disk
$9.39
87185
Microbe susceptible enzyme
$6.47
87186
Microbe susceptible mic
$11.78
87187
Microbe susceptible mlc
$14.12
87188
Microbe suscept macrobroth
$9.04
87190
Microbe suscept mycobacteri
$7.70
87197
Bactericidal level serum
$20.47
87205
Smear gram stain
$5.82
87206
Smear fluorescent/acid stai
$7.33
87207
Smear special stain
$8.16
87209
Smear complex stain
$24.49
87210
Smear wet mount saline/ink
$5.82
87220
Tissue exam for fungi
$5.82
87230
Assay toxin or antitoxin
$26.90
87250
Virus inoculate eggs/animal
$26.65
87252
Virus inoculation tissue
$31.63
87253
Virus inoculate tissue addl
$27.52
87254
Virus inoculation shell via
$26.65
87255
Genet virus isolate hsv
$46.13
87260
Adenovirus ag if
$16.33
87265
Pertussis ag if
$16.33
87267
Enterovirus antibody dfa
$16.33
87269
Giardia ag if
$16.33
87270
Chlamydia trachomatis ag if
$16.33
87271
Cytomegalovirus dfa
$16.33
87272
Cryptosporidium ag if
$16.33
87273
Herpes simplex 2 ag if
$16.33
87274
Herpes simplex 1 ag if
$16.33
87275
Influenza b ag if
$16.33
87276
Influenza a ag if
$16.33
87277
Legionella micdadei ag if
$16.33
87278
Legion pneumophilia ag if
$16.33
87279
Parainfluenza ag if
$16.33
87280
Respiratory syncytial ag if
$16.33
87281
Pneumocystis carinii ag if
$16.33
87283
Rubeola ag if
$16.33
87285
Treponema pallidum ag if
$16.33
87290
Varicella zoster ag if
$16.33
87299
Antibody detection nos if
$16.33
87300
Ag detection polyval if
$16.33
87301
Adenovirus ag ia
$16.33
87305
Aspergillus ag ia
$16.33
87320
Chylmd trach ag ia
$16.33
87324
Clostridium ag ia
$16.33
87327
Cryptococcus neoform ag ia
$16.33
87328
Cryptosporidium ag ia
$16.33
87329
Giardia ag ia
$16.33
87332
Cytomegalovirus ag ia
$16.33
87335
E coli 0157 ag ia
$16.33
87336
Entamoeb hist dispr ag ia
$16.33
87337
Entamoeb hist group ag ia
$16.33
87338
Hpylori stool ia
$19.59
87339
H pylori ag ia
$16.33
87340
Hepatitis b surface ag ia
$14.07
87341
Hepatitis b surface ag ia
$14.07
87350
Hepatitis be ag ia
$15.70
87380
Hepatitis delta ag ia
$22.36
87385
Histoplasma capsul ag ia
$16.33
87389
Hiv-1 ag w/hiv-1 & hiv-2 ab
$32.80
87390
Hiv-1 ag ia
$24.03
87391
Hiv-2 ag ia
$24.03
87400
Influenza a/b ag ia
$16.33
87420
Resp syncytial ag ia
$16.33
87425
Rotavirus ag ia
$16.33
87427
Shiga-like toxin ag ia
$16.33
87430
Strep a ag ia
$16.33
87449
Ag detect nos ia mult
$16.33
87450
Ag detect nos ia single
$13.07
87451
Ag detect polyval ia mult
$13.07
87470
Bartonella dna dir probe
$27.32
87471
Bartonella dna amp probe
$47.80
87472
Bartonella dna quant
$58.35
87475
Lyme dis dna dir probe
$27.32
87476
Lyme dis dna amp probe
$47.80
87477
Lyme dis dna quant
$58.35
87480
Candida dna dir probe
$27.32
87481
Candida dna amp probe
$47.80
87482
Candida dna quant
$56.88
87485
Chylmd pneum dna dir probe
$27.32
87486
Chylmd pneum dna amp probe
$47.80
87487
Chylmd pneum dna quant
$58.35
87490
Chylmd trach dna dir probe
$27.32
87491
Chylmd trach dna amp probe
$47.80
87492
Chylmd trach dna quant
$47.62
87493
C diff amplified probe
$47.80
87495
Cytomeg dna dir probe
$27.32
87496
Cytomeg dna amp probe
$47.80
87497
Cytomeg dna quant
$58.35
87498
Enterovirus probe&revrs trns
$47.80
87500
Vanomycin dna amp probe
$47.80
87501
Influenza dna amp prob 1+
$69.90
87502
Influenza dna amp probe
$115.92
87503
Influenza dna amp prob addl
$28.29
87505
Nfct agent detection gi
$174.76
87506
Iadna-dna/rna probe tq 6-11
$290.74
87507
