2020 clinical diagnostic laboratory fee schedule0078u pain mgt opi use gnotyp pnl $450.91 0080u onc...

2020 Clinical Diagnostic Laboratory Fee Schedule CPT codes, descriptions and other data only are copyright 2018 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).Codes in green are enddated. NOTE: Zero pay (0.00) codes will be reimbursed at 45% of billed charges** The appearance on this schedule of a code and rate is not an indication of coverage, nor a guarantee of payment.

HCPCS MODIFIER SHORT DESCRIPTION RATE 2020 End Date

0001U Rbc dna hea 35 ag 11 bld grp $720.000002M Liver dis 10 assays w/ash $503.400002U Onc clrct 3 ur metab alg plp $25.000003M Liver dis 10 assays w/nash $503.400003U Onc ovar 5 prtn ser alg scor $950.000004M Scoliosis dna alys $79.000005U Onco prst8 3 gene ur alg $760.000006M Onc hep gene risk classifier $150.000006U Detc ia meds 120+ analytes $246.920007M Onc gastro 51 gene nomogram $375.000007U Rx test prsmv ur w/def conf $114.430008U Hpylori detcj abx rstnc dna $597.910009U Onc brst ca erbb2 amp/nonamp $107.000010U Nfct ds strn typ whl gen seq $427.260011M Onc prst8 ca mrna 12 gen alg $760.000011U Rx mntr lc-ms/ms oral fluid $114.430012M Onc mrna 5 gen rsk urthl ca $760.000012U Germln do gene reargmt detcj $2,515.600013M Onc mrna 5 gen recr urthl ca $760.000013U Onc sld org neo gene reargmt $2,515.600014U Hem hmtlmf neo gene reargmt $2,515.600016U Onc hmtlmf neo rna bcr/abl1 $163.960017U Onc hmtlmf neo jak2 mut dna $91.660018U Onc thyr 10 microrna seq alg $3,002.090019U Onc rna tiss predict alg $3,675.000021U Onc prst8 detcj 8 autoantb $760.000022U Trgt gen seq dna&rna 23 gene $1,950.000023U Onc aml dna detcj/nondetcj $248.510024U Glyca nuc mr spectrsc quan $34.190025U Tenofovir liq chrom ur quan $85.770026U Onc thyr dna&mrna 112 genes $3,600.000027U Jak2 gene trgt seq alys $135.460029U Rx metab advrs trgt seq alys $742.270030U Rx metab warf trgt seq alys $134.130031U Cyp1a2 gene $174.810032U Comt gene $174.81



0033U Htr2a htr2c genes $349.620034U Tpmt nudt15 genes $466.170035U Neuro csf prion prtn qual $540.990036U Xome tum & nml spec seq alys $4,780.000037U Trgt gen seq dna 324 genes $3,500.000038U Vitamin d srm microsamp quan $29.600039U Dna antb 2strand hi avidity $13.740040U Bcr/abl1 gene major bp quan $409.900041U B brgdrferi antb 5 prtn igm $17.210042U B brgdrferi antb 12 prtn igg $17.210043U Tbrf b grp antb 4 prtn igm $14.860044U Tbrf b grp antb 4 prtn igg $14.860045U Onc brst dux carc is 12 gene $3,873.000046U Flt3 gene itd variants quan $0.000047U Onc prst8 mrna 17 gene alg $3,873.000048U Onc sld org neo dna 468 gene $2,919.600049U Npm1 gene analysis quan $0.000050U Trgt gen seq dna 194 genes $2,916.600051U Rx mntr lc-ms/ms ur 31 pnl $193.710052U Lpoprtn bld w/5 maj classes $33.860053U Onc prst8 ca fish alys 4 gen $2,030.000054U Rx mntr 14+ drugs & sbsts $148.960055U Card hrt trnspl 96 dna seq $3,240.000056U Hem aml dna gene reargmt $2,515.600058U Onc merkel cll carc srm quan $322.960059U Onc merkel cll carc srm +/- $322.960060U Twn zyg gen seq alys chrms2 $759.050061U Tc meas 5 bmrk sfdi m-s alys $25.100062U Ai sle igg&igm alys 80 bmrk $0.000063U Neuro autism 32 amines alg $0.000064U Antb tp total&rpr ia qual $31.330065U Syfls tst nontreponemal antb $18.090066U Pamg-1 ia cervico-vag fluid $15.290067U Onc brst imhchem prfl 4 bmrk $0.000068U Candida species pnl amp prb $142.630069U Onc clrct microrna mir-31-3p $380.00



0070U Cyp2d6 gen com&slct rar vrnt $676.370071U Cyp2d6 full gene sequence $301.350072U Cyp2d6 gen cyp2d6-2d7 hybrid $450.910073U Cyp2d6 gen cyp2d7-2d6 hybrid $450.910074U Cyp2d6 nonduplicated gene $450.910075U Cyp2d6 5' gene dup/mlt $450.910076U Cyp2d6 3' gene dup/mlt $450.910077U Ig paraprotein qual bld/ur $0.000078U Pain mgt opi use gnotyp pnl $450.910080U Onc lng 5 clin rsk factr alg $3,520.000082U Rx test def 90+ rx/sbsts ur $246.920083U Onc rspse chemo cntrst tomog $0.000084U Rbc dna gnotyp 10 bld groups $720.000086U Nfct ds bact&fng org id 6+ $0.000087U Crd hrt trnspl mrna 1283 gen $0.000088U Trnsplj kdn algrft rej 1494 $0.000089U Onc mlnma prame & linc00518 $760.000090U Onc cutan mlnma mrna 23 gene $1,950.000092U Onc lng 3 prtn bmrk plsm alg $0.000093U Rx mntr 65 com drugs urine $62.140094U Genome rapid sequence alys $0.000095U Inflm ee elisa alys alg $0.000096U Hpv hi risk types male urine $35.090097U Gi pathogen 22 targets $0.000098U Respir pathogen 14 targets $0.000099U Respir pathogen 20 targets $0.000100U Respir pathogen 21 targets $0.000101U Hered colon ca do 15 genes $1,169.800102U Hered brst ca rltd do 17 gen $1,117.980103U Hered ova ca pnl 24 genes $1,117.980105U Neph ckd mult eclia tum nec $950.000106U Gstr emptg 7 timed brth spec $0.000107U C diff tox ag detcj ia stool $16.000108U Gi barrett esoph 9 prtn bmrk $0.000109U Id aspergillus dna 4 species $142.630110U Rx mntr 1+oral onc rx&sbsts $27.11



0111U Onc colon ca kras&nras alys $682.290112U Iadi 16s&18s rrna genes $0.000113U Onc prst8 pca3&tmprss2-erg $760.000114U Gi barretts esoph vim&ccna1 $0.000115U Respir iadna 18 viral&2 bact $0.000116U Rx mntr nzm ia 35+oral flu $246.920117U Pain mgmt 11 endogenous anal $0.000118U Trnsplj don-drv cll-fr dna $0.000119U Crd ceramides liq chrom plsm $0.000120U Onc b cll lymphm mrna 58 gen $2,789.120121U Sc dis vcam-1 whole blood $0.000122U Sc dis p-selectin whl blood $0.000123U Mchnl fragility rbc prflg $0.000124U Ftl cgen abnor 3 analytes $55.540125U Ftl cgen abnor prnt comp 5 $69.520126U Ftl cgen abnor prnt comp 5 y $69.520127U Ob pe 3 analytes $55.540128U Ob pe 3 analytes y chrmsm $55.540129U Hered brst ca rltd do panel $1,117.980130U Hered colon ca do mrna pnl $584.900131U Hered brst ca rltd do pnl 13 $0.000132U Hered ova ca rltd do pnl 17 $0.000133U Hered prst8 ca rltd do 11 $0.000134U Hered pan ca mrna pnl 18 gen $0.000135U Hered gyn ca mrna pnl 12 gen $0.000136U Atm mrna seq alys $0.000137U Palb2 mrna seq alys $0.000138U Brca1 brca2 mrna seq alys $0.000139U Neuro austm meas 6 c metablt $0.000140U Nfct ds fungi dna 15 trgt $0.000141U Nfct ds bact&fng gram pos $0.000142U Nfct ds bact&fng gram neg $0.000143U Drug assay 120+ rx/metablt $0.000144U Drug assay 160+ rx/metablt $0.000145U Drug assay 65+ rx/metablt $0.000146U Drug assay 80+ rx/metablt $0.00



0147U Drug assay 85+ rx/metablt $0.000148U Drug assay 100+ rx/metablt $0.000149U Drug assay 60+ rx/metablt $0.000150U Drug assay 120+ rx/metablt $0.000151U Nfct bct/vir resp nfctj 33 $0.000152U Nfct bct fng prst dna >1000 $0.000153U Onc breast mrna 101 genes $0.000154U Fgfr3 gene analysis $0.000155U Pik3ca gene analysis $0.000156U Copy number sequence alys $0.000157U Apc mrna seq alys $0.000158U Mlh1 mrna seq alys $0.000159U Msh2 mrna seq alys $0.000160U Msh6 mrna seq alys $0.000161U Pms2 mrna seq alys $0.000162U Hered colon ca trgt mrna pnl $0.0036415 Routine venipuncture $3.0078267 Breath tst attain/anal c-14 $11.0678268 Breath test analysis c-14 $94.4180047 Metabolic panel ionized ca $13.7380047 QW Metabolic panel ionized ca $13.7380048 Metabolic panel total ca $8.4680048 QW Metabolic panel total ca $8.4680051 Electrolyte panel $7.0180051 QW Electrolyte panel $7.0180053 Comprehen metabolic panel $10.5680053 QW Comprehen metabolic panel $10.5680055 Obstetric panel $47.8180061 Lipid panel $13.3980061 QW Lipid panel $13.3980069 Renal function panel $8.6880069 QW Renal function panel $8.6880074 Acute hepatitis panel $47.6380076 Hepatic function panel $8.1780081 Obstetric panel $74.8680145 Drug assay adalimumab $38.57



