Copper Queen Community Hospital

Shoppable services are the expected costs for an entire service.

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All Services Pathology and Laboratory Services

CPT 80051

Blood test panel for electrolytes (sodium potassium, chloride, carbon dioxide)

Standard Charge $92.00

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CPT 80053

Blood test, comprehensive group o blood chemicals

Standard Charge $395.00

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CPT 80061

Blood test, lipids (cholesterol and triglycerides)

Standard Charge $199.00

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CPT 80069

Kidney function panel test

Standard Charge $152.00

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CPT 80074

Acute hepatitis panel

Standard Charge $1,162.00

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CPT 80076

Liver function blood test panel

Standard Charge $200.00

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CPT 80162

Digoxin level

Standard Charge $186.00

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CPT 80164

Valproic acid level

Standard Charge $242.00

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CPT 80178

Lithium Level

Standard Charge $123.00

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CPT 80184

Phenobarbital level

Standard Charge $208.00

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CPT 80185

Phenytoin level

Standard Charge $203.00

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CPT 80197

Test is used to measure the amount of the drug in the blood to determine whether the concentration has reached a therapeutic level and is below the toxic level

Standard Charge $344.00

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CPT 80202

Vancomycin (antibiotic) level

Standard Charge $177.00

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CPT 80299

Cortisol (hormone) measurement

Standard Charge $284.00

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CPT 80307

Testing for presence of drug

Standard Charge $271.00

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CPT 81001

Manual urinalysis test with examination with or without using microscope

Standard Charge $45.00

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CPT 81002

Manual urinalysis test with examination without using microscope

Standard Charge $25.00

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CPT 81025

Urine pregnancy test

Standard Charge $152.00

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CPT 82043

Urine test to measure albumin

Standard Charge $125.00

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CPT 82103

Alpha-1-antitrypsin; total

Standard Charge $174.00

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CPT 82105

Alpha-Fetoprotein (AFP) Level, Serum

Standard Charge $334.00

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CPT 82140

Ammonia level

Standard Charge $125.00

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CPT 82150

Amylase (enzyme) level

Standard Charge $191.00

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CPT 82164

Angiotensin l - converting enzyme (ACE) level

Standard Charge $259.00

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CPT 82232

Beta-2 microglobulin (protein) level

Standard Charge $259.00

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CPT 82247

Bilirubin level (Total)

