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Test Code Test Name RETAIL CPT Code
4304 17-HYDROXYPROGESTERONE $32.50 83498
2079 24HR CREATININE CLEARANCE $10.50 82575
4310 5-HIAA, 24 HOUR URINE $48.00 83497
3800 ABO & RH $15.00 86900, 86901
4814 ACTH $52.00 82024
5490 ADULT FOOD I IgE PANEL $180.00 86003 X13  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5494 ADULT FOOD II IgE PANEL $200.00 86003 X15  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5495 ADULT FOOD III IgE PANEL $196.00 86003 X14  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5478 ADULT FOOD IV IgE PANEL $160.00 86003 X11  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5523 AEROALLERGEN IgE PANEL $350.00 86003 X23  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
6133 AEROBIC & ANAEROBIC CULT $24.00 87070, 87075
2625 AFP TUMOR MARKER $30.00 82105
4891 ALBUMIN, URINE, RANDOM $16.00 82043
4892 ALBUMIN,URINE,24HR QNT $20.00 82043
Test Code Test Name CPT Code
4893 ALBUMIN/CRT RATIO,24HR UR $20.00 82043, 82570
4895 ALBUMIN/CRT RATIO,RNDM UR $20.50 82043, 82570
4201 ALDOSTERONE $70.00 82088
4816 ALPHA-1-ANTITRYPSIN $34.00 82103
2020 AMMONIA $30.00 82140
2025 AMYLASE $9.00 82150
4884 ANA AUTOIMMUNE PNL/FARR $150.00 86038, 86235 X6,
83516 X2, 86376,
86160 X2, 86431,
86225
4521 ANA AUTOIMMUNE PROFILE $80.00 86038 (IF POS ADD
86039),86235
X8,86376,86160 X2,86431,86225,83516
3551 ANA TITER $14.00 86039
6237 ANAEROBE IDENT $6.00 87076
4263 ANDROSTENEDIONE $66.00 82157
4966 ANGIO CONVERTING ENZYME $34.00 82164
6397 ANTIBIOTIC PLATE CONFIRM $8.00 87181
5786 ANTI-MULLERIAN HORMONE $120.00 82397
3550 ANTI-NUCLEAR ANTIBODIES $12.00 86038
4140 ANTIPHOSPHOLIPID AB PANEL $250.00 86147 X3, 86148 X3,
83516 X6
5637 APOLIPOPROTEIN E MUTATION $280.00 81401
4003 APOLIPOPROTEIN, B-100 $30.00 82172
391 ARTHRITIS PROFILE $30.00 86431, 84550, 85652,
86038
3555 ASO TITER $11.00 86060
810010 AUTO UA W/ MICROSCOPIC $6.60 81001
3920 BACT VAGINOSIS,PCR,APTIMA $136.00 87798 X8, 87511
6235 BACTERIAL IDENT $6.00 87077
142 BASIC METABOLIC PANEL $9.00 80048 (AMA DEFINED
PANEL)
5321 BETA-2 GLYCOPROTEIN AB’S $70.00 86146 X2
2036 BILIRUBIN, DIRECT $6.00 82248
926 BREATH TEK COLLECTION $22.00 83014
6015 C DIFF CULT RFLX CYTOTOX $1498.80 87075, IF REFLEX MAY ADD 87230, 87176,
87015, 87076 (UP TO
X3)
6335 C DIFF GDH RFLX TOXIN,PCR $30.00 87449
4733 C DIFF TOXIN B BY PCR $278.00 87493
6336 C DIFFICILE TOXIN A AND B $36.00 87324
4826 CALCITONIN $64.00 82308
2209 CALCIUM $6.00 82310
2236 CALCIUM, MEASURED IONIC $12.00 82330
4824 CANCER ANTIGEN 125 $24.00 86304
3914 CANDIDA BY PCR,APTIMA $136.00 87481 X5
3025 CARBAMAZEPINE,TOTAL $20.00 80156
2640 CARBON MONOXIDE (CO) $136.00 82375
4809 CARDIOLIPIN ANTIBODIES $42.00 86147 X3
4211 CATECHOLAMINES $92.00 82384
1041 CBC W/O DIFF,WITH PLATE $12.00 85027
4875 CD4 (T4) ENUMERATION $50.00 86361
2645 CEA $22.00 82378
4833 CELIAC DISEASE PANEL $164.00 83516 X4
5519 CENTRAL TEXAS IgE PANEL $336.00 86003 X24  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
