144
Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List Period: September 1, 2015 through August 31, 2017 LabCorp Test Number LabCorp Test Name Comments 2015 CPT Code** RFP Test Directory of Services Test ATB Discountable Test 2015 Book Price 2015 Book Price Less 65% ATB Special Price Net Fee Stat Fees: 099895 Stat Fee (normal hours) 99199 Y N N $40.00 $40.00 $30.57 $30.57 270466 Stat Service (normal hours) 99199 N N N $34.00 $34.00 $30.57 $30.57 900414 STAT Fee (after hours) 99199 Y N N $59.50 $59.50 $61.11 $61.11 990895 STAT Fee (normal hours) 99199 Y N N $18.00 $18.00 $30.57 $30.57 998074 STAT (normal hours) 99199 Y N N $34.00 $34.00 $30.57 $30.57 998492 STAT Fee (normal hours) 99199 Y N N $29.75 $29.75 $30.57 $30.57 998591 STAT Charge (normal hours) 99199 Y N N $12.00 $12.00 $30.57 $30.57 Courier Fees: 998120 Courier Charge 99199 Y N N $6.00 $6.00 $6.00 Draw Fees: 099812 Drawing Fee 36415 Y N N $20.00 $20.00 $3.32 $3.32 996660 Drawing Fee 36415 Y N N $20.00 $20.00 $3.32 $3.32 998085 Venipuncture 36415 Y N N $20.00 $20.00 $3.32 $3.32 998205 Vendor Phlebotomy Fee 36415 N N N $20.00 $20.00 $3.32 $3.32 998542 Drawing Fee 36415 N N N $20.00 $20.00 $20.00 999326 Offsite Venipuncture Multi Pt 36415 N N N $20.00 $20.00 $20.00 995407 Hourly Phlebotomy Coverage Fee (>72 Hours Notice) Charge for each hour phleb service provided where notice >72 hours and not regularly scheduled. This charge is in addition to the per collection or draw fee referenced above. 36415 N N N $24.00 $24.00 $55.42 $55.42 Reference Testing Fees: 480848 %fPSA Reflex 84154 N N N $65.00 $65.00 $8.87 $8.87 071175 071175 7 Drug-Unb 80301 Y N N $63.00 $63.00 $10.11 $10.11 071910 071910 7 Drug-Scr 80301 Y N N $63.00 $63.00 $63.00 072306 072306 7+Alc-Scr 80301 Y N N $66.25 $66.25 $11.59 $11.59 074021 074021 9 Drug-Scr 80301 Y N N $76.00 $76.00 $10.48 $10.48 070340 17-OH P/Creat Ratio, Urine 83498, 82570 Y Y N $246.50 $246.50 $246.50 070085 17-OH Progesterone LCMS 83498 Y Y N $121.75 $121.75 $23.29 $23.29 504115 25-Hydroxyvitamin D LCMS D2+D3 82306 N Y N $294.00 $294.00 $104.69 $104.69 001701 5' Nucleotidase 83915 Y Y N $95.75 $95.75 $6.66 $6.66 316205 5-HIAA Qn,Random Urine 83497, 82570 Y Y N $107.00 $107.00 $16.08 $16.08 004069 5-HIAA,Quant.,24 Hr Urine 83497 Y Y N $71.50 $71.50 $25.66 $25.66 716159 6-Acetylmorphine, Conf 80356 Y Y N $137.50 $137.50 $37.74 $37.74 704411 704411 5 Drug-Unbund 80301 N N N $50.00 $50.00 $10.42 $10.42 725788 725788 7 Drug-Unbund 80301 Y Y N $63.00 $63.00 $63.00 726778 726778 7+Alc-Unbund 80301 Y Y N $69.50 $69.50 $10.48 $10.48 733339 733339 10+Alc-Scr 80301 N N N $100.00 $100.00 $13.31 $13.31 733690 733690 12+Oxycodone+Crt-Scr 80301, 80302 (x3) Y Y N $188.25 $188.25 $107.83 $107.83 733692 733692 9+Oxycodone+Crt-Scr 80301 N Y N $140.00 $140.00 $59.31 $59.31 733694 733694 9+Alc+Crt-Scr 80301 N N N $88.00 $88.00 $11.25 $11.25 **Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case. Page 1 of 144

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Page 1: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

Stat Fees:

099895 Stat Fee (normal hours) 99199 Y N N $40.00 $40.00 $30.57 $30.57

270466 Stat Service (normal hours) 99199 N N N $34.00 $34.00 $30.57 $30.57

900414 STAT Fee (after hours) 99199 Y N N $59.50 $59.50 $61.11 $61.11

990895 STAT Fee (normal hours) 99199 Y N N $18.00 $18.00 $30.57 $30.57

998074 STAT (normal hours) 99199 Y N N $34.00 $34.00 $30.57 $30.57

998492 STAT Fee (normal hours) 99199 Y N N $29.75 $29.75 $30.57 $30.57

998591 STAT Charge (normal hours) 99199 Y N N $12.00 $12.00 $30.57 $30.57

Courier Fees:

998120 Courier Charge 99199 Y N N $6.00 $6.00 $6.00

Draw Fees:

099812 Drawing Fee 36415 Y N N $20.00 $20.00 $3.32 $3.32

996660 Drawing Fee 36415 Y N N $20.00 $20.00 $3.32 $3.32

998085 Venipuncture 36415 Y N N $20.00 $20.00 $3.32 $3.32

998205 Vendor Phlebotomy Fee 36415 N N N $20.00 $20.00 $3.32 $3.32

998542 Drawing Fee 36415 N N N $20.00 $20.00 $20.00

999326 Offsite Venipuncture Multi Pt 36415 N N N $20.00 $20.00 $20.00

995407 Hourly Phlebotomy Coverage Fee (>72 Hours Notice)

Charge for each hour phleb

service provided where notice >72

hours and not regularly

scheduled. This charge is in

addition to the per collection or

draw fee referenced above. 36415 N N N $24.00 $24.00 $55.42 $55.42

Reference Testing Fees:

480848 %fPSA Reflex 84154 N N N $65.00 $65.00 $8.87 $8.87

071175 071175 7 Drug-Unb 80301 Y N N $63.00 $63.00 $10.11 $10.11

071910 071910 7 Drug-Scr 80301 Y N N $63.00 $63.00 $63.00

072306 072306 7+Alc-Scr 80301 Y N N $66.25 $66.25 $11.59 $11.59

074021 074021 9 Drug-Scr 80301 Y N N $76.00 $76.00 $10.48 $10.48

070340 17-OH P/Creat Ratio, Urine 83498, 82570 Y Y N $246.50 $246.50 $246.50

070085 17-OH Progesterone LCMS 83498 Y Y N $121.75 $121.75 $23.29 $23.29

504115 25-Hydroxyvitamin D LCMS D2+D3 82306 N Y N $294.00 $294.00 $104.69 $104.69

001701 5' Nucleotidase 83915 Y Y N $95.75 $95.75 $6.66 $6.66

316205 5-HIAA Qn,Random Urine 83497, 82570 Y Y N $107.00 $107.00 $16.08 $16.08

004069 5-HIAA,Quant.,24 Hr Urine 83497 Y Y N $71.50 $71.50 $25.66 $25.66

716159 6-Acetylmorphine, Conf 80356 Y Y N $137.50 $137.50 $37.74 $37.74

704411 704411 5 Drug-Unbund 80301 N N N $50.00 $50.00 $10.42 $10.42

725788 725788 7 Drug-Unbund 80301 Y Y N $63.00 $63.00 $63.00

726778 726778 7+Alc-Unbund 80301 Y Y N $69.50 $69.50 $10.48 $10.48

733339 733339 10+Alc-Scr 80301 N N N $100.00 $100.00 $13.31 $13.31

733690 733690 12+Oxycodone+Crt-Scr 80301, 80302 (x3) Y Y N $188.25 $188.25 $107.83 $107.83

733692 733692 9+Oxycodone+Crt-Scr 80301 N Y N $140.00 $140.00 $59.31 $59.31

733694 733694 9+Alc+Crt-Scr 80301 N N N $88.00 $88.00 $11.25 $11.25

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

Page 1 of 144

Page 2: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

733726 733726 13+Oxycodone+Crt-Scr 80301, 80302 (x3) Y Y N $205.00 $205.00 $205.00

733848 733848 9+Alc+Crt-Scr 80301 Y N N $90.50 $90.50 $90.50

734349 734349 3 Drug-Scr Test Not Coded Y N N $37.00 $37.00 $8.91 $8.91

734351 734351 5 Drug-Scr 80301 Y N N $50.00 $50.00 $9.85 $9.85

734352 734352 6 Drug-Scr Test Not Coded Y N N $56.50 $56.50 $10.27 $10.27

734353 734353 7 Drug-Scr Test Not Coded Y N N $63.00 $63.00 $10.66 $10.66

737921 737921 12+Oxycodone+Crt-Unbund 80301, 80302 (x3), 80346 N N N $301.75 $301.75 $240.56 $240.56

763824 763824 12+Oxycodone+Crt-Unbund 80301, 80302 (x3) Y Y N $198.00 $198.00 $198.00

764227 764227 9+Oxyco+Crt-Unbund 80301, 80346 N N N $255.00 $255.00 $190.04 $190.04

764883 764883 11+Oxyco+Alc+Crt-Bund 80301, 80302 (x2) Y N N $196.00 $196.00 $47.15 $47.15

764888 764888 10+Oxyco+Alc+Crt-Bund 80301, 80302 Y Y N $190.00 $190.00 $40.51 $40.51

764928 764928 11+Oxycodone+Crt-Bund 80301, 80302 (x3), 80346 N N N $313.50 $313.50 $60.98 $60.98

765000 765000 11+Oxyco+Alc+Crt-Bund 80301, 80302 (x2) N N N $196.50 $196.50 $32.35 $32.35

765204 765204 15+Oxyco-Bund+Bup-Scr 80301, 80302 (x4), 80304 Y N N $308.00 $308.00 $70.09 $70.09

765507 765507 9+MDMA+Oxyco+Crt-Bund 80301 Y N N $158.50 $158.50 $23.39 $23.39

768431 768431 10+Oxycodone+Crt-Bund 80301, 80302 N N N $185.50 $185.50 $42.86 $42.86

770628 770628 7 Drug-Scr 80301 Y N N $63.00 $63.00 $10.48 $10.48

772111 772111 9+Alc+Crt-Scr 80301 Y N N $88.00 $88.00 $11.25 $11.25

772236 772236 8+Alc-Scr 80301 Y N N $81.50 $81.50 $12.36 $12.36

788243 788243 10+Alc-Bund 80301 Y N N $106.75 $106.75 $13.31 $13.31

788423 788423 7 Drug-Bund 80301 N N N $66.00 $66.00 $11.77 $11.77

788583 788583 10+Crt-Bund 80301 Y N N $109.00 $109.00 $16.63 $16.63

788878 788878 9+MDMA-Bund 80301 Y N N $92.50 $92.50 $92.50

788941 788941 7+MDMA-Bund 80301 N N N $71.50 $71.50 $73.29 $73.29

789034 789034 7+Crt-Bund 80301 Y N N $71.50 $71.50 $11.77 $11.77

789888 789888 6+MDMA+Crt-Bund Test Not Coded N N N $79.00 $79.00 $15.34 $15.34

790034 790034 9+MDMA+Crt-Bund 80301 Y N N $98.50 $98.50 $98.50

791742 791742 10+Oxycodone+Alc-Bund 80301, 80302 Y N N $171.50 $171.50 $171.50

794388 794388 7 Drug-Bund 80301 Y Y N $73.00 $73.00 $11.77 $11.77

799007 799007 7 Drug-Bund 80301 Y N N $73.00 $73.00 $11.77 $11.77

799452 799452 5 Drug-Bund 80301 Y N N $60.00 $60.00 $12.11 $12.11

883001 88300 Surgical Pathology 88300 Y N N $40.00 $40.00 $21.50 $21.50

T83001 88300 Tech Comp-1st Site 88300 TC N N N $31.25 $31.25 $16.66 $16.66

883041 88304 Surgical Path-1st Site 88304 Y N N $102.75 $102.75 $43.50 $43.50

883042 88304 Surgical Path-2nd Site 88304 Y N N $102.75 $102.75 $43.50 $43.50

T83041 88304 Tech Comp-1st Site 88304 TC N N N $80.75 $80.75 $33.93 $33.93

T83042 88304 Tech Comp-2nd Site 88304 TC N N N $80.75 $80.75 $33.93 $33.93

P83051 88305 Prof Comp-1st Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83052 88305 Prof Comp-2nd Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83053 88305 Prof Comp-3rd Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83054 88305 Prof Comp-4th Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83055 88305 Prof Comp-5th Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83056 88305 Prof Comp-6th Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83057 88305 Prof Comp-7th Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

P83058 88305 Prof Comp-8th Site 88305 26 N N N $62.00 $62.00 $20.58 $20.58

Page 2 of 144

Page 3: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

883051 88305 Surg Path-1st Site 88305 Y N N $148.00 $148.00 $49.00 $49.00

883052 88305 Surg Path-2nd Site 88305 Y N N $148.00 $148.00 $49.00 $49.00

883053 88305 Surg Path-3rd Site 88305 Y N N $148.00 $148.00 $49.00 $49.00

883054 88305 Surg Path-4th Site 88305 Y N N $148.00 $148.00 $49.00 $49.00

883055 88305 Surg Path-5th Site 88305 Y N N $148.00 $148.00 $49.00 $49.00

883056 88305 Surg Path-6th Site 88305 Y N N $148.00 $148.00 $49.00 $49.00

883057 88305 Surg Path-7th Site 88305 N N N $148.00 $148.00 $49.00 $49.00

883058 88305 Surg Path-8th Site 88305 N N N $148.00 $148.00 $49.00 $49.00

T83051 88305 Tech Comp-1st Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

T83052 88305 Tech Comp-2nd Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

T83053 88305 Tech Comp-3rd Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

T83054 88305 Tech Comp-4th Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

T83056 88305 Tech Comp-6th Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

T83057 88305 Tech Comp-7th Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

T83058 88305 Tech Comp-8th Site 88305 TC N N N $86.00 $86.00 $28.42 $28.42

883071 88307 Surgical Pathology 88307 Y N N $260.50 $260.50 $70.80 $70.80

883072 88307 Surgical Pathology 88307 Y N N $260.50 $260.50 $70.80 $70.80

883073 88307 Surgical Pathology 88307 Y N N $260.50 $260.50 $260.50

T83071 88307 Tech Comp-1st Site 88307 TC N N N $132.25 $132.25 $35.75 $35.75

T83072 88307 Tech Comp-2nd Site 88307 TC N N N $132.25 $132.25 $35.75 $35.75

T83121 88312 Tech Comp-1st Stain 88312 TC N N N $78.50 $78.50 $33.43 $33.43

114041 Ab Scr+Antibody ID 86870 Y N N $87.00 $87.00 $30.20 $30.20

006056 ABO Grouping 86900 Y Y Y $30.25 $10.59 $10.59

006049 ABO Grouping and Rho(D) Typing 86900, 86901 Y Y Y $60.25 $21.09 $5.52 $5.52

007740 Acetaminophen (Tylenol), S 80329 Y Y N $98.25 $98.25 $22.17 $22.17

086007 Acetylcholine Receptor Ab, All 83519 (x3) Y Y N $700.50 $700.50 $700.50

085902 AChR Binding Abs, Serum 83519 N Y N $259.75 $259.75 $33.80 $33.80

183753 Acid Fast Smear+Culture 87206, 87116 Y Y N $132.00 $132.00 $29.43 $29.43

183764 Acid Fast Smear+Culture W/Rflx 87206, 87116 Y Y N $132.00 $132.00 $29.43 $29.43

004440 ACTH, Plasma 82024 Y Y N $171.75 $171.75 $35.49 $35.49

006643 Actin (Smooth Muscle) Antibody 83516 Y Y N $98.50 $98.50 $11.09 $11.09

117762 Activated Protein C Resistance 85307 N Y N $135.00 $135.00 $49.89 $49.89

017422 Add On: hCG,uE3,Inhibin 84702, 82677, 86336 Y N N $267.00 $267.00 $267.00

W20321 Add'l IHC Per Slide X1 Glbl Test Not Coded N N N $100.00 $100.00 $100.00 $100.00

P20321 Add'l IHC Per Slide X1 Prof Test Not Coded N N N $65.00 $65.00 $65.00 $65.00

T20321 Add'l IHC Per Slide X1 Tech Test Not Coded N N N $35.00 $35.00 $35.00 $35.00

010447 ADH 84588 Y Y N $233.00 $233.00 $30.75 $30.75

788890 Adulteration (Dilution), Urine Test Not Coded Y Y N $8.00 $8.00 $1.94 $1.94

182261 Aerobe ID + Suscept 87077 Y Y N $82.75 $82.75 $17.73 $17.73

008649 Aerobic Bacterial Culture 87070 Y Y N $65.25 $65.25 $11.09 $11.09

180803 Aerobic Cult, Extend Incubat 87073 N Y N $65.25 $65.25 $11.09 $11.09

088161 AFB Antibiotic Suscep 87190 (x4) N Y N $323.50 $323.50 $138.57 $138.57

182675 AFB Cult/Smear, Broth, Suscep 87081, 87149 Y N N $163.25 $163.25 $38.80 $38.80

182402 AFB Culture and Smear,Broth 87116, 87206, 87015 Y N N $163.25 $163.25 $38.80 $38.80

017319 AFP Tetra 82105, 82677, 84702, 86336 Y Y N $348.75 $348.75 $36.64 $36.64

Page 3 of 144

Page 4: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

141300 AFP with AFP-L3% 82107 Y Y N $257.25 $257.25 $83.14 $83.14

010801 AFP, Serum, Open Spina Bifida 82105 Y Y N $81.75 $81.75 $12.20 $12.20

002253 AFP, Serum, Tumor Marker 82105 Y Y Y $76.25 $26.69 $8.87 $8.87

480012 AFP, Tumor Marker (Serial) 82105 Y Y Y $99.25 $34.74 $19.68 $19.68

480300 AFP-L3% (Serial Monitor) 82107 Y Y N $280.25 $280.25 $280.25

096354 ALA Delta, 24-Hour Urine 82135 N Y N $198.25 $198.25 $71.24 $71.24

007351 ALA Delta, Random Urine 82135 N Y N $198.25 $198.25 $48.50 $48.50

375268 Alb+AST+Fe+Prot+PT+Plt

85049, 85610, 84155, 82040,

84450, 83540 Y N Y $83.00 $29.05 $29.05

001909 Alb+Prot 82040, 84155 N N Y $27.50 $9.63 $1.95 $1.95

001081 Albumin, Serum 82040 Y Y Y $27.00 $9.45 $1.75 $1.75

002030 Aldolase 82085 Y Y N $59.25 $59.25 $3.60 $3.60

004374 Aldosterone LCMS, Serum 82088 Y Y N $141.00 $141.00 $23.29 $23.29

004291 Aldosterone, Urine 82088 N Y N $193.75 $193.75 $69.63 $69.63

004354 Aldosterone/Renin Ratio 82088, 84244 Y Y N $255.75 $255.75 $255.75

001612 Alk Phos Isoenzyme 84080, 84075 Y Y N $89.75 $89.75 $11.09 $11.09

513160 Alk Phosphatase, Bone Specific 84080 N N N $101.25 $101.25 $33.26 $33.26

513002 Alk Phosphatase, Bone Specific 84080 Y Y N $101.25 $101.25 $33.26 $33.26

480004 Alkaline Phosphatase (Serial) 84075 Y Y Y $50.00 $17.50 $17.50

001107 Alkaline Phosphatase, S 84075 Y Y Y $27.00 $9.45 $1.75 $1.75

600973 Allergen Panel, Food-Berry 86003 (x3) Y Y N $72.75 $72.75 $72.75

660423 Allergen Profile, Basic Food 86003 (x9), 86005 Y Y N $242.50 $242.50 $44.50 $44.50

648014 Allergen Profile, Food-Basic 86003 (x6) Y Y N $145.50 $145.50 $26.70 $26.70

601013 Allergen Profile, Food-Fish 86003 (x7) Y Y N $169.75 $169.75 $31.15 $31.15

601872 Allergen Profile, Food-Fruit 86003 (x5) Y Y N $121.25 $121.25 $121.25

600999 Allergen Profile, Food-Legume 86003 (x3) Y Y N $72.75 $72.75 $72.75

602284 Allergen Profile, Food-Meat 86003 (x3) Y Y N $72.75 $72.75 $13.35 $13.35

601856 Allergen Profile, Food-Milk 86003 (x6) Y Y N $145.50 $145.50 $26.70 $26.70

649749 Allergen Profile, Mini-Panel 86003 (x12) Y Y N $291.00 $291.00 $44.50 $44.50

062448 Allergen Profile, Mold 86003 (x12) Y Y N $291.00 $291.00 $57.85 $57.85

672486 Allergen Profile, Ragweed Plus 86003 (x4) N Y N $97.00 $97.00 $22.25 $22.25

062695 Allergen Profile, Shellfish 86003 (x6) Y Y N $145.50 $145.50 $26.70 $26.70

601831 Allergen Profile, Vegetable I 86003 (x7) Y Y N $169.75 $169.75 $31.15 $31.15

601823 Allergen Profile, Vegetable II 86003 (x9) Y Y N $218.25 $218.25 $40.05 $40.05

602421 Allergens (4) Foods 86003 (x4) Y N N $97.00 $97.00 $97.00

607523 Allergens(10) 86003 (x10) N N N $242.50 $242.50 $44.50 $44.50

602292 Allergens(4) 86003 (x4) Y N N $97.00 $97.00 $97.00

670797 Allergens(5) 86003 (x5) N N N $121.25 $121.25 $22.25 $22.25

671926 Allergens(7) 86003 (x7) Y Y N $169.75 $169.75 $31.15 $31.15

672208 Allergens(9) 86003 (x9) N N N $218.25 $218.25 $40.05 $40.05

672489 Allergens(9) 86003 (x9) N N N $218.25 $218.25 $40.05 $40.05

603203 Allergens(92) Foods 86003 (x92) Y N N $2,231.00 $2,231.00 $2,231.00

676528 Allergens, Zone 2 86003 (x30) N N N $703.25 $703.25 $129.05 $129.05

676536 Allergens, Zone 3 86003 (x26) Y N N $630.50 $630.50 $115.70 $115.70

082553 Allyl Alcohol, Blood 84600 N N N $575.75 $575.75 $402.22 $402.22

Page 4 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

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2015 Book

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**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

347692 AlP+ALT+AST+Creat+Glu+TBili...

85027, 82947, 84550, 82565,

82247, 84075, 84450, 84460 Y N Y $55.50 $19.43 $4.70 $4.70

332158 AlP+ALT+AST+Creat+TBili+Uri...

85027, 84550, 82565, 82247,

84075, 84450, 84460 Y N Y $46.25 $16.19 $4.58 $4.58

315865 AlP+ALT+AST+TBili+Uric A+CB...

85027, 82247, 84075, 84450,

84460, 84550 Y N Y $45.75 $16.01 $4.46 $4.46

001982 Alpha-1-Antitrypsin, Serum 82103 Y Y Y $72.50 $25.38 $6.66 $6.66

511172 Alpha-Thalassemia 81257 N Y N $450.00 $450.00 $461.25 $461.25

001545 ALT (SGPT) 84460 Y Y Y $27.00 $9.45 $1.75 $1.75

316566 ALT+AST+Creat+Uric A+Hgb+Plt

85018, 85049, 84550, 82565,

84450, 84460 Y N Y $64.00 $22.40 $6.52 $6.52

257451 ALT+AST+TBili 82247, 84450, 84460 Y N Y $22.50 $7.88 $2.07 $2.07

071548 Aluminum, Plasma/Serum 82108 N Y N $120.25 $120.25 $22.17 $22.17

071555 Aluminum, Urine 82108, 82570 N Y N $86.25 $86.25 $33.26 $33.26

031138 Amenorrhea Profile 83001, 83002, 84146 N Y Y $284.50 $99.58 $15.84 $15.84

717330 Amikacin , Serum, Peak/Trough 80150 (x2) N Y Y $194.00 $67.90 $33.26 $33.26

700068 Amino Acid Profile, Qn, Plasma 82139 N Y N $561.00 $561.00 $171.82 $171.82

700140 Amino Acid Profile, Qn, Urine 82139 N Y N $561.00 $561.00 $215.67 $215.67

706705 Amiodarone (Cordarone), Serum 80299 N Y N $141.00 $141.00 $25.49 $25.49

007476 Amitriptyline (Elavil), Serum 80335 Y Y N $127.25 $127.25 $15.52 $15.52

007054 Ammonia, Plasma 82140 Y Y Y $98.25 $34.39 $3.88 $3.88

791588 Amphetamine Analysis, WB 80301 N Y N $82.25 $82.25 $27.72 $27.72

071282 Amphetamine Confirmation, Ur 80324 Y Y N $119.50 $119.50 $33.26 $33.26

074401 Amphetamine Screen, Urine 80301 Y Y N $24.00 $24.00 $24.00

737693 Amphetamine, Urine 80301 Y Y N $24.00 $24.00 $24.00

737892 Amphetamines (GC/MS), Urine 80324 Y N N $119.50 $119.50 $119.50

707013 Amphetamines Confirm, Urine Test Not Coded Y N N $119.50 $119.50 $119.50

027094 Amy+Lipase 82150, 83690 Y N Y $74.50 $26.08 $4.88 $4.88

001396 Amylase, Serum 82150 Y Y Y $37.25 $13.04 $2.44 $2.44

003293 Amylase, Urine 82150 N Y Y $37.25 $13.04 $4.43 $4.43

341776 ANA 86038 Y N Y $69.25 $24.24 $4.17 $4.17

165092 ANA Comprehensive Panel 86225, 86235 (x8) Y Y N $929.25 $929.25 $174.56 $174.56

164962 ANA w/Reflex 86038 Y Y Y $69.25 $24.24 $4.17 $4.17

164863 ANA w/Reflex if Positive 86038 Y Y Y $69.25 $24.24 $4.17 $4.17

368894 ANA+ENA+C3+C4+DNA/DS+Card(I...

86038, 86147 (x3), 86160 (x2),

86225, 86235 (x4) N N N $841.75 $841.75 $128.87 $128.87

024141 ANA+RA Qn 86038, 86431 Y N Y $102.75 $35.96 $7.39 $7.39

008003 Anaerobic and Aerobic Culture 87070, 87075 Y Y N $198.50 $198.50 $34.38 $34.38

008900 Anaerobic Cult, Extend Incubat 87073 N Y N $133.25 $133.25 $23.29 $23.29

008904 Anaerobic Culture 87075 Y Y N $133.25 $133.25 $23.29 $23.29

183111 Anaerobic/Aerobic/Gram Stain 87070, 87075, 87205 Y Y N $235.75 $235.75 $41.69 $41.69

009160 Anal(Rectal) Cytology, LBP 88112 Y Y N $133.00 $133.00 $55.42 $55.42

163873 ANCA Panel 86256 (x3), 83520 (x2) Y Y N $477.25 $477.25 $55.42 $55.42

030577 Anemia Profile A 83550, 85025, 85045, 83540 N Y Y $109.50 $38.33 $9.09 $9.09

Page 5 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

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RFP

Test

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Discountable

Test

2015 Book

Price

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Special

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**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

042077 Anemia Profile B

82607, 82728, 82746, 83550,

85025, 85045, 83540 Y Y Y $328.00 $114.80 $24.18 $24.18

010116 Angiotensin-Converting Enzyme 82164 Y Y N $81.25 $81.25 $8.31 $8.31

082024 Antiadrenal Antibodies, Quant 86255 N Y N $101.00 $101.00 $19.96 $19.96

006023 Antibody Identification 86870 N N N $87.00 $87.00 $25.78 $25.78

006213 Antibody Identification 86870 Y Y N $87.00 $87.00 $25.78 $25.78

006015 Antibody Screen 86850 Y Y Y $30.50 $10.68 $7.77 $7.77

161950 Anticardiolip Ab, IgA/G/M, Qn 86147 (x3) Y Y Y $273.00 $95.55 $59.30 $59.30

161836 Anticardiolipin Ab, IgA, Qn 86147 Y Y N $91.00 $91.00 $91.00

161810 Anticardiolipin Ab, IgG, Qn 86147 Y Y N $91.00 $91.00 $13.30 $13.30

161802 Anticardiolipin Ab, IgG/M, Qn 86147 (x2) Y Y Y $182.00 $63.70 $45.95 $45.95

161828 Anticardiolipin Ab, IgM, Qn 86147 Y Y N $91.00 $91.00 $32.65 $32.65

164814 Anti-Centromere B Antibodies 86235 Y Y N $103.25 $103.25 $103.25

012580 Antichromatin Antibodies 86235 N Y N $103.25 $103.25 $22.17 $22.17

160154 Antichromatin Antibodies 86235 Y N N $103.25 $103.25 $22.17 $22.17

046557 Antidiuretic Hormone Profile 83930, 84588 Y Y N $288.00 $288.00 $36.29 $36.29

161422 Anti-DNA(SS)IgG, Ab, Qn 86226 N Y N $110.75 $110.75 $24.40 $24.40

096289 Anti-DNase B Strep Antibodies 86215 Y Y N $114.25 $114.25 $19.96 $19.96

096339 Anti-dsDNA Antibodies 86225 Y Y N $103.25 $103.25 $6.66 $6.66

160151 Anti-dsDNA Antibodies 86225 Y N N $103.25 $103.25 $6.66 $6.66

006338 Antiextractable Nuclear Ag 86235 (x2) Y Y N $206.50 $206.50 $24.94 $24.94

012518 Antihistone Antibodies 86235 N Y N $103.25 $103.25 $38.97 $38.97

163840 Antimyeloperoxidase (MPO) Abs 83520 N Y N $138.00 $138.00 $16.63 $16.63

085910 Antimyocardial Antibodies, Qn 86256 (x2) Y Y N $91.75 $91.75 $91.75

162388 Antineutrophil Cytoplasmic Ab 86256 (x3) Y Y N $201.25 $201.25 $22.17 $22.17

164880 Antinuclear Ab Reflex Cascade 86038 Y Y Y $69.25 $24.24 $4.17 $4.17

164855 Antinuclear Antibodies Direct 86038 Y Y Y $69.25 $24.24 $4.17 $4.17

164947 Antinuclear Antibodies, IFA 86038 Y Y Y $83.00 $29.05 $4.17 $4.17

160721 Antipancreatic Islet Cells 86341 N Y N $141.00 $141.00 $24.40 $24.40

006486 Antiparietal Cell Antibody 83516 N Y N $98.50 $98.50 $35.37 $35.37

250555 Antiphospholipid Syndrome Prof 85613, 85732, 86147 (x2) N N N $374.75 $374.75 $101.37 $101.37

163857 Antiproteinase 3 (PR-3) Abs 83520 N Y N $138.00 $138.00 $16.63 $16.63

018705 Antiscleroderma-70 Antibodies 86235 Y Y N $103.25 $103.25 $18.45 $18.45

160158 Antiscleroderma-70 Antibodies 86235 Y N N $103.25 $103.25 $103.25

006031 Antistreptolysin O Ab 86060 Y Y Y $41.50 $14.53 $4.43 $4.43

015040 Antithrombin Activity 85300 Y Y N $170.00 $170.00 $29.93 $29.93

015594 Antithrombin III, Func/Immunol 85300, 85301 Y Y N $330.00 $330.00 $45.45 $45.45

006692 Antithyroglobulin Ab 86800 Y Y N $84.50 $84.50 $10.26 $10.26

500555 Anti-Thyroglobulin Antibodies 86800 Y N N $84.50 $84.50 $84.50

216010 Apo A1 + B + Ratio 82172 (x2) N Y Y $118.50 $41.48 $18.29 $18.29

167015 Apolipoprotein B 82172 Y Y Y $59.25 $20.74 $20.74

117199 aPTT Mixing Studies 85730, 85732 (x3) Y Y N $221.00 $221.00 $221.00

809671 Aripiprazole 80342 Y Y N $189.50 $189.50 $97.86 $97.86

112185 Arterial Blood Gas 82803 N N N $122.75 $122.75 $16.63 $16.63

001123 AST (SGOT) 84450 Y Y Y $27.00 $9.45 $1.75 $1.75

Page 6 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

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Test

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Discountable

Test

2015 Book

Price

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Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

