| 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 |