Standard Charge $113.00

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CPT 82248

Measurement of direct bilirubin

Standard Charge $113.00

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CPT 82270

Stool analysis for blood

Standard Charge $90.00

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CPT 82306

Blood test to monitor vitamin D levels

Standard Charge $280.00

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CPT 82310

Calcium level

Standard Charge $75.00

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CPT 82330

Ionized Calcium

Standard Charge $162.00

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CPT 82340

Urine calcium level

Standard Charge $139.00

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CPT 82378

Carcinoembryonic antigen (CEA) protein level

Standard Charge $162.00

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CPT 82525

Copper level

Standard Charge $0.00

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CPT 82533

Cortisol Measurement

Standard Charge $248.00

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CPT 82542

Mass spectrometry

Standard Charge $329.00

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CPT 82550

Creatine kinase Level (cardiac enzyme) - Total

Standard Charge $59.00

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CPT 82553

Blood test to detect heart enzymes

Standard Charge $308.00

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CPT 82565

Blood creatinine level

Standard Charge $76.00

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CPT 82570

Test to measure creatinine in the urine

Standard Charge $95.00

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CPT 82607

Blood test to measure B-12

Standard Charge $103.00

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CPT 82626

Dehydroepiandrosterone (DHEA-S) hormone level

Standard Charge $805.00

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CPT 82627

Blood test to measure an enzyme i the blood

Standard Charge $464.00

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CPT 82670

Blood test to measure a type of estrogen in the blood

Standard Charge $268.00

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CPT 82728

Test to determine level of iron in the blood

Standard Charge $172.00

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CPT 82746

Folic acid; serum

Standard Charge $111.00

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CPT 82784

Test to determine levels of immunoglobulins in the blood

Standard Charge $115.00

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CPT 82803

Test to measure arterial blood gases

Standard Charge $297.00

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CPT 82947

Quantitative measure of glucose build up in the blood over time

Standard Charge $78.00

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CPT 82950

Test of glucose level in the blood

Standard Charge $79.00

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CPT 82951

Test to predict likelihood of gestational diabetes

Standard Charge $273.00

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CPT 82977

Glutamyltransferase (liver enzyme) level

Standard Charge $151.00

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CPT 83001

Test of hormone in the blood

Standard Charge $424.00

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CPT 83002

Test of hormone in the blood

Standard Charge $475.00

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CPT 83010

Haptoglobin (serum protein) level

Standard Charge $197.00

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CPT 83013

Test of breath for a stomach bacterium

Standard Charge $496.00

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CPT 83021

Liver function blood test panel

Standard Charge $110.00

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CPT 83036

Blood test to measure average blood glucose levels for past 2-3 months

Standard Charge $140.00

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CPT 83516

Chemical test of the blood to measure presence or concentration of a substance in the blood

Standard Charge $215.00

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CPT 83519

Procalcitonin (hormone) level

Standard Charge $306.00

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CPT 83525

Insulin Measurement; Total

Standard Charge $185.00

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CPT 83540

Blood test to measure the amount of iron that is in transit in the body

Standard Charge $76.00

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CPT 83550

Blood test that measures the amount of iron carried in the blood

Standard Charge $326.00

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CPT 83615

Lactate dehydrogenase (enzyme) level

Standard Charge $66.00

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CPT 83655

Blood test to determine the concentration of lead in the blood

Standard Charge $271.00

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CPT 83690

Lipase (fat enzyme) level

Standard Charge $176.00

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CPT 83718

Blood test to measure the level of lipoproteins in the blood

Standard Charge $100.00

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CPT 83721

LDL cholesterol level

Standard Charge $151.00

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CPT 83735

Magnesium Level

Standard Charge $80.00

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CPT 83880

Blood test used to diagnose heart failure

Standard Charge $344.00

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CPT 83883

Nephelometry, test method using light

Standard Charge $263.00

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CPT 83935

Urine osmolality (concentration) measurement

Standard Charge $142.00

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CPT 83945

Oxalate level

Standard Charge $124.00

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CPT 83970

Parathormone

Standard Charge $321.00

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CPT 84132

Blood potassium level

Standard Charge $72.00

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CPT 84133

Urine potassium level

Standard Charge $68.00

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CPT 84134

Blood test to measure level of prealbumin

Standard Charge $205.00

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CPT 84146

Prolactin (milk producing hormone) level

Standard Charge $223.00

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CPT 84153

PSA (prostate specific antigen)

Standard Charge $215.00

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CPT 84154

PSA (prostate specific antigen) measurement

Standard Charge $259.00

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CPT 84165

Protein Measurement, Serum

Standard Charge $139.00

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CPT 84166

Troponin (protein) analysis

Standard Charge $130.00

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CPT 84300

Urine sodium level

Standard Charge $84.00

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CPT 84402

Testosterone Level; Free

Standard Charge $267.00

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CPT 84403

Testosterone (hormone) level

Standard Charge $279.00

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CPT 84436

Blood test to measure a type of thyroid hormone

Standard Charge $111.00

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CPT 84439

Blood test to evaluate thyroid function

Standard Charge $359.00

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CPT 84443

Blood test, thyroid stimulating hormone (TSH)

Standard Charge $136.00

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CPT 84445

Thyroid stimulating immune globulins (thyroid related protein) level

Standard Charge $588.00

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CPT 84450

Liver enzyme (SGOT), level

Standard Charge $125.00

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CPT 84460

Blood test to evaluate liver function

Standard Charge $125.00

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CPT 84478

Blood test, lipids (cholesterol and triglycerides)

Standard Charge $100.00

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CPT 84479

Thyroid Hormone, T3 Measurement, Free

Standard Charge $125.00

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CPT 84480

Blood test to evaluate thyroid function

Standard Charge $248.00

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CPT 84484

Blood test to measure a certain protein in the blood to determine heart muscle damage