80150 Assay of amikacin $15.0880155 Drug assay caffeine $38.5780156 Assay carbamazepine total $14.5780157 Assay carbamazepine free $13.2580158 Drug assay cyclosporine $18.0580159 Drug assay clozapine $20.1580162 Assay of digoxin total $13.2880163 Assay of digoxin free $13.2880164 Assay dipropylacetic acd tot $13.5480165 Dipropylacetic acid free $13.5480168 Assay of ethosuximide $16.3480169 Drug assay everolimus $13.7380170 Assay of gentamicin $16.3880171 Drug screen quant gabapentin $21.6780173 Assay of haloperidol $15.7880175 Drug screen quan lamotrigine $13.2580176 Assay of lidocaine $14.6980177 Drug scrn quan levetiracetam $13.2580178 Assay of lithium $6.6180178 QW Assay of lithium $6.6180180 Drug scrn quan mycophenolate $18.0580183 Drug scrn quant oxcarbazepin $13.2580184 Assay of phenobarbital $15.3080185 Assay of phenytoin total $13.2580186 Assay of phenytoin free $13.7680187 Drug assay posaconazole $27.1180188 Assay of primidone $16.5980190 Assay of procainamide $60.0080192 Assay of procainamide $16.7580194 Assay of quinidine $14.6080195 Assay of sirolimus $13.7380197 Assay of tacrolimus $13.7380198 Assay of theophylline $14.1480199 Drug screen quant tiagabine $27.1180200 Assay of tobramycin $16.1380201 Assay of topiramate $11.92



80202 Assay of vancomycin $13.5480203 Drug screen quant zonisamide $13.2580230 Drug assay infliximab $38.5780235 Drug assay lacosamide $27.1180280 Drug assay vedolizumab $38.5780285 Drug assay voriconazole $27.1180299 Quantitative assay drug $18.6480305 Drug test prsmv dir opt obs $12.6080305 QW Drug test prsmv dir opt obs $12.6080306 Drug test prsmv instrmnt $17.1480307 Drug test prsmv chem anlyzr $62.1480400 Acth stimulation panel $32.6280402 Acth stimulation panel $86.9680406 Acth stimulation panel $78.2680408 Aldosterone suppression eval $125.5080410 Calcitonin stimul panel $80.3780412 Crh stimulation panel $801.6280414 Testosterone response $51.6480415 Estradiol response panel $55.8980416 Renin stimulation panel $209.3280417 Renin stimulation panel $43.9980418 Pituitary evaluation panel $579.4880420 Dexamethasone panel $161.8880422 Glucagon tolerance panel $46.0780424 Glucagon tolerance panel $50.5080426 Gonadotropin hormone panel $148.4180428 Growth hormone panel $66.7080430 Growth hormone panel $129.3380432 Insulin suppression panel $165.6180434 Insulin tolerance panel $285.0380435 Insulin tolerance panel $103.0080436 Metyrapone panel $91.1680438 Trh stimulation panel $50.4180439 Trh stimulation panel $67.2181000 Urinalysis nonauto w/scope $4.0281001 Urinalysis auto w/scope $3.17



81002 Urinalysis nonauto w/o scope $3.4881003 Urinalysis auto w/o scope $2.2581003 QW Urinalysis auto w/o scope $2.2581005 Urinalysis $2.1781007 Urine screen for bacteria $29.9881007 QW Urine screen for bacteria $29.9881015 Microscopic exam of urine $3.0581020 Urinalysis glass test $4.7081025 Urine pregnancy test $8.6181050 Urinalysis volume measure $3.6481105 Hpa-1 genotyping $122.2281106 Hpa-2 genotyping $122.2281107 Hpa-3 genotyping $122.2281108 Hpa-4 genotyping $122.2281109 Hpa-5 genotyping $122.2281110 Hpa-6 genotyping $122.2281111 Hpa-9 genotyping $122.2281112 Hpa-15 genotyping $122.2281120 Idh1 common variants $193.2581121 Idh2 common variants $295.7981161 Dmd dup/delet analysis $279.0081162 Brca1&2 gen full seq dup/del $1,824.8881163 Brca1&2 gene full seq alys $936.0081164 Brca1&2 gen ful dup/del alys $584.2381165 Brca1 gene full seq alys $565.7681166 Brca1 gene full dup/del alys $301.3581167 Brca2 gene full dup/del alys $282.8881170 Abl1 gene $300.0081171 Aff2 gene detc abnor alleles $137.0081172 Aff2 gene charac alleles $274.8381173 Ar gene full gene sequence $301.3581174 Ar gene known famil variant $185.2081175 Asxl1 full gene sequence $676.5081176 Asxl1 gene target seq alys $241.9081177 Atn1 gene detc abnor alleles $137.0081178 Atxn1 gene detc abnor allele $137.00



81179 Atxn2 gene detc abnor allele $137.0081180 Atxn3 gene detc abnor allele $137.0081181 Atxn7 gene detc abnor allele $137.0081182 Atxn8os gen detc abnor allel $137.0081183 Atxn10 gene detc abnor allel $137.0081184 Cacna1a gen detc abnor allel $137.0081185 Cacna1a gene full gene seq $846.2781186 Cacna1a gen known famil vrnt $185.2081187 Cnbp gene detc abnor allele $137.0081188 Cstb gene detc abnor allele $137.0081189 Cstb gene full gene sequence $274.8381190 Cstb gene known famil vrnt $185.2081200 Aspa gene $47.2581201 Apc gene full sequence $780.0081202 Apc gene known fam variants $280.0081203 Apc gene dup/delet variants $200.0081204 Ar gene charac alleles $137.0081205 Bckdhb gene $94.9981206 Bcr/abl1 gene major bp $163.9681207 Bcr/abl1 gene minor bp $144.8481208 Bcr/abl1 gene other bp $214.6281209 Blm gene $39.3181210 Braf gene $175.4081212 Brca1&2 185&5385&6174 vrnt $440.0081215 Brca1 gene known famil vrnt $375.2581216 Brca2 gene full seq alys $185.1281217 Brca2 gene known famil vrnt $375.2581218 Cebpa gene full sequence $241.9081219 Calr gene com variants $121.6381220 Cftr gene com variants $556.6081221 Cftr gene known fam variants $97.2281222 Cftr gene dup/delet variants $435.0781223 Cftr gene full sequence $499.0081224 Cftr gene intron poly t $168.7581225 Cyp2c19 gene com variants $291.3681226 Cyp2d6 gene com variants $450.91



81227 Cyp2c9 gene com variants $174.8181228 Cytogen micrarray copy nmbr $900.0081229 Cytogen m array copy no&snp $1,160.0081230 Cyp3a4 gene common variants $174.8181231 Cyp3a5 gene common variants $174.8181232 Dpyd gene common variants $174.8181233 Btk gene common variants $175.4081234 Dmpk gene detc abnor allele $137.0081235 Egfr gene com variants $324.5881236 Ezh2 gene full gene sequence $282.8881237 Ezh2 gene common variants $175.4081238 F9 full gene sequence $600.0081239 Dmpk gene charac alleles $274.8381240 F2 gene $65.6981241 F5 gene $73.3781242 Fancc gene $36.6281243 Fmr1 gene detection $57.0481244 Fmr1 gene charac alleles $44.8981245 Flt3 gene $165.5181246 Flt3 gene analysis $83.0081247 G6pd gene alys cmn variant $174.8181248 G6pd known familial variant $375.2581249 G6pd full gene sequence $600.0081250 G6pc gene $58.4981251 Gba gene $47.2581252 Gjb2 gene full sequence $101.1281253 Gjb2 gene known fam variants $61.5281254 Gjb6 gene com variants $35.0081255 Hexa gene $51.4581256 Hfe gene $65.3681257 Hba1/hba2 gene $102.2681258 Hba1/hba2 gene fam vrnt $375.2581259 Hba1/hba2 full gene sequence $600.0081260 Ikbkap gene $39.3181261 Igh gene rearrange amp meth $197.9981262 Igh gene rearrang dir probe $68.55



81263 Igh vari regional mutation $294.5281264 Igk rearrangeabn clonal pop $172.7381265 Str markers specimen anal $233.0781266 Str markers spec anal addl $304.8181267 Chimerism anal no cell selec $207.4681268 Chimerism anal w/cell select $260.7981269 Hba1/hba2 gene dup/del vrnts $202.4081270 Jak2 gene $91.6681271 Htt gene detc abnor alleles $137.0081272 Kit gene targeted seq analys $329.5181273 Kit gene analys d816 variant $124.8781274 Htt gene charac alleles $274.8381275 Kras gene variants exon 2 $193.2581276 Kras gene addl variants $193.2581277 Cytogenomic neo microra alys $1,160.0081283 Ifnl3 gene $73.3781284 Fxn gene detc abnor alleles $137.0081285 Fxn gene charac alleles $274.8381286 Fxn gene full gene sequence $274.8381287 Mgmt gene prmtr mthyltn alys $124.6481288 Mlh1 gene $192.3281289 Fxn gene known famil variant $185.2081290 Mcoln1 gene $39.3181291 Mthfr gene $65.3481292 Mlh1 gene full seq $675.4081293 Mlh1 gene known variants $331.0081294 Mlh1 gene dup/delete variant $202.4081295 Msh2 gene full seq $381.7081296 Msh2 gene known variants $337.7381297 Msh2 gene dup/delete variant $213.3081298 Msh6 gene full seq $641.8581299 Msh6 gene known variants $308.0081300 Msh6 gene dup/delete variant $238.0081301 Microsatellite instability $348.5681302 Mecp2 gene full seq $527.8781303 Mecp2 gene known variant $120.00



