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Laboratory Fee Schedule

2025
2024
QW Tests

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2025
2024

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2025-January
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CMS Transmittals



.

2025 Clinical Laboratory Fee Schedule CLIA Waived Tests (QW)

Fee schedules do not reflect 2% Payment Adjustment (Sequestration). Click here for more information.

Procedure
Short Descriptor
2024 CLFS
2025 CLFS
XXXXX
Nfct ds vir resp rna 3 trgt
$142.63
$XXX.XX
XXXXX
Nfct ds vir resp rna 4 trgt
$142.63
$XXX.XX
XXXXX
Metabolic panel ionized ca
$13.73
$XXX.XX
XXXXX
Metabolic panel total ca
$8.46
$XXX.XX
XXXXX
Electrolyte panel
$7.01
$XXX.XX
XXXXX
Comprehen metabolic panel
$10.56
$XXX.XX
XXXXX
Lipid panel
$13.39
$XXX.XX
XXXXX
Renal function panel
$8.68
$XXX.XX
XXXXX
Assay of lithium
$6.61
$XXX.XX
XXXXX
Drug test prsmv dir opt obs
$12.60
$XXX.XX
XXXXX
Urinalysis auto w/o scope
$2.25
$XXX.XX
XXXXX
Urine screen for bacteria
$29.98
$XXX.XX
XXXXX
Nfct ds bv&vaginitis dna alg
$XXX.XX
XXXXX
Ketone bodys quan
$8.17
$XXX.XX
XXXXX
Assay of serum albumin
$4.95
$XXX.XX
XXXXX
Other source albumin quan ea
$7.78
$XXX.XX
XXXXX
Ur albumin quantitative
$5.78
$XXX.XX
XXXXX
Ur albumin semiquantitative
$6.23
$XXX.XX
XXXXX
Amines vaginal fluid qual
$5.99
$XXX.XX
XXXXX
Assay of amylase
$6.48
$XXX.XX
XXXXX
Bilirubin total
$5.02
$XXX.XX
XXXXX
Occult blood other sources
$5.32
$XXX.XX
XXXXX
Assay test for blood fecal
$15.92
$XXX.XX
XXXXX
Assay of calcium
$5.16
$XXX.XX
XXXXX
Assay of calcium
$13.68
$XXX.XX
XXXXX
Assay blood carbon dioxide
$4.88
$XXX.XX
XXXXX
Assay of blood chloride
$4.60
$XXX.XX
XXXXX
Assay bld/serum cholesterol
$4.35
$XXX.XX
XXXXX
Collagen crosslinks
$18.68
$XXX.XX
XXXXX
Assay of ck (cpk)
$6.51
$XXX.XX
XXXXX
Assay of creatinine
$5.12
$XXX.XX
XXXXX
Assay of urine creatinine
$5.18
$XXX.XX
XXXXX
Assay of estrone
$24.95
$XXX.XX
XXXXX
Assay glucose blood quant
$3.93
$XXX.XX
XXXXX
Glucose test
$4.75
$XXX.XX
XXXXX
Glucose tolerance test (gtt)
$12.87
$XXX.XX
XXXXX
Gtt-added samples
$3.92
$XXX.XX
XXXXX
Assay of ggt
$7.20
$XXX.XX
XXXXX
Assay of glycated protein
$16.76
$XXX.XX
XXXXX
Assay of gonadotropin (fsh)
$18.58
$XXX.XX
XXXXX
Assay of gonadotropin (lh)
$18.52
$XXX.XX
XXXXX
Hemoglobin glycosylated a1c
$9.71
$XXX.XX
XXXXX
Hb glycosylated a1c home dev
$9.71
$XXX.XX
XXXXX
Immunoassay nonantibody
$11.53
$XXX.XX
XXXXX
Immunoassay dipstick
$9.64
$XXX.XX
XXXXX
Immunoassay quant nos nonab
$17.27
$XXX.XX
XXXXX
Assay of lactic acid
$11.57
$XXX.XX
XXXXX
Assay of lead
$12.11
$XXX.XX
XXXXX
Assay of lipoprotein
$8.19
$XXX.XX
XXXXX
Assay of blood lipoprotein
$10.50
$XXX.XX
XXXXX
Microfluid analy tears
$22.48
$XXX.XX
XXXXX
Assay of natriuretic peptide
$39.26
$XXX.XX
XXXXX
Assay ph body fluid nos
$3.58
$XXX.XX
XXXXX
Assay alkaline phosphatase