Iadna-dna/rna probe tq 12-25
$567.75
87510
Gardner vag dna dir probe
$27.32
87511
Gardner vag dna amp probe
$47.80
87512
Gardner vag dna quant
$56.88
87515
Hepatitis b dna dir probe
$27.32
87516
Hepatitis b dna amp probe
$47.80
87517
Hepatitis b dna quant
$58.35
87520
Hepatitis c rna dir probe
$27.32
87521
Hepatitis c probe&rvrs trnsc
$47.80
87522
Hepatitis c revrs trnscrpj
$58.35
87525
Hepatitis g dna dir probe
$27.32
87526
Hepatitis g dna amp probe
$47.80
87527
Hepatitis g dna quant
$56.88
87528
Hsv dna dir probe
$27.32
87529
Hsv dna amp probe
$47.80
87530
Hsv dna quant
$58.35
87531
Hhv-6 dna dir probe
$27.32
87532
Hhv-6 dna amp probe
$47.80
87533
Hhv-6 dna quant
$56.88
87534
Hiv-1 dna dir probe
$27.32
87535
Hiv-1 probe&reverse trnscrpj
$47.80
87536
Hiv-1 quant&revrse trnscrpj
$115.92
87537
Hiv-2 dna dir probe
$27.32
87538
Hiv-2 probe&revrse trnscripj
$47.80
87539
Hiv-2 quant&revrse trnscripj
$58.35
87540
Legion pneumo dna dir prob
$27.32
87541
Legion pneumo dna amp prob
$47.80
87542
Legion pneumo dna quant
$56.88
87550
Mycobacteria dna dir probe
$27.32
87551
Mycobacteria dna amp probe
$47.80
87552
Mycobacteria dna quant
$58.35
87555
M.tuberculo dna dir probe
$27.32
87556
M.tuberculo dna amp probe
$47.80
87557
M.tuberculo dna quant
$58.35
87560
M.avium-intra dna dir prob
$27.32
87561
M.avium-intra dna amp prob
$47.80
87562
M.avium-intra dna quant
$58.35
87580
M.pneumon dna dir probe
$27.32
87581
M.pneumon dna amp probe
$47.80
87582
M.pneumon dna quant
$56.88
87590
N.gonorrhoeae dna dir prob
$27.32
87591
N.gonorrhoeae dna amp prob
$47.80
87592
N.gonorrhoeae dna quant
$58.35
87623
Hpv low-risk types
$47.80
87624
Hpv high-risk types
$47.80
87625
Hpv types 16 & 18 only
$47.80
87631
Resp virus 3-5 targets
$174.76
87632
Resp virus 6-11 targets
$290.74
87633
Resp virus 12-25 targets
$567.75
87640
Staph a dna amp probe
$47.80
87641
Mr-staph dna amp probe
$47.80
87650
Strep a dna dir probe
$27.32
87651
Strep a dna amp probe
$47.80
87652
Strep a dna quant
$56.88
87653
Strep b dna amp probe
$47.80
87660
Trichomonas vagin dir probe
$27.32
87661
Trichomonas vaginalis amplif
$47.80
87797
Detect agent nos dna dir
$27.32
87798
Detect agent nos dna amp
$47.80
87799
Detect agent nos dna quant
$58.35
87800
Detect agnt mult dna direc
$54.64
87801
Detect agnt mult dna ampli
$95.62
87802
Strep b assay w/optic
$16.33
87803
Clostridium toxin a w/optic
$16.33
87804
Influenza assay w/optic
$16.33
87806
Hiv antigen w/hiv antibodies
$32.80
87807
Rsv assay w/optic
$16.33
87808
Trichomonas assay w/optic
$16.33
87809
Adenovirus assay w/optic
$16.33
87810
Chylmd trach assay w/optic
$16.33
87850
N. gonorrhoeae assay w/optic
$16.33
87880
Strep a assay w/optic
$16.33
87899
Agent nos assay w/optic
$16.33
87900
Phenotype infect agent drug
$158.14
87901
Genotype dna hiv reverse t
$350.69
87902
Genotype dna/rna hep c
$350.69
87903
Phenotype dna hiv w/culture
$665.64
87904
Phenotype dna hiv w/clt add
$31.63
87905
Sialidase enzyme assay
$16.41
87906
Genotype dna/rna hiv
$175.35
87910
Genotype cytomegalovirus
$350.69
87912
Genotype dna hepatitis b
$350.69
88130
Sex chromatin identification
$20.51
88140
Sex chromatin identification
$10.89
88142
Cytopath c/v thin layer
$27.60
88143
Cytopath c/v thin layer redo
$27.60
88147
Cytopath c/v automated
$14.39
88148
Cytopath c/v auto rescreen
$14.39
88150
Cytopath c/v manual
$14.39
88152
Cytopath c/v auto redo