4213 CERULOPLASMIN $27.00 82390
3838 CHIKUNGUNYA IgG/IgM $372.00 86790 X2
1284 CHILDHOOD ALLERGY IgE+TOT $212.00 86003 X15, 82785; SEE INDIVIDUAL COMPONENTS FOR
MC/MD TEST LIMITS
5547 CHILDHOOD DISEASE IgE PNL $180.00 86003 X13  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5505 CHILDHOOD IgE ALLERGY PAN $180.00 86003 X15; SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5398 CHLAMYDIA,TMA,SIMPLESWAB $30.00 87491
5401 CHLAMYDIA,TMA,SUREPATH $30.00 87491
5403 CHLAMYDIA,TMA,THINPREP $30.00 87491
5399 CHLAMYDIA,TMA,URINE $22.00 87491
814603 CHRG NON-IMAGED SP $50.00 88142
814601 CHRG NON-IMAGED TP PAP $50.00 88142
2076 CK REFLEX CKMB $6.40 82550
2075 CK, TOTAL $7.50 82550
2070 CK-MB ONLY $10.00 82553
5822 CLONAZEPAM $30.00 80346
9180 COMP METABOLIC + e-GFR $9.75 80053
9179 COMP METABOLIC PANEL $10.50 80053 (AMA DEFINED
PANEL)
4532 COMPLEMENT C1Q $66.00 86160
3580 COMPLEMENT C3 $20.00 86160
3585 COMPLEMENT C4 $20.00 86160
1000 COMPLETE BLOOD COUNT $9.00 85025
5549 COMPREHENSIVE FOOD IgE $200.00 86003 X16  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5517 COMPREHENSIVE IgE PANEL $224.00 86003 X14  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
4219 COPPER,SERUM/PLASMA $14.00 82525
2185 CORONARY RISK PROFILE $8.25 80061 (AMA DEFINED
PANEL)
2243 CORONARY RISK RFLX D LDL $10.00 80061
4267 CORTISOL, A.M. SPECIMEN $20.00 82533
2655 CORTISOL, RANDOM $18.00 82533
4334 CORTISOL, URINE, FREE $36.00 82530
4832 C-PEPTIDE $29.00 84681
3545 C-REACTIVE PROTEIN $12.00 86140
5083 CRP,HIGH SENSITIVITY $17.00 86141
5249 CT/NG,TMA,SIMPLESWAB $44.00 87491, 87591
5404 CT/NG,TMA,SUREPATH $44.00 87491, 87591
4123 CT/NG,TMA,THINPREP $44.00 87591, 87491
4112 CT/NG,TMA,URINE $44.00 87491, 87591
4335 CT/NG,TMA,URINE $44.00 87491, 87591
6047 CULT,STREP A SCRN,THROAT $18.00 87081
6010 CULTURE,ANAEROBIC $18.00 87075
6013 CULTURE,BLOOD $20.00 87040
6019 CULTURE,CAMPYLOBACTER $22.00 87046
6066 CULTURE,CHLAMYDIA $33.00 87110
6075 CULTURE,FUNGUS SKIN,HAIR, $30.00 87101
6031 CULTURE,GC $22.00 87081
6052 CULTURE,GENITAL $22.00 87070
6069 CULTURE,HERPES SIMPLEX $24.00 87255
6012 CULTURE,MRSA $23.00 87070
6007 CULTURE,ROUTINE $16.00 87070
6042 CULTURE,STOOL $20.00 87045, 87046
6234 CULTURE,SUSCEPTIBILITY $6.00 87186
6046 CULTURE,THROAT $16.00 87070
6049 CULTURE,URINE $16.00 87086
5390 CYCLIC CITRULL PEP IGG $30.00 86200
4543 CYTOMEGALOVIRUS IGG/IGM $66.00 86644, 86645
4546 CYTOMEGALOVIRUS IGM $36.00 86645
1435 D-DIMER $60.00 85379
4225 DHEA SULFATE $24.00 82627
3034 DIGOXIN $15.40 80162
4287 DNA DS ANTIBODY $34.00 86225
3310 DRUG ABUSE 11 W/ETOH,NO $32.00 80307
3254 DRUG ABUSE SCRN 10 RFLX $30.00 80307
3317 DRUG ABUSE SCRN 10,NO CON $30.00 80307
3311 DRUG ABUSE SCRN 11 W/ETOH $32.00 80307
3309 DRUG ABUSE SCRN 13 RFLX $48.00 80307
3312 DRUG ABUSE SCRN 13,NO CON $40.00 80307
3313 DRUG ABUSE SCRN 14 W/ETOH $48.00 80307
3314 DRUG ABUSE SCRN 14 W/ETOH $48.00 80307
3306 DRUG ABUSE SCRN 8 W/CONF $24.00 80307
3305 DRUG ABUSE SCRN 8,NO CONF $24.00 80307