Standard Charge $299.00

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CPT 84550

Uric acid level, blood

Standard Charge $76.00

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CPT 84560

Uric acid level

Standard Charge $61.00

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CPT 84630

Zinc level

Standard Charge $251.00

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CPT 84681

C-peptide (protein) level

Standard Charge $585.00

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CPT 84703

Blood test to assess for pregnancy

Standard Charge $203.00

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CPT 85007

Blood test to assess for infection

Standard Charge $26.00

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CPT 85018

Blood test to measure levels of hemoglobin

Standard Charge $47.00

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CPT 85025

Complete blood cell count, with differential white blood cells, automated

Standard Charge $170.00

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CPT 85610

Blood test, clotting time

Standard Charge $68.00

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CPT 85730

Coagulation assessment blood test

Standard Charge $0.00

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CPT 86003

Measurement of antibody (IgE) to allergic substance

Standard Charge $0.00

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CPT 86140

Measurement C-reactive protein

Standard Charge $111.00

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CPT 86200

Blood test to diagnose rheumatoid arthritis

Standard Charge $376.00

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CPT 86225

Deoxyribonucleic acid (DNA) antibody; native or double stranded

Standard Charge $114.00

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CPT 86255

Measurement of antibody to noninfectious agent

Standard Charge $150.00

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CPT 86300

Blood test to monitor breast cance

Standard Charge $265.00

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CPT 86304

Blood test to monitor for cancer

Standard Charge $656.00

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CPT 86308

Screening test for mononucleosis (mono)

Standard Charge $130.00

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CPT 86360

T cells; absolute CD4 and CD8 count, including ratio

Standard Charge $456.00

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CPT 86376

Microsomal Antibodies Measurement

Standard Charge $234.00

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CPT 86592

Blood test to screen for syphilis

Standard Charge $62.00

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CPT 86644

Blood test to monitor for cytomegalovirus

Standard Charge $221.00

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CPT 86677

Blood test to if peptic ulcers are caused by a certain bacterium

Standard Charge $203.00

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CPT 86704

Blood test indicating infection with Hepatitis B

Standard Charge $234.00

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CPT 86706

Hepatitis B surface antibody measurement

Standard Charge $388.00

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CPT 86708

Blood test indicating infection with Hepatitis A

Standard Charge $233.00

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CPT 86762

Blood test to determine if antibodies exist for rubella

Standard Charge $166.00

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CPT 86800

Thyroglobulin (thyroid protein) antibody measurement

Standard Charge $219.00

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CPT 86803

Blood test to determine infection with Hepatitis C

Standard Charge $381.00

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CPT 86850

Blood test to screen for antibodies that could harm red blood cells

Standard Charge $103.00

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CPT 86900

Blood Typing, ABO

Standard Charge $81.00

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CPT 86901

Blood Typing, Rh (D)

Standard Charge $95.00

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CPT 87040

Blood test to screen for bacteria in the blood

Standard Charge $159.00

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CPT 87045

Stool Culture

Standard Charge $158.00

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CPT 87070

Test of body fluid other than blood to assess for bacteria

Standard Charge $299.00

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CPT 87081

Medical test to find an infection

Standard Charge $122.00

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CPT 87086

Culture of the urine to determine number of bacteria

Standard Charge $166.00

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CPT 87177

Smear for Parasites

Standard Charge $194.00

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CPT 87205

A lab test used to detect bacteria or fungi in a sample taken from the site of a suspected infection

Standard Charge $102.00

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CPT 87210

A lab test to screen for evidence of vaginal infection

Standard Charge $126.00

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CPT 87324

A test of the stool to diagnose Clostridium difficile (C. diff) infection

Standard Charge $89.00

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CPT 87340

Detection test for Hepatitis Be surface antigen

Standard Charge $297.00

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CPT 87389

Test for HIV

Standard Charge $186.00

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CPT 87491

Test that detects Chlamydia

Standard Charge $283.00

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CPT 87517

Hepatitis B Detection

Standard Charge $994.00

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CPT 87536

Detection test for HIV-1 virus, quantification

Standard Charge $905.00

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CPT 87591

Blood test for an STD

Standard Charge $301.00

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CPT 87635

Covid-19 current infection test

Standard Charge $268.00

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CPT 87804

Flu test

Standard Charge $125.00

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CPT 87807

Test for RSV

Standard Charge $241.00

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CPT 87880

Test for strep A

Standard Charge $125.00

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CPT 88305

Test of tissues for diagnosis of abnormalities

Standard Charge $252.00

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CPT 88312

Blood test to assist with diagnosis

Standard Charge $344.00

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CPT 88313

Blood test to assist with diagnosis

Standard Charge $277.00

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CPT 88342

Pathology test

Standard Charge $235.00

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CPT G0103

Prostate cancer screening; prostate specific antigen test (psa)

Standard Charge $215.00

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CPT P9016

Red Blood Cells, Leukocytes Reduced, Each Unit

Standard Charge $731.00

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