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All Services Pathology and Laboratory Services

CPT 87505

Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets

$338.00 Standard Charge

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CPT 82306

Vitamin D; 25 hydroxy, includes fraction(s), if performed

$139.00 Standard Charge

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CPT 82172

Apolipoprotein, each

$75.00 Standard Charge

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CPT 81003

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, without microscopy

$31.00 Standard Charge

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CPT 83605

Lactate (lactic acid)

$139.00 Standard Charge

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CPT 85025

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

$80.00 Standard Charge

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CPT 80305

Drug test(s), presumptive, any number of drug classes, any number of devices or procedures; capable of being read by direct optical observation only (eg, utilizing immunoassay [eg, dipsticks, cups, cards, or cartridges]), includes sample validation when performed, per date of service

$148.00 Standard Charge

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CPT 81025

Urine pregnancy test, by visual color comparison methods

$60.00 Standard Charge

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CPT 83695

Lipoprotein (a)

$140.00 Standard Charge

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CPT 87591

Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique

$128.00 Standard Charge

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CPT 82150

Amylase

$64.00 Standard Charge

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CPT 80076

Liver function blood test panel

$111.00 Standard Charge

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CPT 83735

Magnesium

$64.00 Standard Charge

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CPT 81001

Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any number of these constituents; automated, with microscopy

$31.00 Standard Charge

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CPT 80050

General health panel This panel must include the following: Comprehensive metabolic panel (80053) Blood count, complete (CBC), automated and automated differential WBC count (85025 or 85027 and 85004) OR Blood count, complete (CBC), automated (85027) and appropriate manual differential WBC count (85007 or 85009) Thyroid stimulating hormone (TSH) (84443)

$344.00 Standard Charge

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CPT 80069

Kidney function panel test

$162.00 Standard Charge

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CPT 87070

Culture, bacterial; any other source except urine, blood or stool, aerobic, with isolation and presumptive identification of isolates

$100.00 Standard Charge

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CPT 85610

Blood test, clotting time

$43.00 Standard Charge

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CPT 84403

Testosterone; total

$157.00 Standard Charge

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CPT 85652

Sedimentation rate, erythrocyte; automated

$36.00 Standard Charge

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CPT 86900

Blood typing, serologic; ABO

$52.00 Standard Charge

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CPT 85027

Complete blood count, automated

$66.00 Standard Charge

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CPT 85379

Fibrin degradation products, D-dimer; quantitative

$77.00 Standard Charge

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CPT 86901

Blood typing, serologic; Rh (D)

$52.00 Standard Charge

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CPT 87040

Culture, bacterial; blood, aerobic, with isolation and presumptive identification of isolates (includes anaerobic culture, if appropriate)

$107.00 Standard Charge

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CPT 80048

Basic metabolic panel

$141.00 Standard Charge

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CPT 87635

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), amplified probe technique

$128.00 Standard Charge

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CPT 87186

Susceptibility studies, antimicrobial agent; microdilution or agar dilution (minimum inhibitory concentration [MIC] or breakpoint), each multi-antimicrobial, per plate

$71.00 Standard Charge

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CPT 87205

Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, fungi, or cell types

$41.00 Standard Charge

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CPT 82728

Ferritin

$110.00 Standard Charge

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CPT 85730

Coagulation assessment blood test

$64.00 Standard Charge

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CPT 80053

Blood test, comprehensive group o blood chemicals

$198.00 Standard Charge

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CPT 80061

Blood test, lipids (cholesterol and triglycerides)

$109.00 Standard Charge

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CPT 82550

Creatine kinase (CK), (CPK); total

$71.00 Standard Charge

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CPT 82043

Albumin; urine (eg, microalbumin), quantitative

$55.00 Standard Charge

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CPT 82565

Creatinine; blood

$61.00 Standard Charge

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CPT 82607

Cyanocobalamin (Vitamin B-12);

$103.00 Standard Charge

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CPT 86140

C-reactive protein

$83.00 Standard Charge

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CPT 84145

Procalcitonin (PCT)

$135.00 Standard Charge

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CPT 84550

Uric acid; blood

$46.00 Standard Charge

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CPT 82310

Calcium; total

$49.00 Standard Charge

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CPT 86803

Hepatitis C antibody;

$117.00 Standard Charge

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CPT 87077

Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate

$59.00 Standard Charge

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CPT 87086

Culture, bacterial; quantitative colony count, urine

$88.00 Standard Charge

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CPT 87491

Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique

$142.00 Standard Charge

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CPT 83036

Hemoglobin; glycosylated (A1C)

$77.00 Standard Charge

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CPT 84443

Blood test, thyroid stimulating hormone (TSH)

$137.00 Standard Charge

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CPT 82803

Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including calculated O2 saturation);

$175.00 Standard Charge

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CPT 87804

Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza

$82.00 Standard Charge

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CPT 82746

Folic acid; serum

$100.00 Standard Charge

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CPT 83690

Lipase

$72.00 Standard Charge

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CPT 84100

Phosphorus inorganic (phosphate);

$45.00 Standard Charge

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CPT 84153

PSA (prostate specific antigen)

$150.00 Standard Charge

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CPT 84155

Protein, total, except by refractometry; serum, plasma or whole blood

$40.00 Standard Charge

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CPT 84165

Protein; electrophoretic fractionation and quantitation, serum

$104.00 Standard Charge

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CPT 87807

Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; respiratory syncytial virus

$114.00 Standard Charge

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CPT 87880

Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Streptococcus, group A

$49.00 Standard Charge

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CPT 83550

Iron binding capacity

$72.00 Standard Charge

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CPT 83880

Natriuretic peptide

$231.00 Standard Charge

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CPT 84439

Thyroxine; free

$82.00 Standard Charge

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CPT 84484

Troponin, quantitative

$155.00 Standard Charge

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CPT 83540

Iron

$71.00 Standard Charge

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