006981 Autoimmune Profile 86038, 86160, 86225 N Y N $206.00 $206.00 $15.26 $15.26

811338 Azathioprine (Imuran) 80375 Y Y N $180.00 $180.00 $180.00

164541 B pertussis IgG/M/A Ab 86615 (x3) Y Y N $398.25 $398.25 $398.25

006890 Bacterial Antigens 87802, 87899 (x3) N Y N $602.00 $602.00 $216.26 $216.26

180812 Bacterial Antigens 87802, 87899 (x3) N Y N $602.00 $602.00 $216.26 $216.26

180060 Bacterial Vaginosis, NAA 87798, 87798 59 (x2) Y Y N $270.00 $270.00 $62.00 $62.00

071290 Barbiturate Confirmation, Ur 80345 Y Y N $119.50 $119.50 $33.26 $33.26

074419 Barbiturate Screen, Urine 80301 Y Y N $24.00 $24.00 $24.00

814483 Bartonella + Bact. Aerobic 87070 N N N $153.00 $153.00 $99.77 $99.77

163162 Bartonella Antibody Panel 86611 (x4) N Y N $216.00 $216.00 $77.56 $77.56

164075 Bartonella henselae IgG/M 86611 (x2) N N N $216.00 $216.00 $77.56 $77.56

303758 Basic Metabolic Panel (7) 80051, 82565, 82947, 84520 Y N Y $30.00 $10.50 $2.55 $2.55

322758 Basic Metabolic Panel (8) 80048 Y Y Y $30.50 $10.68 $2.67 $2.67

791710 Benzodiazepine Confirm, QT, WB 80347, 82742 N Y N $314.50 $314.50 $83.14 $83.14

071308 Benzodiazepine Confirmation,Ur 80346 Y Y N $119.50 $119.50 $33.26 $33.26

074427 Benzodiazepine Screen, Urine 80301 N Y N $24.00 $24.00 $7.78 $7.78

763910 Benzodiazepines Confirm, Urine 80346 Y Y N $119.50 $119.50 $33.26 $33.26

764060 Benzodiazepines Confirm, Urine 80346 Y N N $119.50 $119.50 $119.50

798419 Benzodiazepines GC/MS Retest 80346 N N N $183.75 $183.75 $107.83 $107.83

008169 Beta Strep Gp A Culture 87081 Y Y N $37.25 $37.25 $6.09 $6.09

252823 Beta Thalassemia: HBB 81404 Y Y N $735.00 $735.00 $735.00

163915 Beta-2 Glycoprotein I Ab,G,A,M 86146 (x3) Y Y N $255.00 $255.00 $16.63 $16.63

010181 Beta-2 Microglobulin, Serum 82232 N Y N $104.50 $104.50 $16.63 $16.63

010173 Beta-2 Microglobulin, Urine 82232 Y Y N $125.25 $125.25 $125.25

503610 Beta-Hydroxybutyrate 82010 Y Y N $82.00 $82.00 $82.00

010330 Bile Acids 82239 Y Y N $67.75 $67.75 $12.74 $12.74

003228 Bile, Qualitative, Urine 81005 N Y Y $37.25 $13.04 $7.48 $7.48

205500 Bilirubin Fraction, Neonatal 82247, 82248 Y Y Y $27.50 $9.63 $3.88 $3.88

001222 Bilirubin, Direct 82248 Y Y Y $27.00 $9.45 $1.75 $1.75

001099 Bilirubin, Total 82247 Y Y Y $27.00 $9.45 $1.75 $1.75

001214 Bilirubin, Total/Direct, Serum 82247, 82248 Y Y Y $27.50 $9.63 $1.95 $1.95

826700 Black Bean IgE 86003 Y N N $48.50 $48.50 $48.50

791706 Bld Drugs of Abuse, 7, WB 80301 Y Y N $302.50 $302.50 $302.50

008300 Blood Culture, Routine 87040 Y Y N $63.50 $63.50 $12.20 $12.20

005702 Blood Drawing 36415 N N N $20.00 $20.00 $3.32 $3.32

791570 Blood Drugs of Abuse 6, WB 80301 Y Y N $227.50 $227.50 $106.70 $106.70

791590 Blood Drugs of Abuse 8, WB 80301 Y Y N $289.50 $289.50 $149.65 $149.65

850601 Blood-SMR,Periph;Int/Phy 1st 85060 N N N $84.50 $84.50 $60.98 $60.98

335362 BMP8+eGFR 80048 Y N Y $30.50 $10.68 $2.67 $2.67

322458 BMP8+LP+1AC+Hb A1c 80048, 80061, 83036, 84450 Y N Y $153.75 $53.81 $10.31 $10.31

180802 Body Fluid Culture, Sterile 87070 Y Y N $89.75 $89.75 $17.73 $17.73

009134 Breast Discharge Cytology 88161 Y Y N $113.50 $113.50 $44.34 $44.34

164608 Brucella Antibody IgG, EIA 86622 Y Y N $80.00 $80.00 $28.69 $28.69

164624 Brucella Antibody IgM, EIA 86622 Y Y N $80.00 $80.00 $28.69 $28.69

140889 B-Type Natriuretic Peptide 83880 Y Y N $183.75 $183.75 $36.58 $36.58

Page 7 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

001040 BUN 84520 Y Y Y $27.00 $9.45 $1.75 $1.75

024778 BUN+Creat 82565, 84520 Y N Y $27.50 $9.63 $1.95 $1.95

764400 Buprenorphine Confirm, Urine 80348 Y Y N $119.50 $119.50 $48.52 $48.52

761153 Buprenorphine, Urine 80301 Y N N $58.00 $58.00 $17.43 $17.43

763400 Buprenorphine, Urine 80301 N Y N $58.00 $58.00 $20.49 $20.49

764130 Buprenorphine, Urine 80301 Y N N $60.00 $60.00 $17.73 $17.73

220955 Burkholderia Pseudom. Ab, IFA 86609 (x2) N N N $251.25 $251.25 $215.67 $215.67

182725 BV+Ct/Ng/Tv NAA+Yeast Culture

87905, 87102, 87491, 87591,

87661 Y Y N $484.75 $484.75 $135.48 $135.48

182717 BV+Trich NAA+Yeast Culture 87905, 87102, 87661 N Y N $261.25 $261.25 $120.18 $120.18

182709 BV+Yeast Culture 87905, 87102 N Y N $201.75 $201.75 $89.18 $89.18

180055 C albicans + C glabrata, NAA 87481, 87481 59 Y Y N $202.50 $202.50 $52.00 $52.00

188045 C difficile Toxigenic Culture 87075 Y N N $67.75 $67.75 $13.86 $13.86

183988 C difficile Toxin Gene NAA 87493 Y Y N $125.00 $125.00 $125.00

086207 C difficile Toxins A+B, EIA 87324 Y Y N $107.00 $107.00 $11.96 $11.96

180448 C difficile, Cytotoxin B 87230 Y Y N $120.00 $120.00 $12.25 $12.25

183620 C. trachomatis NAA, Confirm 87491 59 Y N N $160.00 $160.00 $160.00

067108 C001-IgE Penicillin G 86003 Y Y N $19.75 $19.75 $4.45 $4.45

067116 C002-IgE Penicillin V 86003 N Y N $19.75 $19.75 $4.45 $4.45

120220 C1 Esterase Inhibitor, Func 86161 N Y N $189.00 $189.00 $67.94 $67.94

123014 C3d Immune Complexes 86332 N Y N $153.00 $153.00 $38.80 $38.80

033852 C4+C3 86160 (x2) Y N Y $133.00 $46.55 $8.86 $8.86

144733 CA 125 in the Presence of HAMA 86304 N Y N $153.25 $153.25 $15.80 $15.80

480061 CA 125, Serum (Serial) 86304 Y Y Y $145.75 $51.01 $51.01

483404 CA 15-3 (Serial Monitor) 86300 Y Y N $133.75 $133.75 $133.75

002261 CA 19-9 86301 Y Y N $119.50 $119.50 $119.50

140293 CA 27.29 86300 Y Y N $122.75 $122.75 $13.30 $13.30

480293 CA 27.29 (Serial Monitor) 86300 N Y N $145.75 $145.75 $55.00 $55.00

004945 Ca+Creat+P+PTH Intact 83970, 82310, 82565, 84100 Y N Y $164.50 $57.58 $15.37 $15.37

054601 Ca+PTH Intact 83970, 82310 Y Y Y $163.50 $57.23 $57.23

004895 Calcitonin, Serum 82308 Y Y N $175.50 $175.50 $175.50

081091 Calcitriol(1,25 di-OH Vit D) 82652 Y Y N $245.25 $245.25 $26.60 $26.60

003269 Calcium, 24Hr Urine 82340 Y Y Y $28.50 $9.98 $2.78 $2.78

004804 Calcium, Ionized, Serum 82330 Y Y Y $75.25 $26.34 $4.43 $4.43

013706 Calcium, Random Urine 82340 Y N Y $28.50 $9.98 $2.44 $2.44

001016 Calcium, Serum 82310 Y Y Y $27.00 $9.45 $1.75 $1.75

058099 Calcium+Calcium, Ionized 82330, 82310 Y N Y $87.25 $30.54 $30.54

120790 Calculi, Urinary 82360 Y Y N $70.25 $70.25 $16.63 $16.63

120691 Calculi, Urinary, with Photo 82360 N Y N $81.25 $81.25 $16.63 $16.63

123255 Calprotectin, Fecal 83993 Y Y N $200.00 $200.00 $200.00

180141 Campylobacter Culture 87046 Y Y N $50.75 $50.75 $16.80 $16.80

002303 Cancer Antigen (CA) 125 86304 Y Y Y $122.75 $42.96 $13.30 $13.30

143404 Cancer Antigen (CA) 15-3 86300 N Y N $110.75 $110.75 $15.80 $15.80

180033 Candida 4 Species Profile, NAA 87481 (x4) N N N $405.00 $405.00 $104.00 $104.00

180010 Candida 6 Species Profile, NAA 87481, 87481 59 (x5) N Y N $607.50 $607.50 $156.00 $156.00

Page 8 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

737735 Cannabinoid (GC/MS), Urine 80349 Y Y N $119.50 $119.50 $119.50

791566 Cannabinoid Analysis, WB 80301 Y Y N $82.25 $82.25 $82.25

071316 Cannabinoid Confirmation, Ur 80349 Y Y N $119.50 $119.50 $33.26 $33.26

712562 Cannabinoid Confirmation, Ur 80349 Y N N $119.50 $119.50 $33.26 $33.26

701869 Cannabinoid Screen, Urine 80301 Y Y N $24.00 $24.00 $24.00

074435 Cannabinoid, Qual, Urine 80301 Y Y N $24.00 $24.00 $24.00

070409 Cannabinoid/Creatinine Ratio 80301, 82570 N Y N $69.25 $69.25 $13.30 $13.30

007419 Carbamazepine(Tegretol), S 80156 Y Y Y $98.25 $34.39 $3.88 $3.88

070748 Carbamazepine, Free, Serum 80157 Y Y N $134.50 $134.50 $134.50

716803 Carbamazepine-10,11 Epoxide 80339 Y Y N $98.25 $98.25 $11.09 $11.09

001578 Carbon Dioxide, Total 82374 Y Y Y $27.00 $9.45 $1.75 $1.75

007187 Carbon Monoxide, Blood 82375 N Y N $88.50 $88.50 $31.79 $31.79

764024 Carisoprodol/Meprobamate, Ur 80302 Y N N $143.75 $143.75 $58.63 $58.63

706501 Carnitine, Total 82131 N N N $65.75 $65.75 $10.80 $10.80

706500 Carnitine, Total and Free 82379 N Y N $131.50 $131.50 $18.57 $18.57

001529 Carotene, Beta 82380 Y Y N $87.75 $87.75 $31.51 $31.51

286161 Catecholamine+VMA, 24-Hr Urine 82384, 84585 Y Y N $227.25 $227.25 $35.20 $35.20

084152 Catecholamines, Plasma 82384 Y Y N $181.50 $181.50 $33.26 $33.26

004176 Catecholamines,Ur.,Free,24 Hr 82384 Y Y N $152.00 $152.00 $21.89 $21.89

316203 Catecholamines,Ur.,Free,Random 82384, 82570 N Y N $152.00 $152.00 $27.72 $27.72

005009 CBC With Differential/Platelet 85025 Y Y Y $25.75 $9.01 $2.60 $2.60

005017 CBC, No Differential/Platelet 85014, 85018, 85041, 85048 Y N Y $25.25 $8.84 $2.15 $2.15

028142 CBC, Platelet, No Differential 85027 Y Y Y $25.50 $8.93 $2.15 $2.15

282020 CBC/D/Plt+RPR+Rh+ABO+Rub Ab...

85025, 87340, 86592, 86762,

86787, 86850, 86900, 86901 Y N N $290.00 $290.00 $29.61 $29.61

371184 CBC/D/Plt+RPR+Rh+ABO+Rub Ab...

82306, 87340, 86592, 86850,

86900, 86762, 86901, 83655,

85025 Y N N $511.75 $511.75 $511.75

233783 CBC/D/Plt+RPR+UA+Rh+ABO+Rub...

81003, 85025, 87340, 86592,

86703, 86762, 86850, 86900,

86901 N N N $395.00 $395.00 $31.55 $31.55

977709 CBC/Diff Ambiguous Default 85025 Y N Y $25.75 $9.01 $2.60 $2.60

115907 CBC/Differential (No Platelet)

85014, 85018, 85041, 85048,

85004 Y N Y $25.50 $8.93 $2.15 $2.15

350512 CBC+Hematology Review

85014, 85018, 85041, 85048,

85007 N N N $51.50 $51.50 $18.40 $18.40

115300 CBC+Platelet+Hem Review 85027, 85007 Y N N $51.50 $51.50 $18.40 $18.40

371653 CBC+TestT+DHEA S+Prog+E2+Te... Test Not Coded Y N N $769.25 $769.25 $769.25

164914 CCP Antibodies IgG/IgA 86200 Y Y N $83.50 $83.50 $17.73 $17.73

505271 CD4/CD8 Ratio Profile 86360 Y Y N $202.50 $202.50 $15.52 $15.52

002139 CEA 82378 Y Y Y $86.00 $30.10 $7.77 $7.77

480095 CEA (Serial Monitor) 82378 N Y Y $109.00 $38.15 $11.09 $11.09

165118 Celiac Disease Ab Screen w/Rfx 82784, 83516 (x2) Y N N $255.75 $255.75 $255.75

334971 Celiac Disease Antibody Screen 82784, 83516 (x2) Y N N $255.75 $255.75 $43.18 $43.18

341142 Celiac Disease Complete Panel 82784, 83516 (x4) Y Y N $464.25 $464.25 $102.65 $102.65

Page 9 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

165126 Celiac Disease Comprehensive 82784, 83516 (x4), 86255 Y Y N $542.25 $542.25 $104.20 $104.20

167082 Celiac Disease HLA DQ Assoc. 81377, 81383 N Y N $490.75 $490.75 $150.97 $150.97

165134 Celiac Disease II 82784, 83516 (x2), 86255 Y N N $345.25 $345.25 $345.25

165142 Celiac Disease Panel 86255, 83516, 82784 Y Y N $258.25 $258.25 $258.25

005256 Cell Count, CSF 89051 N Y N $55.50 $55.50 $19.91 $19.91

005231 Cell Ct, Synovial w/Crystals 89051, 89060 Y Y N $122.25 $122.25 $22.17 $22.17

215996 Cell Ct, Synovial w/o Crystals 89051 Y Y N $55.50 $55.50 $19.91 $19.91

001560 Ceruloplasmin 82390 Y Y Y $56.50 $19.78 $4.43 $4.43

070466 Chain-of-Custody Protocol 99199 Y Y N $4.25 $4.25 $0.00 $0.00

192555 Change IG Pap to LB Pap 88142 Y N N $74.00 $74.00 $15.10 $15.10

096180 Chlamydia Antibodies, IgG 86631 Y Y N $110.75 $110.75 $16.63 $16.63

008565 Chlamydia trachomatis Culture 87110, 87140 Y Y N $118.25 $118.25 $17.73 $17.73

188078 Chlamydia trachomatis, NAA 87491 Y Y N $108.25 $108.25 $7.65 $7.65

188080 Chlamydia, Conjunctiva, NAA 87491 N Y N $108.25 $108.25 $7.65 $7.65

180098 Chlamydia/GC Amplification 87491, 87591 N N N $227.50 $227.50 $15.30 $15.30

183194 Chlamydia/GC Amplification 87491, 87591 Y Y N $227.50 $227.50 $15.30 $15.30

183616 Chlamydia/GC NAA, Confirmation 87491, 87591 Y Y N $227.50 $227.50 $15.30 $15.30

003160 Chloride, 24 hr Urine 82436 N Y Y $28.50 $9.98 $2.44 $2.44

001206 Chloride, Serum 82435 N Y Y $27.00 $9.45 $1.75 $1.75

013656 Chloride, Urine 82436 Y N Y $28.50 $9.98 $2.44 $2.44

072132 Chlorpromazine, Serum 80342 N Y N $133.75 $133.75 $22.17 $22.17

001065 Cholesterol, Total 82465 Y Y Y $27.00 $9.45 $1.75 $1.75

007286 Cholinesterase, RBC 82482 Y Y N $76.75 $76.75 $10.54 $10.54

C90142 Chrom Analy 5 Cell 1 Karyo 88261 N N N $250.00 $250.00 $205.00 $205.00

071522 Chromium, Plasma 82495 Y Y N $110.75 $110.75 $110.75

140848 Chromogranin A 86316 Y Y N $198.00 $198.00 $198.00

C90149 Chromosome Amniotic Fluid 88235 N N N $250.00 $250.00 $205.00 $205.00

C90140 Chromosome Blood Routine 88230 88230 N N N $250.00 $250.00 $205.00 $205.00

016865 Citric Acid (Citrate), Urine 82507 Y Y N $167.75 $167.75 $23.00 $23.00

002154 CK, Total+Isoenzymes, Serum 82550, 82552 Y Y N $73.50 $73.50 $3.32 $3.32

001859 CK+LD, Totals+Isoenzymes 82550, 82552, 83625, 83615 N Y N $153.50 $153.50 $11.19 $11.19

000604 Cl+K+Na 82435, 84132, 84295 N N Y $28.00 $9.80 $2.07 $2.07

706465 Clomipramine, Serum 80335 Y Y N $116.75 $116.75 $22.17 $22.17

071712 Clonazepam (Klonopin(R)),Serum 80346 Y Y N $116.75 $116.75 $15.52 $15.52

811903 Clonazepam, Ur as Metabolite 80346 Y Y N $168.00 $168.00 $168.00

007930 Clorazepate (Tranxene), Serum 80346 N Y N $110.75 $110.75 $39.71 $39.71

706440 Clozapine (Clozaril), Serum 80159 Y Y N $116.75 $116.75 $8.87 $8.87

304148 CMP12+1AC

82040, 82247, 82310, 82435,

82565, 82947, 84075, 84132,

84155, 84295, 84450, 84460,

84520 Y N Y $28.00 $9.80 $9.80

Page 10 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

020313 CMP12+5AC

82040, 82247, 82310, 82435,

82465, 82565, 82947, 83615,

84075, 84100, 84132, 84155,

84295, 84450, 84460, 84520,

84550 Y N Y $31.50 $11.03 $3.75 $3.75

030601 CMP12+5AC

84478, 82040, 82247, 82310,

82435, 82465, 82565, 82947,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84520,

84550 N N Y $31.50 $11.03 $3.75 $3.75

000273 CMP12+6AC

82977, 82040, 82247, 82310,

82435, 82465, 82565, 82947,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84460,

84520, 84550 Y N Y $32.25 $11.29 $11.29

023051 CMP12+6AC

82977, 82040, 82247, 82310,

82435, 82465, 82565, 82947,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84460,

84520, 84550 Y N Y $32.25 $11.29 $11.29

203430 CMP12+6AC

82977, 82040, 82247, 82310,

82435, 82565, 82947, 83540,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84460,

84520, 84550 Y N Y $32.25 $11.29 $3.87 $3.87

242545 CMP12+6AC+CBC/D/Plt

85025, 82977, 82040, 82247,

82310, 82435, 82565, 82947,

83540, 83615, 84075, 84100,

84132, 84155, 84295, 84450,

84460, 84520, 84550 Y N Y $54.75 $19.16 $19.16

021550 CMP12+7AC

82977, 84478, 82040, 82247,

82310, 82435, 82465, 82565,

82947, 83615, 84075, 84100,

84132, 84155, 84295, 84450,

84460, 84520, 84550 Y N Y $33.00 $11.55 $3.99 $3.99

301622 CMP12+7AC+Mg

83735, 82977, 84478, 82040,

82247, 82310, 82435, 82465,

82565, 82947, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 N N Y $64.75 $22.66 $4.11 $4.11

058867 CMP12+8AC

82977, 84478, 82040, 82247,

82310, 82435, 82465, 82565,

82947, 83540, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 Y N Y $36.50 $12.78 $4.11 $4.11

Page 11 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

303560 CMP12+8AC

82977, 84478, 82040, 82247,

82310, 82435, 82465, 82565,

82947, 83540, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 Y N Y $34.25 $11.99 $11.99

221214 CMP12+8AC

80076, 84478, 84550, 84100,

83615, 83540, 82465, 82310,

82435, 82565, 82947, 84132,

84295, 84520 N N Y $34.25 $11.99 $4.11 $4.11

311779 CMP12+8AC+CBC/D/Plt

85025, 82977, 84478, 82040,

82247, 82310, 82435, 82465,

82565, 82947, 83540, 83615,

84075, 84100, 84132, 84155,

84295, 84450, 84460, 84520,

84550 N N Y $62.25 $21.79 $6.71 $6.71

300327 CMP12+8AC+Mg+TIBC

83550, 83735, 82977, 84478,

82040, 82247, 82310, 82435,

82465, 82565, 82947, 83540,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84460,

84520, 84550 Y N Y $87.75 $30.71 $7.28 $7.28

360495 CMP12+9AC

80076, 82977, 84478, 82310,

82435, 82465, 82565, 82947,

83540, 83615, 84100, 84132,

84295, 84520, 84550 N N Y $35.00 $12.25 $4.23 $4.23

027623 CMP12+LP+6AC

80061, 82977, 82040, 82247,

82310, 82435, 82565, 82947,

83540, 83615, 84075, 84100,

84132, 84155, 84295, 84450,

84460, 84520, 84550 Y N Y $86.00 $30.10 $7.47 $7.47

030932 CMP12+LP+6AC+CBC/D/Plt

80061, 85025, 82977, 82040,

82247, 82310, 82435, 82565,

82947, 83540, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 Y N Y $111.75 $39.11 $10.07 $10.07

332403 CMP12+LP+6AC+CBC/D/Plt

80061, 85025, 82977, 82040,

82247, 82310, 82435, 82565,

82947, 83540, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 N N Y $96.00 $33.60 $10.07 $10.07

Page 12 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

348532 CMP12+LP+6AC+CBC/D/Plt+RPR+...

80061, 81003, 83550, 83735,

85025, 86592, 82977, 82040,

82247, 82310, 82435, 82565,

82947, 83540, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 Y N Y $192.00 $67.20 $17.32 $17.32

371643 CMP12+LP+6AC+CBC/D/Plt+TSH+...

80061, 82728, 84443, 82306,

85025, 82977, 82947, 84550,

82565, 84520, 82435, 84132,

84295, 82310, 84100, 82040,

84155, 82247, 84075, 83615,

84450, 84460, 83540 Y N N $443.50 $443.50 $36.68 $36.68

312264 CMP12+LP+6AC+CBC/D/Plt+TSH+Fer

80061, 82728, 84443, 85025,

82977, 82040, 82247, 82310,

82435, 82565, 82947, 83540,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84460,

84520, 84550 Y N Y $218.00 $76.30 $17.27 $17.27

303785 CMP12+LP+TP+TSH+5AC+CBC/D/P...

80061, 82985, 85025, 84153,

84436, 84443, 84479, 82040,

82247, 82310, 82435, 82565,

82947, 83540, 83615, 84075,

84100, 84132, 84155, 84295,

84450, 84460, 84520, 84550 N N Y $328.25 $114.89 $20.69 $20.69

032268 CMP12+LP+TP+TSH+6AC

80061, 82977, 84436, 84443,

84479, 82040, 82247, 82310,

82435, 82565, 82947, 83540,

83615, 84075, 84100, 84132,

84155, 84295, 84450, 84460,

84520, 84550 Y N Y $223.50 $78.23 $13.99 $13.99

048827 CMP12+LP+TP+TSH+6AC+CBC/D/Plt

80061, 85025, 84436, 84443,

84479, 82977, 82040, 82247,

82310, 82435, 82565, 82947,

83540, 83615, 84075, 84100,

84132, 84155, 84295, 84450,

84460, 84520, 84550 N N Y $249.25 $87.24 $16.59 $16.59

315423 CMP12+LP+TP+TSH+6AC+CBC/D/Plt

80061, 85025, 82977, 84436,

84443, 84479, 82040, 82247,

82310, 82435, 82565, 82947,

83540, 83615, 84075, 84100,

84132, 84155, 84295, 84450,

84460, 84520, 84550 Y N Y $216.75 $75.86 $16.59 $16.59

Page 13 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

315652 CMP12+TP+TSH+8AC+CBC/D/Plt+...

83735, 85652, 82607, 82746,

83550, 85025, 86592, 81003,

82977, 84478, 84436, 84443,

84479, 82040, 82247, 82310,

82435, 82465, 82565, 82947,

83540, 83615, 84075, 84100,

84132, 84155, 84295, 84450,

84460, 84520, 84550 N N Y $433.50 $151.73 $33.30 $33.30

310700 CMP13+2AC

80069, 82977, 82247, 84075,

84155, 84450 Y N Y $29.75 $10.41 $10.41

316280 CMP13+CBC/D/Plt+RPR+Mg+TSH

80048, 83735, 84443, 86592,

85025, 82040, 82247, 84075,

84155, 84450 Y N Y $172.75 $60.46 $11.07 $11.07

314918 CMP13+LP+2AC+CBC/D/Plt 80053, 80061, 85025, 82248 Y N Y $93.25 $32.64 $32.64

314903 CMP13+LP+TP+TSH+2AC+CBC/D/P...

80053, 80061, 84443, 85025,

84479, 84436, 82248 Y N Y $214.00 $74.90 $74.90

331258 CMP14+1AC+TSH+PTT+Sickle+PT...

80053, 84443, 84439, 86803,

85660, 85610, 85730, 84550 Y N N $340.25 $340.25 $340.25

362165 CMP14+2AC+CEA+CA125

80053, 82378, 86304, 82248,

83615 Y N Y $231.25 $80.94 $80.94

303750 CMP14+4AC

80053, 82977, 82465, 83615,

84100 Y N Y $32.25 $11.29 $11.29

347845 CMP14+5AC

80053, 82977, 84478, 84550,

84100, 82465 Y N Y $36.00 $12.60 $3.99 $3.99

376426 CMP14+8AC

80053, 82977, 84478, 82248,

82465, 83540, 83615, 84100,

84550 Y N Y $35.75 $12.51 $4.35 $4.35

334943 CMP14+eGFR 80053 Y N Y $33.50 $11.73 $3.39 $3.39

210849 CMP14+Lipid+5AC

80053, 80061, 82977, 83540,

83615, 84100, 84550 Y N Y $86.50 $30.28 $7.59 $7.59

333126 CMP14+LP+1AC 80053, 80061, 82248 Y N Y $70.75 $24.76 $24.76

315388 CMP14+LP+5AC+TIBC

80053, 80061, 83550, 82977,

84550, 84100, 83615, 83540 N N Y $101.25 $35.44 $10.64 $10.64

315874 CMP14+LP+6AC

80053, 80061, 82977, 82248,

83540, 83615, 84100, 84550 Y N Y $75.25 $26.34 $7.71 $7.71

361446 CMP14+LP+6AC+CBC/D/Plt+RPR+...

80053, 80061, 83550, 84436,

86592, 85025, 81003, 82977,

84550, 84100, 82248, 83615,

83540 Y N Y $207.75 $72.71 $72.71

337036 CMP14+LP+CBC/D/Plt+Prl+Test...

80053, 80061, 86141, 84403,

84146, 84144, 82670, 85025 Y N Y $531.50 $186.03 $186.03

371841 CMP14+LP+Uric A+CBC/D/Plt+E...

80053, 80061, 84443, 84481,

84439, 84153, 82306, 85025,

85652, 84550 Y N N $731.50 $731.50 $731.50

Page 14 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

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of Services

Test

ATB

Discountable

Test

2015 Book

Price

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Price Less

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Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

334993 CMP14+TP+7AC

80053, 84436, 84479, 82977,

84478, 84550, 84100, 82248,

82465, 83615 Y N Y $88.75 $31.06 $31.06

221085 CMV Abs IgG/IgM 86644, 86645 Y N N $184.00 $184.00 $11.62 $11.62

139149 CMV Quant DNA PCR (Plasma) 87497 Y Y N $367.50 $367.50 $367.50

508005 cobas HPV, Rectal 87624 N Y N $267.75 $267.75 $107.00 $107.00

737752 Cocaine (GC/MS), Urine 80353 Y Y N $119.50 $119.50 $119.50

707031 Cocaine Metabolite Confirm Test Not Coded Y N N $119.50 $119.50 $119.50

071324 Cocaine Metabolite Confirm,Ur 80353 Y Y N $119.50 $119.50 $33.26 $33.26

770565 Cocaine(Metab.)Screen, Urine 80301 N N N $43.50 $43.50 $42.12 $42.12

164301 Coccidioides Abs, Qn, DID 86635 Y Y N $104.50 $104.50 $104.50

006353 Cold Agglutinin Titer, Quant 86157 N Y Y $74.00 $25.90 $11.09 $11.09

302085 Comp. Metabolic Panel (12)

82040, 82247, 82310, 82435,

82565, 82947, 84075, 84132,

84155, 84295, 84450, 84520 N N Y $32.50 $11.38 $3.15 $3.15

310900 Comp. Metabolic Panel (13)

80048, 82040, 82247, 84075,

84155, 84450 Y N Y $33.00 $11.55 $3.27 $3.27

322000 Comp. Metabolic Panel (14) 80053 Y Y Y $33.50 $11.73 $3.39 $3.39

006452 Complement C3, Serum 86160 Y Y Y $66.50 $23.28 $4.43 $4.43

001834 Complement C4, Serum 86160 Y Y Y $66.50 $23.28 $4.43 $4.43

001941 Complement, Total (CH50) 86162 Y Y N $102.75 $102.75 $6.66 $6.66

790600 Compliance Drug Analysis, Ur

82570, 80301, 80302, 80348,

80354, 80358, 80366, 80355,

80370, 80364, 80368, 80360,

80326, 83992, 80334, 80337,

80338, 80331, 80344, 80341,

80371, 80372, 80353, 80377,

80373, 80346, 80361, 80367,

80365, 80357, 80359 N Y N $354.00 $354.00 $153.75 $153.75

791194 Comprehensive Drug Analysis,Ur

82570, 80301, 80302 (x2),

80358, 80348, 80354, 80366,

80355, 80370, 80364, 80368,

80360, 80326, 83992, 80334,

80337, 80338, 80331, 80344,

80341, 80371, 80372, 80353,

80377, 80373, 80346, 80361,

80367, 80365, 80357, 80359 Y N N $434.60 $434.60 $434.60

183156 Concentration 87015 Y N N $31.25 $31.25 $12.15 $12.15

883211 Consul+Rep/Ref Slides 1st Site 88321 N N N $170.25 $170.25 $98.00 $98.00

006270 Coombs', Direct 86880 Y Y N $35.25 $35.25 $7.77 $7.77

001586 Copper, Serum 82525 Y Y N $81.25 $81.25 $8.87 $8.87

003343 Copper, Urine 82525, 82570 N Y N $81.25 $81.25 $33.26 $33.26

805891 Coriander/Cilantro IgE 86003 Y N N $48.50 $48.50 $48.50

004051 Cortisol 82533 Y Y N $80.00 $80.00 $5.54 $5.54

104018 Cortisol - AM 82533 Y Y N $80.00 $80.00 $6.66 $6.66

Page 15 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

104026 Cortisol - PM 82533 Y Y N $80.00 $80.00 $6.66 $6.66

028498 Cortisol (3 Specimens) 82533 (x3) N Y N $240.00 $240.00 $16.61 $16.61

140761 Cortisol, ACTH Stimulation 82533 (x2) Y Y N $160.00 $160.00 $160.00

104000 Cortisol, AM/PM 82533 (x2) N Y N $160.00 $160.00 $13.33 $13.33

004432 Cortisol, Urinary Free 82530 Y Y N $146.75 $146.75 $52.75 $52.75

C90145 Count 15-20 cells, 2 Karyotype 88262 N N N $424.00 $424.00 $147.24 $147.24