3307 DRUG ABUSE SCRN 9,NO THC $26.00 80307
3308 DRUG ABUSE SCRN 9,NO THC $26.00 80307
3315 DRUG ABUSE SCRN 9,W/ETOH $26.00 80307
3316 DRUG ABUSE SCRN 9,W/ETOH, $26.00 80307
5671 DRUG SCREEN PRESC/OTC UR $148.00 80307
5989 DRUG SCREEN,SERUM $50.00 80301; NOTE CPT FOR MEDICARE IS G0479
5518 EAST TEXAS IgE PANEL $364.00 86003 X24  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
4642 EB VCA IgG/IgM $54.50 86665 X2
1963 EGG WHITE IgE RFLX $14.00 86003
115 ELECTROLYTES PANEL $4.80 80051 (AMA DEFINED
PANEL)
5488 ENVIRONMENTAL IgE PANEL $94.00 86003 X7  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
4550 EPSTEIN BARR PANEL $76.00 86665 X2, 86663,
86664
4552 EPSTEIN BARR VCA IgG $28.00 86665
4495 EPSTEIN BARR VCA IgM $30.00 86665
2675 ESTRADIOL $20.00 82670
4840 ESTRIOL, UNCONJUGATED $36.00 82677
4982 ESTRONE (E1) $40.00 82679
4845 FACTOR V LEIDEN $150.00 81241
4503 FARR DNA DS AB $132.00 86225
7020 FECAL LEUKOCYTES $16.00 89055
2090 FERRITIN $10.00 82728
2695 FOLIC ACID $14.00 82746
2700 FOLLICLE STIM HORMONE $12.00 83001
5548 FOOD ALLERGY IgE PANEL $112.00 86003 X12; SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
1281 FOOD ALLERGY IgE+TOTAL Ig $193.50 86003 X12, 82785; SEE INDIVIDUAL COMPONENTS FOR
MC/MD TEST LIMITS
5496 FOOD IgE PANEL $160.00 86003 X10  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
4273 FREE T3 $19.00 84481
2823 FREE T4 (THYROXINE) $12.90 84439
438 FSH + LH PROFILE $28.00 83001, 83002
4001 GAD 65 ANTIBODY $118.00 86341
3967 GLUTATHIONE 82978
9329 GENERAL HEALTH PANEL $20.50 80050 NOT COVERED
BY MEDICARE.
2216 GGT $6.00 82977
2217 GLUCOSE $6.00 82947
2705 GLUCOSE-6-PD, QUANT $30.00 82955
4803 GLYCATED HEMOGLOBIN $40.00 83036
5396 GONORRHEA,TMA,SIMPLESWAB $30.00 87591
5400 GONORRHEA,TMA,SUREPATH $40.00 87591
5402 GONORRHEA,TMA,THINPREP $40.00 87591
5397 GONORRHEA,TMA,URINE $22.00 87591
6106 GRAM STAIN $16.00 87205
4854 GROWTH HORMONE (HGH) $26.00 83003
2110 GTT,2HR 75GM LOAD $11.50 82951, 82952
4499 H PYLORI AG, STOOL $90.00 87338
5591 H PYLORI BREATH TEST $132.00 83013
5653 H. PYLORI (BREATH), PEDI $132.00 83013
4856 HAPTOGLOBIN, QUANTITATIVE $20.00 83010
2713 HCG QUANTITATIVE $16.00 84702
2704 HCG RFLX TO PROG AND ESTR $20.00 84702
2714 HCG,QUALITATIVE,SERUM $12.00 84703
1030 HEMATOCRIT $4.00 85014
1025 HEMOGLOBIN $4.00 85018
2708 HEMOGLOBIN A1C $12.00 83036
2720 HEMOGLOBIN ELECTROPHORESI $24.00 83020
9175 HEPATIC FUNCTION PANEL $9.00 80076 (AMA DEFINED
PANEL)
2724 HEPATITIS A TOTAL AB $16.00 86708
4644 HEPATITIS B CORE IGM $16.00 86705
2729 HEPATITIS B CORE TOTAL AB $16.00 86704
2733 HEPATITIS B E ANTIBODY $30.00 86707
4286 HEPATITIS B QUANT BY PCR $176.00 87517
2737 HEPATITIS B SURF AB $16.00 86706
2739 HEPATITIS B SURF AG $16.00 87340
2738 HEPATITIS Bs AB QUANT $16.00 86706
4675 HEPATITIS C ANTIBODY $18.00 86803
4677 HEPATITIS C REFLEX QNT $18.00 86803
4571 HEPATITIS C RNA BY PCR, Q $160.00 87522
9325 HEPATITIS PANEL,ACUTE $44.00 80074 LIMITED COVERAGE TEST FOR MEDICARE.  ABN
REQUIRED.