81304 Mecp2 gene dup/delet variant $150.0081305 Myd88 gene p.leu265pro vrnt $175.4081306 Nudt15 gene common variants $291.3681307 Palb2 gene full gene seq $282.8881308 Palb2 gene known famil vrnt $301.3581309 Pik3ca gene trgt seq alys $274.8381310 Npm1 gene $246.5281311 Nras gene variants exon 2&3 $295.7981312 Pabpn1 gene detc abnor allel $137.0081313 Pca3/klk3 antigen $255.0581314 Pdgfra gene $329.5181315 Pml/raralpha com breakpoints $207.3181316 Pml/raralpha 1 breakpoint $207.3181317 Pms2 gene full seq analysis $676.5081318 Pms2 known familial variants $331.0081319 Pms2 gene dup/delet variants $203.5081320 Plcg2 gene common variants $291.3681321 Pten gene full sequence $600.0081322 Pten gene known fam variant $46.6081323 Pten gene dup/delet variant $300.0081324 Pmp22 gene dup/delet $758.3681325 Pmp22 gene full sequence $769.5881326 Pmp22 gene known fam variant $46.6081327 Sept9 gen prmtr mthyltn alys $192.0081328 Slco1b1 gene com variants $174.8181329 Smn1 gene dos/deletion alys $137.0081330 Smpd1 gene common variants $47.0081331 Snrpn/ube3a gene $51.0781332 Serpina1 gene $43.6581333 Tgfbi gene common variants $137.0081334 Runx1 gene targeted seq alys $329.5181335 Tpmt gene com variants $174.8181336 Smn1 gene full gene sequence $301.3581337 Smn1 gen nown famil seq vrnt $185.2081340 Trb@ gene rearrange amplify $208.9281341 Trb@ gene rearrange dirprobe $49.59



81342 Trg gene rearrangement anal $201.5081343 Ppp2r2b gen detc abnor allel $137.0081344 Tbp gene detc abnor alleles $137.0081345 Tert gene targeted seq alys $185.2081346 Tyms gene com variants $174.8181350 Ugt1a1 gene common variants $234.0081355 Vkorc1 gene $88.2081361 Hbb gene com variants $174.8181362 Hbb gene known fam variant $375.2581363 Hbb gene dup/del variants $202.4081364 Hbb full gene sequence $324.5881370 Hla i & ii typing lr $402.1281371 Hla i & ii type verify lr $404.5281372 Hla i typing complete lr $403.5981373 Hla i typing 1 locus lr $127.4381374 Hla i typing 1 antigen lr $74.3381375 Hla ii typing ag equiv lr $220.7481376 Hla ii typing 1 locus lr $122.2281377 Hla ii type 1 ag equiv lr $94.7481378 Hla i & ii typing hr $345.5781379 Hla i typing complete hr $335.3881380 Hla i typing 1 locus hr $177.2581381 Hla i typing 1 allele hr $169.9081382 Hla ii typing 1 loc hr $123.6881383 Hla ii typing 1 allele hr $109.1381400 Mopath procedure level 1 $63.9681401 Mopath procedure level 2 $137.0081402 Mopath procedure level 3 $150.3381403 Mopath procedure level 4 $185.2081404 Mopath procedure level 5 $274.8381405 Mopath procedure level 6 $301.3581406 Mopath procedure level 7 $282.8881407 Mopath procedure level 8 $846.2781408 Mopath procedure level 9 $2,000.0081410 Aortic dysfunction/dilation $504.0081411 Aortic dysfunction/dilation $1,350.19



81412 Ashkenazi jewish assoc dis $2,448.5681413 Car ion chnnlpath inc 10 gns $584.9081414 Car ion chnnlpath inc 2 gns $584.9081415 Exome sequence analysis $4,780.0081416 Exome sequence analysis $12,000.0081417 Exome re-evaluation $320.0081420 Fetal chrmoml aneuploidy $759.0581422 Fetal chrmoml microdeltj $759.0581425 Genome sequence analysis $5,031.2081426 Genome sequence analysis $2,709.9581427 Genome re-evaluation $2,337.6581430 Hearing loss sequence analys $1,625.0081431 Hearing loss dup/del analys $679.5781432 Hrdtry brst ca-rlatd dsordrs $679.0581433 Hrdtry brst ca-rlatd dsordrs $438.9381434 Hereditary retinal disorders $597.9181435 Hereditary colon ca dsordrs $584.9081436 Hereditary colon ca dsordrs $584.9081437 Heredtry nurondcrn tum dsrdr $438.9381438 Heredtry nurondcrn tum dsrdr $438.9381439 Hrdtry cardmypy gene panel $584.9081440 Mitochondrial gene $3,324.0081442 Noonan spectrum disorders $2,143.6081443 Genetic tstg severe inh cond $2,448.5681445 Targeted genomic seq analys $597.9181448 Hrdtry perph neurphy panel $584.9081450 Targeted genomic seq analys $759.5381455 Targeted genomic seq analys $2,919.6081460 Whole mitochondrial genome $1,287.0081465 Whole mitochondrial genome $936.0081470 X-linked intellectual dblt $914.0081471 X-linked intellectual dblt $914.0081490 Autoimmune rheumatoid arthr $840.6581493 Cor artery disease mrna $1,050.0081500 Onco (ovar) two proteins $260.5081503 Onco (ovar) five proteins $897.00



81504 Oncology tissue of origin $520.0081506 Endo assay seven anal $68.9281507 Fetal aneuploidy trisom risk $795.0081508 Ftl cgen abnor two proteins $54.3081509 Ftl cgen abnor 3 proteins $1,487.3781510 Ftl cgen abnor three anal $55.5481511 Ftl cgen abnor four anal $153.5081512 Ftl cgen abnor five anal $69.5281518 Onc brst mrna 11 genes $3,873.0081519 Oncology breast mrna $3,873.0081520 Onc breast mrna 58 genes $2,510.2181521 Onc breast mrna 70 genes $3,873.0081522 Onc breast mrna 12 genes $3,873.0081525 Oncology colon mrna $3,116.0081528 Oncology colorectal scr $508.8781535 Oncology gynecologic $579.4681536 Oncology gynecologic $177.5681538 Oncology lung $2,871.0081539 Oncology prostate prob score $760.0081540 Oncology tum unknown origin $3,750.0081541 Onc prostate mrna 46 genes $3,873.0081542 Onc prostate mrna 22 cnt gen $0.0081545 Oncology thyroid $3,600.0081551 Onc prostate 3 genes $2,030.0081595 Cardiology hrt trnspl mrna $3,240.0081596 Nfct ds chrnc hcv 6 assays $72.1982009 Test for acetone/ketones $4.5282010 Acetone assay $8.1782010 QW Acetone assay $8.1782013 Acetylcholinesterase assay $12.2982016 Acylcarnitines qual $16.4982017 Acylcarnitines quant $16.8782024 Assay of acth $38.6282030 Assay of adp & amp $25.8082040 Assay of serum albumin $4.9582040 QW Assay of serum albumin $4.95



82042 Other source albumin quan ea $7.7882042 QW Other source albumin quan ea $7.7882043 Ur albumin quantitative $5.7882043 QW Ur albumin quantitative $5.7882044 Ur albumin semiquantitative $6.2382044 QW Ur albumin semiquantitative $6.2382045 Albumin ischemia modified $33.9482075 Assay of breath ethanol $30.0082085 Assay of aldolase $9.7182088 Assay of aldosterone $40.7582103 Alpha-1-antitrypsin total $13.4482104 Alpha-1-antitrypsin pheno $14.4682105 Alpha-fetoprotein serum $16.7782106 Alpha-fetoprotein amniotic $17.0082107 Alpha-fetoprotein l3 $64.4182108 Assay of aluminum $25.4882120 Amines vaginal fluid qual $5.9982120 QW Amines vaginal fluid qual $5.9982127 Amino acid single qual $14.1882128 Amino acids mult qual $13.8782131 Amino acids single quant $22.9882135 Assay aminolevulinic acid $16.4582136 Amino acids quant 2-5 $19.6182139 Amino acids quan 6 or more $16.8782140 Assay of ammonia $14.5782143 Amniotic fluid scan $9.3582150 Assay of amylase $6.4882150 QW Assay of amylase $6.4882154 Androstanediol glucuronide $28.8382157 Assay of androstenedione $29.2882160 Assay of androsterone $25.5582163 Assay of angiotensin ii $20.5282164 Angiotensin i enzyme test $14.6082172 Assay of apolipoprotein $21.0982175 Assay of arsenic $18.9782180 Assay of ascorbic acid $9.89