$5.18
$XXX.XX
XXXXX
Assay of serum potassium
$4.76
$XXX.XX
XXXXX
Assay of protein serum
$3.67
$XXX.XX
XXXXX
Assay of protein other
$4.00
$XXX.XX
XXXXX
Assay of serum sodium
$4.81
$XXX.XX
XXXXX
Assay thyroid stim hormone
$16.80
$XXX.XX
XXXXX
Transferase (ast) (sgot)
$5.18
$XXX.XX
XXXXX
Alanine amino (alt) (sgpt)
$5.30
$XXX.XX
XXXXX
Assay of triglycerides
$5.74
$XXX.XX
XXXXX
Assay of urea nitrogen
$3.95
$XXX.XX
XXXXX
Assay of blood/uric acid
$4.52
$XXX.XX
XXXXX
Chorionic gonadotropin assay
$7.52
$XXX.XX
XXXXX
Hematocrit
$2.37
$XXX.XX
XXXXX
Hemoglobin
$2.37
$XXX.XX
XXXXX
Complete cbc w/auto diff wbc
$7.77
$XXX.XX
XXXXX
Blood platelet aggregation
$24.91
$XXX.XX
XXXXX
Prothrombin time
$4.29
$XXX.XX
XXXXX
Immunoassay tumor qual
$25.57
$XXX.XX
XXXXX
Heterophile antibody screen
$5.18
$XXX.XX
XXXXX
Ia infectious agent antibody
$18.09
$XXX.XX
XXXXX
Ia nfct ab sarscov2 covid19
$45.28
$XXX.XX
XXXXX
Nuclear matrix protein 22
$21.78
$XXX.XX
XXXXX
Lyme disease antibody
$17.03
$XXX.XX
XXXXX
Hiv-1antibody
$8.89
$XXX.XX
XXXXX
Treponema pallidum
$13.24
$XXX.XX
XXXXX
Hepatitis c ab test
$14.27
$XXX.XX
XXXXX
Culture aerobic identify
$8.08
$XXX.XX
XXXXX
Smear wet mount saline/ink
$5.82
$XXX.XX
XXXXX
Hpylori stool ag ia
$14.38
$XXX.XX
XXXXX
Hiv-1 ag w/hiv-1&-2 ab ag ia
$24.08
$XXX.XX
XXXXX
Influenza a/b each ag ia
$14.13
$XXX.XX
XXXXX
Resp syncytial virus ag ia
$13.91
$XXX.XX
XXXXX
Sarscov coronavirus ag ia
$35.33
$XXX.XX
XXXXX
Sarscov & inf vir a&b ag ia
$70.29
$XXX.XX
XXXXX
Strep a ag ia
$16.81
$XXX.XX
XXXXX
Nos each organism ag ia
$11.98
$XXX.XX
XXXXX
Influenza dna amp probe
$95.80
$XXX.XX
XXXXX
Hepatitis c probe&rvrs trnsc
$35.09
$XXX.XX
XXXXX
Resp virus 3-5 targets
$142.63
$XXX.XX
XXXXX
Resp virus 12-25 targets
$416.78
$XXX.XX
XXXXX
Rsv dna/rna amp probe
$70.20
$XXX.XX
XXXXX
Sars-cov-2 covid-19 amp prb
$51.31
$XXX.XX
XXXXX
Sarscov2 & inf a&b amp prb
$142.63
$XXX.XX
XXXXX
Sarscov2&inf a&b&rsv amp prb
$142.63
$XXX.XX
XXXXX
Strep a dna dir probe
$20.05
$XXX.XX
XXXXX
Strep a dna amp probe
$35.09
$XXX.XX
XXXXX
Detect agnt mult dna ampli
$70.20
$XXX.XX
XXXXX
Influenza assay w/optic
$16.55
$XXX.XX
XXXXX
Hiv ag w/hiv1&2 antb w/optic
$32.77
$XXX.XX
XXXXX
Rsv assay w/optic
$13.10
$XXX.XX
XXXXX
Trichomonas assay w/optic
$15.29
$XXX.XX
XXXXX
Adenovirus assay w/optic
$21.76
$XXX.XX
XXXXX
Sars-cov-2 covid19 w/optic
$41.38
$XXX.XX
XXXXX
Strep a assay w/optic
$16.53
$XXX.XX
XXXXX
Agent nos assay w/optic
$16.07
$XXX.XX
XXXXX
Sialidase enzyme assay
$12.22
$XXX.XX
XXXXX
Semen analysis w/huhner
$9.84
$XXX.XX
XXXXX
Semen anal sperm detection
$12.05
$XXX.XX
XXXXX
Fecal blood scrn immunoassay
$18.05
$XXX.XX
XXXXX
Elisa hiv-1/hiv-2 screen
$18.29
$XXX.XX
XXXXX
Hep c screen high risk/other
$46.35
$XXX.XX
XXXXX
Hiv combination assay
$24.08
$XXX.XX
XXXXX
Covid-19 lab test non-cdc
$51.31
$XXX.XX



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