162 HEPATITIS PROFILE(A,B,C) $50.00 86704, 86706, 86708,
86803, 87340
4564 HERPES 1 & 2 IgM $54.00 86694
4592 HERPES SIMPLEX 1 & 2 IGG $40.00 86695, 86696
5342 HERPES SIMPLEX TYPE 2 IGG $24.00 86696
2709 HGB A1C W/ GLUC ESTIMATE $10.00 83036
3540 HIV 1/2 4TH GEN,RFLX CONF $16.00 87389
3518 HIV 1/2 CONFIRMATION $156.00 86701, 86702
4705 HIV-1 RNA PCR RFXL GENO $184.00 87536
4141 HIV-1,QUANT,PCR $184.00 87536
4864 HLA B-27 $50.00 86812
4288 HOMOCYSTEINE $36.00 83090
8037 HPV HI RISK GENOTYPE, SP $46.00 87624
8038 HPV HI RISK GENOTYPE, TP $50.00 87624
4647 HSV IGG & IGM $80.00 86695, 86696, 86694
5545 HYPERSENSITIVE PNEUM II $94.00 86331 X2, 86606 X3
4608 IGF-1 WITH Z-SCORE $120.00 84305
1125 IgG GLUTEN $16.00 86001
2768 IgG4 $16.00 82787
2751 IMMUNOGLOBULIN A (IgA) $52.00 82784
4874 IMMUNOGLOBULIN E (IGE) $26.00 82785
2753 IMMUNOGLOBULIN G (IgG) $64.00 82784
2755 IMMUNOGLOBULIN M (IgM) $64.00 82784
6084 INDICATED URINE CULTURE $16.00
5486 INFANT FOOD IgE PANEL $66.00 86003 X5  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5444 INFLUENZA A, IgM $20.00 86710
5542 INHALENT IgE PANEL $131.60 86003 X10  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
2760 INSULIN $18.00 83525
4650 INTRINSIC FACTOR ANTIBODI $44.00 86340
2118 IRON+IBC+SATURATION % $14.00 83550, 83540
6396 KIRBY-BAUER SUSCEPTIBILIT $6.00 87184
2119 LACTIC ACID,PLASMA $28.00 83605
2224 LDH $6.00 83615
4239 LEAD,BLOOD,VENIPUNCTURE $14.00 83655
5571 LEVETIRACETAM $60.00 80177
2124 LIPASE $12.00 83690
173 LIPID PANEL $10.35 80061 (AMA DEFINED
PANEL)
2128 LITHIUM $16.00 80178
1493 LUPUS ANTICOAG W/OUT PT $46.00 85730, 85613; (IF POSITIVE, REFER TO LUPUS CONFIRM CODE
1477)
1478 LUPUS ANTICOAGULANT CONF $1128.80 SEE UNIT CODES
1485 LUPUS ANTICOAGULANT SCRN $68.00 85610, 85730,
85613(IF POSITIVE, REFER TO LUPUS CONFIRM CODE 1478)
2776 LUTEINIZING HORMONE $16.00 83002
3605 LYME ANTIBODY,IgG/IgM $54.00 86618
4505 LYME DIS WB IgG, IgM $94.00 86617 X2
2130 MAGNESIUM $10.00 83735
5000 MAGNESIUM, RBC $142.00 83735
850440 MANUAL RETIC $8.00 85044
856510 MANUAL SEDRATE $6.50 85651
810000 MANUAL UA W/MICRO $6.60 81000
2293 MC DIABETES SCRN FAST GLU $6.00 82947
2297 MC PRE-DIAB SCRN FAST GLU $6.00 82947
4245 MERCURY $20.00 83825
4369 METANEPHRINES,24HR URINE $54.00 83835
5116 METANEPHRINES,PLASMA $78.00 83835
4291 METHYLMALONIC ACID $54.00 83921
4581 MHA-TP (T PALLIDUM AB) $36.00 86780
1960 MILK IgE WITH RFLX $14.00 86003
152 MMR PROFILE $50.00 86765, 86735, 86762
6239 MOLD IDENT $6.00 87107
5489 MOLD IgE PANEL $66.00 86003 X5  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
3510 MONO SCREEN $10.00 86308
5362 MTHFR $212.00 81291
5443 MUMPS IGG/IGM $60.00 86735, 86735-91
4585 MUMPS VIRUS IgG $12.00 86735
4965 MYELOPEROXIDASE AB, IgG $40.00 83516
4511 NEUTROPHIL CYTOPLASMIC AB $70.00 86255, IF POSITIVE
ADD 86256 AND 83516 X2
3154 NMR 8 PANEL $64.00 83704
5483 NORTH TEXAS IgE PANEL $288.00 86003 X24  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5722 NT-proBNP $156.00 83880