82190 Atomic absorption $15.9082232 Assay of beta-2 protein $16.1882239 Bile acids total $17.1282240 Bile acids cholylglycine $26.5882247 Bilirubin total $5.0282247 QW Bilirubin total $5.0282248 Bilirubin direct $5.0282252 Fecal bilirubin test $4.5682261 Assay of biotinidase $16.8782270 Occult blood feces $4.3882271 Occult blood other sources $5.3282271 QW Occult blood other sources $5.3282272 Occult bld feces 1-3 tests $4.2382274 Assay test for blood fecal $15.9282274 QW Assay test for blood fecal $15.9282286 Assay of bradykinin $5.1682300 Assay of cadmium $23.6482306 Vitamin d 25 hydroxy $29.6082308 Assay of calcitonin $26.7982310 Assay of calcium $5.1682310 QW Assay of calcium $5.1682330 Assay of calcium $13.6882330 QW Assay of calcium $13.6882331 Calcium infusion test $13.3482340 Assay of calcium in urine $6.0382355 Calculus analysis qual $11.5882360 Calculus assay quant $12.8782365 Calculus spectroscopy $12.9082370 X-ray assay calculus $12.5282373 Assay c-d transfer measure $18.0682374 Assay blood carbon dioxide $4.8882374 QW Assay blood carbon dioxide $4.8882375 Assay carboxyhb quant $12.3282376 Assay carboxyhb qual $14.0782378 Carcinoembryonic antigen $18.9682379 Assay of carnitine $16.87



82380 Assay of carotene $9.2282382 Assay urine catecholamines $27.3082383 Assay blood catecholamines $29.0882384 Assay three catecholamines $25.2582387 Assay of cathepsin-d $18.0682390 Assay of ceruloplasmin $10.7482397 Chemiluminescent assay $14.1282415 Assay of chloramphenicol $12.6782435 Assay of blood chloride $4.6082435 QW Assay of blood chloride $4.6082436 Assay of urine chloride $5.7582438 Assay other fluid chlorides $5.0082441 Test for chlorohydrocarbons $6.0182465 Assay bld/serum cholesterol $4.3582465 QW Assay bld/serum cholesterol $4.3582480 Assay serum cholinesterase $7.8782482 Assay rbc cholinesterase $9.8182485 Assay chondroitin sulfate $20.6582495 Assay of chromium $20.2882507 Assay of citrate $27.8082523 Collagen crosslinks $18.6882523 QW Collagen crosslinks $18.6882525 Assay of copper $12.4182528 Assay of corticosterone $22.5282530 Cortisol free $16.7182533 Total cortisol $16.3082540 Assay of creatine $4.6482542 Col chromotography qual/quan $24.0982550 Assay of ck (cpk) $6.5182550 QW Assay of ck (cpk) $6.5182552 Assay of cpk in blood $13.3982553 Creatine mb fraction $11.5582554 Creatine isoforms $11.8782565 Assay of creatinine $5.1282565 QW Assay of creatinine $5.1282570 Assay of urine creatinine $5.18



82570 QW Assay of urine creatinine $5.1882575 Creatinine clearance test $9.4682585 Assay of cryofibrinogen $14.1482595 Assay of cryoglobulin $6.4782600 Assay of cyanide $19.4082607 Vitamin b-12 $15.0882608 B-12 binding capacity $14.3282610 Cystatin c $18.5282615 Test for urine cystines $9.5582626 Dehydroepiandrosterone $25.2782627 Dehydroepiandrosterone $22.2382633 Desoxycorticosterone $30.9882634 Deoxycortisol $29.2882638 Assay of dibucaine number $12.2582642 Dihydrotestosterone $29.2882652 Vit d 1 25-dihydroxy $38.5082656 Pancreatic elastase fecal $11.5382657 Enzyme cell activity $22.1782658 Enzyme cell activity ra $44.0382664 Electrophoretic test $61.5082668 Assay of erythropoietin $18.7982670 Assay of estradiol $27.9482671 Assay of estrogens $32.3082672 Assay of estrogen $21.7082677 Assay of estriol $24.1882679 Assay of estrone $24.9582679 QW Assay of estrone $24.9582693 Assay of ethylene glycol $14.9082696 Assay of etiocholanolone $26.2482705 Fats/lipids feces qual $5.1082710 Fats/lipids feces quant $16.8082715 Assay of fecal fat $22.9782725 Assay of blood fatty acids $18.7782726 Long chain fatty acids $19.7582728 Assay of ferritin $13.6382731 Assay of fetal fibronectin $64.41



82735 Assay of fluoride $18.5482746 Assay of folic acid serum $14.7082747 Assay of folic acid rbc $17.6582757 Assay of semen fructose $17.3482759 Assay of rbc galactokinase $21.4882760 Assay of galactose $11.2082775 Assay galactose transferase $21.0782776 Galactose transferase test $11.7482777 Galectin-3 $44.2582784 Assay iga/igd/igg/igm each $9.3082785 Assay of ige $16.4682787 Igg 1 2 3 or 4 each $8.0282800 Blood ph $11.0082803 Blood gases any combination $26.0782805 Blood gases w/o2 saturation $78.7782810 Blood gases o2 sat only $9.7782820 Hemoglobin-oxygen affinity $13.3482930 Gastric analy w/ph ea spec $6.7182938 Gastrin test $17.6982941 Assay of gastrin $17.6382943 Assay of glucagon $14.2982945 Glucose other fluid $3.9382946 Glucagon tolerance test $17.7782947 Assay glucose blood quant $3.9382947 QW Assay glucose blood quant $3.9382948 Reagent strip/blood glucose $5.0482950 Glucose test $4.7582950 QW Glucose test $4.7582951 Glucose tolerance test (gtt) $12.8782951 QW Glucose tolerance test (gtt) $12.8782952 Gtt-added samples $3.9282952 QW Gtt-added samples $3.9282955 Assay of g6pd enzyme $9.7082960 Test for g6pd enzyme $6.0582962 Glucose blood test $3.2882963 Assay of glucosidase $21.48



82965 Assay of gdh enzyme $13.1582977 Assay of ggt $7.2082977 QW Assay of ggt $7.2082978 Assay of glutathione $15.4582979 Assay rbc glutathione $9.4482985 Assay of glycated protein $16.7682985 QW Assay of glycated protein $16.7683001 Assay of gonadotropin (fsh) $18.5883001 QW Assay of gonadotropin (fsh) $18.5883002 Assay of gonadotropin (lh) $18.5283002 QW Assay of gonadotropin (lh) $18.5283003 Assay growth hormone (hgh) $16.6783006 Growth stimulation gene 2 $75.6083009 H pylori (c-13) blood $67.3683010 Assay of haptoglobin quant $12.5883012 Assay of haptoglobins $26.8983013 H pylori (c-13) breath $67.3683014 H pylori drug admin $7.8683015 Heavy metal qual any anal $20.9483018 Heavy metal quant each nes $21.9683020 Hemoglobin electrophoresis $12.8783021 Hemoglobin chromotography $18.0683026 Hemoglobin copper sulfate $4.0183030 Fetal hemoglobin chemical $10.7483033 Fetal hemoglobin assay qual $8.0083036 Glycosylated hemoglobin test $9.7183036 QW Glycosylated hemoglobin test $9.7183037 Glycosylated hb home device $9.7183037 QW Glycosylated hb home device $9.7183045 Blood methemoglobin test $6.4983050 Blood methemoglobin assay $8.2083051 Assay of plasma hemoglobin $7.3183060 Blood sulfhemoglobin assay $8.8083065 Assay of hemoglobin heat $9.0083068 Hemoglobin stability screen $9.4783069 Assay of urine hemoglobin $3.95



83070 Assay of hemosiderin qual $4.7583080 Assay of b hexosaminidase $16.8783088 Assay of histamine $29.5383090 Assay of homocystine $17.9283150 Assay of homovanillic acid $22.4183491 Assay of corticosteroids 17 $17.9083497 Assay of 5-hiaa $12.9083498 Assay of progesterone 17-d $27.1783500 Assay free hydroxyproline $22.6583505 Assay total hydroxyproline $24.3083516 Immunoassay nonantibody $11.5383516 QW Immunoassay nonantibody $11.5383518 Immunoassay dipstick $9.6483518 QW Immunoassay dipstick $9.6483519 Ria nonantibody $18.4083520 Immunoassay quant nos nonab $17.2783520 QW Immunoassay quant nos nonab $17.2783525 Assay of insulin $11.4383527 Assay of insulin $12.9583528 Assay of intrinsic factor $19.8283540 Assay of iron $6.4783550 Iron binding test $8.7483570 Assay of idh enzyme $8.8583582 Assay of ketogenic steroids $15.4783586 Assay 17- ketosteroids $12.8083593 Fractionation ketosteroids $28.5083605 Assay of lactic acid $11.5783605 QW Assay of lactic acid $11.5783615 Lactate (ld) (ldh) enzyme $6.0483625 Assay of ldh enzymes $12.7983630 Lactoferrin fecal (qual) $19.7083631 Lactoferrin fecal (quant) $19.6383632 Placental lactogen $20.2283633 Test urine for lactose $11.2583655 Assay of lead $12.1183655 QW Assay of lead $12.11