010108 C-Peptide, Serum 84681 Y Y N $94.50 $94.50 $7.77 $7.77

120766 C-Reactive Protein, Cardiac 86141 Y Y Y $57.25 $20.04 $5.38 $5.38

006627 C-Reactive Protein, Quant 86140 Y Y Y $52.25 $18.29 $5.54 $5.54

276024 Creat Clearance, Normalized 82575 N Y Y $63.00 $22.05 $8.31 $8.31

120816 Creatine Kinase (CK), MB 82553 Y Y N $137.50 $137.50 $5.54 $5.54

002311 Creatine Kinase (CK), MB/Total 82550, 82553 Y Y N $164.50 $164.50 $5.54 $5.54

001362 Creatine Kinase,Total,Serum 82550 Y Y Y $27.00 $9.45 $1.75 $1.75

003475 Creatine, 24-Hour Urine 82540 N Y N $40.25 $40.25 $5.82 $5.82

002402 Creatine, Serum 82540 Y Y N $40.25 $40.25 $5.27 $5.27

003855 Creatine+Creatinine, 24-Hr Ur 82540, 82570 N Y N $76.25 $76.25 $8.60 $8.60

003004 Creatinine Clearance 82575 Y Y Y $63.00 $22.05 $3.65 $3.65

003012 Creatinine, 24-Hour Urine 82570 Y Y Y $36.00 $12.60 $2.78 $2.78

001370 Creatinine, Serum 82565 Y Y Y $27.00 $9.45 $1.75 $1.75

013672 Creatinine, Urine 82570 Y Y Y $36.00 $12.60 $2.44 $2.44

788927 Creatinine, Urine Test Not Coded Y N N $17.00 $17.00 $9.43 $9.43

130005 Creatinine, Urine, 12hr 82570 N N Y $36.00 $12.60 $2.44 $2.44

788877 CreatU+pH U+Specific Gravity Test Not Coded N N N $8.00 $8.00 $1.94 $1.94

236000 CreatU+Prot U 82570, 84156 Y N Y $65.25 $22.84 $8.26 $8.26

120956 Cryoglobulin, Ql, Serum 82595 Y N N $29.75 $29.75 $10.66 $10.66

001594 Cryoglobulin, Ql, Serum, Rflx 82595 Y Y N $29.75 $29.75 $5.54 $5.54

183048 Crypto Ag, CSF, Rebaseline Test Not Coded N N N $90.75 $90.75 $11.09 $11.09

183060 Crypto Ag, Serum, Rebaseline Test Not Coded Y N N $90.75 $90.75 $11.09 $11.09

006553 Cryptococcus Ag Titer Test Not Coded Y N N $90.75 $90.75 $32.55 $32.55

183036 Cryptococcus Ag Titer, Serum 87899 N N N $90.75 $90.75 $32.55 $32.55

183050 Cryptococcus Ag, Titer, Serum Test Not Coded Y N N $90.75 $90.75 $32.55 $32.55

082891 Cryptococcus Antibodies, Quant 86641 N Y N $115.50 $115.50 $25.49 $25.49

183016 Cryptococcus Antigen, CSF 87899 N Y N $90.75 $90.75 $11.09 $11.09

183025 Cryptococcus Antigen, Serum 87899 N Y N $90.75 $90.75 $11.09 $11.09

183020 Cryptosporidium EIA 87328 Y Y N $122.75 $122.75 $21.99 $21.99

182378 Cryptosporidium/Isospora Smear 87206, 87015 Y N N $75.75 $75.75 $12.74 $12.74

005355 Crystal,Synovial/Joint Fl 89060 Y Y N $66.75 $66.75 $13.30 $13.30

188714 Ct NAA, Pharyngeal 87491 Y Y N $108.25 $108.25 $7.65 $7.65

188706 Ct NAA, Rectal 87491 Y Y N $108.25 $108.25 $7.65 $7.65

188065 Ct Ng HSV by NAA 87491, 87591, 87529 (x2) N Y N $537.50 $537.50 $87.80 $87.80

180049 Ct Ng M genitalium NAA, Urine 87798, 87491, 87591 Y Y N $317.50 $317.50 $317.50

188070 Ct Ng TV HSV by NAA 87491, 87661, 87591, 87529 (x2) Y Y N $645.25 $645.25 $118.80 $118.80

183160 Ct, Ng, Trich vag by NAA 87491, 87591, 87661 Y Y N $335.25 $335.25 $46.30 $46.30

188698 Ct/GC NAA, Pharyngeal 87491, 87591 Y Y N $227.50 $227.50 $15.30 $15.30

Page 16 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

188672 Ct/GC NAA, Rectal 87491, 87591 Y Y N $227.50 $227.50 $15.30 $15.30

180307 Culture of Dialysis Water Test Not Coded N Y N $34.00 $34.00 $11.09 $11.09

182782 Customer Request Culture 87070 Y N N $57.25 $57.25 $57.25

C90139 CVS Chrom Analysis 88235 88235 N N N $250.00 $250.00 $205.00 $205.00

183145 Cyclospora Smear, Stool 87015, 87206 Y Y N $81.25 $81.25 $26.99 $26.99

706557 Cyclosporine, Blood 80158 N Y N $141.00 $141.00 $50.67 $50.67

450020 Cystic Fibrosis Mutation 97 81220 Y Y N $800.00 $800.00 $282.67 $282.67

480701 Cystic Fibrosis Mutation 97 81220 N N N $447.50 $447.50 $282.67 $282.67

480533 Cystic Fibrosis Profile 81220 Y Y N $306.50 $306.50 $149.65 $149.65

700195 Cystine, Quant. 24 hr Urine 82131 N Y N $187.00 $187.00 $23.40 $23.40

511230 Cytochrome P450 2D6 Genotyping 81226 Y Y N $490.25 $490.25 $490.25

006494 Cytomegalovirus (CMV) Ab, IgG 86644 Y Y N $92.00 $92.00 $5.54 $5.54

096727 Cytomegalovirus (CMV) Ab, IgM 86645 Y Y N $92.00 $92.00 $6.09 $6.09

008201 Cytomegalovirus (CMV) Culture 87252, 87254 Y Y N $168.00 $168.00 $168.00

188047 Cytotoxin B Production 87230 N N N $120.00 $120.00 $12.25 $12.25

707100 D/L Methamphetamine Test Not Coded N N N $136.50 $136.50 $32.56 $32.56

602467 D001-IgE D pteronyssinus 86003 N Y N $24.25 $24.25 $4.45 $4.45

602475 D002-IgE D farinae Mite 86003 N Y N $24.25 $24.25 $4.45 $4.45

115188 D-Dimer 85379 Y Y N $165.00 $165.00 $22.17 $22.17

828391 Dengue Fever Ab 86790 (x2) N N N $176.00 $176.00 $168.82 $168.82

828470 Dengue Fever Virus Ab, IgG 86790 N N N $87.00 $87.00 $32.29 $32.29

828395 Dengue Fever Virus Ab, IgM 86790 N N N $93.75 $93.75 $32.29 $32.29

182337 Dermatophyte Only, Culture 87101 Y Y N $77.00 $77.00 $16.91 $16.91

007765 Desipramine, Serum 80335 N Y N $130.00 $130.00 $18.85 $18.85

004100 DHEA, Serum 82626 Y Y N $181.75 $181.75 $23.29 $23.29

004020 DHEA-Sulfate 82627 Y Y N $110.25 $110.25 $17.47 $17.47

500161 DHEA-Sulfate, Serum 82627 Y Y N $110.25 $110.25 $110.25

007989 Diazepam (Valium), Serum 80346 Y Y N $116.75 $116.75 $23.29 $23.29

155002 Diff Slide Preparation Test Not Coded Y N Y $12.75 $4.46 $4.46

005090 Differential WBC Count 85004 N N Y $24.25 $8.49 $2.44 $2.44

015173 Differential/Total WBC Count 85048, 85004 Y Y Y $24.75 $8.66 $2.44 $2.44

007385 Digoxin, Serum 80162 Y Y Y $77.50 $27.13 $3.65 $3.65

117887 Dilute Russell's Viper Venom 85613 N Y N $90.75 $90.75 $33.26 $33.26

138741 DONOR ABO Group/Rho(D) Type 86900, 86901 Y N N $60.25 $60.25 $60.25

138820 DONOR HBsAg Confirmation 87341 Y N N $175.00 $175.00 $66.63 $66.63

138931 DONOR Panel 138931 Rflx to WB 86703 Y N N $115.50 $115.50 $115.50

138981 DONOR Panel 138981 WB 86689 N N N $225.50 $225.50 $102.50 $102.50

139730 Donor Panel 139730 Test Not Coded Y N N $108.50 $108.50 $76.88 $76.88

007609 Doxepin (Sinequan), Serum 80335 Y Y N $120.25 $120.25 $15.52 $15.52

708120 Drug Abuse, HHS/DOT - Bund Test Not Coded N N N $83.00 $83.00 $13.50 $13.50

707080 Drug Abuse, HHS/DOT - Unbund 80301 Y Y N $73.00 $73.00 $13.79 $13.79

708080 Drug Abuse, HHS/DOT-Bund 80301 Y Y N $83.00 $83.00 $13.79 $13.79

764875 Drug Profile 764875 80301, 80302 (x2) N Y N $208.50 $208.50 $49.60 $49.60

772012 DRUG PROFILE 772012 80301, 80320 Y N N $82.50 $82.50 $11.64 $11.64

766550 Drug Profile, Blood (5 Drugs) Test Not Coded N N N $227.50 $227.50 $106.70 $106.70

Page 17 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

794370 Drug Profile, Ur, 9 Drugs 80301 Y Y N $86.00 $86.00 $12.55 $12.55

007034 Drug Screen (Blood or Serum)

80184, 80320, 80345, 80329,

80346 Y Y N $200.00 $200.00 $200.00

770701 Drug Scrn, Treatment Center 80301 Y Y N $80.00 $80.00 $10.87 $10.87

791632 Drugs of Abuse Scr ONLY, 10,WB 80301 Y Y N $271.30 $271.30 $271.30

790430 Drugs of Abuse Screen, 10 WB 80301 Y Y N $290.96 $290.96 $290.96

790390 Drugs of Abuse Screen,11 Serum 80301 Y Y N $207.50 $207.50 $93.63 $93.63

117923 dRVVT Confirm 85613 Y N N $90.75 $90.75 $90.75

117912 dRVVT Mix 85613 Y N N $90.75 $90.75 $90.75

602454 E001-IgE Cat Dander 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602684 E003-IgE Horse Dander 86003 N Y N $24.25 $24.25 $4.45 $4.45

602456 E005-IgE Dog Dander 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602688 E070-IgE Goose Feathers 86003 N Y N $24.25 $24.25 $4.45 $4.45

602699 E081-IgE Sheep epithelia 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602703 E085-IgE Chicken Feathers 86003 N Y N $24.25 $24.25 $4.45 $4.45

602704 E086-IgE Duck Feathers 86003 N Y N $24.25 $24.25 $4.45 $4.45

602708 E089-IgE Turkey Feathers 86003 N Y N $24.25 $24.25 $4.45 $4.45

096230 EBV Ab VCA, IgG 86665 Y Y N $87.25 $87.25 $11.17 $11.17

096735 EBV Ab VCA, IgM 86665 Y Y N $87.25 $87.25 $11.17 $11.17

216655 EBV Acute Infection Antibodies 86663, 86664, 86665 (x2) Y Y Y $349.00 $122.15 $44.64 $44.64

096248 EBV Early Antigen Ab, IgG 86663 N Y N $87.25 $87.25 $11.17 $11.17

010272 EBV Nuclear Antigen Ab, IgG 86664 Y Y N $87.25 $87.25 $87.25

010280 EBV, Chronic/Active Infection 86663, 86664, 86665 Y Y Y $261.75 $91.61 $91.61

303754 Electrolyte Panel 80051 Y Y Y $28.50 $9.98 $2.19 $2.19

160014 ENA+DNA/DS+Antich+Centro+Jo... 86225, 86235 (x8) Y N N $929.25 $929.25 $135.59 $135.59

160093 ENA+DNA/DS+SCL-70+SjoSSA+Sj... 86225, 86235 (x5) Y N N $515.25 $515.25 $74.99 $74.99

016123 ENA+DNA/DS+Sjorgen's 86225, 86235 (x4) Y N N $516.25 $516.25 $56.54 $56.54

165105 Endomysial Ab IgA w/Reflex 86255 N N N $101.00 $101.00 $33.26 $33.26

164996 Endomysial Antibody IgA 86255 Y Y N $101.00 $101.00 $33.26 $33.26

010777 Enterovirus Antibodies Profile 86658 (x7) Y Y N $328.75 $328.75 $328.75

008557 Environmental Culture Test Not Coded Y Y N $45.75 $45.75 $9.42 $9.42

005298 Eosinophil Count 85048 N Y Y $24.50 $8.58 $4.43 $4.43

115055 Eosinophil, Urine 87205 Y Y Y $47.00 $16.45 $16.45

480277 ER/PR,Immunohistochem,Paraffin 88360 (x2) Y Y N $285.00 $285.00 $285.00

140277 Erythropoietin (EPO), Serum 82668 Y Y N $111.75 $111.75 $13.30 $13.30

004515 Estradiol 82670 Y Y Y $144.25 $50.49 $6.66 $6.66

140244 Estradiol, Sensitive 82670 N Y N $181.75 $181.75 $33.26 $33.26

004549 Estrogens, Total 82672 Y Y N $122.75 $122.75 $22.17 $22.17

017996 Ethanol, Blood 80320 Y Y N $88.50 $88.50 $18.38 $18.38

007237 Ethanol, Urine 80301 Y Y N $67.75 $67.75 $9.43 $9.43

716167 Ethanol, Urine 80301 Y N N $24.00 $24.00 $7.78 $7.78

798067 Ethyl Glucuronide, Urine 80302 Y N N $121.00 $121.00 $27.72 $27.72

602452 F001-IgE Egg White 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602453 F002-IgE Milk 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602465 F003-IgE Codfish 86003 Y Y N $24.25 $24.25 $4.45 $4.45

Page 18 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

602459 F004-IgE Wheat 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602983 F004W-IgE Wheat Test Not Coded N N N $24.25 $24.25 $4.45 $4.45

602553 F007-IgE Oat 86003 N Y N $24.25 $24.25 $4.45 $4.45

602460 F008-IgE Corn 86003 Y Y N $24.25 $24.25 $24.25

602511 F009-IgE Rice 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602485 F010-IgE Sesame Seed 86003 N Y N $24.25 $24.25 $4.45 $4.45

602517 F012-IgE Green Pea 86003 N Y N $24.25 $24.25 $4.45 $4.45

602451 F013-IgE Peanut 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602457 F014-IgE Soybean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602525 F015-IgE White Bean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602493 F023-IgE Crab 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602473 F024-IgE Shrimp 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602468 F025-IgE Tomato 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602498 F026-IgE Pork 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602509 F027-IgE Beef 86003 N Y N $24.25 $24.25 $4.45 $4.45

602521 F031-IgE Carrot 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602472 F033-IgE Orange 86003 N Y N $24.25 $24.25 $4.45 $4.45

602512 F036-IgE Coconut 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602510 F040-IgE Tuna 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602507 F041-IgE Salmon 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602720 F042-IgE Haddock 86003 Y Y N $24.25 $24.25 $24.25

602513 F044-IgE Strawberry 86003 N Y N $24.25 $24.25 $4.45 $4.45

602567 F045-IgE Yeast, Baker's 86003 N Y N $24.25 $24.25 $4.45 $4.45

602519 F047-IgE Garlic 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602723 F048-IgE Onion 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602724 F049-IgE Apple 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602725 F050-IgE Mackerel 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602726 F054-IgE Sweet Potato 86003 N Y N $24.25 $24.25 $4.45 $4.45

602487 F075-IgE Egg (Yolk) 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602497 F079-IgE Gluten 86003 N Y N $24.25 $24.25 $4.45 $4.45

602495 F080-IgE Lobster 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602732 F081-IgE Cheese, Cheddar Type 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602500 F083-IgE Chicken 86003 N Y N $24.25 $24.25 $4.45 $4.45

602734 F084-IgE Kiwi Fruit 86003 Y Y N $24.25 $24.25 $24.25

602735 F085-IgE Celery 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602736 F086-IgE Parsley 86003 Y Y N $24.25 $24.25 $24.25

602737 F087-IgE Melon 86003 N Y N $24.25 $24.25 $4.45 $4.45

602739 F089-IgE Mustard 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602742 F092-IgE Banana 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602492 F093-IgE Chocolate/Cacao 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602743 F094-IgE Pear 86003 N Y N $24.25 $24.25 $4.45 $4.45

602744 F095-IgE Peach 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602759 F147-IgE Flounder 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602765 F182-IgE Lima Bean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602470 F201-IgE Pecan Nut 86003 Y Y N $24.25 $24.25 $4.45 $4.45

Page 19 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

602486 F203-IgE Pistachio Nut 86003 Y Y N $24.25 $24.25 $24.25

602523 F204-IgE Trout 86003 Y Y N $24.25 $24.25 $24.25

602529 F207-IgE Clam 86003 Y Y N $24.25 $24.25 $24.25

602770 F210-IgE Pineapple 86003 N Y N $24.25 $24.25 $4.45 $4.45

602773 F212-IgE Mushroom 86003 N Y N $24.25 $24.25 $4.45 $4.45

602775 F214-IgE Spinach 86003 N Y N $24.25 $24.25 $4.45 $4.45

602776 F215-IgE Lettuce 86003 N Y N $24.25 $24.25 $4.45 $4.45

602777 F216-IgE Cabbage 86003 N Y N $24.25 $24.25 $4.45 $4.45

602779 F218-IgE Paprika 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602781 F220-IgE Cinnamon 86003 Y Y N $24.25 $24.25 $24.25

602782 F221-IgE Coffee 86003 N Y N $24.25 $24.25 $4.45 $4.45

602786 F225-IgE Pumpkin 86003 N Y N $24.25 $24.25 $4.45 $4.45

602793 F234-IgE Vanilla 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602794 F235-IgE Lentil 86003 N Y N $24.25 $24.25 $4.45 $4.45

602501 F236-IgE Whey 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602796 F242-IgE Bing Cherry 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602798 F244-IgE Cucumber 86003 N Y N $24.25 $24.25 $4.45 $4.45

602528 F245-IgE Egg, Whole 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602530 F256-IgE Walnut 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602802 F259-IgE Grape 86003 N Y N $24.25 $24.25 $4.45 $4.45

602803 F260-IgE Broccoli 86003 N Y N $24.25 $24.25 $4.45 $4.45

602806 F262-IgE Eggplant 86003 N Y N $24.25 $24.25 $4.45 $4.45

602760 F263-IgE Green Bell Pepper 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602807 F265-IgE Cumin 86003 Y Y N $24.25 $24.25 $24.25

602816 F278-IgE Bayleaf (Laurel) 86003 Y Y N $24.25 $24.25 $24.25

602817 F279-IgE Chili Pepper 86003 N Y N $24.25 $24.25 $4.45 $4.45

602818 F280-IgE Black Pepper 86003 N Y N $24.25 $24.25 $4.45 $4.45

602822 F283-IgE Oregano 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602823 F284-IgE Turkey 86003 N Y N $24.25 $24.25 $4.45 $4.45

602824 F287-IgE Kidney Bean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602829 F296-IgE Carob Bean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602835 F309-IgE Chick Pea 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602838 F315-IgE Green Bean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602757 F319-IgE Red Beet 86003 N Y N $24.25 $24.25 $4.45 $4.45

602718 F329-IgE Watermelon 86003 Y Y N $24.25 $24.25 $24.25

602478 F338-IgE Scallop 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602756 F342-IgE Olive, Black 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602780 F344-IgE Sage, Salvia 86003 N Y N $24.25 $24.25 $4.45 $4.45

602845 F369-IgE Catfish 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602857 F381-IgE Red Snapper 86003 Y Y N $24.25 $24.25 $24.25

602858 F384-IgE Whitefish 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602539 F414-IgE Tilapia 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602728 F415-IgE Walleye Pike 86003 Y Y N $24.25 $24.25 $24.25

511162 Factor II, DNA Analysis 81240 Y Y N $300.00 $300.00 $127.49 $127.49

086249 Factor V Activity 85220 N Y N $175.00 $175.00 $83.14 $83.14

Page 20 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

511154 Factor V Leiden Mutation 81241 Y Y N $275.00 $275.00 $127.49 $127.49

503853 Factor V Leiden Reflex to R2 81241 Y Y N $275.00 $275.00 $275.00

086264 Factor VIII Activity 85240 Y Y N $175.00 $175.00 $175.00

500196 Factor VIII Antigen 83520 Y Y N $200.00 $200.00 $200.00

086330 Factor XIII 85291 N Y N $175.00 $175.00 $83.14 $83.14

081893 Fatty Acids, Free (Nonester) 82725 N Y N $91.00 $91.00 $32.65 $32.65

115402 FDP, Plasma 85362 Y Y N $83.25 $83.25 $83.25

275180 Fe+CBC/D/Plt+TIBC+Fer+CRP

82728, 83550, 85025, 86140,

83540 N N Y $165.00 $57.75 $15.53 $15.53

030825 Fe+TIBC+Fer 82728, 83550, 83540 Y N Y $116.75 $40.86 $7.39 $7.39

038091 Fe+TIBC+Fer+B12+Folic

82607, 82728, 82746, 83550,

83540 Y N Y $272.50 $95.38 $18.26 $18.26

001677 Fecal Fat, Qualitative 82705 Y Y N $81.00 $81.00 $11.09 $11.09

001354 Fecal Fat, Quantitative 82710 Y Y N $125.25 $125.25 $18.85 $18.85

761141 Fentanyl, Urine 80302 Y N N $60.00 $60.00 $60.00

004598 Ferritin, Serum 82728 Y Y Y $62.75 $21.96 $4.22 $4.22

480111 Ferritin, Serum (Serial) 82728 N Y Y $85.75 $30.01 $8.87 $8.87

001610 Fibrinogen Activity 85384 Y Y N $75.00 $75.00 $5.54 $5.54

009001 Fine-Needle Aspiration 88173 N Y N $184.00 $184.00 $97.83 $97.83

017500 First Trimester Screen w/NT 84702, 86336, 84163 Y Y N $257.00 $257.00 $257.00

489316 Flow Interp 16 or more 88189 Y N N $309.00 $309.00 $309.00

489111 Flow Marker, First 88184 Y N N $111.75 $111.75 $111.75

489146 Flow Markers X 10 88185 (x10) Y N N $580.00 $580.00 $580.00

489153 Flow Markers X 15 88185 (x15) Y N N $870.00 $870.00 $870.00

489179 Flow Markers X 20 88184, 88185 (x19), 88189 N N N $1,522.75 $1,522.75 $332.56 $332.56

489112 Flow Markers X 3 88185 (x3) Y N N $174.00 $174.00 $174.00

489120 Flow Markers X 4 88185 (x4) Y N N $232.00 $232.00 $232.00

489138 Flow Markers X 5 88185 (x5) Y N N $290.00 $290.00 $290.00

489128 Flow Markers X28 88184, 88189, 88185 (x27) N N N $1,986.75 $1,986.75 $1,376.53 $1,376.53

706838 Fluoxetine (Prozac(R)), Serum 80332 Y Y N $141.00 $141.00 $22.17 $22.17

706887 Fluphenazine (Prolixin(R)), S 80342 Y Y N $133.75 $133.75 $21.06 $21.06

002014 Folate (Folic Acid), Serum 82746 Y Y Y $70.75 $24.76 $5.43 $5.43

266015 Folate, RBC 82747, 85014 Y Y Y $137.50 $48.13 $18.29 $18.29

285700 Folate, RBC and Serum 82746, 82747, 85014 Y Y Y $208.25 $72.89 $72.89

602989 Food Allergy Profile 86003 (x12) Y Y N $291.00 $291.00 $291.00

823263 Francisella tularensis Abs 86668 (x2) Y N N $139.50 $139.50 $139.50

121137 Free K+L Lt Chains,Qn,S 83883 (x2) Y Y N $245.25 $245.25 $88.12 $88.12

121155 Free K+L Lt Chains,Qn,S Serial 83883 (x2) Y Y N $268.50 $268.50 $268.50

121228 Free K+L Lt Chains,Qn,Ur 83883 (x2) N Y N $245.25 $245.25 $88.12 $88.12

070789 Free Valproic Acid (Depakote) 80165 Y Y N $118.75 $118.75 $14.19 $14.19

100800 Fructosamine 82985 Y Y Y $40.75 $14.26 $3.32 $3.32

028480 FSH and LH 83001, 83002 Y Y Y $173.75 $60.81 $11.07 $11.07

502280 FSH, Pediatric 83001 Y Y N $88.00 $88.00 $88.00

004309 FSH, Serum 83001 Y Y Y $88.00 $30.80 $5.54 $5.54

503600 FT3 Dialysis MS 84481 N Y N $250.00 $250.00 $242.63 $242.63

Page 21 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

091454 Fungal Antibodies, Quant 86606 (x3), 86612, 86635, 86698 N Y N $545.50 $545.50 $149.65 $149.65

008482 Fungus (Mycology) Culture 87101 Y Y N $83.75 $83.75 $16.91 $16.91

188243 Fungus Culture With Stain 87101, 87206 Y Y N $138.75 $138.75 $31.60 $31.60

008136 Fungus Stain 87206 N Y N $55.00 $55.00 $14.69 $14.69

602860 FX02-IgE Food Mix (Seafoods) 86005 Y Y N $24.25 $24.25 $4.45 $4.45

602464 G002-IgE Bermuda Grass 86003 N Y N $24.25 $24.25 $4.45 $4.45

602506 G006-IgE Timothy Grass 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602503 G010-IgE Johnson Grass 86003 N Y N $24.25 $24.25 $4.45 $4.45