4266 NUCLEAR ANTIBODY PROFILE $150.00 86235 X9, 86225
5492 NUTS IgE PANEL $120.00 86003 X9  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
7017 OCCULT BLD $12.00 82272
7015 OCCULT BLOOD SCREEN (1-3) $12.00 82270
2133 OSMOLALITY, SERUM $32.00 83930
2134 OSMOLALITY, URINE $32.00 83935
7000 OVA AND PARASITES $162.00 87177, 87209 (BOTH X
1-3)
3080 PAIN MGMT DRUG SCRN,UR $190.00 80307
881410 PAP PATH INTERP $10.00 88141
8275 PAP SMEAR, SUREPATH $40.00 88142
8281 PAP SMEAR, THINPREP $100.00 88142
8972 PAP TEST,SUREPATH,IMAGED $40.00 88175
8277 PAP,MC 1YR SUREPATH SCRN $40.00 G0123
8276 PAP,MC 2YR SUREPATH SCRN $40.00 G0123
8278 PAP,MC DIAG SUREPATH $40.00 88142
8974 PAP,SUREPATH,MC 1YR,IMAGE $40.00 G0145
8973 PAP,SUREPATH,MC 2YR,IMAGE $40.00 G0145
8975 PAP,SUREPATH,MC DIAG,IMAG $40.00 88175
8282 PAP,THINPREP MC DIAGNOST $100.00 88142
8285 PAP,THINPREP,1YR MC $100.00 G0123
8284 PAP,THINPREP,2YR MC $100.00 G0123
1812 PEANUT IgE,RFLX PEANUT CO $14.00 86003
5482 PEDI AEROALLERGEN IgE PNL $336.00 86003 X24  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5524 PEDIATRIC FOOD IgE PANEL $140.00 86003 X11  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5481 PEDIATRIC FOOD II IgE PNL $140.00 86003 X10  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5499 PEDIATRIC IgE PANEL $140.00 86003 X10  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
3064 PHENYTOIN (DILANTIN) $19.20 80185
919 PHLEB FEE,NON-CPL PT $4.00 36415
920 PHLEBOTOMY FEE – SINGLE $6.00 36415
2227 PHOSPHORUS $6.00 84100
4593 POLIO AB’S 1,3 $86.00 86382 X2
2228 POTASSIUM $6.00 84132
4909 PREALBUMIN $26.00 84134
1540 PREGNANCY TEST, URINE $14.00 81025
2790 PROGESTERONE $18.00 84144
2800 PROLACTIN $20.00 84146
2804 PROLACTIN 45 MIN POST DOS $28.00 84146
2810 PROTEIN ELEC,UR RFLX IEP $52.10 84156, 84166
2805 PROTEIN ELECTRO,SERUM $22.00 84155, 84165
2149 PROTEIN, 24 HOUR URINE $10.50 84156
1425 PROTHROMBIN TIME $9.00 85610
1401 PROTIME & PTT $12.00 85610, 85730
2608 PSA TOTAL,SCRN MEDICARE $15.00 G0103
4915 PSA, FREE & TOTAL $32.00 84153, 84154
2606 PSA, TOTAL $14.00 84153
5046 PTH RELATED PEPTIDE $132.00 82397
2814 PTH, INTACT $50.00 83970
1430 PTT $9.75 85730
2159 RANDOM UR PROTEIN/CREAT $16.00 84156, 82570
6061 REFLEX STREP CULTURE $24.00 87880
4294 REFLEXED DIRECT LDL $20.00 83721
865930 REFLEXED RPR TITER $10.00 86593
1392 REG XIII RESPIRATORY $288.00
1587 REGION VI RESP DISEASE AL $300.00 86003 X22
5477 REGION X (TX,OK) IgE PAN $234.00 86003 X25  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
1280 REGION X IgE PANEL+TOTAL $332.00 86003 X25, 82785; SEE INDIVIDUAL COMPONENTS FOR
MC/MD TEST LIMITS
9326 RENAL FUNCTION + e-GFR $12.60 80069
9324 RENAL FUNCTION PANEL $7.95 80069 (AMA DEFINED
PANEL)
3795 RESPIRATORY PATHOGEN PCR $1092.00 87633, 87486, 87581
1050 RETICULOCYTE COUNT $8.00 85045
4275 REVERSE T3 $58.00 84482
3505 RHEUMATOID FACTOR $8.50 86431
2241 RISK RATIO (CHOL/HDL) $5.70
4284 RNP ANTIBODY $28.00 86235
3500 RPR $7.00 86592 (IF POSITIVE,
86593)