83661 L/s ratio fetal lung $21.9983662 Foam stability fetal lung $18.9183663 Fluoro polarize fetal lung $18.9183664 Lamellar bdy fetal lung $19.3283670 Assay of lap enzyme $9.8183690 Assay of lipase $6.8983695 Assay of lipoprotein(a) $14.3283698 Assay lipoprotein pla2 $46.3183700 Lipopro bld electrophoretic $11.2683701 Lipoprotein bld hr fraction $33.8683704 Lipoprotein bld quan part $34.1983718 Assay of lipoprotein $8.1983718 QW Assay of lipoprotein $8.1983719 Assay of blood lipoprotein $12.7583721 Assay of blood lipoprotein $10.5083721 QW Assay of blood lipoprotein $10.5083722 Lipoprtn dir meas sd ldl chl $34.1983727 Assay of lrh hormone $17.1983735 Assay of magnesium $6.7083775 Assay malate dehydrogenase $7.3783785 Assay of manganese $26.6583789 Mass spectrometry qual/quan $24.1183825 Assay of mercury $16.2683835 Assay of metanephrines $16.9483857 Assay of methemalbumin $10.7483861 Microfluid analy tears $22.4883861 QW Microfluid analy tears $22.4883864 Mucopolysaccharides $28.5083872 Assay synovial fluid mucin $5.8683873 Assay of csf protein $17.2083874 Assay of myoglobin $12.9283876 Assay myeloperoxidase $50.8683880 Assay of natriuretic peptide $39.2683880 QW Assay of natriuretic peptide $39.2683883 Assay nephelometry not spec $13.6083885 Assay of nickel $24.51



83915 Assay of nucleotidase $11.1583916 Oligoclonal bands $27.3983918 Organic acids total quant $23.6083919 Organic acids qual each $16.4583921 Organic acid single quant $21.2183930 Assay of blood osmolality $6.6183935 Assay of urine osmolality $6.8283937 Assay of osteocalcin $29.8583945 Assay of oxalate $14.4583950 Oncoprotein her-2/neu $64.4183951 Oncoprotein dcp $64.4183970 Assay of parathormone $41.2883986 Assay ph body fluid nos $3.5883986 QW Assay ph body fluid nos $3.5883987 Exhaled breath condensate $3.5883993 Assay for calprotectin fecal $19.6384030 Assay of blood pku $5.5084035 Assay of phenylketones $3.9884060 Assay acid phosphatase $7.6484066 Assay prostate phosphatase $9.6684075 Assay alkaline phosphatase $5.1884075 QW Assay alkaline phosphatase $5.1884078 Assay alkaline phosphatase $8.2684080 Assay alkaline phosphatases $14.7884081 Assay phosphatidylglycerol $16.5284085 Assay of rbc pg6d enzyme $9.4484087 Assay phosphohexose enzymes $10.7384100 Assay of phosphorus $4.7484105 Assay of urine phosphorus $5.7884106 Test for porphobilinogen $5.8284110 Assay of porphobilinogen $8.4484112 Eval amniotic fluid protein $98.1184119 Test urine for porphyrins $13.3684120 Assay of urine porphyrins $14.7184126 Assay of feces porphyrins $39.1184132 Assay of serum potassium $4.76



84132 QW Assay of serum potassium $4.7684133 Assay of urine potassium $4.7384134 Assay of prealbumin $14.5984135 Assay of pregnanediol $21.2784138 Assay of pregnanetriol $21.0584140 Assay of pregnenolone $20.6784143 Assay of 17-hydroxypregneno $22.8184144 Assay of progesterone $20.8684145 Procalcitonin (pct) $27.2284146 Assay of prolactin $19.3884150 Assay of prostaglandin $41.7784152 Assay of psa complexed $18.3984153 Assay of psa total $18.3984154 Assay of psa free $18.3984155 Assay of protein serum $3.6784155 QW Assay of protein serum $3.6784156 Assay of protein urine $3.6784157 Assay of protein other $4.0084157 QW Assay of protein other $4.0084160 Assay of protein any source $5.6184163 Pappa serum $15.0584165 Protein e-phoresis serum $10.7484166 Protein e-phoresis/urine/csf $17.8384181 Western blot test $17.0384182 Protein western blot test $29.2184202 Assay rbc protoporphyrin $14.3584203 Test rbc protoporphyrin $9.7484206 Assay of proinsulin $26.6984207 Assay of vitamin b-6 $28.1084210 Assay of pyruvate $14.4884220 Assay of pyruvate kinase $9.4484228 Assay of quinine $11.6384233 Assay of estrogen $87.8884234 Assay of progesterone $64.8884235 Assay of endocrine hormone $71.2384238 Assay nonendocrine receptor $36.57



84244 Assay of renin $21.9984252 Assay of vitamin b-2 $20.2484255 Assay of selenium $25.5384260 Assay of serotonin $30.9884270 Assay of sex hormone globul $21.7384275 Assay of sialic acid $13.4484285 Assay of silica $25.2184295 Assay of serum sodium $4.8184295 QW Assay of serum sodium $4.8184300 Assay of urine sodium $5.0684302 Assay of sweat sodium $4.8684305 Assay of somatomedin $21.2684307 Assay of somatostatin $18.2884311 Spectrophotometry $8.1084315 Body fluid specific gravity $3.2884375 Chromatogram assay sugars $39.0084376 Sugars single qual $5.5084377 Sugars multiple qual $5.5084378 Sugars single quant $11.5384379 Sugars multiple quant $11.5384392 Assay of urine sulfate $5.4984402 Assay of free testosterone $25.4784403 Assay of total testosterone $25.8184410 Testosterone bioavailable $51.2884425 Assay of vitamin b-1 $21.2384430 Assay of thiocyanate $11.6384431 Thromboxane urine $35.1184432 Assay of thyroglobulin $16.0684436 Assay of total thyroxine $6.8784437 Assay of neonatal thyroxine $6.4784439 Assay of free thyroxine $9.0284442 Assay of thyroid activity $14.7884443 Assay thyroid stim hormone $16.8084443 QW Assay thyroid stim hormone $16.8084445 Assay of tsi globulin $50.8684446 Assay of vitamin e $14.18



84449 Assay of transcortin $18.0084450 Transferase (ast) (sgot) $5.1884450 QW Transferase (ast) (sgot) $5.1884460 Alanine amino (alt) (sgpt) $5.3084460 QW Alanine amino (alt) (sgpt) $5.3084466 Assay of transferrin $12.7684478 Assay of triglycerides $5.7484478 QW Assay of triglycerides $5.7484479 Assay of thyroid (t3 or t4) $6.4784480 Assay triiodothyronine (t3) $14.1884481 Free assay (ft-3) $16.9484482 T3 reverse $15.7684484 Assay of troponin quant $12.4784485 Assay duodenal fluid trypsin $7.2084488 Test feces for trypsin $7.3084490 Assay of feces for trypsin $9.9384510 Assay of tyrosine $10.6384512 Assay of troponin qual $10.0984520 Assay of urea nitrogen $3.9584520 QW Assay of urea nitrogen $3.9584525 Urea nitrogen semi-quant $5.1384540 Assay of urine/urea-n $5.5684545 Urea-n clearance test $7.2084550 Assay of blood/uric acid $4.5284550 QW Assay of blood/uric acid $4.5284560 Assay of urine/uric acid $5.0884577 Assay of feces/urobilinogen $16.8084578 Test urine urobilinogen $4.4784580 Assay of urine urobilinogen $9.5584583 Assay of urine urobilinogen $6.0584585 Assay of urine vma $15.5084586 Assay of vip $35.3384588 Assay of vasopressin $33.9484590 Assay of vitamin a $11.6184591 Assay of nos vitamin $17.0684597 Assay of vitamin k $13.72



84600 Assay of volatiles $17.1184620 Xylose tolerance test $12.9184630 Assay of zinc $11.3984681 Assay of c-peptide $20.8184702 Chorionic gonadotropin test $15.0584703 Chorionic gonadotropin assay $7.5284703 QW Chorionic gonadotropin assay $7.5284704 Hcg free betachain test $15.2984830 Ovulation tests $12.7085002 Bleeding time test $4.8285004 Automated diff wbc count $6.4785007 Bl smear w/diff wbc count $3.8085008 Bl smear w/o diff wbc count $3.4385009 Manual diff wbc count b-coat $5.0785013 Spun microhematocrit $7.0085014 Hematocrit $2.3785014 QW Hematocrit $2.3785018 Hemoglobin $2.3785018 QW Hemoglobin $2.3785025 Complete cbc w/auto diff wbc $7.7785025 QW Complete cbc w/auto diff wbc $7.7785027 Complete cbc automated $6.4785032 Manual cell count each $4.3185041 Automated rbc count $3.0285044 Manual reticulocyte count $4.3185045 Automated reticulocyte count $3.9985046 Reticyte/hgb concentrate $5.5785048 Automated leukocyte count $2.5485049 Automated platelet count $4.4885055 Reticulated platelet assay $35.7485130 Chromogenic substrate assay $11.8985170 Blood clot retraction $16.3085175 Blood clot lysis time $20.3785210 Clot factor ii prothrom spec $12.9885220 Blooc clot factor v test $17.6585230 Clot factor vii proconvertin $17.90



85240 Clot factor viii ahg 1 stage $17.9085244 Clot factor viii reltd antgn $20.4285245 Clot factor viii vw ristoctn $22.9485246 Clot factor viii vw antigen $22.9485247 Clot factor viii multimetric $22.9485250 Clot factor ix ptc/chrstmas $19.0485260 Clot factor x stuart-power $17.9085270 Clot factor xi pta $17.9085280 Clot factor xii hageman $19.3585290 Clot factor xiii fibrin stab $16.3485291 Clot factor xiii fibrin scrn $9.1185292 Clot factor fletcher fact $18.9385293 Clot factor wght kininogen $18.9385300 Antithrombin iii activity $11.8585301 Antithrombin iii antigen $10.8185302 Clot inhibit prot c antigen $12.0185303 Clot inhibit prot c activity $13.8485305 Clot inhibit prot s total $11.6185306 Clot inhibit prot s free $15.3285307 Assay activated protein c $15.3285335 Factor inhibitor test $12.8785337 Thrombomodulin $17.2785345 Coagulation time lee & white $4.6985347 Coagulation time activated $4.2885348 Coagulation time otr method $4.4985360 Euglobulin lysis $8.4185362 Fibrin degradation products $6.8985366 Fibrinogen test $80.4685370 Fibrinogen test $12.4385378 Fibrin degrade semiquant $9.7285379 Fibrin degradation quant $10.1885380 Fibrin degradj d-dimer $10.1885384 Fibrinogen activity $9.7285385 Fibrinogen antigen $14.4685390 Fibrinolysins screen i&r $15.4885397 Clotting funct activity $30.86