602874 G014-IgE Oat, Cultivated 86003 N Y N $24.25 $24.25 $4.45 $4.45

001917 G-6-PD, Quant, Blood and RBC 82955, 85041 Y Y N $86.50 $86.50 $8.87 $8.87

716811 Gabapentin (Neurontin), Serum 80171 Y Y N $133.25 $133.25 $18.85 $18.85

790394 Gabapentin, Urine 80171 Y Y N $177.50 $177.50 $40.83 $40.83

143008 GAD-65 Autoantibody 83519 Y Y N $178.50 $178.50 $49.89 $49.89

252816 Galactosemia: GALT 81406 Y Y N $680.00 $680.00 $680.00

140080 Galectin-3 with BNP 82777, 83880 Y Y N $333.00 $333.00 $304.77 $304.77

142005 Galectin-3 with proBNP 82777, 83880 N Y N $345.00 $345.00 $335.85 $335.85

004390 Gastrin, Serum 82941 Y Y N $78.50 $78.50 $78.50

008128 GC Culture Only 87081 Y Y N $37.25 $37.25 $8.54 $8.54

188748 GC NAA, Pharyngeal 87591 Y Y N $119.25 $119.25 $7.65 $7.65

188730 GC NAA, Rectal 87591 Y Y N $119.25 $119.25 $7.65 $7.65

008334 Genital Culture, Routine 87070 Y Y N $65.25 $65.25 $13.86 $13.86

180089 Genital Mycoplasmas NAA, Swab 87798, 87798 59 (x2) Y Y N $270.00 $270.00 $270.00

551704 GenoSure PRIme(R) 87901, 87906 Y N N $665.50 $665.50 $412.67 $412.67

551707 GenoSure PRIme(R) 87900 Y N N $224.50 $224.50 $177.33 $177.33

007162 Gentamicin Peak, Serum 80170 N Y Y $90.00 $31.50 $9.97 $9.97

007161 Gentamicin Random, Serum 80170 N N Y $90.00 $31.50 $13.49 $13.49

007163 Gentamicin Trough, Serum 80170 Y Y Y $90.00 $31.50 $12.74 $12.74

102277 Gest. Diabetes 1-Hr Screen 82950 Y Y Y $27.00 $9.45 $1.75 $1.75

101000 Gestational 2 hour GTT 82951 Y Y Y $81.00 $28.35 $5.25 $5.25

313700 Gestational Glucose (X2) 82950, 82947 N N Y $54.00 $18.90 $3.50 $3.50

102053 Gestational Glucose (X3) 82951 N N Y $81.00 $28.35 $5.25 $5.25

102004 Gestational Glucose Tolerance 82951, 82952 Y Y Y $108.00 $37.80 $7.00 $7.00

371862 GG1hr+RPR+Ab Scr+CBC/Plt+HB...

82950, 87340, 86850, 86592,

86703, 85027 Y N N $285.50 $285.50 $285.50

001958 GGT 82977 Y Y Y $27.00 $9.45 $1.75 $1.75

182204 Giardia lamblia Ag, EIA 87329 Y Y N $90.00 $90.00 $16.63 $16.63

188110 Giardia, EIA, Ova/Parasite 87329, 87177, 87209 Y Y N $165.25 $165.25 $165.25

183558 Giardia/Cryptosporidium EIA 87329, 87328 Y Y N $212.75 $212.75 $38.61 $38.61

163402 Gliadin IgG/IgA Ab Prof, EIA 83516 (x2) Y N N $197.00 $197.00 $9.97 $9.97

100768 Glom Filt Rate, Estimated 82565 Y Y Y $27.00 $9.45 $3.60 $3.60

302857 Glu+CBC/D/Plt+RPR+UA 85025, 86592, 81003, 82947 Y N Y $86.25 $30.19 $8.56 $8.56

302832 Glu+CBC/D/Plt+RPR+UA+Sickle

85025, 85660, 86592, 81003,

82947 N N N $145.75 $145.75 $12.15 $12.15

303476 Glu+CBC/D/Plt+Sickle 85025, 85660, 82947 Y N N $103.25 $103.25 $7.95 $7.95

Page 22 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

025239 Glu+Hb A1c 83036, 82947 N N Y $77.75 $27.21 $5.68 $5.68

239822 Glucose (2 Spec) Tolerance, S 82950, 82947 Y N Y $54.00 $18.90 $18.90

101200 Glucose (2 Spec, WHO) Toler,S 82950, 82947 Y Y Y $54.00 $18.90 $18.90

001255 Glucose Fasting and 2hr 82950, 82947 Y N Y $54.00 $18.90 $3.55 $3.55

102087 Glucose Hemocue Waived 82947 QW Y N Y $27.00 $9.45 $9.45

211193 Glucose Tolerance (3 Sp Bl/Ur) 81005 (x3), 82951 N N Y $145.50 $50.93 $15.75 $15.75

095588 Glucose Tolerance (3 Sp Blood) 82951 Y N Y $81.00 $28.35 $5.25 $5.25

090365 Glucose Tolerance (4 Sp Blood) 82951, 82952 Y N Y $108.00 $37.80 $7.00 $7.00

090373 Glucose Tolerance (5 Sp Blood) 82951, 82952 (x2) N N Y $135.00 $47.25 $8.75 $8.75

211425 Glucose Tolerance Prof (4 Sp) 82951, 82952, 82985 N N Y $106.00 $37.10 $10.32 $10.32

019497 Glucose, Body Fluid 82945 N Y Y $27.00 $9.45 $3.60 $3.60

001818 Glucose, Plasma 82947 Y Y Y $27.00 $9.45 $1.75 $1.75

003376 Glucose, Quantitative, Urine 82945 N Y Y $27.00 $9.45 $2.44 $2.44

001032 Glucose, Serum 82947 Y Y Y $27.00 $9.45 $1.75 $1.75

002022 Glucose, Two-Hour Postprandial 82950 Y Y Y $27.00 $9.45 $1.75 $1.75

054130 Glucose/Insulin Resp (5 Spec) 82951, 82952 (x2), 83525 (x5) N N Y $430.00 $150.50 $44.78 $44.78

001693 Glycohemoglobin (GHb),Total 83036 N N N $50.75 $50.75 $3.32 $3.32

502421 Gonadotropin Releasing Hormone 83727 Y Y N $241.00 $241.00 $241.00

008540 Gram Stain 87205 Y Y N $37.25 $37.25 $7.31 $7.31

182352 Gram Stain w/Sputum Cult Rflx 87205 Y Y N $37.25 $37.25 $7.31 $7.31

188284 Gram Stain/Body Fluid Culture 87205, 87070 Y N N $127.00 $127.00 $127.00

188177 Gram Stn+Lower Resp Cult 87070, 87205 N N N $102.50 $102.50 $20.61 $20.61

004275 Growth Hormone, Serum 83003 Y Y Y $84.50 $29.58 $10.80 $10.80

163683 H pylori, IgM, IgG, IgA Ab 86677 (x3) Y Y Y $291.75 $102.11 $20.61 $20.61

180836 H. pylori Breath Test 83013 Y Y N $270.00 $270.00 $270.00

180764 H. pylori Stool Ag, EIA 87338 Y Y N $183.75 $183.75 $41.57 $41.57

162289 H. pylori, IgG Abs 86677 Y Y Y $97.25 $34.04 $5.09 $5.09

602546 H002-IgE House Dust(Hollister) 86003 N Y N $24.25 $24.25 $4.45 $4.45

816212 Hair Drug Screen 9 Panel 80301 N N N $408.25 $408.25 $70.73 $70.73

806698 Hair Standard 80301 N N N $70.00 $70.00 $55.48 $55.48

070482 Haloperidol (Haldol(R)) Serum 80173 Y Y N $147.50 $147.50 $9.97 $9.97

001628 Haptoglobin 83010 Y Y Y $83.00 $29.05 $8.60 $8.60

812238 Harmony with XY Analysis 81507, 81599 Y N N $1,104.75 $1,104.75 $1,104.75

058552 HAV/HBV (Profile VII)

87340, 86704, 86705, 86706,

87350, 86707, 86708, 86709 Y Y Y $561.75 $196.61 $52.31 $52.31

058537 HAV/HBV Immune Status (Pro IV) 86704, 86706, 86708, 86709 Y Y Y $298.50 $104.48 $23.50 $23.50

005330 HB Solu + Rflx Frac 85660 Y Y N $67.75 $67.75 $3.60 $3.60

037184 HBcAb+HBsAb+Ag 87340, 86704, 86706 Y N Y $181.75 $63.61 $11.51 $11.51

301021 HBcAb+M+HBsAb+HCVAb 87340, 86705, 86704, 86803 N N Y $268.00 $93.80 $24.69 $24.69

200477 HBeAb+Ag 87350, 86707 Y N N $108.75 $108.75 $108.75

035774 HBsAb+Ag 87340, 86706 Y N Y $113.75 $39.81 $6.74 $6.74

006510 HBsAg Screen 87340 Y Y Y $59.50 $20.83 $3.30 $3.30

098418 HBV Core Ab, IgG/IgM Diff 86704, 86705 Y Y Y $157.50 $55.13 $14.19 $14.19

091108 HBV Follow-Up (Profile XII) 87340, 86706, 87350, 86707 Y Y Y $253.50 $88.73 $88.73

551610 HBV Real-Time PCR, Quant 87517 Y Y N $520.75 $520.75 $166.29 $166.29

Page 23 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

551620 HBV RT PCR, Quant (Graph) 87517 Y Y N $543.50 $543.50 $543.50

265389 HBV Vaccine Follow-Up (Pro XI) 86706 N Y Y $70.25 $24.59 $3.44 $3.44

255505 HBV/HCV (Profile VIII)

87340, 86704, 86706, 87350,

86707, 86803, 86705 Y Y N $500.75 $500.75 $44.22 $44.22

480038 hCG, Beta Subunit, Qn (Serial) 84702 N Y Y $123.00 $43.05 $7.77 $7.77

004416 hCG,Beta Subunit, Qnt, Serum 84702 Y Y Y $100.00 $35.00 $4.09 $4.09

004556 hCG,Beta Subunit,Qual,Serum 84703 Y Y Y $91.50 $32.03 $3.60 $3.60

144075 HCV Ab Verification 86804 Y N N $386.00 $386.00 $92.00 $92.00

144065 HCV Ab w/Rflx to Verification 86803 Y Y Y $88.00 $30.80 $7.21 $7.21

140659 HCV Antibody 86803 Y Y Y $88.00 $30.80 $7.21 $7.21

144045 HCV Antibody reflex to NAA 86803 Y Y Y $88.00 $30.80 $7.21 $7.21

144090 HCV Antibody Verification 86804 Y Y N $386.00 $386.00 $92.00 $92.00

550123 HCV FibroSure

83883, 83010, 82172, 82977,

82247, 84460 Y N N $263.75 $263.75 $166.29 $166.29

550555 HCV Genotype Reflex NS3/4A 87902 Y Y N $561.25 $561.25 $561.25

550475 HCV Genotyping Non Reflex 87902 Y Y N $561.25 $561.25 $271.59 $271.59

550825 HCV NAA Qualitative (rfx Geno) 87521 Y Y N $347.25 $347.25 $129.43 $129.43

551300 HCV RealTime Abbott 87522 Y Y N $647.75 $647.75 $647.75

550312 HCV Real-Time, PCR, Quant 87522 Y N N $448.00 $448.00 $151.87 $151.87

144028 HCV reflex to Quant RT PCR 86803 Y N N $88.00 $88.00 $7.21 $7.21

550090 HCV RNA by PCR, Qn Rfx Geno 87522 Y Y N $425.00 $425.00 $143.00 $143.00

550100 HCV RNA by PCR, Qn Rfx Geno 87522 Y Y N $448.00 $448.00 $151.87 $151.87

550840 HCV RNA NAA Qual rfx to Quant 87521 Y Y N $347.25 $347.25 $129.43 $129.43

550713 HCV RNA NAA Qualitative 87521 Y Y N $347.25 $347.25 $116.84 $116.84

550850 HCV RNA NAA Qualitative 87521 Y N N $347.25 $347.25 $116.84 $116.84

550072 HCV RNA PCR Qn Rfx NS3/4A 87522 Y Y N $386.00 $386.00 $386.00

550066 HCV RNA Qn (Graph) Rfx NS3/4A 87522 Y Y N $448.00 $448.00 $448.00

550296 HCV RT-PCR, Quant 87522 Y N N $425.00 $425.00 $143.00 $143.00

550515 HCV RT-PCR, Quant 87522 N N N $425.00 $425.00 $143.00 $143.00

550070 HCV RT-PCR, Quant (Graph) 87522 Y Y N $448.00 $448.00 $151.87 $151.87

550080 HCV RT-PCR, Quant (Non-Graph) 87522 Y Y N $425.00 $425.00 $143.00 $143.00

001925 HDL Cholesterol 83718 Y Y Y $49.50 $17.33 $2.00 $2.00

042580 Heavy Metals Profile I, Blood 82175, 83655, 83825 Y Y N $304.25 $304.25 $14.92 $14.92

706200 Heavy Metals Profile II, Blood 82175, 82300, 83655, 83825 Y Y N $440.25 $440.25 $129.14 $129.14

007492 Heavy Metals Profile, Urine 82175, 82570, 83655, 83825 N Y N $257.50 $257.50 $109.19 $109.19

163170 Helicobacter pylori, IgA 86677 Y Y Y $97.25 $34.04 $8.87 $8.87

163204 Helicobacter pylori, IgM Ab 86677 Y Y Y $97.25 $34.04 $6.66 $6.66

505008 Helper T-Lymph-CD4 86361 Y Y N $113.00 $113.00 $11.09 $11.09

005058 Hematocrit 85014 Y Y Y $24.50 $8.58 $2.10 $2.10

005300 Hematopath Consultation, Smear 85060 Y Y N $70.25 $70.25 $17.25 $17.25

005041 Hemoglobin 85018 Y Y Y $24.50 $8.58 $2.10 $2.10

001453 Hemoglobin A1c 83036 Y Y Y $50.75 $17.76 $3.93 $3.93

120880 Hemoglobin Frac.w/o Solubility 83021 Y N N $98.25 $98.25 $12.48 $12.48

005595 Hemoglobin, Free, Plasma 83051 N Y N $75.25 $75.25 $26.98 $26.98

080176 Hemoglobin, Free, Qual, Urine 81003 N Y N $26.00 $26.00 $9.34 $9.34

Page 24 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

006734 Hep A Ab, IgM 86709 Y Y Y $77.25 $27.04 $8.87 $8.87

006726 Hep A Ab, Total 86708 Y Y Y $73.50 $25.73 $6.43 $6.43

016881 Hep B Core Ab, IgM 86705 Y Y Y $80.00 $28.00 $9.42 $9.42

006718 Hep B Core Ab, Tot 86704 Y Y Y $77.50 $27.13 $4.77 $4.77

006395 Hep B Surface Ab 86706 Y Y Y $70.25 $24.59 $3.44 $3.44

006635 Hep Be Ab 86707 Y Y N $62.75 $62.75 $8.65 $8.65

006619 Hep Be Ag 87350 Y Y N $62.75 $62.75 $7.43 $7.43

117101 Heparin Anti-Xa 85520 Y Y N $175.00 $175.00 $61.50 $61.50

500187 Heparin Cofactor II 85130 Y Y N $185.00 $185.00 $185.00

303755 Hepatic Function Panel (6)

82040, 82247, 82248, 84075,

84450, 84460 Y N Y $29.50 $10.33 $2.43 $2.43

322755 Hepatic Function Panel (7) 80076 Y Y Y $30.00 $10.50 $2.55 $2.55

028928 Hepatitis A (Prof V) 86709, 86708 Y Y Y $150.75 $52.76 $15.29 $15.29

006530 Hepatitis B Surf Ab Quant 86317 Y Y Y $70.25 $24.59 $3.44 $3.44

058545 Hepatitis B Virus (Profile VI)

87340, 86704, 86706, 87350,

86707, 86705 Y Y Y $412.75 $144.46 $37.01 $37.01

550481 Hepatitis C Genotype 87902 Y N N $561.25 $561.25 $271.59 $271.59

550486 Hepatitis C Genotype 87902 Y N N $561.25 $561.25 $271.59 $271.59

284452 Hepatitis D Total 86692 Y N N $64.50 $64.50 $64.50

823334 Hepatitis E IgG 86790 Y N N $173.25 $173.25 $161.76 $161.76

823331 Hepatitis E IgM 86790 Y N N $173.25 $173.25 $173.25

322744 Hepatitis Panel (4) 80074 Y Y Y $304.75 $106.66 $28.79 $28.79

045849 Hepatitis Pt Mgmnt (Prof III) 87340, 87350, 86707 N Y Y $183.25 $64.14 $19.38 $19.38

058560 Hepatitis, Diagnostic (Prof I) 87340, 86705, 86709 Y Y Y $216.75 $75.86 $26.35 $26.35

483248 HER-2/CEP17 FISH 88271 (x2), 88274 Y Y N $731.00 $731.00 $731.00

511345 Hered.Hemochromatosis, DNA 81256 Y Y N $400.00 $400.00 $110.02 $110.02

790560 Heroin, Serum/Plasma/WB 80361, 80356 Y Y N $267.74 $267.74 $267.74

188035 Herpes Simplex Virus, PCR Test Not Coded N N N $310.00 $310.00 $83.75 $83.75

117008 Hexagonal Phase Phospholipid 85598 N N N $140.00 $140.00 $49.89 $49.89

117020 Hexagonal Phase Phospholipid 85598 Y N N $140.00 $140.00 $49.89 $49.89

316370 HFP+2AC+CBC/D/Plt+CreatCx+P...

82575, 85025, 84550, 82040,

84075, 82247, 82248, 84450,

84460, 84156 Y N Y $125.50 $43.93 $43.93

237842 HFP7+2AC 80076, 82977, 83615 Y N Y $31.00 $10.85 $2.79 $2.79

368878 HFP7+2AC 80076, 82977, 82465 Y N Y $25.50 $8.93 $2.79 $2.79

000505 HFP7+3AC 80076, 82977, 82465, 83615 N N Y $31.50 $11.03 $2.91 $2.91

002626 HFP7+3AC 80076, 82977, 82465, 83615 N N Y $26.00 $9.10 $2.91 $2.91

102525 Hgb A1c with eAG Estimation 83036 Y Y Y $50.75 $17.76 $3.93 $3.93

121020 Hgb A2, Quant 83021 Y Y N $98.25 $98.25 $12.48 $12.48

121679 Hgb Frac. Profile 83021, 85660 Y Y N $166.00 $166.00 $16.41 $16.41

122101 Hgb Frac. w/o Solubility 83021 Y Y N $98.25 $98.25 $12.20 $12.20

005223 Hgb Solubility 85660 Y Y N $67.75 $67.75 $3.60 $3.60

031088 Hgb+Hct 85014, 85018 Y N Y $24.75 $8.66 $1.95 $1.95

164319 Histoplasma Abs, Qn, DID 86698 N Y N $109.25 $109.25 $39.25 $39.25

823203 Histoplasma Antigen, Urine 87385 N N N $115.25 $115.25 $94.23 $94.23

Page 25 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

083860 HIV 1/2 Ab Differentiation 86701, 86702 Y N N $260.00 $260.00 $37.67 $37.67

083940 HIV 1/2 Ab Differentiation 86701, 86702 Y N N $260.00 $260.00 $37.67 $37.67

551874 HIV GenoSure(R) Integrase 87906, 87900 Y N N $350.00 $350.00 $350.00

551619 HIV GenoSure(R) MG 87900 Y N N $224.25 $224.25 $130.36 $130.36

551624 HIV GenoSure(R) MG 87901 Y N N $443.25 $443.25 $257.63 $257.63

551781 HIV GSArchive 87901, 87906 N N N $665.50 $665.50 $412.67 $412.67

551782 HIV GSArchive Interp 87900 N N N $224.50 $224.50 $177.33 $177.33

551734 HIVDNASeq PRRT 87901 N N N $443.25 $443.25 $257.63 $257.63

551743 HIVDNASeq PRRT Interp 87900 N N N $224.25 $224.25 $130.36 $130.36

167116 HLA A,B,C (IR) 81372 N Y N $600.00 $600.00 $110.85 $110.85

006924 HLA B 27 Disease Association 81374 Y Y N $170.00 $170.00 $33.26 $33.26

006926 HLA B5701 Test 81381 Y Y N $143.75 $143.75 $143.75

167267 HLA-A (IR) 81373 N Y N $200.00 $200.00 $36.96 $36.96

167292 HLA-B (IR) 81373 N Y N $200.00 $200.00 $36.95 $36.95

167316 HLA-C (IR) 81373 N Y N $200.00 $200.00 $36.95 $36.95

706994 Homocyst(e)ine, Plasma 83090 Y Y N $143.25 $143.25 $27.72 $27.72

716290 Homocysteine, Urine 83090 N N N $213.75 $213.75 $55.42 $55.42

120253 Homovanillic Acid, 24-Hr Urine 83150 N Y N $88.50 $88.50 $31.79 $31.79

257188 HP4 80074 N N Y $304.75 $106.66 $28.79 $28.79

303744 HP5

86708, 86803, 86704, 86706,

87340 Y N Y $368.75 $129.06 $25.14 $25.14

257238 HP5+HAVIgM+HBcIgM 80074, 86708, 86704, 86706 Y N Y $526.00 $184.10 $43.43 $43.43

257113 HP5+HAVIgM+HBcIgM+HBeAb+Ag

80074, 87350, 86707, 86708,

86704, 86706 Y N N $649.75 $649.75 $59.51 $59.51

507800 HPV Aptima 87624 Y Y N $187.75 $187.75 $187.75

507460 HPV Genotype, 16/18 87625 Y N N $80.00 $80.00 $68.00 $68.00

507810 HPV Genotypes 16/18,45 87625 Y Y N $80.00 $80.00 $68.00 $68.00

507820 HPV Genotypes 16/18,45 87625 Y N N $80.00 $80.00 $80.00

507815 HPV, 16/18,45 87624 Y Y N $187.75 $187.75 $39.00 $39.00

507385 HPV, cobas high-risk/16/18 87624 N Y N $267.75 $267.75 $107.00 $107.00

500306 HPV, high+low-risk 87624 Y Y N $201.00 $201.00 $78.00 $78.00

507301 HPV, high-risk 87624 Y Y N $187.75 $187.75 $39.00 $39.00

507310 HPV, high-risk 87624 Y N N $187.75 $187.75 $39.00 $39.00

507405 HPV, low volume rfx 87624 Y N N $187.75 $187.75 $39.00 $39.00

165180 HSV 1 and 2 IgM Abs, Indirect 86695, 86696 Y Y N $96.50 $96.50 $96.50

164905 HSV 1 and 2-Specific Ab, IgG 86695, 86696 Y Y N $181.00 $181.00 $31.50 $31.50

138651 HSV 1/2 PCR 87529 (x2) Y Y N $310.00 $310.00 $182.91 $182.91

008250 HSV Culture and Typing 87255 Y Y N $127.25 $127.25 $15.52 $15.52

186072 HSV Culture Without Typing 87255 Y Y N $112.50 $112.50 $12.20 $12.20

188056 HSV NAA 87529 (x2) Y Y N $310.00 $310.00 $72.50 $72.50

164897 HSV Type 1-Specific Ab, IgG 86695 Y Y N $74.00 $74.00 $26.51 $26.51

163147 HSV Type 2-Specific Ab, IgG 86696 Y Y N $107.00 $107.00 $4.99 $4.99

164806 HSV, IgM I/II Combination 86694 Y Y N $80.00 $80.00 $13.30 $13.30

164277 HTLV-I/II Antibodies, Qual. 86790 Y Y N $93.50 $93.50 $93.50

138529 Human Herpes Virus Type 6 IgM 86790 Y Y N $166.50 $166.50 $166.50

Page 26 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

829044 Huntington Disease Mutation 81401 N N N $679.50 $679.50 $264.19 $264.19

803301 Hydrocodone + Metabolites, U 80361 Y Y N $157.50 $157.50 $157.50

071526 Hydrocodone and Metabolite 80361 Y Y N $111.00 $111.00 $111.00

067710 Hymenoptera Profile 86003 (x5) Y Y N $121.25 $121.25 $22.25 $22.25

671871 Hymenoptera Profile 2 86003 (x6) Y Y N $145.50 $145.50 $26.70 $26.70

660670 Hypersensitivity Pneumonitis

86331, 86609, 86606, 86671,

86602 (x2) Y Y N $433.50 $433.50 $433.50

602886 I001-IgE Honeybee 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602887 I002-IgE Hornet, White Face 86003 Y Y N $24.25 $24.25 $24.25

602889 I003-IgE Yellow Jacket 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602890 I004-IgE Paper Wasp 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602891 I005-IgE Hornet, Yellow 86003 Y Y N $24.25 $24.25 $4.45 $4.45

602481 I100-IgE Cockroach, American 86003 N Y N $24.25 $24.25 $4.45 $4.45

602897 I205-IgE Bumblebee 86003 Y Y N $24.25 $24.25 $4.45 $4.45

162045 IBD Expanded Panel 86671, 83516 (x3), 86255 Y Y N $243.00 $243.00 $243.00

808462 Ibuprofen, Serum/Plasma 80329 Y Y N $76.25 $76.25 $76.25

182786 ID 3 87077 (x3) Y N N $120.00 $120.00 $120.00

122390 IFE and PE, Random Urine 86335, 84166, 84156 N Y N $301.50 $301.50 $32.71 $32.71

001495 IFE and PE, Serum 82784 (x3), 84165, 86334, 84155 Y Y N $280.25 $280.25 $39.07 $39.07

120256 IFE, PE and FLC, Serum

82784 (x3), 84165, 86334, 83883

(x2), 84155 N Y N $525.50 $525.50 $127.19 $127.19

003467 IFE+Protein Electro, 24-Hr Ur 86335, 84166, 84156 N Y N $301.50 $301.50 $47.11 $47.11

123050 IgA, Subclass 1 83883 Y Y N $41.75 $41.75 $41.75

123049 IgA, Subclasses (1-2) 82784, 83883 (x2) N Y N $130.75 $130.75 $49.34 $49.34

603940 IgE Egg White w/Component Rflx 86003 N Y N $24.25 $24.25 $4.45 $4.45

603857 IgE Food Basic w/Component Rfx 86003 (x6) N Y N $145.50 $145.50 $26.70 $26.70

603927 IgE Milk w/ Component Reflex 86003 N Y N $24.25 $24.25 $4.45 $4.45

603916 IgE Peanut w/Component Reflex 86003 N Y N $24.25 $24.25 $4.45 $4.45

665349 IgE+Latex 82785, 86003 N N N $105.50 $105.50 $85.70 $85.70

010363 IGF-1 84305 Y Y N $196.50 $196.50 $26.05 $26.05

010540 IGF-1 with Z-Score 84305 N Y N $196.50 $196.50 $26.05 $26.05

141770 IGF-2 83519 Y Y N $85.00 $85.00 $85.00

140822 IGF-BP1 83520 N Y N $95.00 $95.00 $49.89 $49.89

160507 IgG, Subclass 1 82787 Y Y N $104.75 $104.75 $104.75

199305 IGP, Aptima HPV, rfx 16/18,45 87624, 88175 N Y N $275.75 $275.75 $61.95 $61.95

196210 IGP, cobasHPV16/18 87624, 88175 N Y N $355.75 $355.75 $129.95 $129.95

196215 IGP, CtNg, cobasHPV16/18 87624, 88175, 87491, 87591 N Y N $583.25 $583.25 $145.25 $145.25

199320 IGP, CtNg, rfx Aptima HPV ASCU 87491, 87591, 88175 Y Y N $315.50 $315.50 $315.50

196220 IGP, CtNgTv, cobasHPV16/18

87591, 87491, 87661, 87624,

88175 N Y N $691.00 $691.00 $176.25 $176.25

199310 IGP,CtNg,AptimaHPV,rfx16/18,45 87624, 87491, 87591, 88175 N Y N $503.25 $503.25 $77.25 $77.25

199405 IGP,CtNg,rfxHPVpath+rfxQS 88175, 87491, 87591 N Y N $315.50 $315.50 $38.25 $38.25

199315 IGP,CtNgTv,Apt HPV,rfx16/18,45

87624, 87491, 87591, 87661,

88175 N Y N $600.00 $600.00 $108.25 $108.25

Page 27 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

199425 IGP,CtNgTv,HPV rfx16/18+rfxQS

88175, 87491, 87591, 87624,

87661 N Y N $611.00 $611.00 $108.25 $108.25

199410 IGP,CtNgTv,rfxHPVpath+rfxQS 88175, 87491, 87591, 87661 N Y N $423.25 $423.25 $69.25 $69.25

199400 IGP,rfxHPVpath+rfxQS 88175 N Y N $88.00 $88.00 $22.95 $22.95

W20061 IHC 1st AB Stain x1 GLBL 88342 Y N N $219.00 $219.00 $87.25 $87.25

P20061 IHC 1st AB Stain x1 PROF 88342 26 N N N $118.25 $118.25 $47.12 $47.12

W20070 IHC 1st AB Stain x10 GLBL 88342 (x10) N N N $2,190.00 $2,190.00 $872.50 $872.50

P20070 IHC 1st AB Stain x10 PROF 88342 26 (x10) N N N $1,182.50 $1,182.50 $471.20 $471.20

W20071 IHC 1st AB Stain x11 GLBL 88342 (x11) N N N $2,409.00 $2,409.00 $959.75 $959.75

P20071 IHC 1st AB Stain x11 PROF 88342 26 (x11) N N N $1,300.75 $1,300.75 $518.32 $518.32

P20072 IHC 1st AB Stain x12 PROF 88342 26 (x12) N N N $1,419.00 $1,419.00 $565.44 $565.44

W20073 IHC 1st AB Stain x13 GLBL 88342 (x13) N N N $2,847.00 $2,847.00 $1,134.25 $1,134.25

P20073 IHC 1st AB Stain x13 PROF 88342 26 (x13) N N N $1,537.25 $1,537.25 $612.56 $612.56

P20074 IHC 1st AB Stain x14 PROF 88342 26 (x14) N N N $1,655.50 $1,655.50 $659.68 $659.68

W20075 IHC 1st AB Stain x15 GLBL 88342 (x15) N N N $3,285.00 $3,285.00 $1,308.75 $1,308.75

P20075 IHC 1st AB Stain x15 PROF 88342 26 (x15) N N N $1,773.75 $1,773.75 $706.80 $706.80

W20076 IHC 1st AB Stain x16 GLBL 88342 (x16) N N N $3,504.00 $3,504.00 $1,396.00 $1,396.00

P20076 IHC 1st AB Stain x16 PROF 88342 26 (x16) N N N $1,892.00 $1,892.00 $753.92 $753.92

P20077 IHC 1st AB Stain x17 PROF 88342 26 (x17) N N N $2,010.25 $2,010.25 $801.04 $801.04

W20078 IHC 1st AB Stain x18 GLBL 88342 (x18) N N N $3,942.00 $3,942.00 $1,570.50 $1,570.50

P20078 IHC 1st AB Stain x18 PROF 88342 26 (x18) N N N $2,128.50 $2,128.50 $848.16 $848.16

W20079 IHC 1st AB Stain x19 GLBL 88342 (x19) N N N $4,161.00 $4,161.00 $1,657.75 $1,657.75

P20079 IHC 1st AB Stain x19 PROF 88342 26 (x19) N N N $2,246.75 $2,246.75 $895.28 $895.28

W20062 IHC 1st AB Stain x2 GLBL 88342 (x2) Y N N $438.00 $438.00 $174.50 $174.50

P20062 IHC 1st AB Stain x2 PROF 88342 26 (x2) N N N $236.50 $236.50 $94.24 $94.24

W20080 IHC 1st AB Stain x20 GLBL 88342 (x20) N N N $4,380.00 $4,380.00 $1,745.00 $1,745.00

P20080 IHC 1st AB Stain x20 PROF 88342 26 (x20) N N N $2,365.00 $2,365.00 $942.40 $942.40

W20081 IHC 1st AB Stain x21 GLBL 88342 (x21) N N N $4,599.00 $4,599.00 $1,832.25 $1,832.25

P20081 IHC 1st AB Stain x21 PROF 88342 26 (x21) N N N $2,483.25 $2,483.25 $989.52 $989.52

T20081 IHC 1st AB Stain x21 TECH 88342 TC (x21) N N N $2,115.75 $2,115.75 $842.73 $842.73

W20082 IHC 1st AB Stain x22 GLBL 88342 (x22) N N N $4,818.00 $4,818.00 $1,919.50 $1,919.50

P20082 IHC 1st AB Stain x22 PROF 88342 26 (x22) N N N $2,601.50 $2,601.50 $1,036.64 $1,036.64

W20083 IHC 1st AB Stain x23 GLBL 88342 (x23) N N N $5,037.00 $5,037.00 $2,006.75 $2,006.75

P20083 IHC 1st AB Stain x23 PROF 88342 26 (x23) N N N $2,719.75 $2,719.75 $1,083.76 $1,083.76

T20083 IHC 1st AB Stain x23 TECH 88342 TC (x23) N N N $2,317.25 $2,317.25 $922.99 $922.99

W20084 IHC 1st AB Stain x24 GLBL 88342 (x24) N N N $5,256.00 $5,256.00 $2,094.00 $2,094.00

P20084 IHC 1st AB Stain x24 PROF 88342 26 (x24) N N N $2,838.00 $2,838.00 $1,130.88 $1,130.88

T20084 IHC 1st AB Stain x24 TECH 88342 TC (x24) N N N $2,418.00 $2,418.00 $963.12 $963.12

W20085 IHC 1st AB Stain x25 GLBL 88342 (x25) N N N $5,475.00 $5,475.00 $2,181.25 $2,181.25

P20085 IHC 1st AB Stain x25 PROF 88342 26 (x25) N N N $2,956.25 $2,956.25 $1,178.00 $1,178.00

W20086 IHC 1st AB Stain x26 GLBL 88342 (x26) N N N $5,694.00 $5,694.00 $2,268.50 $2,268.50

P20086 IHC 1st AB Stain x26 PROF 88342 26 (x26) N N N $3,074.50 $3,074.50 $1,225.12 $1,225.12

T20086 IHC 1st AB Stain x26 TECH 88342 TC (x26) N N N $2,619.50 $2,619.50 $1,043.38 $1,043.38

W20087 IHC 1st AB Stain x27 GLBL 88342 (x27) N N N $5,913.00 $5,913.00 $2,355.75 $2,355.75

P20087 IHC 1st AB Stain x27 PROF 88342 26 (x27) N N N $3,192.75 $3,192.75 $1,272.24 $1,272.24

Page 28 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

T20087 IHC 1st AB Stain x27 TECH 88342 TC (x27) N N N $2,720.25 $2,720.25 $1,083.51 $1,083.51

W20088 IHC 1st AB Stain x28 GLBL 88342 (x28) N N N $6,132.00 $6,132.00 $2,443.00 $2,443.00

P20088 IHC 1st AB Stain x28 PROF 88342 26 (x28) N N N $3,311.00 $3,311.00 $1,319.36 $1,319.36

T20088 IHC 1st AB Stain x28 TECH 88342 TC (x28) N N N $2,821.00 $2,821.00 $1,123.64 $1,123.64

W20089 IHC 1st AB Stain x29 GLBL 88342 (x29) N N N $6,351.00 $6,351.00 $2,530.25 $2,530.25

P20089 IHC 1st AB Stain x29 PROF 88342 26 (x29) N N N $3,429.25 $3,429.25 $1,366.48 $1,366.48

T20089 IHC 1st AB Stain x29 TECH 88342 TC (x29) N N N $2,921.75 $2,921.75 $1,163.77 $1,163.77

W20063 IHC 1st AB Stain x3 GLBL 88342 (x3) N N N $657.00 $657.00 $261.75 $261.75

P20063 IHC 1st AB Stain x3 PROF 88342 26 (x3) N N N $354.75 $354.75 $141.36 $141.36