3503 RPR REFLEX TO TP-PA $7.00 86592
4613 RUBELLA IgG & IgM $46.00 86762 X2
4604 RUBEOLA IgG ANTIBODY $22.00 86765
4508 RUBEOLA IgG/IgM ANTIBODIE $58.00 86765 X2
2371 RX AMPHET,DES CONFIRM $50.00 80325
2353 RX AMPHETAMINES CONFIRM $50.00 80326
2359 RX BARBITUATES CONFIRM $50.00 80345
2349 RX BENZODIAZEPINES CONFIR $50.00 80347
2377 RX ETHANOL METAB CONFIRM $50.00 80321
2379 RX FENTANYL CONFIRMATION $50.00 80354
2381 RX GABA/PREGAB CONFIRM $50.00 80355
2365 RX ILLICIT,CLASS CONFIRM $50.00 80376
2367 RX OPIOIDS CONFIRMATION $50.00 80361
2405 RX OXYCODONE CONFIRMATION $50.00 80365
2451 RX PAIN MGMT $60.00 80307
4606 SCL-70 (SCLERODERMA) AB $40.00 86235
5491 SEAFOOD IgE PANEL $66.00 86003 X5  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
1055 SEDIMENTATION RATE $6.50 85652
4967 SERINE PROTEASE 3, IgG $40.00 83516
4258 SEROTONIN,SERUM $100.00 84260
2222 SERUM IRON $9.75 83540
4933 SEX HORMONE BIND GLOBULIN $20.00 84270
2218 SGOT (AST) $6.00 84450
2219 SGPT (ALT) $6.00 84460
5980 SHIGA TOXIN BY PCR $582.00 87798
4282 SJOGREN’S AB’S,SS-A/SS-B $40.00 86235 X2
4280 SJOGREN’S SS-A AB $26.00 86235
4281 SJOGREN’S SS-B AB $26.00 86235
4283 SMITH (SM) ANTIBODY $28.00 86235
5485 SOUTH TEXAS IgE PANEL $336.00 86003 X24  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
6040 SPUTUM, GRAM STAIN $18.00 87205 (GRAM STAIN).
6247 STAPH ID $6.00 87147
4828 STONE ANALYSIS $64.00 82365
6027 STOOL CULTURE,NO SENS $18.00 87045, 87046
6248 STREP ID $6.00 87147
5065 STRONGYLOIDES IGG AB $172.00 86682
2818 T3 TOTAL $12.00 84480
2819 T4 $11.25 84436
2830 TESTOSTERONE $20.00 84403
4937 TESTOSTERONE,FR/TOT W/SBG $48.00 84403, 84270
5543 TEXAS IgE PANEL $160.00 86003 X10  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5546 TEXAS REGIONAL IgE PANEL $230.00 86003 X16  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
8146 THINPREP PAP,IMAGED $42.00 88175
8148 THINPREP PAP,IMAGED MC 1Y $42.00 G0145
8147 THINPREP PAP,IMAGED MC 2Y $42.00 G0145
8149 THINPREP,IMAGED MC DIAG $42.00 88175
1468 THROMBOPHILIA PROFILE $102.00 85303, 85306, 85300
4516 THYROBLOGULIN AB $30.00 86800
4927 THYROGLOBULIN QNT & AB $36.00 84432, 86800
4610 THYROID ANTIBODY GROUP $38.00 86800, 86376