85400 Fibrinolytic plasmin $7.7185410 Fibrinolytic antiplasmin $7.7185415 Fibrinolytic plasminogen $17.1985420 Fibrinolytic plasminogen $6.5385421 Fibrinolytic plasminogen $10.1885441 Heinz bodies direct $4.2085445 Heinz bodies induced $6.8285460 Hemoglobin fetal $7.7385461 Hemoglobin fetal $9.3685475 Hemolysin acid $8.8785520 Heparin assay $13.0985525 Heparin neutralization $11.8485530 Heparin-protamine tolerance $13.0985536 Iron stain peripheral blood $6.8885540 Wbc alkaline phosphatase $8.6085547 Rbc mechanical fragility $8.6085549 Muramidase $18.7585555 Rbc osmotic fragility $7.4785557 Rbc osmotic fragility $13.3685576 Blood platelet aggregation $24.9185576 QW Blood platelet aggregation $24.9185597 Phospholipid pltlt neutraliz $17.9885598 Hexagnal phosph pltlt neutrl $17.9885610 Prothrombin time $4.2985610 QW Prothrombin time $4.2985611 Prothrombin test $3.9485612 Viper venom prothrombin time $17.4985613 Russell viper venom diluted $9.5885635 Reptilase test $9.8585651 Rbc sed rate nonautomated $4.2785652 Rbc sed rate automated $2.7085660 Rbc sickle cell test $5.5185670 Thrombin time plasma $5.7785675 Thrombin time titer $6.8585705 Thromboplastin inhibition $9.6385730 Thromboplastin time partial $6.01



85732 Thromboplastin time partial $6.4785810 Blood viscosity examination $11.6786000 Agglutinins febrile antigen $6.9886001 Allergen specific igg $7.8286003 Allg spec ige crude xtrc ea $5.2286005 Allg spec ige multiallg scr $7.9786008 Allg spec ige recomb ea $17.9386021 Wbc antibody identification $15.0586022 Platelet antibodies $18.3786023 Immunoglobulin assay $12.4686038 Antinuclear antibodies $12.0986039 Antinuclear antibodies (ana) $11.1686060 Antistreptolysin o titer $7.3086063 Antistreptolysin o screen $5.7786140 C-reactive protein $5.1886141 C-reactive protein hs $12.9586146 Beta-2 glycoprotein antibody $25.4586147 Cardiolipin antibody ea ig $25.4586148 Anti-phospholipid antibody $16.0786152 Cell enumeration & id $250.7886155 Chemotaxis assay $15.9986156 Cold agglutinin screen $8.0786157 Cold agglutinin titer $8.0686160 Complement antigen $12.0086161 Complement/function activity $12.0086162 Complement total (ch50) $20.3286171 Complement fixation each $10.0186200 Ccp antibody $12.9586215 Deoxyribonuclease antibody $13.2586225 Dna antibody native $13.7486226 Dna antibody single strand $12.1186235 Nuclear antigen antibody $17.9386255 Fluorescent antibody screen $12.0586256 Fluorescent antibody titer $12.0586277 Growth hormone antibody $15.7486280 Hemagglutination inhibition $8.19



86294 Immunoassay tumor qual $25.5786294 QW Immunoassay tumor qual $25.5786300 Immunoassay tumor ca 15-3 $20.8186301 Immunoassay tumor ca 19-9 $20.8186304 Immunoassay tumor ca 125 $20.8186305 Human epididymis protein 4 $20.8186308 Heterophile antibody screen $5.1886308 QW Heterophile antibody screen $5.1886309 Heterophile antibody titer $6.4786310 Heterophile antibody absrbj $7.3786316 Immunoassay tumor other $20.8186317 Immunoassay infectious agent $14.9986318 Immunoassay infectious agent $18.0986318 QW Immunoassay infectious agent $18.0986320 Serum immunoelectrophoresis $29.9286325 Other immunoelectrophoresis $23.1386327 Immunoelectrophoresis assay $29.9286329 Immunodiffusion nes $14.0586331 Immunodiffusion ouchterlony $11.9886332 Immune complex assay $24.3786334 Immunofix e-phoresis serum $22.3486335 Immunfix e-phorsis/urine/csf $29.3586336 Inhibin a $15.5986337 Insulin antibodies $21.4186340 Intrinsic factor antibody $15.0886341 Islet cell antibody $23.5786343 Leukocyte histamine release $12.4686344 Leukocyte phagocytosis $10.3986352 Cell function assay w/stim $135.8686353 Lymphocyte transformation $49.0386355 B cells total count $37.7386356 Mononuclear cell antigen $26.7886357 Nk cells total count $37.7386359 T cells total count $37.7386360 T cell absolute count/ratio $46.9886361 T cell absolute count $26.78



86367 Stem cells total count $77.7886376 Microsomal antibody each $14.5586382 Neutralization test viral $16.9186384 Nitroblue tetrazolium dye $13.6186386 Nuclear matrix protein 22 $21.7886386 QW Nuclear matrix protein 22 $21.7886403 Particle agglut antbdy scrn $11.5486406 Particle agglut antbdy titr $10.6486430 Rheumatoid factor test qual $6.1486431 Rheumatoid factor quant $5.6786480 Tb test cell immun measure $61.9886481 Tb ag response t-cell susp $100.0086590 Streptokinase antibody $12.6686592 Syphilis test non-trep qual $4.2786593 Syphilis test non-trep quant $4.4086602 Antinomyces antibody $10.1886603 Adenovirus antibody $12.8786606 Aspergillus antibody $15.0586609 Bacterium antibody $12.8886611 Bartonella antibody $10.1886612 Blastomyces antibody $12.9086615 Bordetella antibody $13.1986617 Lyme disease antibody $15.4986618 Lyme disease antibody $17.0386618 QW Lyme disease antibody $17.0386619 Borrelia antibody $13.3886622 Brucella antibody $8.9386625 Campylobacter antibody $13.1286628 Candida antibody $12.0186631 Chlamydia antibody $11.8286632 Chlamydia igm antibody $12.6886635 Coccidioides antibody $11.4786638 Q fever antibody $12.1286641 Cryptococcus antibody $14.4186644 Cmv antibody $14.3986645 Cmv antibody igm $16.85



86648 Diphtheria antibody $15.2186651 Encephalitis californ antbdy $13.1986652 Encephaltis east eqne anbdy $13.1986653 Encephaltis st louis antbody $13.1986654 Encephaltis west eqne antbdy $13.1986658 Enterovirus antibody $13.0386663 Epstein-barr antibody $13.1286664 Epstein-barr nuclear antigen $15.2986665 Epstein-barr capsid vca $18.1486666 Ehrlichia antibody $10.1886668 Francisella tularensis $14.1686671 Fungus nes antibody $12.2586674 Giardia lamblia antibody $14.7286677 Helicobacter pylori antibody $16.8586682 Helminth antibody $13.0186684 Hemophilus influenza antibdy $15.8486687 Htlv-i antibody $9.0986688 Htlv-ii antibody $14.0086689 Htlv/hiv confirmj antibody $19.3586692 Hepatitis delta agent antbdy $17.1686694 Herpes simplex nes antbdy $14.3986695 Herpes simplex type 1 test $13.1986696 Herpes simplex type 2 test $19.3586698 Histoplasma antibody $13.7986701 Hiv-1antibody $8.8986701 QW Hiv-1antibody $8.8986702 Hiv-2 antibody $13.5286703 Hiv-1/hiv-2 1 result antbdy $13.7186704 Hep b core antibody total $12.0586705 Hep b core antibody igm $11.7786706 Hep b surface antibody $10.7486707 Hepatitis be antibody $11.5786708 Hepatitis a antibody $12.3986709 Hepatitis a igm antibody $11.2686710 Influenza virus antibody $13.5586711 John cunningham antibody $16.89



86713 Legionella antibody $15.3086717 Leishmania antibody $12.2586720 Leptospira antibody $16.2086723 Listeria monocytogenes $13.1986727 Lymph choriomeningitis ab $12.8786732 Mucormycosis antibody $15.0086735 Mumps antibody $13.0586738 Mycoplasma antibody $13.2486741 Neisseria meningitidis $13.1986744 Nocardia antibody $15.9986747 Parvovirus antibody $15.0386750 Malaria antibody $13.1986753 Protozoa antibody nos $12.3986756 Respiratory virus antibody $15.8986757 Rickettsia antibody $19.3586759 Rotavirus antibody $18.2386762 Rubella antibody $14.3986765 Rubeola antibody $12.8886768 Salmonella antibody $13.1986771 Shigella antibody $24.4886774 Tetanus antibody $14.8086777 Toxoplasma antibody $14.3986778 Toxoplasma antibody igm $14.4186780 Treponema pallidum $13.2486780 QW Treponema pallidum $13.2486784 Trichinella antibody $12.5686787 Varicella-zoster antibody $12.8886788 West nile virus ab igm $16.8586789 West nile virus antibody $14.3986790 Virus antibody nos $12.8886793 Yersinia antibody $13.1986794 Zika virus igm antibody $16.8586800 Thyroglobulin antibody $15.9186803 Hepatitis c ab test $14.2786803 QW Hepatitis c ab test $14.2786804 Hep c ab test confirm $15.49