W20090 IHC 1st AB Stain x30 GLBL 88342 (x30) N N N $6,570.00 $6,570.00 $2,617.50 $2,617.50

P20090 IHC 1st AB Stain x30 PROF 88342 26 (x30) N N N $3,547.50 $3,547.50 $1,413.60 $1,413.60

P20064 IHC 1st AB Stain x4 PROF 88342 26 (x4) N N N $473.00 $473.00 $188.48 $188.48

P20065 IHC 1st AB Stain x5 PROF 88342 26 (x5) N N N $591.25 $591.25 $235.60 $235.60

W20066 IHC 1st AB Stain x6 GLBL 88342 (x6) N N N $1,314.00 $1,314.00 $523.50 $523.50

P20066 IHC 1st AB Stain x6 PROF 88342 26 (x6) N N N $709.50 $709.50 $282.72 $282.72

W20067 IHC 1st AB Stain x7 GLBL 88342 (x7) N N N $1,533.00 $1,533.00 $610.75 $610.75

P20067 IHC 1st AB Stain x7 PROF 88342 26 (x7) N N N $827.75 $827.75 $329.84 $329.84

W20068 IHC 1st AB Stain x8 GLBL 88342 (x8) N N N $1,752.00 $1,752.00 $698.00 $698.00

P20068 IHC 1st AB Stain x8 PROF 88342 26 (x8) N N N $946.00 $946.00 $376.96 $376.96

W20069 IHC 1st AB Stain x9 GLBL 88342 (x9) N N N $1,971.00 $1,971.00 $785.25 $785.25

P20069 IHC 1st AB Stain x9 PROF 88342 26 (x9) N N N $1,064.25 $1,064.25 $424.08 $424.08

W20530 IHC ea addl AB Stain x1 GLBL 88341 Y N N $219.00 $219.00 $87.25 $87.25

P20530 IHC ea addl AB Stain x1 PROF 88341 26 N N N $118.25 $118.25 $47.12 $47.12

T20530 IHC ea addl AB Stain x1 TECH 88341 TC N N N $100.75 $100.75 $40.13 $40.13

W20539 IHC ea addl AB Stain x10 GLBL 88341 (x10) N N N $2,190.00 $2,190.00 $872.50 $872.50

P20539 IHC ea addl AB Stain x10 PROF 88341 26 (x10) N N N $1,182.50 $1,182.50 $471.20 $471.20

T20539 IHC ea addl AB Stain x10 TECH 88341 TC (x10) N N N $1,007.50 $1,007.50 $401.30 $401.30

W20540 IHC ea addl AB Stain x11 GLBL 88341 (x11) N N N $2,409.00 $2,409.00 $959.75 $959.75

P20540 IHC ea addl AB Stain x11 PROF 88341 26 (x11) N N N $1,300.75 $1,300.75 $518.32 $518.32

T20540 IHC ea addl AB Stain x11 TECH 88341 TC (x11) N N N $1,108.25 $1,108.25 $441.43 $441.43

W20541 IHC ea addl AB Stain x12 GLBL 88341 (x12) N N N $2,628.00 $2,628.00 $1,047.00 $1,047.00

P20541 IHC ea addl AB Stain x12 PROF 88341 26 (x12) N N N $1,419.00 $1,419.00 $565.44 $565.44

T20541 IHC ea addl AB Stain x12 TECH 88341 TC (x12) N N N $1,209.00 $1,209.00 $481.56 $481.56

W20542 IHC ea addl AB Stain x13 GLBL 88341 (x13) N N N $2,847.00 $2,847.00 $1,134.25 $1,134.25

P20542 IHC ea addl AB Stain x13 PROF 88341 26 (x13) N N N $1,537.25 $1,537.25 $612.56 $612.56

T20542 IHC ea addl AB Stain x13 TECH 88341 TC (x13) N N N $1,309.75 $1,309.75 $521.69 $521.69

W20543 IHC ea addl AB Stain x14 GLBL 88341 (x14) N N N $3,066.00 $3,066.00 $1,221.50 $1,221.50

P20543 IHC ea addl AB Stain x14 PROF 88341 26 (x14) N N N $1,655.50 $1,655.50 $659.68 $659.68

T20543 IHC ea addl AB Stain x14 TECH 88341 TC (x14) N N N $1,410.50 $1,410.50 $561.82 $561.82

W20544 IHC ea addl AB Stain x15 GLBL 88341 (x15) N N N $3,285.00 $3,285.00 $1,308.75 $1,308.75

P20544 IHC ea addl AB Stain x15 PROF 88341 26 (x15) N N N $1,773.75 $1,773.75 $706.80 $706.80

T20544 IHC ea addl AB Stain x15 TECH 88341 TC (x15) N N N $1,511.25 $1,511.25 $601.95 $601.95

W20545 IHC ea addl AB Stain x16 GLBL 88341 (x16) N N N $3,504.00 $3,504.00 $1,396.00 $1,396.00

P20545 IHC ea addl AB Stain x16 PROF 88341 26 (x16) N N N $1,892.00 $1,892.00 $753.92 $753.92

T20545 IHC ea addl AB Stain x16 TECH 88341 TC (x16) N N N $1,612.00 $1,612.00 $642.08 $642.08

Page 29 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

W20546 IHC ea addl AB Stain x17 GLBL 88341 (x17) N N N $3,723.00 $3,723.00 $1,483.25 $1,483.25

P20546 IHC ea addl AB Stain x17 PROF 88341 26 (x17) N N N $2,010.25 $2,010.25 $801.04 $801.04

T20546 IHC ea addl AB Stain x17 TECH 88341 TC (x17) N N N $1,712.75 $1,712.75 $682.21 $682.21

W20547 IHC ea addl AB Stain x18 GLBL 88341 (x18) N N N $3,942.00 $3,942.00 $1,570.50 $1,570.50

P20547 IHC ea addl AB Stain x18 PROF 88341 26 (x18) N N N $2,128.50 $2,128.50 $848.16 $848.16

T20547 IHC ea addl AB Stain x18 TECH Test Not Coded N N N $1,813.50 $1,813.50 $722.34 $722.34

W20548 IHC ea addl AB Stain x19 GLBL 88341 (x19) N N N $4,161.00 $4,161.00 $1,657.75 $1,657.75

P20548 IHC ea addl AB Stain x19 PROF 88341 26 (x19) N N N $2,246.75 $2,246.75 $895.28 $895.28

T20548 IHC ea addl AB Stain x19 TECH 88341 TC (x19) N N N $1,914.25 $1,914.25 $762.47 $762.47

W20531 IHC ea addl AB Stain x2 GLBL 88341 (x2) Y N N $438.00 $438.00 $174.50 $174.50

P20531 IHC ea addl AB Stain x2 PROF 88341 26 (x2) N N N $236.50 $236.50 $94.24 $94.24

T20531 IHC ea addl AB Stain x2 TECH 88341 TC (x2) N N N $201.50 $201.50 $80.26 $80.26

W20549 IHC ea addl AB Stain x20 GLBL 88341 (x20) N N N $4,380.00 $4,380.00 $1,745.00 $1,745.00

P20549 IHC ea addl AB Stain x20 PROF 88341 26 (x20) N N N $2,365.00 $2,365.00 $942.40 $942.40

T20549 IHC ea addl AB Stain x20 TECH 88341 TC (x20) N N N $2,015.00 $2,015.00 $802.60 $802.60

W20550 IHC ea addl AB Stain x21 GLBL 88341 (x21) N N N $4,599.00 $4,599.00 $1,832.25 $1,832.25

P20550 IHC ea addl AB Stain x21 PROF 88341 26 (x21) N N N $2,483.25 $2,483.25 $989.52 $989.52

T20550 IHC ea addl AB Stain x21 TECH Test Not Coded N N N $2,115.75 $2,115.75 $842.73 $842.73

W20551 IHC ea addl AB Stain x22 GLBL 88341 (x22) N N N $4,818.00 $4,818.00 $1,919.50 $1,919.50

P20551 IHC ea addl AB Stain x22 PROF 88341 26 (x22) N N N $2,601.50 $2,601.50 $1,036.64 $1,036.64

T20551 IHC ea addl AB Stain x22 TECH 88341 TC (x22) N N N $2,216.50 $2,216.50 $882.86 $882.86

W20552 IHC ea addl AB Stain x23 GLBL 88341 (x23) N N N $5,037.00 $5,037.00 $2,006.75 $2,006.75

P20552 IHC ea addl AB Stain x23 PROF 88341 26 (x23) N N N $2,719.75 $2,719.75 $1,083.76 $1,083.76

T20552 IHC ea addl AB Stain x23 TECH 88341 TC (x23) N N N $2,317.25 $2,317.25 $922.99 $922.99

W20553 IHC ea addl AB Stain x24 GLBL 88341 (x24) N N N $5,256.00 $5,256.00 $2,094.00 $2,094.00

P20553 IHC ea addl AB Stain x24 PROF 88341 26 (x24) N N N $2,838.00 $2,838.00 $1,130.88 $1,130.88

T20553 IHC ea addl AB Stain x24 TECH 88341 TC (x24) N N N $2,418.00 $2,418.00 $963.12 $963.12

W20554 IHC ea addl AB Stain x25 GLBL Test Not Coded N N N $5,475.00 $5,475.00 $2,181.25 $2,181.25

P20554 IHC ea addl AB Stain x25 PROF Test Not Coded N N N $2,956.25 $2,956.25 $1,178.00 $1,178.00

T20554 IHC ea addl AB Stain x25 TECH Test Not Coded N N N $2,518.75 $2,518.75 $1,003.25 $1,003.25

W20555 IHC ea addl AB Stain x26 GLBL 88341 (x26) N N N $5,694.00 $5,694.00 $2,268.50 $2,268.50

P20555 IHC ea addl AB Stain x26 PROF Test Not Coded N N N $3,074.50 $3,074.50 $1,225.12 $1,225.12

T20555 IHC ea addl AB Stain x26 TECH Test Not Coded N N N $2,619.50 $2,619.50 $1,043.38 $1,043.38

W20556 IHC ea addl AB Stain x27 GLBL Test Not Coded N N N $5,913.00 $5,913.00 $2,355.75 $2,355.75

P20556 IHC ea addl AB Stain x27 PROF Test Not Coded N N N $3,192.75 $3,192.75 $1,272.24 $1,272.24

T20556 IHC ea addl AB Stain x27 TECH Test Not Coded N N N $2,720.25 $2,720.25 $1,083.51 $1,083.51

W20557 IHC ea addl AB Stain x28 GLBL 88341 (x28) N N N $6,132.00 $6,132.00 $2,443.00 $2,443.00

P20557 IHC ea addl AB Stain x28 PROF Test Not Coded N N N $3,311.00 $3,311.00 $1,319.36 $1,319.36

T20557 IHC ea addl AB Stain x28 TECH Test Not Coded N N N $2,821.00 $2,821.00 $1,123.64 $1,123.64

W20558 IHC ea addl AB Stain x29 GLBL 88341 (x29) N N N $6,351.00 $6,351.00 $2,530.25 $2,530.25

P20558 IHC ea addl AB Stain x29 PROF Test Not Coded N N N $3,429.25 $3,429.25 $1,366.48 $1,366.48

T20558 IHC ea addl AB Stain x29 TECH Test Not Coded N N N $2,921.75 $2,921.75 $1,163.77 $1,163.77

W20532 IHC ea addl AB Stain x3 GLBL 88341 (x3) N N N $657.00 $657.00 $261.75 $261.75

P20532 IHC ea addl AB Stain x3 PROF 88341 26 (x3) N N N $354.75 $354.75 $141.36 $141.36

T20532 IHC ea addl AB Stain x3 TECH 88341 TC (x3) N N N $302.25 $302.25 $120.39 $120.39

Page 30 of 144

Page 31: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

W20559 IHC ea addl AB Stain x30 GLBL 88341 (x30) N N N $6,570.00 $6,570.00 $2,617.50 $2,617.50

P20559 IHC ea addl AB Stain x30 PROF 88341 26 (x30) N N N $3,547.50 $3,547.50 $1,413.60 $1,413.60

T20559 IHC ea addl AB Stain x30 TECG 88341 TC (x30) N N N $3,022.50 $3,022.50 $1,203.90 $1,203.90

W20533 IHC ea addl AB Stain x4 GLBL 88341 (x4) N N N $876.00 $876.00 $349.00 $349.00

P20533 IHC ea addl AB Stain x4 PROF 88341 26 (x4) N N N $473.00 $473.00 $188.48 $188.48

T20533 IHC ea addl AB Stain x4 TECH 88341 TC (x4) N N N $403.00 $403.00 $160.52 $160.52

W20534 IHC ea addl AB Stain x5 GLBL 88341 (x5) N N N $1,095.00 $1,095.00 $436.25 $436.25

P20534 IHC ea addl AB Stain x5 PROF 88341 26 (x5) N N N $591.25 $591.25 $235.60 $235.60

T20534 IHC ea addl AB Stain x5 TECH 88341 TC (x5) N N N $503.75 $503.75 $200.65 $200.65

W20535 IHC ea addl AB Stain x6 GLBL 88341 (x6) N N N $1,314.00 $1,314.00 $523.50 $523.50

P20535 IHC ea addl AB Stain x6 PROF 88341 26 (x6) N N N $709.50 $709.50 $282.72 $282.72

T20535 IHC ea addl AB Stain x6 TECH 88341 TC (x6) N N N $604.50 $604.50 $240.78 $240.78

W20536 IHC ea addl AB Stain x7 GLBL 88341 (x7) N N N $1,533.00 $1,533.00 $610.75 $610.75

P20536 IHC ea addl AB Stain x7 PROF 88341 26 (x7) N N N $827.75 $827.75 $329.84 $329.84

T20536 IHC ea addl AB Stain x7 TECH 88341 TC (x7) N N N $705.25 $705.25 $280.91 $280.91

W20537 IHC ea addl AB Stain x8 GLBL 88341 (x8) N N N $1,752.00 $1,752.00 $698.00 $698.00

P20537 IHC ea addl AB Stain x8 PROF 88341 26 (x8) N N N $946.00 $946.00 $376.96 $376.96

T20537 IHC ea addl AB Stain x8 TECH 88341 TC (x8) N N N $806.00 $806.00 $321.04 $321.04

W20538 IHC ea addl AB Stain x9 GLBL 88341 (x9) N N N $1,971.00 $1,971.00 $785.25 $785.25

P20538 IHC ea addl AB Stain x9 PROF 88341 26 (x9) N N N $1,064.25 $1,064.25 $424.08 $424.08

T20538 IHC ea addl AB Stain x9 TECH 88341 TC (x9) N N N $906.75 $906.75 $361.17 $361.17

W20401 IHC ea Addl x1 RUO GLBL 88341 N N N $219.00 $219.00 $87.25 $87.25

P20401 IHC ea Addl x1 RUO PROF 88341 26 N N N $118.25 $118.25 $47.12 $47.12

T20401 IHC ea Addl x1 RUO TECH 88341 TC N N N $100.75 $100.75 $40.13 $40.13

W20410 IHC ea Addl x10 RUO GLBL Test Not Coded N N N $2,190.00 $2,190.00 $872.50 $872.50

P20410 IHC ea Addl x10 RUO PROF Test Not Coded N N N $1,182.50 $1,182.50 $471.20 $471.20

T20410 IHC ea Addl x10 RUO TECH Test Not Coded N N N $1,007.50 $1,007.50 $401.30 $401.30

W20402 IHC ea Addl x2 RUO GLBL 88341 (x2) N N N $438.00 $438.00 $174.50 $174.50

P20402 IHC ea Addl x2 RUO PROF 88341 26 (x2) N N N $236.50 $236.50 $94.24 $94.24

T20402 IHC ea Addl x2 RUO TECH 88341 TC (x2) N N N $201.50 $201.50 $80.26 $80.26

W20403 IHC ea Addl x3 RUO GLBL 88341 (x3) N N N $657.00 $657.00 $261.75 $261.75

P20403 IHC ea Addl x3 RUO PROF 88341 26 (x3) N N N $354.75 $354.75 $141.36 $141.36

T20403 IHC ea Addl x3 RUO TECH 88341 TC (x3) N N N $302.25 $302.25 $120.39 $120.39

W20404 IHC ea Addl x4 RUO GLBL 88341 (x4) N N N $876.00 $876.00 $349.00 $349.00

P20404 IHC ea Addl x4 RUO PROF 88341 26 (x4) N N N $473.00 $473.00 $188.48 $188.48

T20404 IHC ea Addl x4 RUO TECH 88341 TC (x4) N N N $403.00 $403.00 $160.52 $160.52

W20405 IHC ea Addl x5 RUO GLBL 88341 (x5) N N N $1,095.00 $1,095.00 $436.25 $436.25

P20405 IHC ea Addl x5 RUO PROF 88341 26 (x5) N N N $591.25 $591.25 $235.60 $235.60

T20405 IHC ea Addl x5 RUO TECH 88341 TC (x5) N N N $503.75 $503.75 $200.65 $200.65

W20406 IHC ea Addl x6 RUO GLBL Test Not Coded N N N $1,314.00 $1,314.00 $523.50 $523.50

P20406 IHC ea Addl x6 RUO PROF Test Not Coded N N N $709.50 $709.50 $282.72 $282.72

T20406 IHC ea Addl x6 RUO TECH Test Not Coded N N N $604.50 $604.50 $240.78 $240.78

W20407 IHC ea Addl x7 RUO GLBL Test Not Coded N N N $1,533.00 $1,533.00 $610.75 $610.75

P20407 IHC ea Addl x7 RUO PROF Test Not Coded N N N $827.75 $827.75 $329.84 $329.84

T20407 IHC ea Addl x7 RUO TECH Test Not Coded N N N $705.25 $705.25 $280.91 $280.91

Page 31 of 144

Page 32: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

W20408 IHC ea Addl x8 RUO GLBL 88341 (x8) N N N $1,752.00 $1,752.00 $698.00 $698.00

P20408 IHC ea Addl x8 RUO PROF Test Not Coded N N N $946.00 $946.00 $376.96 $376.96

T20408 IHC ea Addl x8 RUO TECH Test Not Coded N N N $806.00 $806.00 $321.04 $321.04

W20409 IHC ea Addl x9 RUO GLBL Test Not Coded N N N $1,971.00 $1,971.00 $785.25 $785.25

P20409 IHC ea Addl x9 RUO PROF Test Not Coded N N N $1,064.25 $1,064.25 $424.08 $424.08

T20409 IHC ea Addl x9 RUO TECH Test Not Coded N N N $906.75 $906.75 $361.17 $361.17

W30001 IHC Multiplex X1 Gbl 88344 N N N $419.00 $419.00 $261.75 $261.75

W30010 IHC Multiplex X10 Gbl 88344 (x10) N N N $4,190.00 $4,190.00 $2,617.50 $2,617.50

W30002 IHC Multiplex X2 Gbl 88344 (x2) N N N $838.00 $838.00 $523.50 $523.50

W30003 IHC Multiplex X3 Gbl 88344 (x3) N N N $1,257.00 $1,257.00 $785.25 $785.25

W30004 IHC Multiplex X4 Gbl 88344 (x4) N N N $1,676.00 $1,676.00 $1,047.00 $1,047.00

W30005 IHC Multiplex X5 Gbl 88344 (x5) N N N $2,095.00 $2,095.00 $1,308.75 $1,308.75

W30006 IHC Multiplex X6 Gbl 88344 (x6) N N N $2,514.00 $2,514.00 $1,570.50 $1,570.50

W30007 IHC Multiplex X7 Gbl 88344 (x7) N N N $2,933.00 $2,933.00 $1,832.25 $1,832.25

W30008 IHC Multiplex X8 Gbl 88344 (x8) N N N $3,352.00 $3,352.00 $2,094.00 $2,094.00

W30009 IHC Multiplex X9 Gbl 88344 (x9) N N N $3,771.00 $3,771.00 $2,355.75 $2,355.75

P30001 IHC Multiplex x1 Prof 88344 26 N N N $248.25 $248.25 $170.13 $170.13

T30001 IHC Multiplex x1 Tech 88344 TC N N N $170.75 $170.75 $91.62 $91.62

P30010 IHC Multiplex x10 Prof 88344 26 (x10) N N N $2,482.50 $2,482.50 $1,701.30 $1,701.30

T30010 IHC Multiplex x10 Tech 88344 TC (x10) N N N $1,707.50 $1,707.50 $916.20 $916.20

W30111 IHC Multiplex X11 Gbl Test Not Coded N N N $4,609.00 $4,609.00 $2,879.25 $2,879.25

P30111 IHC Multiplex x11 Prof Test Not Coded N N N $2,730.75 $2,730.75 $1,871.43 $1,871.43

T30111 IHC Multiplex x11 Tech Test Not Coded N N N $1,878.25 $1,878.25 $1,007.82 $1,007.82

W30112 IHC Multiplex X12 Gbl Test Not Coded N N N $5,028.00 $5,028.00 $3,141.00 $3,141.00

P30112 IHC Multiplex x12 Prof Test Not Coded N N N $2,979.00 $2,979.00 $2,041.56 $2,041.56

T30112 IHC Multiplex x12 Tech Test Not Coded N N N $2,049.00 $2,049.00 $1,099.44 $1,099.44

P30002 IHC Multiplex x2 Prof 88344 26 (x2) N N N $496.50 $496.50 $340.26 $340.26

T30002 IHC Multiplex x2 Tech 88344 TC (x2) N N N $341.50 $341.50 $183.24 $183.24

P30003 IHC Multiplex x3 Prof 88344 26 (x3) N N N $744.75 $744.75 $510.39 $510.39

T30003 IHC Multiplex x3 Tech 88344 TC (x3) N N N $512.25 $512.25 $274.86 $274.86

P30004 IHC Multiplex x4 Prof 88344 26 (x4) N N N $993.00 $993.00 $680.52 $680.52

T30004 IHC Multiplex x4 Tech 88344 TC (x4) N N N $683.00 $683.00 $366.48 $366.48

P30005 IHC Multiplex x5 Prof 88344 26 (x5) N N N $1,241.25 $1,241.25 $850.65 $850.65

T30005 IHC Multiplex x5 Tech 88344 TC (x5) N N N $853.75 $853.75 $458.10 $458.10

P30006 IHC Multiplex x6 Prof 88344 26 (x6) N N N $1,489.50 $1,489.50 $1,020.78 $1,020.78

T30006 IHC Multiplex x6 Tech 88344 TC (x6) N N N $1,024.50 $1,024.50 $549.72 $549.72

P30007 IHC Multiplex x7 PROF 88344 26 (x7) N N N $1,737.75 $1,737.75 $1,190.91 $1,190.91

T30007 IHC Multiplex x7 Tech 88344 TC (x7) N N N $1,195.25 $1,195.25 $641.34 $641.34

P30008 IHC Multiplex x8 Prof 88344 26 (x8) N N N $1,986.00 $1,986.00 $1,361.04 $1,361.04

T30008 IHC Multiplex x8 Tech 88344 TC (x8) N N N $1,366.00 $1,366.00 $732.96 $732.96

P30009 IHC Multiplex x9 Prof 88344 26 (x9) N N N $2,234.25 $2,234.25 $1,531.17 $1,531.17

T30009 IHC Multiplex x9 Tech 88344 TC (x9) N N N $1,536.75 $1,536.75 $824.58 $824.58

W20291 IHC X1 RUO Global 88342 N N N $219.00 $219.00 $87.25 $87.25

P20291 IHC X1 RUO Prof 88342 26 N N N $118.25 $118.25 $47.12 $47.12

T20291 IHC X1 RUO Tech 88342 TC N N N $100.75 $100.75 $40.13 $40.13

Page 32 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

W20310 IHC X10 RUO Global 88342 (x10) N N N $2,190.00 $2,190.00 $872.50 $872.50

P20310 IHC X10 RUO Prof 88342 26 (x10) N N N $1,182.50 $1,182.50 $471.20 $471.20

T20310 IHC X10 RUO Tech 88342 TC (x10) N N N $1,007.50 $1,007.50 $401.30 $401.30

W20292 IHC X2 RUO Global 88342 (x2) N N N $438.00 $438.00 $174.50 $174.50

P20292 IHC X2 RUO Prof 88342 26 (x2) N N N $236.50 $236.50 $94.24 $94.24

T20292 IHC X2 RUO Tech 88342 TC (x2) N N N $201.50 $201.50 $80.26 $80.26

W20293 IHC X3 RUO Global 88342 (x3) N N N $657.00 $657.00 $261.75 $261.75

P20293 IHC X3 RUO Prof 88342 26 (x3) N N N $354.75 $354.75 $141.36 $141.36

T20293 IHC X3 RUO Tech 88342 TC (x3) N N N $302.25 $302.25 $120.39 $120.39

W20294 IHC X4 RUO Global 88342 (x4) N N N $876.00 $876.00 $349.00 $349.00

P20294 IHC X4 RUO Prof 88342 26 (x4) N N N $473.00 $473.00 $188.48 $188.48

T20294 IHC X4 RUO Tech 88342 TC (x4) N N N $403.00 $403.00 $160.52 $160.52

W20295 IHC X5 RUO Global 88342 (x5) N N N $1,095.00 $1,095.00 $436.25 $436.25

P20295 IHC X5 RUO Prof 88342 26 (x5) N N N $591.25 $591.25 $235.60 $235.60

T20295 IHC X5 RUO Tech 88342 TC (x5) N N N $503.75 $503.75 $200.65 $200.65

W20296 IHC X6 RUO Global 88342 (x6) N N N $1,314.00 $1,314.00 $523.50 $523.50

P20296 IHC X6 RUO Prof 88342 26 (x6) N N N $709.50 $709.50 $282.72 $282.72

T20296 IHC X6 RUO Tech 88342 TC (x6) N N N $604.50 $604.50 $240.78 $240.78

W20297 IHC X7 RUO Global 88342 (x7) N N N $1,533.00 $1,533.00 $610.75 $610.75

P20297 IHC X7 RUO Prof 88342 26 (x7) N N N $827.75 $827.75 $329.84 $329.84

T20297 IHC X7 RUO Tech 88342 TC (x7) N N N $705.25 $705.25 $280.91 $280.91

W20298 IHC X8 RUO Global 88342 (x8) N N N $1,752.00 $1,752.00 $698.00 $698.00

P20298 IHC X8 RUO Prof 88342 26 (x8) N N N $946.00 $946.00 $376.96 $376.96

T20298 IHC X8 RUO Tech 88342 TC (x8) N N N $806.00 $806.00 $321.04 $321.04

W20299 IHC X9 RUO Global 88342 (x9) N N N $1,971.00 $1,971.00 $785.25 $785.25

P20299 IHC X9 RUO Prof 88342 26 (x9) N N N $1,064.25 $1,064.25 $424.08 $424.08

T20299 IHC X9 RUO Tech 88342 TC (x9) N N N $906.75 $906.75 $361.17 $361.17

007468 Imipramine (Tofranil), Serum 80335 Y Y N $120.25 $120.25 $19.96 $19.96

001496 Immunofixation Reflex, Serum 82784 (x3), 86334 N N N $212.50 $212.50 $39.07 $39.07

001685 Immunofixation, Serum 82784 (x3), 86334 Y Y N $212.50 $212.50 $33.54 $33.54

123034 Immunofixation, Urine 86335 N Y N $168.75 $168.75 $60.58 $60.58

001784 Immunoglobulin A, Qn, Serum 82784 Y Y Y $47.25 $16.54 $5.82 $5.82

002170 Immunoglobulin E, Total 82785 Y Y Y $81.25 $28.44 $6.38 $6.38

001776 Immunoglobulin G, Qn, Serum 82784 N Y Y $47.25 $16.54 $5.82 $5.82

001792 Immunoglobulin M, Qn, Serum 82784 N Y Y $47.25 $16.54 $5.82 $5.82

002295 Immunoglobulins A/E/G/M, Serum 82785, 82784 (x3) Y Y Y $223.00 $78.05 $23.84 $23.84

001768 Immunoglobulins A/G/M, Qn, Ser 82784 (x3) Y Y Y $141.75 $49.61 $17.47 $17.47

T20061 Immunohistochem X1 Tech 88342 TC N N N $100.75 $100.75 $40.13 $40.13

T20070 Immunohistochem X10 Tech 88342 TC (x10) N N N $1,007.50 $1,007.50 $401.30 $401.30

T20071 Immunohistochem X11 Tech 88342 TC (x11) N N N $1,108.25 $1,108.25 $441.43 $441.43

W20072 Immunohistochem X12 Global 88342 (x12) N N N $2,628.00 $2,628.00 $1,047.00 $1,047.00

T20072 Immunohistochem X12 Tech 88342 TC (x12) N N N $1,209.00 $1,209.00 $481.56 $481.56

T20073 Immunohistochem X13 Tech 88342 TC (x13) N N N $1,309.75 $1,309.75 $521.69 $521.69

W20074 Immunohistochem X14 Global 88342 (x14) N N N $3,066.00 $3,066.00 $1,221.50 $1,221.50

T20074 Immunohistochem X14 Tech 88342 TC (x14) N N N $1,410.50 $1,410.50 $561.82 $561.82

Page 33 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

T20075 Immunohistochem X15 Tech 88342 TC (x15) N N N $1,511.25 $1,511.25 $601.95 $601.95

T20076 Immunohistochem X16 Tech 88342 TC (x16) N N N $1,612.00 $1,612.00 $642.08 $642.08

W20077 Immunohistochem X17 Global 88342 (x17) N N N $3,723.00 $3,723.00 $1,483.25 $1,483.25

T20077 Immunohistochem X17 Tech 88342 TC (x17) N N N $1,712.75 $1,712.75 $682.21 $682.21

T20078 Immunohistochem X18 Tech 88342 TC (x18) N N N $1,813.50 $1,813.50 $722.34 $722.34

T20079 Immunohistochem X19 Tech 88342 TC (x19) N N N $1,914.25 $1,914.25 $762.47 $762.47

T20062 Immunohistochem X2 Tech 88342 TC (x2) N N N $201.50 $201.50 $80.26 $80.26

T20080 Immunohistochem X20 Tech 88342 TC (x20) N N N $2,015.00 $2,015.00 $802.60 $802.60

T20082 Immunohistochem X22 Tech 88342 TC (x22) N N N $2,216.50 $2,216.50 $882.86 $882.86

T20085 Immunohistochem X25 Tech 88342 TC (x25) N N N $2,518.75 $2,518.75 $1,003.25 $1,003.25

T20063 Immunohistochem X3 Tech 88342 TC (x3) N N N $302.25 $302.25 $120.39 $120.39

T20090 Immunohistochem X30 Tech 88342 TC (x30) N N N $3,022.50 $3,022.50 $1,203.90 $1,203.90

W20064 Immunohistochem X4 Global 88342 (x4) N N N $876.00 $876.00 $349.00 $349.00

T20064 Immunohistochem X4 Tech 88342 TC (x4) N N N $403.00 $403.00 $160.52 $160.52

W20065 Immunohistochem X5 Global 88342 (x5) N N N $1,095.00 $1,095.00 $436.25 $436.25

T20065 Immunohistochem X5 Tech 88342 TC (x5) N N N $503.75 $503.75 $200.65 $200.65

T20066 Immunohistochem X6 Tech 88342 TC (x6) N N N $604.50 $604.50 $240.78 $240.78

T20067 Immunohistochem X7 Tech 88342 TC (x7) N N N $705.25 $705.25 $280.91 $280.91

T20068 Immunohistochem X8 Tech 88342 TC (x8) N N N $806.00 $806.00 $321.04 $321.04

T20069 Immunohistochem X9 Tech 88342 TC (x9) N N N $906.75 $906.75 $361.17 $361.17