117 THYROID I PROFILE $11.50 84479, 84436
119 THYROID II PROFILE $20.00 84479, 84436, 84443
4513 THYROID PEROXIDASE AB $24.00 86376
4807 THYROID STIM IMM (THYRETA $120.00 84445
4931 THYROTROPIN RECPT AUTOAB $54.00 83520
210 TOTAL & DIRECT BILIRUBIN $8.00 82247, 82248
4142 TOTAL ESTROGENS $54.00 82672
4936 TRANSFERRIN $18.00 84466
5498 TREES IgE PANEL $96.00 86003 X6  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
3913 TRICHOMONAS URINE AMP $52.00 87661
3910 TRICHOMONAS VAG SWAB AMP $52.00 87661
2242 TRIGLYC RFLX TO DIR LDL $4.00 84478
4017 TROPONIN T $42.00 84484
2835 TSH $13.50 84443
2834 TSH REFLEX TO FREE T4 $14.25 84443
2836 TSH+FREE T4 $20.00 84443, 84439
2817 T-UPTAKE $7.00 84479
810020 UA MANUAL DIPSTICK $9.90 81002
6041 UA MICROSCOPIC & RFLX CUL $12.00 81001
2611 ULTRASENSITIVE PSA $16.00 84153
5480 UPPER RESPITORY IgE PANEL $224.00 86003 X16  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
2233 URIC ACID $9.00 84550
1501 URINALYSIS W/REFLEX MICRO $9.90 81003
1505 URINALYSIS WITH MICROSCOP $11.25 81001
1510 URINALYSIS,MICROSCOPIC $8.85 81015
6051 URINE,CULT IF INDICATED $11.25 81003
1515 UROGRAM $4.50 81003
2030 VAG PATHOGENS DNA PANEL $60.00 87480, 87510, 87660
3094 VALPROIC ACID (DEPAKENE) $18.60 80164
4737 VALPROIC ACID,FR AND TOT $164.00 80164, 80165
4665 VARICELLA ZOSTER IGG $18.00 86787
4664 VARICELLA ZOSTER IGM $18.00 86787
5487 VENOM IgE PANEL $84.00 86003 X6  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
4950 VITAMIN A $42.00 84590
2955 VITAMIN B 12 AND FOLIC AC $24.00 82607, 82746
4952 VITAMIN B-1 $62.00 84425
2840 VITAMIN B-12 $16.00 82607
4955 VITAMIN B3 $330.00 84591
4956 VITAMIN B-6 $40.00 84207
4958 VITAMIN D, 25-HYDROXY $40.00 82306
4962 VITAMIN E $42.00 84446
4963 VITAMIN K1 $130.00 84597
403 VON WILLEBRAND PANEL $318.00 85240, 85245, 85246
5497 WEEDS IgE PANEL $48.00 86003 X3  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
5484 WEST TEXAS IgE PANEL $303.00 86003 X24  SEE INDIVIDUAL COMPONENTS FOR MC/MD TEST
LIMITATIONS
6105 WET PREP $12.00 87210
1005 WHITE BLOOD COUNT $6.00 85048
6238 YEAST IDENT $9.00 87106
3112 ZIKA VIRUS BY PCR,SERUM $282.00 87662
4261 ZINC,SERUM/PLASMA $32.00 84630