86805 Lymphocytotoxicity assay $189.5186806 Lymphocytotoxicity assay $47.5986807 Cytotoxic antibody screening $78.6586808 Cytotoxic antibody screening $29.6886812 Hla typing a b or c $25.8186813 Hla typing a b or c $58.0086816 Hla typing dr/dq $30.1786817 Hla typing dr/dq $106.1486821 Lymphocyte culture mixed $36.5686825 Hla x-math non-cytotoxic $109.4986826 Hla x-match noncytotoxc addl $36.5386828 Hla class i&ii antibody qual $64.1986829 Hla class i/ii antibody qual $64.1986830 Hla class i phenotype qual $95.5286831 Hla class ii phenotype qual $81.8886832 Hla class i high defin qual $323.7586833 Hla class ii high defin qual $325.8086834 Hla class i semiquant panel $357.5686835 Hla class ii semiquant panel $322.9686850 Rbc antibody screen $9.7786880 Coombs test direct $5.3986885 Coombs test indirect qual $5.7286886 Coombs test indirect titer $5.1886900 Blood typing serologic abo $2.9986901 Blood typing serologic rh(d) $2.9986902 Blood type antigen donor ea $6.3586904 Blood typing patient serum $16.3486905 Blood typing rbc antigens $3.8386906 Bld typing serologic rh phnt $7.7586940 Hemolysins/agglutinins auto $8.7786941 Hemolysins/agglutinins $12.1187003 Small animal inoculation $16.8487015 Specimen infect agnt concntj $6.6887040 Blood culture for bacteria $10.3287045 Feces culture aerobic bact $9.4487046 Stool cultr aerobic bact ea $9.44



87070 Culture othr specimn aerobic $8.6287071 Culture aerobic quant other $9.8987073 Culture bacteria anaerobic $9.6687075 Cultr bacteria except blood $9.4787076 Culture anaerobe ident each $8.0887077 Culture aerobic identify $8.0887077 QW Culture aerobic identify $8.0887081 Culture screen only $6.6387084 Culture of specimen by kit $27.0787086 Urine culture/colony count $8.0787088 Urine bacteria culture $8.0987101 Skin fungi culture $7.7187102 Fungus isolation culture $8.4187103 Blood fungus culture $20.4687106 Fungi identification yeast $10.3287107 Fungi identification mold $10.3287109 Mycoplasma $15.3987110 Chlamydia culture $19.6087116 Mycobacteria culture $10.8087118 Mycobacteric identification $14.6187140 Culture type immunofluoresc $5.5787143 Culture typing glc/hplc $12.5287147 Culture type immunologic $5.1887149 Dna/rna direct probe $20.0587150 Dna/rna amplified probe $35.0987152 Culture type pulse field gel $7.7487153 Dna/rna sequencing $115.3687158 Culture typing added method $7.7487164 Dark field examination $10.7487166 Dark field examination $11.3087168 Macroscopic exam arthropod $4.2787169 Macroscopic exam parasite $4.3187172 Pinworm exam $4.2787176 Tissue homogenization cultr $5.8887177 Ova and parasites smears $8.9087181 Microbe susceptible diffuse $4.75



87184 Microbe susceptible disk $7.4887185 Microbe susceptible enzyme $4.7587186 Microbe susceptible mic $8.6587187 Microbe susceptible mlc $40.1787188 Microbe suscept macrobroth $6.6487190 Microbe suscept mycobacteri $7.3187197 Bactericidal level serum $15.0287205 Smear gram stain $4.2787206 Smear fluorescent/acid stai $5.3987207 Smear special stain $5.9987209 Smear complex stain $17.9887210 Smear wet mount saline/ink $5.8287210 QW Smear wet mount saline/ink $5.8287220 Tissue exam for fungi $4.2787230 Assay toxin or antitoxin $19.7487250 Virus inoculate eggs/animal $19.5687252 Virus inoculation tissue $26.0787253 Virus inoculate tissue addl $20.2087254 Virus inoculation shell via $19.5687255 Genet virus isolate hsv $33.8687260 Adenovirus ag if $14.4387265 Pertussis ag if $11.9887267 Enterovirus antibody dfa $13.4287269 Giardia ag if $13.6187270 Chlamydia trachomatis ag if $11.9887271 Cytomegalovirus dfa $13.4287272 Cryptosporidium ag if $11.9887273 Herpes simplex 2 ag if $11.9887274 Herpes simplex 1 ag if $11.9887275 Influenza b ag if $12.2587276 Influenza a ag if $16.0787278 Legion pneumophilia ag if $15.6087279 Parainfluenza ag if $16.4387280 Respiratory syncytial ag if $13.4287281 Pneumocystis carinii ag if $11.9887283 Rubeola ag if $60.80



87285 Treponema pallidum ag if $12.1887290 Varicella zoster ag if $13.4287299 Antibody detection nos if $16.1087300 Ag detection polyval if $11.9887301 Adenovirus ag ia $11.9887305 Aspergillus ag ia $11.9887320 Chylmd trach ag ia $15.0087324 Clostridium ag ia $11.9887327 Cryptococcus neoform ag ia $13.4287328 Cryptosporidium ag ia $13.8287329 Giardia ag ia $11.9887332 Cytomegalovirus ag ia $11.9887335 E coli 0157 ag ia $12.6687336 Entamoeb hist dispr ag ia $16.0087337 Entamoeb hist group ag ia $11.9887338 Hpylori stool ia $14.3887338 QW Hpylori stool ia $14.3887339 H pylori ag ia $16.0087340 Hepatitis b surface ag ia $10.3387341 Hepatitis b surface ag ia $10.3387350 Hepatitis be ag ia $11.5387380 Hepatitis delta ag ia $18.3687385 Histoplasma capsul ag ia $13.2587389 Hiv-1 ag w/hiv-1 & hiv-2 ab $24.0887389 QW Hiv-1 ag w/hiv-1 & hiv-2 ab $24.0887390 Hiv-1 ag ia $24.0687391 Hiv-2 ag ia $21.9087400 Influenza a/b ag ia $14.1387420 Resp syncytial ag ia $13.9187425 Rotavirus ag ia $11.9887427 Shiga-like toxin ag ia $11.9887430 Strep a ag ia $16.8187449 Ag detect nos ia mult $11.9887449 QW Ag detect nos ia mult $11.9887450 Ag detect nos ia single $9.5987451 Ag detect polyval ia mult $10.51



87471 Bartonella dna amp probe $35.0987472 Bartonella dna quant $42.8487475 Lyme dis dna dir probe $20.0587476 Lyme dis dna amp probe $35.0987480 Candida dna dir probe $20.0587481 Candida dna amp probe $35.0987482 Candida dna quant $55.7487483 Cns dna amp probe type 12-25 $416.7887485 Chylmd pneum dna dir probe $20.0587486 Chylmd pneum dna amp probe $35.0987487 Chylmd pneum dna quant $42.8487490 Chylmd trach dna dir probe $22.7587491 Chylmd trach dna amp probe $35.0987492 Chylmd trach dna quant $53.4787493 C diff amplified probe $37.2787495 Cytomeg dna dir probe $30.0387496 Cytomeg dna amp probe $35.0987497 Cytomeg dna quant $42.8487498 Enterovirus probe&revrs trns $35.0987500 Vanomycin dna amp probe $35.0987501 Influenza dna amp prob 1+ $51.3187502 Influenza dna amp probe $95.8087502 QW Influenza dna amp probe $95.8087503 Influenza dna amp prob addl $29.2287505 Nfct agent detection gi $128.2987506 Iadna-dna/rna probe tq 6-11 $262.9987507 Iadna-dna/rna probe tq 12-25 $416.7887510 Gardner vag dna dir probe $20.0587511 Gardner vag dna amp probe $35.0987512 Gardner vag dna quant $41.7687516 Hepatitis b dna amp probe $35.0987517 Hepatitis b dna quant $42.8487520 Hepatitis c rna dir probe $31.2287521 Hepatitis c probe&rvrs trnsc $35.0987522 Hepatitis c revrs trnscrpj $42.8487525 Hepatitis g dna dir probe $29.80



87526 Hepatitis g dna amp probe $39.2687527 Hepatitis g dna quant $41.7687528 Hsv dna dir probe $20.0587529 Hsv dna amp probe $35.0987530 Hsv dna quant $42.8487531 Hhv-6 dna dir probe $58.0087532 Hhv-6 dna amp probe $35.0987533 Hhv-6 dna quant $41.7687534 Hiv-1 dna dir probe $21.9287535 Hiv-1 probe&reverse trnscrpj $35.0987536 Hiv-1 quant&revrse trnscrpj $85.1087537 Hiv-2 dna dir probe $21.9287538 Hiv-2 probe&revrse trnscripj $35.0987539 Hiv-2 quant&revrse trnscripj $58.6287540 Legion pneumo dna dir prob $20.0587541 Legion pneumo dna amp prob $35.0987542 Legion pneumo dna quant $41.7687550 Mycobacteria dna dir probe $20.0587551 Mycobacteria dna amp probe $48.2487552 Mycobacteria dna quant $42.8487555 M.tuberculo dna dir probe $26.8887556 M.tuberculo dna amp probe $41.6887557 M.tuberculo dna quant $42.8487560 M.avium-intra dna dir prob $27.2987561 M.avium-intra dna amp prob $35.0987562 M.avium-intra dna quant $42.8487563 M. genitalium amp probe $35.0987580 M.pneumon dna dir probe $20.0587581 M.pneumon dna amp probe $35.0987582 M.pneumon dna quant $302.6287590 N.gonorrhoeae dna dir prob $26.8887591 N.gonorrhoeae dna amp prob $35.0987592 N.gonorrhoeae dna quant $42.8487623 Hpv low-risk types $35.0987624 Hpv high-risk types $35.0987625 Hpv types 16 & 18 only $40.55