164830 Inflammatory Bowel Disease-IBD 86671 (x2), 86256 Y Y N $418.00 $418.00 $418.00

182295 Influenza A Ag, EIA 87804 N Y N $122.50 $122.50 $27.72 $27.72

186221 Influenza A and B, RT PCR 87502 Y Y N $286.00 $286.00 $286.00

186205 Influenza A, H1N1, RT PCR 87501, 87501 59 N Y N $286.00 $286.00 $242.63 $242.63

186243 Influenza A, H1N1, RT PCR 87501, 87501 59 N N N $286.00 $286.00 $242.63 $242.63

096487 Influenza A/B Ab, Quant 86710 (x2) Y Y N $152.50 $152.50 $54.72 $54.72

186288 Influenza A/B Ag, EIA W/Reflex 87804 (x2) N N Y $226.50 $79.28 $27.72 $27.72

186064 Influenza A+B Ag, EIA 87804 (x2) Y Y N $226.50 $226.50 $27.72 $27.72

550757 informaSeq(SM) with Y Analysis 81420 Y Y N $795.00 $795.00 $795.00

004333 Insulin 83525 Y Y Y $59.00 $20.65 $7.21 $7.21

213660 Insulin and C-Peptide, Serum 83525, 84681 Y Y N $153.25 $153.25 $14.98 $14.98

141598 Insulin Antibodies 86337 Y Y Y $148.00 $51.80 $51.80

010413 Intrinsic Factor Abs, Serum 86340 Y Y N $114.25 $114.25 $13.30 $13.30

070034 Iodine, Serum or Plasma 83789 Y Y N $61.50 $61.50 $61.50

001321 Iron and TIBC 83550, 83540 Y Y Y $54.00 $18.90 $3.17 $3.17

001339 Iron, Serum 83540 Y Y Y $27.00 $9.45 $1.75 $1.75

489200 JAK2 Mutation Analysis, Qual 81270 Y Y N $400.00 $400.00 $400.00

826359 Jalapeno Pepper, IgE 86003 N N N $48.50 $48.50 $4.43 $4.43

602864 K071-IgE Castor Bean 86003 Y Y N $24.25 $24.25 $4.45 $4.45

650390 K082-IgE Latex 86003 Y Y N $24.25 $24.25 $4.45 $4.45

806443 Ketone Bodies Panel, S/P 82010 (x3) N N N $320.50 $320.50 $144.74 $144.74

182246 L. pneumophila Serogp 1 Ur Ag 87449 N Y N $99.25 $99.25 $25.78 $25.78

007012 Lacosamide 80339 Y Y N $186.75 $186.75 $186.75

004770 Lactic Acid, Plasma 83605 Y Y Y $74.00 $25.90 $10.54 $10.54

123016 Lactoferrin, Fecal, Quant. 83631 Y Y N $132.75 $132.75 $132.75

Page 34 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

046300 Lactose Tolerance Test 82951, 82952 (x2) N Y Y $135.00 $47.25 $8.75 $8.75

716944 Lamotrigine (Lamictal), Serum 80175 Y Y N $133.25 $133.25 $9.76 $9.76

001842 LD Isoenzymes 83625, 83615 Y Y N $80.00 $80.00 $9.42 $9.42

100156 LD, Body Fluid 83615 N Y Y $27.00 $9.45 $3.60 $3.60

001115 LDH 83615 Y Y Y $27.00 $9.45 $1.75 $1.75

120295 LDL Cholesterol (Direct) 83721 Y Y Y $75.25 $26.34 $3.88 $3.88

361959 LDL Cholesterol (Direct) 83721 Y N Y $75.25 $26.34 $3.88 $3.88

038158 Lead Standard Profile, Blood 83655, 84202 Y Y N $137.25 $137.25 $10.01 $10.01

007629 Lead, Blood 83655 Y N Y $61.00 $21.35 $21.35

007625 Lead, Blood (Adult) 83655 Y Y N $61.00 $61.00 $5.32 $5.32

717009 Lead, Blood (Pediatric) 83655 Y Y N $61.00 $61.00 $5.32 $5.32

717033 Lead/Protoporphyrin, Pediatric 83655, 84202 N Y N $137.25 $137.25 $16.63 $16.63

164616 Legionella pneumophila Abs. 86713 N Y N $122.75 $122.75 $16.63 $16.63

875194 Leucine Aminopeptidase, Serum 83670 N N N $126.00 $126.00 $82.03 $82.03

485029 Leukemia/Lymphoma Monitor Prof 82232, 84275 N Y N $226.00 $226.00 $38.80 $38.80

001966 Leukocyte Alkaline Phos Score 85540 Y Y N $61.50 $61.50 $22.07 $22.07

P83001 Level I;Gross Only 1st (Prof) 88300 26 N N N $8.75 $8.75 $4.84 $4.84

P83041 Level III Surg Path 1st (Prof) 88304 26 N N N $22.00 $22.00 $9.57 $9.57

P83042 Level III Surg Path 2nd (Prof) 88304 26 N N N $22.00 $22.00 $9.57 $9.57

P83071 Level V Surg Path 1st (Prof) 88307 26 N N N $128.25 $128.25 $35.05 $35.05

P83072 Level V Surg Path 2nd (Prof) 88307 26 N N N $128.25 $128.25 $35.05 $35.05

716936 Levetiracetam (Keppra), S 80177 Y Y N $133.25 $133.25 $31.03 $31.03

001404 Lipase, Serum 83690 Y Y Y $37.25 $13.04 $2.44 $2.44

361946 Lipid Cascade 80061 Y Y Y $77.00 $26.95 $3.60 $3.60

123836 Lipid Cascade w Graph 80061 N Y Y $77.00 $26.95 $3.60 $3.60

363676 Lipid Cascade w/Rflx to ApoliB 80061 Y Y Y $77.00 $26.95 $26.95

303756 Lipid Panel 80061 Y Y Y $77.00 $26.95 $3.60 $3.60

221010 Lipid Panel w/ Chol/HDL Ratio 80061 Y Y Y $77.00 $26.95 $3.60 $3.60

235010 Lipid Panel With LDL/HDL Ratio 80061 Y Y Y $77.00 $26.95 $3.60 $3.60

235011 Lipid Panel with LDL/HDL Ratio 80061 Y N Y $77.00 $26.95 $26.95

120188 Lipoprotein (a) 83695 Y Y N $100.00 $100.00 $27.36 $27.36

884318 Lipoprotein Analysis by NMR 83704 N Y N $80.28 $80.28 $46.29 $46.29

884280 Lipoprotein Analysis, by NMR 83704 Y N N $80.28 $80.28 $46.29 $46.29

123482 Lipoprotein Analysis, by NMR 83704 N N N $80.28 $80.28 $46.29 $46.29

235036 Lipoprotein Phenotyping 80061, 83700 N Y N $93.00 $93.00 $35.11 $35.11

007708 Lithium (Eskalith(R)), Serum 80178 Y Y Y $51.75 $18.11 $3.11 $3.11

910339 Litholink CMP14+P 80053, 84100 Y N Y $29.75 $10.41 $10.41

163980 Liver-Kidney Microsomal Ab 86376 N Y N $80.00 $80.00 $28.69 $28.69

180810 Lower Respiratory Culture 87070 Y Y N $65.25 $65.25 $13.30 $13.30

033969 LP without VLDL+Chol/HDL+CH... 80061 N N Y $77.00 $26.95 $3.60 $3.60

343925 LP+Non-HDL Cholesterol 80061 Y Y Y $77.00 $26.95 $26.95

071159 LSD, Urine 80302 Y Y N $77.75 $77.75 $77.75

500711 Lupus Anticoag/Cardiolipin Ab

85598, 85610, 85613 (x2),

85670, 85730, 85732 (x2), 86147

(x2), 86146 (x3) Y Y N $1,031.00 $1,031.00 $1,031.00

Page 35 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

117054 Lupus Anticoagulant Comp 85705, 85670, 85732, 85613 Y Y N $379.50 $379.50 $131.09 $131.09

500070 Lupus Anticoagulant Panel

85597, 85610, 85613 (x2),

85670, 85730, 85598, 86147

(x2), 85732 (x2), 86146 (x3) Y Y N $1,291.00 $1,291.00 $1,291.00

117892 Lupus Anticoagulant Reflex 85732, 85613 Y Y N $180.50 $180.50 $55.42 $55.42

054619 LUPUS PROFILE 86038, 86225, 86235 (x2) Y N N $303.75 $303.75 $35.77 $35.77

004283 Luteinizing Hormone(LH), S 83002 Y Y Y $85.75 $30.01 $5.54 $5.54

502286 Luteinizing Hormone, Pediatric 83002 Y Y N $26.00 $26.00 $26.00

138685 Lyme (B. burgdorferi) PCR 87476 Y Y N $487.25 $487.25 $487.25

258004 Lyme Ab/Western Blot Reflex 86618 (x2) Y Y N $226.00 $226.00 $35.20 $35.20

160333 Lyme, IgM, Early Test/Reflex 86618 Y Y N $113.00 $113.00 $24.40 $24.40

160325 Lyme, Total Ab Test/Reflex 86618 Y Y N $113.00 $113.00 $10.80 $10.80

163600 Lyme, Western Blot, Serum 86617 (x2) Y Y N $150.00 $150.00 $27.72 $27.72

163601 Lyme, Western Blot, Serum 86617 (x2) N N N $150.00 $150.00 $27.72 $27.72

161653 Lyme/Syphilis Ab Diff Profile 86618, 86592 N Y N $140.50 $140.50 $48.66 $48.66

080713 Lysozyme, Serum 85549 Y Y N $98.25 $98.25 $16.63 $16.63

550087 M tuberculosis Detection, PCR 87556 N Y N $294.00 $294.00 $110.85 $110.85

188540 M tuberculosis, PCR/Culture 87116, 87206, 87015, 87556 N N N $422.75 $422.75 $110.85 $110.85

602462 M002-IgE Cladosporium 86003 N Y N $24.25 $24.25 $4.45 $4.45

602548 M005-IgE Candida albican 86003 N Y N $24.25 $24.25 $4.45 $4.45

602561 M008-IgE Helminthosporium 86003 N Y N $24.25 $24.25 $4.45 $4.45

602560 M009-IgE Fusarium monilif 86003 N Y N $24.25 $24.25 $4.45 $4.45

602555 M011-IgE Rhizopus nigrica 86003 N Y N $24.25 $24.25 $4.45 $4.45

602918 M024-IgE Stachybotrys atra 86003 N Y N $24.25 $24.25 $4.45 $4.45

500324 Macroprolactin 84146 (x2) Y Y N $89.00 $89.00 $89.00

001537 Magnesium, Serum 83735 Y Y Y $36.25 $12.69 $1.75 $1.75

003400 Magnesium, Urine 83735 Y Y N $31.50 $31.50 $31.50

806054 Marjoram IgE 86003 Y N N $62.50 $62.50 $62.50

722118 MDMA 80301 Y Y N $24.00 $24.00 $7.78 $7.78

707052 MDMA Confirm, Urine Test Not Coded Y N N $119.50 $119.50 $119.50

071318 MDMA Confirmation 80359 N Y N $119.50 $119.50 $33.26 $33.26

058495 Measles/Mumps/Rubella Immunity 86735, 86762, 86765 Y Y N $202.25 $202.25 $13.31 $13.31

761050 Meperidine/Normep (GC/MS), U 80362 Y Y N $119.50 $119.50 $119.50

790350 Mephedrone, MDPV, Methylone 80304 Y Y N $131.25 $131.25 $131.25

808377 Mercaptopurine (6-MP,Purin.) 80375 Y Y N $172.50 $172.50 $172.50

007773 Mercury, Urine 82570, 83825 N Y N $116.75 $116.75 $43.80 $43.80

004234 Metanephrines, Frac, Qn, 24-Hr 83835 Y Y N $183.50 $183.50 $27.72 $27.72

121806 Metanephrines, Frac., Pl. Free 83835 Y Y N $285.75 $285.75 $44.34 $44.34

004044 Metanephrines, Pheochromocyt 82570, 83835 Y Y N $219.50 $219.50 $65.95 $65.95

007781 Methadone (Dolophine), Serum 80358 Y Y N $116.75 $116.75 $49.89 $49.89

737000 Methadone (GC/MS), Urine 80358 Y Y N $119.50 $119.50 $119.50

700070 Methadone Confirmation, Urine 80358 Y Y N $119.50 $119.50 $33.26 $33.26

706961 Methylmalonic Acid, Serum 83921 Y Y N $201.25 $201.25 $26.60 $26.60

716365 Methylmalonic Acid, Urine 83921 N Y N $201.25 $201.25 $47.66 $47.66

M90001 MIC Organism #1 87186 Y N N $75.00 $75.00 $5.82 $5.82

Page 36 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

M90002 MIC Organism #2 87186 Y N N $75.00 $75.00 $5.82 $5.82

M90003 MIC Organism #3 87186 N N N $75.00 $75.00 $5.82 $5.82

140285 Microalb/Creat Ratio, Randm Ur 82043, 82570 Y Y Y $102.50 $35.88 $5.21 $5.21

140050 Microalbumin, 24 hr Urine 82043 Y Y Y $66.50 $23.28 $6.09 $6.09

149997 Microalbumin, Random Urine 82043 Y Y Y $66.50 $23.28 $2.78 $2.78

140053 Microalbumin, Timed Urine 82043 Y N Y $66.50 $23.28 $23.28

333427 Microscopic Examination 81015 Y N Y $19.25 $6.74 $6.74

811394 Mineral Profile (7), RBC's

82495, 84255, 83018 (x2),

83785, 84630, 82525 N N N $319.25 $319.25 $89.80 $89.80

009159 Miscellaneous Fluid Cytology 88112 Y Y N $133.00 $133.00 $55.42 $55.42

009126 Miscellaneous Smear Cytology 88161 N Y N $113.50 $113.50 $44.34 $44.34

006650 Mitochondrial (M2) Antibody 83516 Y Y N $98.50 $98.50 $7.31 $7.31

006536 Mono Qual W/Rflx Qn 86308 Y Y Y $50.75 $17.76 $3.60 $3.60

006189 Mononucleosis Test, Qual 86308 Y Y Y $50.75 $17.76 $3.60 $3.60

071532 Morphine 80361 Y Y N $111.00 $111.00 $111.00

183467 MRSA Screening Culture 87081 Y Y N $76.75 $76.75 $29.12 $29.12

183641 Mtb NAA+AFB Smear/Cult/ID 87556, 87206, 87116 N Y N $426.00 $426.00 $110.85 $110.85

511238 MTHFR 81291 Y Y N $325.00 $325.00 $325.00

006841 Mucin Clot,Synovial Fl 83872 N Y N $22.75 $22.75 $4.72 $4.72

096552 Mumps Antibodies, IgG 86735 Y Y N $71.75 $71.75 $4.66 $4.66

160499 Mumps Antibodies, IgM 86735 Y Y N $71.75 $71.75 $13.30 $13.30

234419 Myasthenia Gravis Evaluation 86255, 83519 Y Y N $317.00 $317.00 $317.00

086122 Myasthenia Gravis Panel III 83519 (x2), 86255 Y Y N $576.75 $576.75 $102.16 $102.16

716795 Mycophenolic Acid and Metabo. 80180 N Y N $133.25 $133.25 $88.68 $88.68

163758 Mycoplasma pneu. IgG/IgM Abs 86738 (x2) Y Y N $196.50 $196.50 $74.17 $74.17

123377 Myelin Basic Protein 83873 N Y N $139.50 $139.50 $50.09 $50.09

010405 Myoglobin, Serum 83874 Y Y N $109.25 $109.25 $12.20 $12.20

003079 Myoglobin, Urine 83874 Y Y N $109.25 $109.25 $16.63 $16.63

183624 N. gonorrhoeae NAA, Confirm 87591 59 Y N N $160.00 $160.00 $160.00

808374 Naproxen (Aleve,Naprosyn,Ana.) 80329 Y Y N $134.00 $134.00 $134.00

188086 Neisseria gonorrhoeae, NAA 87591 Y Y N $119.25 $119.25 $7.65 $7.65

140810 NGI HBV SuperQuant 87517 Y Y N $520.75 $520.75 $235.57 $235.57

140622 NGI HBV UltraQual 87516 Y Y N $448.25 $448.25 $448.25

140639 NGI HCV QuantaSure 87522 Y Y N $647.75 $647.75 $329.24 $329.24

140612 NGI HCV SuperQuant 87522 N N N $449.00 $449.00 $274.36 $274.36

140609 NGI HCV UltraQual 87521 N N N $449.00 $449.00 $274.36 $274.36

123489 NMR LipoProf noLp+Graph 83704 N Y N $80.28 $80.28 $46.29 $46.29

123638 NMR LipoProf wSubCls+Graph 80061, 83704 N N N $99.00 $99.00 $49.89 $49.89

123810 NMR LipoProf+Graph 80061, 83704 N Y N $99.00 $99.00 $49.89 $49.89

884247 NMR LipoProfile 83704, 80061 Y Y N $99.00 $99.00 $49.89 $49.89

884000 NMR LipoProfile w/IR Markers 80061, 83704 N N N $99.00 $99.00 $49.89 $49.89

123299 Norepinephrine, Plasma Test Not Coded N N N $181.50 $181.50 $33.26 $33.26

138307 Norovirus, RT-PCR 87798 (x2) Y Y N $254.25 $254.25 $199.54 $199.54

007393 Nortriptyline (Aventyl), Serum 80335 Y Y N $129.00 $129.00 $15.52 $15.52

141093 N-Telopeptide, Urine 82523, 82570 Y Y N $77.50 $77.50 $50.15 $50.15

Page 37 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

180043 NuSwab BV and Candida, NAA

87798, 87481, 87798 59 (x2),

87481 59 Y Y N $472.50 $472.50 $114.00 $114.00

180039 NuSwab Vaginitis (VG)

87798, 87481, 87661, 87481 59,

87798 59 (x2) Y Y N $580.25 $580.25 $145.00 $145.00

180021 NuSwab Vaginitis Plus (VG+)

87798, 87481, 87491, 87591,

87661, 87481 59, 87798 59 (x2) Y Y N $807.75 $807.75 $160.30 $160.30

180071 NuSwab VG, HSV

87798, 87481, 87529, 87661,

87481 59, 87529 59, 87798 59

(x2) N Y N $890.25 $890.25 $217.50 $217.50

180066 NuSwab VG+, HSV

87798, 87529, 87481, 87491,

87591, 87661, 87529 59, 87481

59, 87798 59 (x2) N Y N $1,117.75 $1,117.75 $232.80 $232.80

180851 O+P Exam, Formalin Only 87177 Y N N $45.50 $45.50 $14.69 $14.69

180844 O+P Exam, PVA Only 87177, 87209 N N N $75.00 $75.00 $11.89 $11.89

602673 O001-IgE Cotton Lint 86003 N Y N $24.25 $24.25 $4.45 $4.45

182949 Occult Blood, Fecal, IA 82274 Y Y N $79.00 $79.00 $26.18 $26.18

182196 Occult Blood, Gastric Fluid 82271 N N N $56.00 $56.00 $18.59 $18.59

811513 Olanzapine (Zyprexa) 80342 Y Y N $143.25 $143.25 $98.66 $98.66

071456 Opiate Confirmation, Urine 80361 Y Y N $119.50 $119.50 $33.26 $33.26

767640 Opiates (GC/MS), Blood Test Not Coded N N N $314.50 $314.50 $83.14 $83.14

712570 Opiates Conf (GC/MS) 80361 Y N N $119.50 $119.50 $33.26 $33.26

707033 Opiates Confirm, Urine Test Not Coded Y N N $119.50 $119.50 $119.50

737834 Opiates Confirmation, Urine 80361 Y Y N $119.50 $119.50 $33.26 $33.26

737846 Opiates Confirmation, Urine 80361 Y Y N $119.50 $119.50 $119.50

733071 Opiates GC/MS Retest 80361 N N N $183.75 $183.75 $44.34 $44.34

713751 Opiates GC/MS, Urine 80361 Y N N $119.50 $119.50 $119.50

790621 Opiates, Unconjugated Exp. WB 80361, 80356, 80365 N Y N $314.50 $314.50 $83.14 $83.14

780400 Oral Fluid Drug Analysis 80301 N N N $60.00 $60.00 $28.27 $28.27

716720 Organic Acid Analysis, Urine 83919 N Y N $208.00 $208.00 $64.70 $64.70

008664 Organism ID, Bacteria 87077 N Y N $82.75 $82.75 $14.40 $14.40

182212 Organism Identification, Yeast 87106 Y Y N $96.50 $96.50 $22.17 $22.17

002071 Osmolality 83930 Y Y Y $55.00 $19.25 $5.54 $5.54

003442 Osmolality, Urine 83935 Y Y Y $55.00 $19.25 $5.54 $5.54

008623 Ova + Parasite Exam 87177, 87209 Y Y N $75.25 $75.25 $14.69 $14.69

008629 Ova + Parasite Exam, Urine 87177 N Y N $75.25 $75.25 $14.69 $14.69

140045 Ovarian Malignancy Risk-ROMA 81500 Y Y N $434.25 $434.25 $434.25

003970 Oxalate, Quant, 24-Hour Urine 83945 Y Y N $74.00 $74.00 $13.86 $13.86

716928 Oxcarbazepine (Trileptal),S 80183 Y Y N $122.75 $122.75 $9.97 $9.97

071538 Oxycodone and Metabolite 80365 Y Y N $111.00 $111.00 $111.00

737620 Oxycodone/Oxymorphone (GC/MS) 80365 N N N $119.50 $119.50 $33.26 $33.26

737640 Oxycodone/Oxymorphone (GC/MS) 80365 N N N $119.50 $119.50 $33.26 $33.26

737641 Oxycodone/Oxymorphone (GC/MS) 80365 N N N $119.50 $119.50 $33.26 $33.26

763897 Oxycodone/Oxymorphone Confirm 80365 Y Y N $119.50 $119.50 $119.50

737630 Oxycodone/Oxymorphone, Urine 80301 Y Y N $58.00 $58.00 $58.00

Page 38 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

737637 Oxycodone/Oxymorphone, Urine 80301 N N N $58.00 $58.00 $17.73 $17.73

737638 Oxycodone/Oxymorphone, Urine 80301 Y Y N $58.00 $58.00 $17.73 $17.73

737648 Oxycodone/Oxymorphone, Urine 80301 Y Y N $58.00 $58.00 $11.86 $11.86

790856 Paliperidone, Serum 80342 Y Y N $100.80 $100.80 $100.80

485086 Pancreatic CA Monitor Profile 82378, 84275, 86301 Y Y N $327.00 $327.00 $327.00

123234 Pancreatic Elastase, Fecal 82656 Y Y N $245.00 $245.00 $245.00

083824 Panel 083824 86703 Y Y N $115.50 $115.50 $3.94 $3.94

083870 Panel 083870 86703 N N N $115.50 $115.50 $3.94 $3.94

083904 Panel 083904 86701, 86702 Y Y N $260.00 $260.00 $37.67 $37.67

083935 Panel 083935 87389 Y Y N $140.00 $140.00 $8.20 $8.20

083955 Panel 083955 86701, 86702 N Y N $260.00 $260.00 $37.67 $37.67

083989 Panel 083989 87389 N N N $140.00 $140.00 $8.20 $8.20

138658 Panel 138658 86689 N N N $225.50 $225.50 $102.50 $102.50

161000 Panel 161000 86703 N N N $115.50 $115.50 $3.94 $3.94

162222 Panel 162222 86703 Y N N $115.50 $115.50 $3.94 $3.94

163550 Panel 163550 86702 Y Y N $157.50 $157.50 $44.34 $44.34

164708 Panel 164708 86703 N N N $115.50 $115.50 $3.94 $3.94

193000 Pap IG (Image Guided) 88175 Y Y N $88.00 $88.00 $22.95 $22.95

197676 Pap IG, Ct 88175, 87491 N Y N $196.25 $196.25 $30.60 $30.60

193960 Pap IG, Ct, HPV-hr 88175, 87491, 87624 N N N $384.00 $384.00 $69.60 $69.60

198888 Pap IG, Ct, rfx HPV all pth 88175, 87491 N Y N $196.25 $196.25 $30.60 $30.60

195677 Pap IG, Ct, rfx HPV ASCU 88175, 87491 N Y N $196.25 $196.25 $30.60 $30.60

196402 Pap IG, Ct-Ng 88175, 87491, 87591 Y Y N $315.50 $315.50 $38.25 $38.25

198310 Pap IG, Ct-Ng HSV 1/2 PCR 87491, 87591, 87529 (x2), 88175 N Y N $625.50 $625.50 $110.75 $110.75

198320 Pap IG, Ct-Ng HSV HPV 16/18

87624, 87491, 87591, 87529

(x2), 88175 N Y N $813.25 $813.25 $149.75 $149.75

196502 Pap IG, Ct-Ng TV 88175, 87491, 87591, 87661 N Y N $412.25 $412.25 $69.25 $69.25

196599 Pap IG, Ct-Ng TV HPV 16&18

88175, 87491, 87591, 87661,

87624 N Y N $600.00 $600.00 $108.25 $108.25

196553 Pap IG, Ct-Ng TV HPV-hr

88175, 87491, 87591, 87624,

87661 N Y N $600.00 $600.00 $108.25 $108.25

198315 Pap IG, Ct-Ng TV HSV 1/2 PCR

87491, 87591, 87661, 87529

(x2), 88175 N Y N $733.25 $733.25 $141.75 $141.75

198305 Pap IG, Ct-Ng TV HSV HPV 16/18

87491, 87591, 87661, 87529

(x2), 88175, 87624 N Y N $921.00 $921.00 $180.75 $180.75

196595 Pap IG, Ct-Ng TV rfx HPV all 88175, 87491, 87591, 87661 Y Y N $423.25 $423.25 $69.25 $69.25

196527 Pap IG, Ct-Ng TV rfx HPV ASCU 88175, 87491, 87591, 87661 N Y N $412.25 $412.25 $69.25 $69.25

192153 Pap IG, Ct-Ng, HPV-hr 88175, 87491, 87591, 87624 Y Y N $503.25 $503.25 $77.25 $77.25

196565 Pap IG, Ct-Ng, rfx HPV all 88175, 87491, 87591 Y Y N $315.50 $315.50 $38.25 $38.25

194027 Pap IG, Ct-Ng, rfx HPV ASCU 88175, 87491, 87591 Y Y N $315.50 $315.50 $38.25 $38.25

197102 Pap IG, Ct-Ng,rfxHPV all 16&18 88175, 87491, 87591 N Y N $315.50 $315.50 $38.25 $38.25

198345 Pap IG, CtNgHSV, rfxHPV ASCU 87491, 87591, 87529 (x2), 88175 N Y N $625.50 $625.50 $110.75 $110.75

198190 Pap IG, HPV-h+lr 87624, 88175 Y Y N $289.00 $289.00 $100.95 $100.95

Page 39 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

199123 Pap IG, HPV-hr 87624, 88175 Y Y N $275.75 $275.75 $61.95 $61.95

198300 Pap IG, HSV 1/2 NAA 87529 (x2), 88175 N Y N $398.00 $398.00 $95.45 $95.45

198325 Pap IG, HSV, HPV rfx HPV 16/18 87624, 87529 (x2), 88175 N Y N $585.75 $585.75 $134.45 $134.45

198355 Pap IG, HSV, rfxHPV ASCU 87529 (x2), 88175 N Y N $398.00 $398.00 $95.45 $95.45

196250 Pap IG, rfx HPV all pth 88175 Y Y N $88.00 $88.00 $22.95 $22.95

197116 Pap IG, rfx HPV all pth 16&18 88175 N Y N $88.00 $88.00 $22.95 $22.95

194074 Pap IG, rfx HPV ASCU 88175 Y Y N $88.00 $88.00 $22.95 $22.95

197132 Pap IG, rfx HPV ASCU,16/18 88175 Y Y N $88.00 $88.00 $22.95 $22.95

197117 Pap IG,Ct-Ng,rfxHPV ASCU 16&18 88175, 87491, 87591 N Y N $315.50 $315.50 $38.25 $38.25

192005 Pap Lb (Liquid-based) 88142 Y Y N $74.00 $74.00 $15.10 $15.10

192138 Pap Lb, Ct 88142, 87491 N Y N $182.25 $182.25 $22.75 $22.75

193148 Pap Lb, Ct, rfx HPV all pth 88142, 87491 N Y N $182.25 $182.25 $22.75 $22.75

193130 Pap Lb, Ct, rfx HPV ASCU 88142, 87491 N Y N $182.25 $182.25 $22.75 $22.75

192120 Pap Lb, Ct-Ng 88142, 87491, 87591 Y Y N $301.50 $301.50 $30.40 $30.40

192520 Pap Lb, Ct-Ng TV 88142, 87491, 87591, 87661 N Y N $398.25 $398.25 $61.40 $61.40

192546 Pap Lb, Ct-Ng TV HPV-hr

88142, 87491, 87591, 87624,

87661 Y Y N $586.00 $586.00 $100.40 $100.40

192504 Pap Lb, Ct-Ng TV rfx HPV all 88142, 87491, 87591, 87661 Y Y N $398.25 $398.25 $61.40 $61.40

192512 Pap Lb, Ct-Ng TV rfx HPV ASCU 88142, 87491, 87591, 87661 Y Y N $398.25 $398.25 $61.40 $61.40

193924 Pap Lb, Ct-Ng, HPV-h+lr 87491, 87591, 87624, 88142 N N N $502.50 $502.50 $108.40 $108.40

192146 Pap Lb, Ct-Ng, HPV-hr 88142, 87591, 87491, 87624 Y Y N $489.25 $489.25 $69.40 $69.40

192104 Pap Lb, Ct-Ng, rfx HPV all 88142, 87491, 87591 Y Y N $301.50 $301.50 $30.40 $30.40

192112 Pap Lb, Ct-Ng, rfx HPV ASCU 88142, 87491, 87591 Y Y N $301.50 $301.50 $30.40 $30.40

197014 Pap Lb, Ct-Ng,rfxHPV all 16&18 88142, 87491, 87591 N Y N $301.50 $301.50 $30.40 $30.40

197070 Pap Lb, HPV-h+lr 87624, 88142 Y Y N $275.00 $275.00 $93.10 $93.10

195050 Pap Lb, HPV-hr 88142, 87624 Y Y N $261.75 $261.75 $54.10 $54.10

193970 Pap Lb, Ng 88142, 87591 Y N N $193.25 $193.25 $22.75 $22.75

192630 Pap Lb, rfx HPV all pth 88142 Y Y N $74.00 $74.00 $15.10 $15.10

192047 Pap Lb, rfx HPV ASCU 88142 Y Y N $74.00 $74.00 $15.10 $15.10

192096 Pap Lb, w Mat Indx 88142, 88155 Y Y N $80.75 $80.75 $28.30 $28.30

197012 Pap Lb,Ct-Ng,rfxHPV ASCU 16&18 88142, 87491, 87591 N Y N $301.50 $301.50 $30.40 $30.40

009209 Pap Smear, 1 sld w Mat Indx 88164, 88155 Y Y N $45.00 $45.00 $45.00

009100 Pap Smear, 1 Slide 88164 Y Y N $40.00 $40.00 $11.09 $11.09

009191 Pap Smear, 2 Slide 88164 N Y N $80.00 $80.00 $22.17 $22.17

197124 PapIG, CtNg, HPV, rfx 16/18 88175, 87491, 87591, 87624 Y Y N $503.25 $503.25 $77.25 $77.25

198340 PapIG, CtNgHSV, rfxHPVall 87491, 87591, 87529 (x2), 88175 N Y N $625.50 $625.50 $110.75 $110.75

198335 PapIG, CtNgTvHSV rfxHPV ASCU

87491, 87591, 87661, 87529

(x2), 88175 N Y N $733.25 $733.25 $141.75 $141.75

198330 PapIG, CtNgTVHSV, rfxHPVal

87491, 87591, 87661, 87529

(x2), 88175 N Y N $733.25 $733.25 $141.75 $141.75

197146 PapIG, HPV, rfx 16/18 88175, 87624 Y Y N $275.75 $275.75 $61.95 $61.95

198350 PapIG, HSV rfxHPVall 87529 (x2), 88175 N Y N $398.00 $398.00 $95.45 $95.45

196605 PapIG,Ct-Ng TV rfxHPVall 16&18 88175, 87491, 87591, 87661 N N N $412.25 $412.25 $69.25 $69.25

197017 PapLb, CtNg, HPV, rfx16/18 88142, 87491, 87591, 87624 Y Y N $489.25 $489.25 $69.40 $69.40

Page 40 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

192560 PapLb, CtNgTv, HPV, rfx16/18

88142, 87491, 87591, 87661,

87624 Y Y N $586.00 $586.00 $100.40 $100.40

192197 PapLb, HPV, rfx16/18 88142, 87624 Y Y N $261.75 $261.75 $54.10 $54.10

808966 Paraneoplastic Profile II 86256 (x2) Y N N $556.00 $556.00 $56.54 $56.54

008185 Parasite Exam, Blood 87207 Y Y N $98.25 $98.25 $11.63 $11.63

163303 Parvovirus B19, Human, IgG/IgM 86747 (x2) N Y N $187.00 $187.00 $77.60 $77.60

163048 Parvovirus B19, IgG 86747 N N N $93.50 $93.50 $38.80 $38.80

163154 Parvovirus B19, IgM 86747 N N N $93.50 $93.50 $38.80 $38.80

724542 Pb+As U+Hg U+FEP

82175, 82570, 83655, 83825,

84202 N N N $291.75 $291.75 $36.58 $36.58

827632 PBG Deaminase, Erythrocytes 82657 Y N N $245.00 $245.00 $209.75 $209.75

790890 PCB Serum w/rfx to Confir 82441 Y Y N $100.60 $100.60 $27.72 $27.72

121210 PE and FLC, Serum 84165, 84155, 83883 (x2) Y Y N $311.75 $311.75 $93.65 $93.65

003715 PE(Rfx IFE), Random Ur 84166, 84156 N Y N $132.75 $132.75 $22.17 $22.17

123018 PE+Interp(Rfx IFE), 24-Hr U 84166, 84156 Y Y N $139.25 $139.25 $49.91 $49.91

123026 PE+Interp(Rfx IFE),S 84165, 84155 N Y N $74.25 $74.25 $11.09 $11.09

123055 PE+Interp(Rfx IFE+FLC), S 84165, 84155 Y Y N $74.25 $74.25 $74.25