$14.39
88153
Cytopath c/v redo
$14.39
88154
Cytopath c/v select
$14.39
88155
Cytopath c/v index add-on
$8.16
88164
Cytopath tbs c/v manual
$14.39
88165
Cytopath tbs c/v redo
$14.39
88166
Cytopath tbs c/v auto redo
$14.39
88167
Cytopath tbs c/v select
$14.39
88174
Cytopath c/v auto in fluid
$29.11
88175
Cytopath c/v auto fluid redo
$35.91
88230
Tissue culture lymphocyte
$158.69
88233
Tissue culture skin/biopsy
$191.70
88235
Tissue culture placenta
$200.60
88237
Tissue culture bone marrow
$172.06
88239
Tissue culture tumor
$200.95
88240
Cell cryopreserve/storage
$13.76
88241
Frozen cell preparation
$13.76
88245
Chromosome analysis 20-25
$197.90
88248
Chromosome analysis 50-100
$235.90
88249
Chromosome analysis 100
$235.90
88261
Chromosome analysis 5
$240.76
88262
Chromosome analysis 15-20
$169.79
88263
Chromosome analysis 45
$204.73
88264
Chromosome analysis 20-25
$169.79
88267
Chromosome analys placenta
$244.89
88269
Chromosome analys amniotic
$226.57
88271
Cytogenetics dna probe
$19.72
88272
Cytogenetics 3-5
$34.50
88273
Cytogenetics 10-30
$43.77
88274
Cytogenetics 25-99
$47.42
88275
Cytogenetics 100-300
$54.70
88280
Chromosome karyotype study
$34.19
88283
Chromosome banding study
$53.13
88285
Chromosome count additional
$25.88
88289
Chromosome study additional
$40.24
88371
Protein western blot tissue
$29.67
88372
Protein analysis w/probe
$30.98
88720
Bilirubin total transcut
$6.83
88738
Hgb quant transcutaneous
$6.83
88740
Transcutaneous carboxyhb
$6.83
88741
Transcutaneous methb
$6.83
89050
Body fluid cell count
$6.44
89051
Body fluid cell count
$7.50
89055
Leukocyte assessment fecal
$5.82
89060
Exam synovial fluid crystals
$9.75
89125
Specimen fat stain
$3.95
89160
Exam feces for meat fibers
$4.85
89190
Nasal smear for eosinophils
$6.47
89300
Semen analysis w/huhner
$12.16
89310
Semen analysis w/count
$7.90
89320
Semen anal vol/count/mot
$13.70
89321
Semen anal sperm detection
$13.70
89322
Semen anal strict criteria
$18.44
89325
Sperm antibody test
$14.54
89329
Sperm evaluation test
$28.56
89330
Evaluation cervical mucus
$13.48
89331
Retrograde ejaculation anal
$25.57
G0027
Semen analysis
$8.86
G0103
Psa screening
$25.06
G0123
Screen cerv/vag thin layer
$27.60
G0143
Scr c/v cyto,thinlayer,rescr
$27.60
G0144
Scr c/v cyto,thinlayer,rescr
$29.11
G0145
Scr c/v cyto,thinlayer,rescr
$35.91
G0147
Scr c/v cyto, automated sys
$14.39
G0148
Scr c/v cyto, autosys, rescr
$14.39
G0306
Cbc/diffwbc w/o platelet
$10.59
G0307
Cbc without platelet
$8.81
G0328
Fecal blood scrn immunoassay
$21.67
G0432
Eia hiv-1/hiv-2 screen
$18.67
G0433
Elisa hiv-1/hiv-2 screen
$18.67
G0435
Oral hiv-1/hiv-2 screen
$16.33
G0471
Ven blood coll snf/hha
$5.00
G0472
New for 2016
Hep c screen high risk/other
$19.44
G0480
New for 2016
Drug test def 1-7 classes
$79.94
G0481
New for 2016
Drug test def 8-14 classes
$122.99
G0482
New for 2016
Drug test def 15-21 classes
$166.03
G0483
New for 2016
Drug test def 22+ classes
$215.23
G9143
Warfarin respon genetic test
$164.44
P2038
Blood mucoprotein
$6.85
P3000
Screen pap by tech w md supv
$14.39
P9612
Catheterize for urine spec
$3.00
P9615
Urine specimen collect mult
$3.00
Q0111
Wet mounts/ w preparations
$5.82
Q0112
Potassium hydroxide preps
$5.82
Q0113
Pinworm examinations
$7.37
Q0114
Fern test
$9.75
Q0115
Post-coital mucous exam
$13.48



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