87631 Resp virus 3-5 targets $142.6387631 QW Resp virus 3-5 targets $142.6387632 Resp virus 6-11 targets $218.0687633 Resp virus 12-25 targets $416.7887633 QW Resp virus 12-25 targets $416.7887634 Rsv dna/rna amp probe $70.2087634 QW Rsv dna/rna amp probe $70.2087640 Staph a dna amp probe $35.0987641 Mr-staph dna amp probe $35.0987650 Strep a dna dir probe $20.0587650 QW Strep a dna dir probe $20.0587651 Strep a dna amp probe $35.0987651 QW Strep a dna amp probe $35.0987652 Strep a dna quant $41.7687653 Strep b dna amp probe $35.0987660 Trichomonas vagin dir probe $20.0587661 Trichomonas vaginalis amplif $35.0987662 Zika virus dna/rna amp probe $51.3187797 Detect agent nos dna dir $30.0387798 Detect agent nos dna amp $35.0987799 Detect agent nos dna quant $42.8487800 Detect agnt mult dna direc $43.6787801 Detect agnt mult dna ampli $70.2087801 QW Detect agnt mult dna ampli $70.2087802 Strep b assay w/optic $12.7387803 Clostridium toxin a w/optic $16.0087804 Influenza assay w/optic $16.5587804 QW Influenza assay w/optic $16.5587806 Hiv antigen w/hiv antibodies $32.7787806 QW Hiv antigen w/hiv antibodies $32.7787807 Rsv assay w/optic $13.1087807 QW Rsv assay w/optic $13.1087808 Trichomonas assay w/optic $15.2987808 QW Trichomonas assay w/optic $15.2987809 Adenovirus assay w/optic $21.7687809 QW Adenovirus assay w/optic $21.76



87810 Chylmd trach assay w/optic $35.2987850 N. gonorrhoeae assay w/optic $24.5687880 Strep a assay w/optic $16.5387880 QW Strep a assay w/optic $16.5387899 Agent nos assay w/optic $16.0787899 QW Agent nos assay w/optic $16.0787900 Phenotype infect agent drug $130.3587901 Genotype dna hiv reverse t $257.4587902 Genotype dna/rna hep c $257.4587903 Phenotype dna hiv w/culture $488.6687904 Phenotype dna hiv w/clt add $26.0787905 Sialidase enzyme assay $12.2287905 QW Sialidase enzyme assay $12.2287906 Genotype dna/rna hiv $128.7387910 Genotype cytomegalovirus $257.4587912 Genotype dna hepatitis b $257.4588104 CYTOPATH FLUIDS NONGYN SMEARS $30.51 12/31/201988106 CYTOPATH FLUIDS NONGYN SMEARS INTERP $30.73 12/31/201988108 CYTOPATH CONC TECH SMEAR & INTERP $34.15 12/31/201988112 CYTOPATH CELL ENHANCE TECH CELL EXAM $87.85 12/31/201988125 CYTOPATH FORENSIC INVEST (EG. SPERM) $12.04 12/31/201988130 Sex chromatin identification $17.9888140 Sex chromatin identification $7.9988141 CYTOPATH C/V PHYS INTERP $18.02 12/31/201988142 Cytopath c/v thin layer $20.2688143 Cytopath c/v thin layer redo $23.0488147 Cytopath c/v automated $50.5688148 Cytopath c/v auto rescreen $16.0088150 Cytopath c/v manual $15.1288152 Cytopath c/v auto redo $27.6488153 Cytopath c/v redo $24.0388155 Cytopath c/v index add-on $14.6588160 CYTOPATH FL NONGYN SMEARS CELL EXAM OF BODY FULID $28.69 12/31/201988161 PREP, SCREENING & INTERPRETATION $29.32 12/31/201988162 EXTENDED OVER 5 SLIDES OR DNA ANALYSIS $50.65 12/31/201988164 Cytopath tbs c/v manual $15.12



88165 Cytopath tbs c/v redo $42.2288166 Cytopath tbs c/v auto redo $15.1288167 Cytopath tbs c/v select $15.1288174 Cytopath c/v auto in fluid $25.3788175 Cytopath c/v auto fluid redo $26.6188182 FLOW CYTOMETRY CYCLE OR DNA ANALYSIS $54.53 12/31/201988184 FLOW CYTOMETRY TC1 ONLY $34.20 12/31/201988185 FLOW CYTOMETRY ADD-ON MARKER $16.85 12/31/201988187 FLOW CYTOMETRY 2-8 MARKERs $52.09 12/31/201988188 FLOW CYTOMETRY 9-15 MARKERS $64.95 12/31/201988189 FLOW CYTOMETRY 16 OR MORE MARKERS $85.56 12/31/201988230 Tissue culture lymphocyte $116.4988233 Tissue culture skin/biopsy $140.7388235 Tissue culture placenta $150.3088237 Tissue culture bone marrow $143.7588239 Tissue culture tumor $147.5288240 Cell cryopreserve/storage $13.0788241 Frozen cell preparation $12.0988245 Chromosome analysis 20-25 $173.1788248 Chromosome analysis 50-100 $173.1788249 Chromosome analysis 100 $173.1788261 Chromosome analysis 5 $264.3488262 Chromosome analysis 15-20 $125.4988263 Chromosome analysis 45 $150.2988264 Chromosome analysis 20-25 $144.6188267 Chromosome analys placenta $188.5788269 Chromosome analys amniotic $173.6688271 Cytogenetics dna probe $21.4288272 Cytogenetics 3-5 $40.7088273 Cytogenetics 10-30 $34.8188274 Cytogenetics 25-99 $42.3888275 Cytogenetics 100-300 $51.1988280 Chromosome karyotype study $33.4788283 Chromosome banding study $68.6088285 Chromosome count additional $26.9188289 Chromosome study additional $34.43



88291 CYTOGENICS & MOLECULAR CYTO INTERP & REPORT $21.14 12/31/201988371 Protein western blot tissue $22.2388372 Protein analysis w/probe $26.2288720 Bilirubin total transcut $5.0288738 Hgb quant transcutaneous $5.0288740 Transcutaneous carboxyhb $9.3788741 Transcutaneous methb $9.3789050 Body fluid cell count $4.7289051 Body fluid cell count $5.6089055 Leukocyte assessment fecal $4.2789060 Exam synovial fluid crystals $7.3389125 Specimen fat stain $5.8889160 Exam feces for meat fibers $4.8589190 Nasal smear for eosinophils $5.7989300 Semen analysis w/huhner $9.8489300 QW Semen analysis w/huhner $9.8489310 Semen analysis w/count $8.6189320 Semen anal vol/count/mot $12.3189321 Semen anal sperm detection $12.0589321 QW Semen anal sperm detection $12.0589322 Semen anal strict criteria $15.5089325 Sperm antibody test $10.6789329 Sperm evaluation test $19.5989330 Evaluation cervical mucus $10.3889331 Retrograde ejaculation anal $19.59G0027 Semen analysis $6.50G0103 Psa screening $19.31G0123 Screen cerv/vag thin layer $20.26G0143 Scr c/v cyto,thinlayer,rescr $27.05G0144 Scr c/v cyto,thinlayer,rescr $43.97G0145 Scr c/v cyto,thinlayer,rescr $26.49G0147 Scr c/v cyto, automated sys $15.12G0148 Scr c/v cyto, autosys, rescr $31.94G0306 Cbc/diffwbc w/o platelet $7.77G0307 Cbc without platelet $6.47G0328 Fecal blood scrn immunoassay $18.05



G0328 QW Fecal blood scrn immunoassay $18.05G0432 Eia hiv-1/hiv-2 screen $19.57G0433 Elisa hiv-1/hiv-2 screen $18.29G0433 QW Elisa hiv-1/hiv-2 screen $18.29G0435 Oral hiv-1/hiv-2 screen $11.98G0471 Ven blood coll snf/hha $5.00G0472 Hep c screen high risk/other $46.35G0472 QW Hep c screen high risk/other $46.35G0475 Hiv combination assay $24.08G0475 QW Hiv combination assay $24.08G0476 Hpv combo assay ca screen $35.09G0480 Drug test def 1-7 classes $114.43G0481 Drug test def 8-14 classes $156.59G0482 Drug test def 15-21 classes $198.74G0483 Drug test def 22+ classes $246.92G0499 Hepb screen high risk indiv $28.27G0659 Drug test def simple all cl $62.14G9143 Warfarin respon genetic test $120.72P2028 Cephalin floculation test $4.95P2029 Congo red blood test $4.95P2031 Hair analysis $4.95P2033 Blood thymol turbidity $4.95P2038 Blood mucoprotein $4.95P3000 Screen pap by tech w md supv $15.12P9612 Catheterize for urine spec $3.00P9615 Urine specimen collect mult $3.00Q0111 Wet mounts/ w preparations $15.12Q0112 Potassium hydroxide preps $5.83Q0113 Pinworm examinations $4.27Q0114 Fern test $9.74Q0115 Post-coital mucous exam $25.00

2020 clinical diagnostic laboratory fee schedule0078u pain mgt opi use gnotyp pnl $450.91 0080u onc...

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