011254 pH, Body Fluid 83986 N Y N $49.25 $49.25 $13.30 $13.30

013037 pH, Urine 83986 N Y N $49.25 $49.25 $11.09 $11.09

712588 Phencyclidine Confirmation, Ur 83992 Y N N $119.50 $119.50 $33.26 $33.26

071464 Phencyclidine, Confirm, Urine 83992 N Y N $119.50 $119.50 $33.26 $33.26

007823 Phenobarbital, Serum 80184 Y Y Y $86.25 $30.19 $4.22 $4.22

551690 PhenoSense GT (TM)

87900, 87901, 87903, 87904

(x11) N Y N $2,417.00 $2,417.00 $1,854.23 $1,854.23

551800 PhenoSense(R) 87903, 87904 (x11) Y Y N $1,242.00 $1,242.00 $997.68 $997.68

007401 Phenytoin (Dilantin), Serum 80185 Y Y Y $76.25 $26.69 $3.60 $3.60

070763 Phenytoin, Free, Serum 80186 Y Y N $125.50 $125.50 $21.06 $21.06

070706 Phenytoin,Free and Total,Serum 80185, 80186 Y Y N $201.75 $201.75 $27.72 $27.72

001727 Phospholipids, Serum 84311 N Y N $58.25 $58.25 $11.09 $11.09

003251 Phosphorus, 24 hr Urine 84105 Y Y Y $29.25 $10.24 $2.44 $2.44

001024 Phosphorus, Serum 84100 Y Y Y $27.00 $9.45 $1.75 $1.75

881411 Physician Read Pap 88141 Y N N $53.75 $53.75 $6.66 $6.66

008631 Pinworm Prep - Enterobius 87172 Y Y N $40.00 $40.00 $10.25 $10.25

503850 Platelet Antibody Profile 86022 (x4) Y N N $486.75 $486.75 $486.75

014086 Platelet Antibody, Serum 86022 (x4) Y Y N $606.75 $606.75 $606.75

014102 Platelet Autoantibody Panel 86022 (x3) Y Y N $266.75 $266.75 $266.75

005249 Platelet Count 85049 Y Y Y $24.50 $8.58 $2.22 $2.22

115345 Platelet Count on Citrated Bld 85049 Y Y Y $24.50 $8.58 $2.22 $2.22

816767 Pneumococcal IM (14 Serotype) 86609 (x14) Y N N $269.25 $269.25 $269.25

096669 Poliovirus Antibodies 86658 Y Y N $155.75 $155.75 $55.94 $55.94

138537 Poliovirus Immune Status 86658 (x3) N Y N $292.75 $292.75 $216.19 $216.19

003103 Porphobilinogen, Qn, 24-Hr Ur 84110 N Y N $83.50 $83.50 $29.99 $29.99

003053 Porphobilinogen, Qn, Random Ur 84110 Y Y N $83.50 $83.50 $29.99 $29.99

003194 Porphyrins, Qn, 24 Hr Ur. 84120 N Y N $98.25 $98.25 $11.09 $11.09

120980 Porphyrins, Qn, Random U 84120 N Y N $98.25 $98.25 $11.09 $11.09

Page 41 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

823239 Porphyrins, Total Plasma 84311 Y N N $171.25 $171.25 $171.25

003186 Potassium, 24 hr Urine 84133 Y Y Y $29.25 $10.24 $2.44 $2.44

001180 Potassium, Serum 84132 Y Y Y $27.00 $9.45 $1.75 $1.75

013334 Potassium, Urine 84133 Y N Y $28.50 $9.98 $2.44 $2.44

016931 Prealbumin 84134 Y Y Y $80.50 $28.18 $3.88 $3.88

809623 Pregabalin, Urine 80366 Y Y N $127.00 $127.00 $127.00

004036 Pregnancy Test, Urine 81025 Y Y N $50.75 $50.75 $3.60 $3.60

140707 Pregnenolone, MS 84140 Y Y N $110.00 $110.00 $110.00

038120 Prenat Infect Dis Ab, IgG, Qn

86762, 86777, 86644, 86696,

86695 N Y N $400.75 $400.75 $24.50 $24.50

211581 Prenat Infect Dis Ab, IgM, Qn 86645, 86694, 86762, 86778 N Y N $378.25 $378.25 $42.34 $42.34

030387 Prenatal Panel I/without HBsAg

85025, 86592, 86762, 86850,

86900, 86901 Y Y Y $198.50 $69.48 $69.48

202945 Prenatal Profile I

85025, 87340, 86592, 86762,

86850, 86900, 86901 Y Y Y $258.00 $90.30 $25.52 $25.52

007856 Primidone (Mysoline(R)), Serum 80184, 80188 Y Y N $180.75 $180.75 $24.40 $24.40

300321 Prl+FSH+LH+Prog+hCG Ql

84703, 83001, 83002, 84146,

84144 Y N Y $411.50 $144.03 $144.03

143000 proBNP 83880 Y Y N $195.00 $195.00 $67.66 $67.66

164750 Procalcitonin 84145 Y Y N $261.00 $261.00 $219.09 $219.09

P83501 Prof Only Prostate Biopsy x1 88305 26 N N N $62.16 $62.16 $20.58 $20.58

P83510 Prof Only Prostate Biopsy x10 88305 26 (x10) N N N $621.60 $621.60 $205.80 $205.80

P83511 Prof Only Prostate Biopsy x11 88305 26 (x11) N N N $683.76 $683.76 $226.38 $226.38

P83512 Prof Only Prostate Biopsy x12 88305 26 (x12) N N N $745.92 $745.92 $246.96 $246.96

P83513 Prof Only Prostate Biopsy x13 88305 26 (x13) N N N $808.08 $808.08 $267.54 $267.54

P83514 Prof Only Prostate Biopsy x14 88305 26 (x14) N N N $870.24 $870.24 $288.12 $288.12

P83515 Prof Only Prostate Biopsy x15 Test Not Coded N N N $932.40 $932.40 $308.70 $308.70

P83516 Prof Only Prostate Biopsy x16 Test Not Coded N N N $994.56 $994.56 $329.28 $329.28

P83517 Prof Only Prostate Biopsy x17 Test Not Coded N N N $1,056.72 $1,056.72 $349.86 $349.86

P83518 Prof Only Prostate Biopsy x18 88305 26 (x18) N N N $1,118.88 $1,118.88 $370.44 $370.44

P83519 Prof Only Prostate Biopsy x19 88305 26 (x19) N N N $1,181.04 $1,181.04 $391.02 $391.02

P83502 Prof Only Prostate Biopsy x2 88305 26 (x2) N N N $124.32 $124.32 $41.16 $41.16

P83520 Prof Only Prostate Biopsy x20 Test Not Coded N N N $1,243.20 $1,243.20 $411.60 $411.60

P83521 Prof Only Prostate Biopsy x21 88305 26 (x21) N N N $1,305.36 $1,305.36 $432.18 $432.18

P83522 Prof Only Prostate Biopsy x22 Test Not Coded N N N $1,367.52 $1,367.52 $452.76 $452.76

P83523 Prof Only Prostate Biopsy x23 Test Not Coded N N N $1,429.68 $1,429.68 $473.34 $473.34

P83524 Prof Only Prostate Biopsy x24 Test Not Coded N N N $1,491.84 $1,491.84 $493.92 $493.92

P83525 Prof Only Prostate Biopsy x25 Test Not Coded N N N $1,554.00 $1,554.00 $514.50 $514.50

P83526 Prof Only Prostate Biopsy x26 88305 26 N N N $1,616.16 $1,616.16 $535.08 $535.08

P83527 Prof Only Prostate Biopsy x27 Test Not Coded N N N $1,678.32 $1,678.32 $555.66 $555.66

P83528 Prof Only Prostate Biopsy x28 Test Not Coded N N N $1,740.48 $1,740.48 $576.24 $576.24

P83529 Prof Only Prostate Biopsy x29 Test Not Coded N N N $1,802.64 $1,802.64 $596.82 $596.82

P83503 Prof Only Prostate Biopsy x3 88305 26 (x3) N N N $186.48 $186.48 $61.74 $61.74

P83530 Prof Only Prostate Biopsy x30 Test Not Coded N N N $1,864.80 $1,864.80 $617.40 $617.40

P83531 Prof Only Prostate Biopsy x31 Test Not Coded N N N $1,926.96 $1,926.96 $637.98 $637.98

Page 42 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

P83532 Prof Only Prostate Biopsy x32 Test Not Coded N N N $1,989.12 $1,989.12 $658.56 $658.56

P83533 Prof Only Prostate Biopsy x33 Test Not Coded N N N $2,051.28 $2,051.28 $679.14 $679.14

P83534 Prof Only Prostate Biopsy x34 Test Not Coded N N N $2,113.44 $2,113.44 $699.72 $699.72

P83535 Prof Only Prostate Biopsy x35 Test Not Coded N N N $2,175.60 $2,175.60 $720.30 $720.30

P83536 Prof Only Prostate Biopsy x36 Test Not Coded N N N $2,237.76 $2,237.76 $740.88 $740.88

P83537 Prof Only Prostate Biopsy x37 Test Not Coded N N N $2,299.92 $2,299.92 $761.46 $761.46

P83538 Prof Only Prostate Biopsy x38 Test Not Coded N N N $2,362.08 $2,362.08 $782.04 $782.04

P83539 Prof Only Prostate Biopsy x39 Test Not Coded N N N $2,424.24 $2,424.24 $802.62 $802.62

P83504 Prof Only Prostate Biopsy x4 88305 26 (x4) N N N $248.64 $248.64 $82.32 $82.32

P83540 Prof Only Prostate Biopsy x40 88305 26 (x40) N N N $2,486.40 $2,486.40 $823.20 $823.20

P83505 Prof Only Prostate Biopsy x5 88305 26 (x5) N N N $310.80 $310.80 $102.90 $102.90

P83506 Prof Only Prostate Biopsy x6 88305 26 (x6) N N N $372.96 $372.96 $123.48 $123.48

P83507 Prof Only Prostate Biopsy x7 88305 26 (x7) N N N $435.12 $435.12 $144.06 $144.06

P83508 Prof Only Prostate Biopsy x8 88305 26 (x8) N N N $497.28 $497.28 $164.64 $164.64

P83509 Prof Only Prostate Biopsy x9 88305 26 (x9) N N N $559.44 $559.44 $185.22 $185.22

004317 Progesterone 84144 Y Y Y $110.75 $38.76 $6.66 $6.66

140533 Proinsulin 84206 Y Y N $229.25 $229.25 $229.25

004465 Prolactin 84146 Y Y Y $110.75 $38.76 $4.77 $4.77

500557 Prolactin, Serum (ICMA) 84146 Y N N $110.75 $110.75 $110.75

117796 Prolonged APTT

85240, 85250, 85270, 85280,

85613, 85732 Y Y N $1,062.00 $1,062.00 $304.85 $304.85

117788 Prolonged PT

85384, 85210, 85220, 85230,

85260 N N N $797.00 $797.00 $315.94 $315.94

074567 Propoxyphene Confirmation, Ur 80367 N Y N $119.50 $119.50 $33.26 $33.26

R83501 Prostate Biopsy x1 88305 N N N $148.00 $148.00 $49.00 $49.00

R83510 Prostate Biopsy x10 88305 (x10) N N N $1,480.00 $1,480.00 $490.00 $490.00

R83511 Prostate Biopsy x11 88305 (x11) N N N $1,628.00 $1,628.00 $539.00 $539.00

R83512 Prostate Biopsy x12 88305 (x12) N N N $1,776.00 $1,776.00 $588.00 $588.00

R83513 Prostate Biopsy x13 88305 (x13) N N N $1,924.00 $1,924.00 $637.00 $637.00

R83514 Prostate Biopsy x14 88305 (x14) N N N $2,072.00 $2,072.00 $686.00 $686.00

R83515 Prostate Biopsy x15 Test Not Coded N N N $2,220.00 $2,220.00 $735.00 $735.00

R83516 Prostate Biopsy x16 88305 (x16) N N N $2,368.00 $2,368.00 $784.00 $784.00

R83517 Prostate Biopsy x17 Test Not Coded N N N $2,516.00 $2,516.00 $833.00 $833.00

R83518 Prostate Biopsy x18 Test Not Coded N N N $2,664.00 $2,664.00 $882.00 $882.00

R83519 Prostate Biopsy x19 Test Not Coded N N N $2,812.00 $2,812.00 $931.00 $931.00

R83502 Prostate Biopsy x2 88305 (x2) N N N $296.00 $296.00 $98.00 $98.00

R83520 Prostate Biopsy x20 88305 (x20) N N N $2,960.00 $2,960.00 $980.00 $980.00

R83521 Prostate Biopsy x21 88305 (x21) N N N $3,108.00 $3,108.00 $1,029.00 $1,029.00

R83522 Prostate Biopsy x22 Test Not Coded N N N $3,256.00 $3,256.00 $1,078.00 $1,078.00

R83523 Prostate Biopsy x23 88305 (x23) N N N $3,404.00 $3,404.00 $1,127.00 $1,127.00

R83524 Prostate Biopsy x24 88305 (x24) N N N $3,552.00 $3,552.00 $1,176.00 $1,176.00

R83525 Prostate Biopsy x25 Test Not Coded N N N $3,700.00 $3,700.00 $1,225.00 $1,225.00

R83526 Prostate Biopsy x26 Test Not Coded N N N $3,848.00 $3,848.00 $1,274.00 $1,274.00

R83527 Prostate Biopsy x27 Test Not Coded N N N $3,996.00 $3,996.00 $1,323.00 $1,323.00

R83528 Prostate Biopsy x28 Test Not Coded N N N $4,144.00 $4,144.00 $1,372.00 $1,372.00

Page 43 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

R83529 Prostate Biopsy x29 88305 (x29) N N N $4,292.00 $4,292.00 $1,421.00 $1,421.00

R83503 Prostate Biopsy x3 88305 (x3) N N N $444.00 $444.00 $147.00 $147.00

R83530 Prostate Biopsy x30 Test Not Coded N N N $4,440.00 $4,440.00 $1,470.00 $1,470.00

R83531 Prostate Biopsy x31 Test Not Coded N N N $4,588.00 $4,588.00 $1,519.00 $1,519.00

R83532 Prostate Biopsy x32 Test Not Coded N N N $4,736.00 $4,736.00 $1,568.00 $1,568.00

R83533 Prostate Biopsy x33 Test Not Coded N N N $4,884.00 $4,884.00 $1,617.00 $1,617.00

R83534 Prostate Biopsy x34 Test Not Coded N N N $5,032.00 $5,032.00 $1,666.00 $1,666.00

R83535 Prostate Biopsy x35 Test Not Coded N N N $5,180.00 $5,180.00 $1,715.00 $1,715.00

R83536 Prostate Biopsy x36 Test Not Coded N N N $5,328.00 $5,328.00 $1,764.00 $1,764.00

R83537 Prostate Biopsy x37 Test Not Coded N N N $5,476.00 $5,476.00 $1,813.00 $1,813.00

R83538 Prostate Biopsy x38 Test Not Coded N N N $5,624.00 $5,624.00 $1,862.00 $1,862.00

R83539 Prostate Biopsy x39 Test Not Coded N N N $5,772.00 $5,772.00 $1,911.00 $1,911.00

R83504 Prostate Biopsy x4 88305 (x4) N N N $592.00 $592.00 $196.00 $196.00

R83540 Prostate Biopsy x40 Test Not Coded N N N $5,920.00 $5,920.00 $1,960.00 $1,960.00

R83505 Prostate Biopsy x5 88305 (x5) N N N $740.00 $740.00 $245.00 $245.00

R83506 Prostate Biopsy x6 88305 (x6) N N N $888.00 $888.00 $294.00 $294.00

R83507 Prostate Biopsy x7 88305 (x7) N N N $1,036.00 $1,036.00 $343.00 $343.00

R83508 Prostate Biopsy x8 88305 (x8) N N N $1,184.00 $1,184.00 $392.00 $392.00

R83509 Prostate Biopsy x9 88305 (x9) N N N $1,332.00 $1,332.00 $441.00 $441.00

010322 Prostate-Specific Ag, Serum 84153 Y Y Y $87.50 $30.63 $4.22 $4.22

004747 Prostatic Acid Phos, Serum 84066 Y Y Y $74.00 $25.90 $25.90

261511 Prot Electro Interp, 24-Hr Ur 84166, 84156 N Y N $139.25 $139.25 $25.49 $25.49

003129 Prot+CreatU (Random) 82570, 84156 Y Y Y $65.25 $22.84 $4.88 $4.88

080465 Protein C Antigen 85302 Y Y N $153.50 $153.50 $44.34 $44.34

283655 Protein C Deficiency Profile 85302, 85303 Y Y N $303.50 $303.50 $303.50

117705 Protein C-Functional 85303 Y Y N $150.00 $150.00 $33.26 $33.26

225920 Protein Elec + Interp, Serum 84165, 84155 Y Y N $74.25 $74.25 $11.09 $11.09

003368 Protein Electro, 24-Hour Urine 84166, 84156 Y Y N $132.75 $132.75 $22.17 $22.17

354928 Protein Electro, Random Urine 84166, 84156 Y Y N $132.75 $132.75 $7.77 $7.77

001487 Protein Electro.,S 84165, 84155 Y Y N $67.75 $67.75 $5.54 $5.54

117754 Protein S Panel 85305, 85306 (x2) Y Y N $545.00 $545.00 $149.65 $149.65

164517 Protein S-Antigen 85305, 85306 N Y N $385.00 $385.00 $94.23 $94.23

164525 Protein S-Functional 85306 Y Y N $160.00 $160.00 $55.42 $55.42

003277 Protein Total, Qn, 24-Hr Urine 84156 Y Y Y $29.25 $10.24 $2.78 $2.78

019588 Protein, Body Fluid 84157 N Y Y $27.00 $9.45 $4.72 $4.72

001073 Protein, Total, Serum 84155 Y Y Y $27.00 $9.45 $1.75 $1.75

130021 Protein, Urine 12-Hr 84156 N N Y $29.25 $10.24 $2.78 $2.78

013664 Protein,Total,Urine 84156 Y Y Y $29.25 $10.24 $2.44 $2.44

500016 Prothrombin Fragment 1+2 MoAb 83520 Y Y N $160.00 $160.00 $160.00

005199 Prothrombin Time (PT) 85610 Y Y Y $30.00 $10.50 $1.83 $1.83

485199 Prothrombin Time (PT), Serial 85610 Y Y Y $53.00 $18.55 $18.55

010165 Protoporphyrin, FEP/ZPP 84202 Y Y N $76.25 $76.25 $76.25

500463 Prt C Activity (Chromogenic) 85303 N Y N $150.00 $150.00 $92.25 $92.25

480640 PSA (Reflex To Free) (Serial) 84153 N Y N $110.50 $110.50 $6.09 $6.09

480772 PSA Total (Reflex To Free) 84153 Y Y N $87.50 $87.50 $4.22 $4.22

Page 44 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

480947 PSA Total+% Free 84153, 84154 Y Y N $152.50 $152.50 $13.08 $13.08

140723 PSA Ultra. W/Serial Monitor 84153 Y Y N $161.75 $161.75 $161.75

140674 PSA, Complexed 84152 Y Y N $117.00 $117.00 $117.00

480145 PSA, Serum (Serial Monitor) 84153 Y Y Y $110.50 $38.68 $38.68

708008 PSC Specimen Collection 99199 Y N N $18.75 $18.75 $10.78 $10.78

020321 PT and PTT 85610, 85730 Y Y Y $66.00 $23.10 $3.72 $3.72

015610 PTH, Intact 83970 Y Y Y $136.50 $47.78 $13.30 $13.30

126120 PTH, LIAB 83970 N N N $136.50 $136.50 $13.30 $13.30

503380 PTHrP (PTH-Related Peptide) 82397 Y Y N $151.25 $151.25 $78.53 $78.53

005207 PTT, Activated 85730 Y Y Y $36.00 $12.60 $1.89 $1.89

117004 PTT-LA Mix 85732 N N N $89.75 $89.75 $33.26 $33.26

117040 PTT-LA Mix 85732 Y N N $89.75 $89.75 $33.26 $33.26

550466 Quant, RNA PCR 87536 N N N $409.00 $409.00 $102.50 $102.50

550503 Quant, RNA PCR 87536 Y N N $386.00 $386.00 $111.41 $111.41

551319 Quant, RNA PCR 87536 Y N N $386.00 $386.00 $386.00

550504 Quant, RNA PCR 87536 N N N $386.00 $386.00 $111.41 $111.41

183244 QuantiFERON Client Incubated 86480 Y Y N $189.00 $189.00 $60.98 $60.98

182877 QuantiFERON In Tube 86480 Y N N $189.00 $189.00 $60.98 $60.98

808404 Quetiapine (Seroquel) 80342 Y Y N $113.25 $113.25 $68.73 $68.73

164245 RA Expanded Profile 86431, 86140, 86200, 85652 Y Y N $194.00 $194.00 $194.00

204511 RA Qn+SjoSSA+SjoSSB 86235 (x2), 86431 Y N Y $210.75 $73.76 $73.76

083885 Rabies Neut.Abs Titrat.(RFFIT) 86382 Y N N $65.00 $65.00 $49.89 $49.89

006460 Rapid Plasma Reagin, Quant 86593 Y Y Y $27.50 $9.63 $2.22 $2.22

005033 RBC 85041 Y Y Y $24.50 $8.58 $2.22 $2.22

550880 RealTime Abbott 87536 Y Y N $439.50 $439.50 $439.50

008458 Reference Bacterial Culture ID 87077 N Y N $137.50 $137.50 $68.05 $68.05

322777 Renal Panel (10) 80069 Y Y Y $31.50 $11.03 $2.91 $2.91

000703 Renin Activity and Aldosterone 82088, 84244 Y Y N $255.75 $255.75 $39.82 $39.82

058503 Respiratory Infection Prof A 86603, 86631, 86713, 86738 (x2) N Y N $545.50 $545.50 $139.71 $139.71

005280 Reticulocyte Count 85045 Y Y Y $29.75 $10.41 $3.32 $3.32

070104 Reverse T3, Serum 84482 Y Y N $196.50 $196.50 $196.50

550538 Rfx to GenoSure(R) HCV NS3/4A 87902, 87900 Y N N $686.00 $686.00 $686.00

550539 Rfx to GenoSure(R) HCV NS3/4A 87902, 87900 Y N N $686.00 $686.00 $686.00

550563 Rfx to GenoSure(R) HCV NS3/4A 87900, 87902 Y N N $686.00 $686.00 $686.00

006064 Rh Factor 86901 Y Y Y $30.00 $10.50 $2.77 $2.77

204529 Rheumatic Fever Profile

85652, 86060, 86140, 86256

(x2), 86332 N Y N $363.25 $363.25 $58.52 $58.52

006502 Rheumatoid Arthritis Factor 86431 Y Y Y $33.50 $11.73 $3.22 $3.22

164065 Rheumatoid Arthritis Profile 86431, 86200 Y Y N $117.00 $117.00 $20.95 $20.95

831000 Rheumatoid Factor (RF), IgA 86431 Y N N $46.50 $46.50 $46.50

058008 Rh-hr Genotype w/ABO Grouping 86900, 86906 N Y N $51.50 $51.50 $5.52 $5.52

716563 Risperidone (Risperdal(R)), S 80342 Y Y N $178.25 $178.25 $21.06 $21.06

083950 RNA Qualitative 87535 Y N N $330.00 $330.00 $56.38 $56.38

139350 RNA Qualitative 87535 Y Y N $330.00 $330.00 $56.38 $56.38

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

139450 RNA Qualitative 87535 N N N $330.00 $330.00 $56.38 $56.38

162164 RNA, b-DNA, Quant 87536 Y N N $439.50 $439.50 $117.51 $117.51

551887 RNA, b-DNA, Quant, Non-Graph 87536 Y N N $416.75 $416.75 $108.63 $108.63

550422 RNA, PCR (Graph) rfx/Geno 87536 Y Y N $409.00 $409.00 $111.41 $111.41

550522 RNA, PCR (Graph) rfx/Geno EDI 87536 N N N $409.00 $409.00 $111.41 $111.41

550520 RNA, PCR (Graph) rfx/PS 87536 Y Y N $409.00 $409.00 $111.41 $111.41

550510 RNA, PCR (Graph) rfx/PSGT 87536 N Y N $409.00 $409.00 $111.41 $111.41

550432 RNA, PCR (NonGraph) rfx/Geno 87536 Y Y N $386.00 $386.00 $111.41 $111.41

550470 RNA, PCR (NonGraph) rfx/PS 87536 N Y N $386.00 $386.00 $111.41 $111.41

550450 RNA, PCR (NonGraph) rfx/PSGT 87536 N Y N $386.00 $386.00 $111.41 $111.41

550630 RNA, PCR(Graph)rfx/GenoPRI 87536 Y Y N $409.00 $409.00 $93.78 $93.78

550420 RNA, Real Time PCR (Graph) 87536 Y Y N $409.00 $409.00 $111.41 $111.41

550430 RNA, Real Time PCR (Non-Graph) 87536 Y Y N $386.00 $386.00 $111.41 $111.41

550250 RNA,PCR(Graph)rfx/PS Int 87536 Y Y N $409.00 $409.00 $409.00

160155 RNP Antibodies 86235 Y N N $103.25 $103.25 $103.25

016592 Rocky Mtn Spotted Fev, IgG, Qn 86757 Y Y N $120.25 $120.25 $23.29 $23.29

016667 Rocky Mtn Spotted Fever, IgM 86757 Y Y N $120.25 $120.25 $26.60 $26.60

006866 Rotavirus Ag, EIA 87425 Y Y N $116.75 $116.75 $116.75

006072 RPR 86592 Y Y Y $27.50 $9.63 $2.10 $2.10

006099 RPR 86592 Y N Y $27.50 $9.63 $2.10 $2.10

012021 RPR Qn+TP Abs 86593, 86780 Y N Y $107.25 $37.54 $6.98 $6.98

012005 RPR, Rfx Qn RPR/Confirm TP 86592 Y Y Y $27.50 $9.63 $2.10 $2.10

244681 RPR+Rh+ABO+Rub Ab+Ab Scr+CB...

85027, 87340, 86592, 86762,

86850, 86900, 86901 Y N Y $257.75 $90.21 $27.29 $27.29

341109 RPR+Rh+ABO+Rub Ab+Ab Scr+CB...

87340, 86592, 86850, 86900,

86762, 86901, 86703, 85027 Y N N $335.75 $335.75 $335.75

308336 Rub Ab+ToxoAb+CMV Ab+CMVIgM...

86644, 86645, 86694, 86695,

86696, 86762 (x2), 86777, 86778 N N N $677.50 $677.50 $88.37 $88.37

243766 Rub Ab+VarAb+RubeoAb+MumIgG 86735, 86762, 86787, 86765 Y N N $276.25 $276.25 $17.40 $17.40

006197 Rubella Antibodies, IgG 86762 Y Y Y $54.50 $19.08 $4.22 $4.22

096537 Rubella Antibodies, IgM 86762 Y Y Y $98.25 $34.39 $14.98 $14.98

354415 Rubella+Rubeola+VZ 86762, 86765, 86787 N N N $179.25 $179.25 $12.74 $12.74

096560 Rubeola Antibodies, IgG 86765 Y Y N $76.00 $76.00 $4.43 $4.43

160218 Rubeola Antibodies, IgM 86765 Y Y N $76.00 $76.00 $27.27 $27.27

164657 Saccharomyces cerevisiae Panel 86671 (x2) N Y N $217.25 $217.25 $55.42 $55.42

007849 Salicylate, Serum 80329 Y Y N $82.50 $82.50 $9.97 $9.97

052373 Scleroderma Diagnostic Profile 86038, 86235 Y Y N $172.50 $172.50 $22.62 $22.62

062463 Seasonal Allrgns, Fall--Weed 86003 (x13) N Y N $315.25 $315.25 $57.85 $57.85

062471 Seasonal Allrgns, Summer-Grass 86003 (x10) N Y N $242.50 $242.50 $44.50 $44.50

005215 Sedimentation Rate-Westergren 85652 Y Y Y $24.75 $8.66 $1.83 $1.83

S00001 Sensitivity Organism #1 87186 Y N N $70.00 $70.00 $4.88 $4.88

S00002 Sensitivity Organism #2 87186 Y N N $70.00 $70.00 $4.88 $4.88

S00003 Sensitivity Organism #3 87186 Y N N $70.00 $70.00 $4.88 $4.88

S00004 Sensitivity Organism #4 87186 N N N $70.00 $70.00 $4.88 $4.88

Page 46 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

120204 Serotonin, Serum 84260 Y Y N $221.00 $221.00 $79.35 $79.35

120089 Serotonin, Whole Blood 84260 N Y N $221.00 $221.00 $79.35 $79.35

012708 Sjogren's Ab, Anti-SS-A/-SS-B 86235 (x2) Y Y N $206.50 $206.50 $24.94 $24.94

160156 Sjogren's Anti-SS-A 86235 Y N N $103.25 $103.25 $103.25

160157 Sjogren's Anti-SS-B 86235 Y N N $103.25 $103.25 $103.25

016360 Smith Antibodies 86235 Y N N $103.25 $103.25 $103.25

160152 Smith Antibodies 86235 Y N N $103.25 $103.25 $103.25

160153 Smith/RNP Antibodies 86235 Y N N $103.25 $103.25 $103.25

003178 Sodium, 24 hr Urine 84300 Y Y Y $28.50 $9.98 $2.44 $2.44

001198 Sodium, Serum 84295 Y Y Y $27.00 $9.45 $1.75 $1.75

013326 Sodium, Urine 84300 Y Y Y $28.50 $9.98 $2.44 $2.44

143305 Soluble Transferrin Receptor 84238 Y Y N $153.50 $153.50 $46.57 $46.57

808933 Solvent Inhalants Panel, WB 80320, 84600 N Y N $241.50 $241.50 $101.36 $101.36

P83121 Spec Stn;Grp I Micro 1st(Prof) 88312 26 N N N $50.25 $50.25 $21.37 $21.37

788923 Specific Gravity Test Not Coded Y N N $8.00 $8.00 $8.00

794902 Specific Gravity Test Not Coded Y N Y $6.00 $2.10 $2.07 $2.07

883131 Spec-Stain,GRP II-All-Oth 1st 88313 Y N N $102.25 $102.25 $102.25

883132 Spec-Stain,GRP II-All-Oth 2nd 88313 Y N N $102.25 $102.25 $102.25

883121 Spec-Stain,GRP I-Micro 1st 88312 Y N N $128.75 $128.75 $54.80 $54.80

883122 Spec-Stain,GRP I-Micro 2nd 88312 Y N N $128.75 $128.75 $54.80 $54.80

883123 Spec-Stain;GRP I-Micro 3rd 88312 N N N $128.75 $128.75 $54.80 $54.80

883124 Spec-Stain;GRP I-Micro 4th 88312 N N N $128.75 $128.75 $54.80 $54.80

883125 Spec-Stain;GRP I-Micro 5th 88312 N N N $128.75 $128.75 $54.80 $54.80

182354 Sputum Culture 87070 Y N N $65.25 $65.25 $21.61 $21.61

009076 Sputum Cytology 88108 N Y N $114.00 $114.00 $60.98 $60.98

132209 Stone Analysis 82360 Y N N $81.25 $81.25 $16.34 $16.34

008144 Stool Culture 87045, 87046, 87427 Y Y N $163.25 $163.25 $32.14 $32.14

182410 Stool Culture, Yersinia Only 87046 Y Y N $50.75 $50.75 $50.75

180786 Strep Gp A Direct, DNA Probe 87650 Y Y N $65.00 $65.00 $22.17 $22.17

188130 Strep Gp B Culture 87081 Y Y N $78.00 $78.00 $7.53 $7.53

188135 Strep Gp B Culture+Rflx 87081 Y Y N $78.00 $78.00 $7.53 $7.53

188132 Strep Gp B NAA 87081, 87150 Y Y N $154.00 $154.00 $27.68 $27.68

188139 Strep Gp B NAA+Rflx 87081, 87150 Y Y N $154.00 $154.00 $27.68 $27.68

180797 Strep Gp B Susceptibility 87184 Y N N $35.00 $35.00 $20.50 $20.50

180798 Strep Gp B Susceptibility 87184 Y N N $35.00 $35.00 $20.50 $20.50

183809 Strep Gp B Susceptibility 87184 Y N N $35.00 $35.00 $35.00

018788 Streptococcus pneumoniae Ag 87899 N Y N $150.00 $150.00 $35.49 $35.49

183009 Streptococcus pneumoniae Ag 87899 N Y N $150.00 $150.00 $35.49 $35.49

828755 Strongyloides Ab IgG, ELISA 86682 Y N N $92.25 $92.25 $94.56 $94.56

164000 Strongyloides IgG Antibody 86682 N Y N $92.25 $92.25 $94.56 $94.56

816853 Sugar Cane IgE* 86003 Y N N $37.00 $37.00 $37.00

207631 Sulfapyridine 80299 Y N N $208.50 $208.50 $208.50

008680 Susceptibility, Aer + Anaerob 87186 Y Y N $82.25 $82.25 $14.98 $14.98

182808 Susceptibility, Gram Pos Rods 87186 N N N $72.25 $72.25 $37.69 $37.69

182931 Susceptibility, Haemophilus 87184 Y N N $41.50 $41.50 $41.50

Page 47 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

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65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

790738 Synthetic Cannabinoids, Conf 80352 Y N N $131.25 $131.25 $131.25

790742 Synthetic Cannabinoids, Urine 80304 Y Y N $58.00 $58.00 $58.00

056499 Systemic Lupus Profile A 86225, 86235 (x5), 86431 Y Y N $653.00 $653.00 $81.93 $81.93

203752 Systemic Lupus Profile B 86235, 86038, 86160 (x2), 86225 N Y N $374.75 $374.75 $41.86 $41.86

096917 T + B-Lymphocyte Differential 86359, 86360, 86355 N Y N $443.00 $443.00 $166.29 $166.29

006379 T pallidum Ab (FTA-Ab) 86780 Y Y Y $79.75 $27.91 $6.09 $6.09

082345 T pallidum Screening Cascade 86780 Y Y Y $79.75 $27.91 $4.88 $4.88

602936 T003-IgE Common Silver Birch 86003 Y Y N $24.25 $24.25 $24.25

602491 T006-IgE Cedar, Mountain 86003 N Y N $24.25 $24.25 $4.45 $4.45

602480 T007-IgE Oak, White 86003 N Y N $24.25 $24.25 $4.45 $4.45

602476 T008-IgE Elm, American 86003 N Y N $24.25 $24.25 $4.45 $4.45

602494 T010-IgE Walnut 86003 N Y N $24.25 $24.25 $4.45 $4.45

602948 T011-IgE Maple Leaf Sycamore 86003 N Y N $24.25 $24.25 $4.45 $4.45

602518 T014-IgE Cottonwood 86003 N Y N $24.25 $24.25 $4.45 $4.45

602927 T015-IgE Ash, White 86003 N Y N $24.25 $24.25 $4.45 $4.45

001156 T3 Uptake 84479 Y Y Y $30.75 $10.76 $1.77 $1.77

010390 T3Free 84481 Y N Y $157.50 $55.13 $5.54 $5.54

024026 T4 and TSH 84436, 84443 Y Y Y $106.75 $37.36 $4.75 $4.75

700248 Tacrolimus (FK506), Blood 80197 Y Y N $167.00 $167.00 $66.51 $66.51

711034 Tacrolimus by Immunoassay 80197 Y Y N $167.00 $167.00 $167.00

806021 Tarragon IgE 86003 Y N N $62.50 $62.50 $62.50

T83501 Tech Only Prostate Biopsy x1 88305 TC N N N $85.84 $85.84 $28.42 $28.42

T83510 Tech Only Prostate Biopsy x10 88305 TC (x10) N N N $858.40 $858.40 $284.20 $284.20

T83511 Tech Only Prostate Biopsy x11 88305 TC (x11) N N N $944.24 $944.24 $312.62 $312.62

T83512 Tech Only Prostate Biopsy x12 88305 TC (x12) N N N $1,030.08 $1,030.08 $341.04 $341.04

T83513 Tech Only Prostate Biopsy x13 Test Not Coded N N N $1,115.92 $1,115.92 $369.46 $369.46

T83514 Tech Only Prostate Biopsy x14 Test Not Coded N N N $1,201.76 $1,201.76 $397.88 $397.88

T83515 Tech Only Prostate Biopsy x15 Test Not Coded N N N $1,287.60 $1,287.60 $426.30 $426.30

T83516 Tech Only Prostate Biopsy x16 Test Not Coded N N N $1,373.44 $1,373.44 $454.72 $454.72

T83517 Tech Only Prostate Biopsy x17 Test Not Coded N N N $1,459.28 $1,459.28 $483.14 $483.14

T83518 Tech Only Prostate Biopsy x18 Test Not Coded N N N $1,545.12 $1,545.12 $511.56 $511.56

T83519 Tech Only Prostate Biopsy x19 Test Not Coded N N N $1,630.96 $1,630.96 $539.98 $539.98

T83502 Tech Only Prostate Biopsy x2 88305 TC (x2) N N N $171.68 $171.68 $56.84 $56.84

T83520 Tech Only Prostate Biopsy x20 Test Not Coded N N N $1,716.80 $1,716.80 $568.40 $568.40

T83521 Tech Only Prostate Biopsy x21 88305 TC (x21) N N N $1,802.64 $1,802.64 $596.82 $596.82

T83522 Tech Only Prostate Biopsy x22 Test Not Coded N N N $1,888.48 $1,888.48 $625.24 $625.24

T83523 Tech Only Prostate Biopsy x23 Test Not Coded N N N $1,974.32 $1,974.32 $653.66 $653.66

T83524 Tech Only Prostate Biopsy x24 Test Not Coded N N N $2,060.16 $2,060.16 $682.08 $682.08

T83525 Tech Only Prostate Biopsy x25 Test Not Coded N N N $2,146.00 $2,146.00 $710.50 $710.50

T83526 Tech Only Prostate Biopsy x26 Test Not Coded N N N $2,231.84 $2,231.84 $738.92 $738.92

T83527 Tech Only Prostate Biopsy x27 Test Not Coded N N N $2,317.68 $2,317.68 $767.34 $767.34

T83528 Tech Only Prostate Biopsy x28 Test Not Coded N N N $2,403.52 $2,403.52 $795.76 $795.76

T83529 Tech Only Prostate Biopsy x29 Test Not Coded N N N $2,489.36 $2,489.36 $824.18 $824.18

T83503 Tech Only Prostate Biopsy x3 88305 TC (x3) N N N $257.52 $257.52 $85.26 $85.26

Page 48 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

T83530 Tech Only Prostate Biopsy x30 Test Not Coded N N N $2,575.20 $2,575.20 $852.60 $852.60

T83531 Tech Only Prostate Biopsy x31 Test Not Coded N N N $2,661.04 $2,661.04 $881.02 $881.02

T83532 Tech Only Prostate Biopsy x32 Test Not Coded N N N $2,746.88 $2,746.88 $909.44 $909.44

T83533 Tech Only Prostate Biopsy x33 Test Not Coded N N N $2,832.72 $2,832.72 $937.86 $937.86

T83534 Tech Only Prostate Biopsy x34 Test Not Coded N N N $2,918.56 $2,918.56 $966.28 $966.28

T83535 Tech Only Prostate Biopsy x35 Test Not Coded N N N $3,004.40 $3,004.40 $994.70 $994.70

T83536 Tech Only Prostate Biopsy x36 Test Not Coded N N N $3,090.24 $3,090.24 $1,023.12 $1,023.12

T83537 Tech Only Prostate Biopsy x37 Test Not Coded N N N $3,176.08 $3,176.08 $1,051.54 $1,051.54

T83538 Tech Only Prostate Biopsy x38 Test Not Coded N N N $3,261.92 $3,261.92 $1,079.96 $1,079.96

T83539 Tech Only Prostate Biopsy x39 Test Not Coded N N N $3,347.76 $3,347.76 $1,108.38 $1,108.38

T83504 Tech Only Prostate Biopsy x4 88305 TC (x4) N N N $343.36 $343.36 $113.68 $113.68

T83540 Tech Only Prostate Biopsy x40 88305 TC (x40) N N N $3,433.60 $3,433.60 $1,136.80 $1,136.80

T83505 Tech Only Prostate Biopsy x5 88305 TC (x5) N N N $429.20 $429.20 $142.10 $142.10

T83506 Tech Only Prostate Biopsy x6 88305 TC (x6) N N N $515.04 $515.04 $170.52 $170.52

T83507 Tech Only Prostate Biopsy x7 88305 TC (x7) N N N $600.88 $600.88 $198.94 $198.94

T83508 Tech Only Prostate Biopsy x8 88305 TC (x8) N N N $686.72 $686.72 $227.36 $227.36

T83509 Tech Only Prostate Biopsy x9 88305 TC (x9) N N N $772.56 $772.56 $255.78 $255.78

485151 Testicular Cancer Monitor Prof 82105, 84702 Y Y Y $194.25 $67.99 $16.63 $16.63

070038 Testosterone, F Eqlib+T LC/MS 84403, 84402 Y Y N $311.00 $311.00 $48.23 $48.23

144980 Testosterone, Free, Direct 84402 Y Y N $165.75 $165.75 $33.26 $33.26

081786 Testosterone, Free/Tot Equilib 84402, 84403 Y Y N $289.50 $289.50 $48.23 $48.23

070195 Testosterone, Free+Total LC/MS 84403, 84402 Y Y N $315.75 $315.75 $38.24 $38.24

004226 Testosterone, Serum 84403 Y Y Y $128.50 $44.98 $4.99 $4.99

070001 Testosterone, Serum, LC/MS/MS 84403 N Y N $150.00 $150.00 $4.46 $4.46

140103 Testosterone,Free and Total 84402, 84403 Y Y N $294.25 $294.25 $38.25 $38.25

070282 Testosterone,Free+Weakly Bound 84403, 84402 N Y N $315.00 $315.00 $48.23 $48.23

143255 Testosterone,Free+Weakly Bound 84403, 84402 Y Y N $293.50 $293.50 $48.23 $48.23

502515 TestT+LH+DHEA S+E2+TestF+E1...

83002, 84403, 82679, 84402

(x2), 82670, 82627, 84270 Y N N $370.30 $370.30 $370.30

163253 Tetanus/Diphtheria Ab 86317, 86317 N Y Y $187.00 $65.45 $26.60 $26.60

791718 THC (Tetrahydrocannabinol), W 80349 N Y N $314.50 $314.50 $83.14 $83.14

007336 Theophylline, Serum 80198 Y Y Y $83.50 $29.23 $6.66 $6.66

510750 Thiopurine Methyltransferase 82542 Y Y N $300.00 $300.00 $300.00

117726 Thrombotic Risk Profile II

81240, 83090, 85420, 85300,

85303, 85306, 85307, 85732,

85613, 85705, 86147 (x3), 86146

(x3), 86849 (x2), 86148 (x3) Y Y N $2,559.25 $2,559.25 $2,559.25

503880 Thyroglobulin (TG-RIA) 84432 Y N N $99.00 $99.00 $4.06 $4.06

042100 Thyroglobulin with Anti-TG Ab 86800 Y Y N $84.50 $84.50 $10.26 $10.26

006694 Thyroglobulin, Serum 84432 Y N N $99.00 $99.00 $4.06 $4.06

140318 Thyroglobulin, Serum,(New) 84432 N N N $99.00 $99.00 $4.06 $4.06

006684 Thyroid Antibodies 86376, 86800 Y Y N $150.50 $150.50 $56.81 $56.81

330015 Thyroid Cascade Profile 84443 Y Y Y $76.25 $26.69 $2.97 $2.97

000455 Thyroid Panel 84436, 84479 Y Y Y $61.25 $21.44 $3.55 $3.55

Page 49 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

000620 Thyroid Panel With TSH 84436, 84443, 84479 Y Y Y $137.50 $48.13 $6.52 $6.52

006676 Thyroid Peroxidase (TPO) Ab 86376 Y Y Y $66.00 $23.10 $8.31 $8.31

330018 Thyroid Peroxidase (TPO) Ab 86376 Y N Y $66.00 $23.10 $8.31 $8.31

027011 Thyroid Profile II 84480, 84436, 84443, 84479 Y Y Y $230.75 $80.76 $11.61 $11.61

140749 Thyroid Stim Immunoglobulin 84445 Y Y N $270.00 $270.00 $57.65 $57.65

010314 Thyrotropin Receptor Ab, Serum 83520 Y Y N $165.00 $165.00 $18.85 $18.85

001149 Thyroxine (T4) 84436 Y Y Y $30.50 $10.68 $1.77 $1.77

001974 Thyroxine (T4) Free, Direct, S 84439 Y Y Y $82.50 $28.88 $4.54 $4.54

001976 Thyroxine (T4) Free, Direct, S 84439 Y N Y $82.50 $28.88 $4.54 $4.54

001977 Thyroxine (T4) Free, Direct, S 84439 Y N Y $82.50 $28.88 $4.54 $4.54

001735 Thyroxine Binding Globulin 84442 Y Y Y $98.50 $34.48 $34.48

842104 Tiagabine (Gabitril) 80199 N Y N $80.49 $80.49 $62.08 $62.08

183157 Tissue Grind/Digestion/Decon 87176, 87015 N N N $76.25 $76.25 $60.67 $60.67

096834 T-Lymphocyte CD3 Cells 86359 N N N $130.75 $130.75 $55.42 $55.42

096925 T-Lymphocyte Helper/Suppressor 86359, 86360 Y Y N $358.50 $358.50 $19.96 $19.96

007153 Tobramycin Random, Serum 80200 N N Y $92.00 $32.20 $16.63 $16.63

716285 Topiramate (Topamax), Serum 80201 Y Y N $135.25 $135.25 $21.06 $21.06

116087 Total Neutrophil Count 85048, 85004 Y N Y $24.75 $8.66 $8.66

213561 Toxoplasma Abs IgG/IgM 86777, 86778 Y N N $181.25 $181.25 $12.74 $12.74

006478 Toxoplasma gondii Ab, IgG, Qn 86777 Y Y N $73.25 $73.25 $4.77 $4.77

096651 Toxoplasma gondii Ab,IgM,Qn 86778 Y Y N $108.00 $108.00 $7.97 $7.97

764365 Tramadol 80302 Y Y N $60.00 $60.00 $20.94 $20.94

004937 Transferrin 84466 Y Y Y $67.25 $23.54 $4.99 $4.99

501819 Transferrin Saturation 84466, 83540 Y N N $95.75 $95.75 $95.75

071688 Trazodone, Serum 80338 N Y N $116.75 $116.75 $41.90 $41.90

082370 Treponema pallidum Antibodies 86780 Y Y Y $79.75 $27.91 $4.88 $4.88

188052 Trich vag by NAA 87661 Y Y N $107.75 $107.75 $31.00 $31.00

007690 Tricyclic Antidepressants 80337 Y Y N $110.75 $110.75 $13.58 $13.58

001172 Triglycerides 84478 Y Y Y $27.00 $9.45 $1.75 $1.75

002188 Triiodothyronine (T3) 84480 Y Y Y $93.25 $32.64 $5.09 $5.09

010389 Triiodothyronine,Free,Serum 84481 Y Y Y $157.50 $55.13 $4.99 $4.99

120832 Troponin I 84484 Y Y N $132.75 $132.75 $21.06 $21.06

828737 Trypanosoma Cruzi Ab IgG 86753 Y N N $85.50 $85.50 $87.64 $87.64

828735 Trypanosoma Cruzi Ab, IgM 86753 N N N $85.50 $85.50 $87.64 $87.64

010355 Trypsin 83519 Y Y N $154.25 $154.25 $154.25

004280 Tryptase 83520 Y Y N $146.00 $146.00 $97.36 $97.36

004259 TSH 84443 Y Y Y $76.25 $26.69 $2.97 $2.97

349829 TSH Rfx on Abnormal to Free T4 84443 Y N Y $76.25 $26.69 $2.97 $2.97

224576 TSH+Free T4 84439, 84443 Y Y Y $158.75 $55.56 $7.51 $7.51

332215 TSH+Prl+FSH+LH+DHEA-S+hCG Q...

84443, 84702, 83001, 83002,

84146, 83498, 82627, 82670 Y N N $723.00 $723.00 $723.00

164640 t-Transglutaminase (tTG) IgA 83516 Y Y N $110.00 $110.00 $27.72 $27.72

164988 t-Transglutaminase (tTG) IgG 83516 Y Y N $98.50 $98.50 $98.50

377200 UA/M w/rflx Culture, Comp 81001 Y Y Y $26.00 $9.10 $9.10

377036 UA/M w/rflx Culture, Routine 81001 Y Y Y $26.00 $9.10 $2.65 $2.65

Page 50 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

008342 Upper Respiratory Culture 87070 Y Y N $65.25 $65.25 $8.87 $8.87

317222 UREA and Creatinine, 24-Hr Ur 82570, 84540 Y Y Y $66.75 $23.36 $5.56 $5.56

002329 Urea Nitrogen Clearance 84545 Y Y Y $57.75 $20.21 $20.21

086884 Ureaplasma/Mycoplasma hominis 87109 Y Y N $122.75 $122.75 $122.75

030452 Uric A+ANA+CRP+RF Qn 86038, 86140, 86431, 84550 Y N Y $182.00 $63.70 $14.68 $14.68

097279 Uric A+ANA+RA Qn+CRP+ASO

86038, 86060, 86140, 86431,

84550 Y N Y $223.50 $78.23 $19.10 $19.10

045120 Uric A+ESR-Wes+ANA+RA Qn+CR...

85652, 86038, 86060, 86140,

86431, 84550 Y N Y $248.25 $86.89 $20.94 $20.94

043083 Uric A+RA Qn+CRP+ASO 86060, 86140, 86431, 84550 N N Y $154.25 $53.99 $14.93 $14.93

003418 Uric Acid, 24 hr Urine 84560 Y Y Y $29.25 $10.24 $2.44 $2.44

001057 Uric Acid, Serum 84550 Y Y Y $27.00 $9.45 $1.75 $1.75

012898 Uric Acid, Urine 84560 Y N Y $29.25 $10.24 $10.24

003921 Urinalysis (No Micro) Waived 81002 Y N Y $20.00 $7.00 $7.00

003772 Urinalysis, Complete 81001 Y Y Y $26.00 $9.10 $2.65 $2.65

003038 Urinalysis, Routine 81003 Y Y Y $21.50 $7.53 $2.10 $2.10

008087 Urine Culture, Comprehensive 87086 Y N N $82.50 $82.50 $82.50

008847 Urine Culture, Routine 87086 Y Y N $60.00 $60.00 $5.99 $5.99

008848 Urine Culture, Routine 87086 Y N N $60.00 $60.00 $5.99 $5.99

008086 Urine Culture,Comprehensive 87086 Y Y N $82.50 $82.50 $16.63 $16.63

009068 Urine Cytology 88112 Y Y N $133.00 $133.00 $55.42 $55.42

182493 Vaginal Yeast Culture 87102 Y Y N $69.00 $69.00 $69.00

180026 Vaginitis/Vaginosis, DNA Probe 87480, 87510, 87660 N Y N $275.75 $275.75 $94.28 $94.28

007260 Valproic Acid (Depakote)(R),S 80164 Y Y Y $98.25 $34.39 $3.60 $3.60

706499 Valproic Acid (Total+Free) 80164, 80165 Y N N $217.00 $217.00 $33.26 $33.26

070327 Vancomycin Peak, Serum 80202 N Y Y $92.00 $32.20 $9.97 $9.97

070326 Vancomycin Random, Serum 80202 N N Y $92.00 $32.20 $12.25 $12.25

070328 Vancomycin Trough, Serum 80202 Y Y Y $92.00 $32.20 $9.97 $9.97

182360 Vancomycin-Resist Enterococcus 87081 Y Y N $42.00 $42.00 $9.71 $9.71

004143 Vanillylmandelic Acid, 24-Hr U 84585 N Y N $75.25 $75.25 $13.30 $13.30

804500 VAP Cholesterol Profile 84478, 83701 Y N N $204.50 $204.50 $43.22 $43.22

235945 Varicella Zoster Abs, IgG/IgM 86787 (x2) Y N N $167.50 $167.50 $10.75 $10.75

096776 Varicella-Zoster Ab, IgM 86787 Y Y N $93.50 $93.50 $6.66 $6.66

096206 Varicella-Zoster V Ab, IgG 86787 Y Y N $74.00 $74.00 $4.09 $4.09

006445 VDRL, CSF 86592 N Y N $53.25 $53.25 $19.05 $19.05

805904 Venom European Hornet IgE 86003 N N N $48.50 $48.50 $43.45 $43.45

186239 Viral Cul, Rapid Flu Rfx H1N1 87254 (x2) N Y N $129.00 $129.00 $38.80 $38.80

008573 Viral Culture, General 87252 Y Y N $239.00 $239.00 $50.99 $50.99

186023 Viral Culture,Rapid,Influenza 87254 (x2) Y Y N $129.00 $129.00 $38.80 $38.80

186056 Viral Culture,Rapid,Lesion 87254, 87255 Y Y N $289.75 $289.75 $55.42 $55.42

185009 Virus, Varicella Zoster Ag,DFA 87290 N Y N $97.00 $97.00 $24.40 $24.40

004861 Viscosity, Serum 85810 N Y N $72.50 $72.50 $26.04 $26.04

144006 Vitamin A and E 84446, 84590 Y Y N $174.50 $174.50 $23.93 $23.93

144014 Vitamin A, E, Beta Carotene 82380, 84446, 84590 N Y N $262.25 $262.25 $55.44 $55.44

017509 Vitamin A, Serum 84590 Y Y N $91.50 $91.50 $13.13 $13.13

Page 51 of 144

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Net Fee Schedule

LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

Period: September 1, 2015 through August 31, 2017

LabCorp

Test

Number LabCorp Test Name Comments 2015 CPT Code**

RFP

Test

Directory

of Services

Test

ATB

Discountable

Test

2015 Book

Price

2015 Book

Price Less

65% ATB

Special

Price Net Fee

**Please Note Disclaimer: CPT codes are provided here for your convenience; however, correct coding often varies from one carrier to another. Consequently, the AMA CPT* manual codes presented here are intended as general

guidelines and should not be used without confirming with the applicable payor that their use is appropriate in each case.

121186 Vitamin B1 (Thiamine), Blood 84425 Y Y N $98.25 $98.25 $18.02 $18.02

121178 Vitamin B1 (Thiamine), Plasma Test Not Coded Y N N $98.25 $98.25 $18.02 $18.02

001503 Vitamin B12 82607 Y Y Y $87.00 $30.45 $5.43 $5.43

000810 Vitamin B12 and Folate 82607, 82746 Y Y Y $157.75 $55.21 $10.87 $10.87

123220 Vitamin B2, Whole Blood 84252 N Y N $174.50 $174.50 $62.65 $62.65

070115 Vitamin B3 (Niacin+Metabolite) 84591 Y Y N $310.00 $310.00 $310.00

004655 Vitamin B6, Plasma 84207 Y Y N $158.50 $158.50 $27.72 $27.72

001479 Vitamin C 82180 Y Y N $75.75 $75.75 $16.63 $16.63

500116 Vitamin D 25-Hydroxy, D2 + D3 82306 Y N N $294.00 $294.00 $104.69 $104.69

081950 Vitamin D, 25-Hydroxy 82306 Y Y N $192.75 $192.75 $19.41 $19.41

081000 Vitamin E, Serum 84446 N Y N $83.00 $83.00 $10.80 $10.80

121200 Vitamin K1 84597 N Y N $183.75 $183.75 $22.55 $22.55

123208 VMA, Random Urine 82570, 84585 N Y N $110.75 $110.75 $39.71 $39.71

007062 Volatiles, Blood 80320 Y Y N $86.25 $86.25 $86.25

084715 von Willebrand Profile 85240, 85245, 85246 Y Y N $535.00 $535.00 $232.80 $232.80

384715 von Willebrand Profile Test Not Coded N N N $535.00 $535.00 $232.80 $232.80

138313 VZV Real Time PCR 87798 Y Y N $402.50 $402.50 $402.50

602463 W001-IgE Ragweed, Short 86003 Y Y N $24.25 $24.25 $24.25

602966 W005-IgE Wormwood 86003 N Y N $24.25 $24.25 $4.45 $4.45

602531 W006-IgE Mugwort 86003 Y Y N $24.25 $24.25 $24.25

602536 W009-IgE Plantain, English 86003 N Y N $24.25 $24.25 $4.45 $4.45

602537 W010-IgE Lamb's Quarter 86003 N Y N $24.25 $24.25 $4.45 $4.45

602970 W013-IgE Cocklebur 86003 N Y N $24.25 $24.25 $4.45 $4.45

602484 W014-IgE Pigweed, Rough 86003 N Y N $24.25 $24.25 $4.45 $4.45

602542 W018-IgE Sheep Sorrel 86003 N Y N $24.25 $24.25 $4.45 $4.45

180828 Water Culture Test Not Coded N N N $42.50 $42.50 $15.19 $15.19

005025 WBC 85048 Y Y Y $24.50 $8.58 $2.22 $2.22

138842 West Nile Virus Antibody,Serum 86788, 86789 Y Y N $144.25 $144.25 $144.25

162040 Western Equine Enceph Ab, IgG 86654 N N N $94.50 $94.50 $34.37 $34.37

180901 Wet Prep 87210 Y Y N $40.75 $40.75 $40.75

008656 White Blood Cells (WBC), Stool 89055 Y Y N $48.75 $48.75 $8.31 $8.31

182776 Yeast Only, Culture 87101 Y Y N $81.00 $81.00 $26.90 $26.90

001800 Zinc, Plasma or Serum 84630 Y Y N $74.00 $74.00 $5.54 $5.54

070032 Zinc, Whole Blood 84630 N Y N $92.50 $92.50 $36.64 $36.64

847525 Ziprasidone (Geodon,Zeldox) 80342 N N N $153.00 $153.00 $99.77 $99.77

074000 Zolpidem (Ambien), Urine 80302 N N N $140.75 $140.75 $41.00 $41.00

007915 Zonisamide(Zonegran), Serum 80203 N Y N $102.25 $102.25 $50.99 $50.99

Page 52 of 144

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Test # Test Name Draw / Stat

099812 Drawing Fee ***

099895 Stat Fee ***

270466 Stat Service ***

900414 STAT Fee ***

990895 STAT Fee ***

996660 Drawing Fee ***

998074 STAT ***

998085 Venipuncture ***

998120 Courier Charge ***

998205 Vendor Phlebotomy Fee ***

998492 STAT Fee ***

998591 STAT Charge ***

000273 CMP12+6AC #N/A

000455 Thyroid Panel #N/A

000505 HFP7+3AC #N/A

000604 Cl+K+Na #N/A

000620 Thyroid Panel With TSH #N/A

000703 Renin Activity and Aldosterone #N/A

000810 Vitamin B12 and Folate #N/A

001016 Calcium, Serum #N/A

001024 Phosphorus, Serum #N/A

001032 Glucose, Serum #N/A

001040 BUN #N/A

001057 Uric Acid, Serum #N/A

001065 Cholesterol, Total #N/A

001073 Protein, Total, Serum #N/A

001081 Albumin, Serum #N/A

001099 Bilirubin, Total #N/A

001107 Alkaline Phosphatase, S #N/A

001115 LDH #N/A

001123 AST (SGOT) #N/A

001149 Thyroxine (T4) #N/A

001156 T3 Uptake #N/A

001172 Triglycerides #N/A

001180 Potassium, Serum #N/A

001198 Sodium, Serum #N/A

001206 Chloride, Serum #N/A

001214 Bilirubin, Total/Direct, Serum #N/A

001222 Bilirubin, Direct #N/A

001255 Glucose Fasting and 2hr #N/A

001321 Iron and TIBC #N/A

001339 Iron, Serum #N/A

001354 Fecal Fat, Quantitative #N/A

001362 Creatine Kinase,Total,Serum #N/A

001370 Creatinine, Serum #N/A

001396 Amylase, Serum #N/A

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001404 Lipase, Serum #N/A

001453 Hemoglobin A1c #N/A

001479 Vitamin C #N/A

001487 Protein Electro.,S #N/A

001495 IFE and PE, Serum #N/A

001496 Immunofixation Reflex, Serum #N/A

001503 Vitamin B12 #N/A

001529 Carotene, Beta #N/A

001537 Magnesium, Serum #N/A

001545 ALT (SGPT) #N/A

001560 Ceruloplasmin #N/A

001578 Carbon Dioxide, Total #N/A

001586 Copper, Serum #N/A

001594 Cryoglobulin, Ql, Serum, Rflx #N/A

001610 Fibrinogen Activity #N/A

001612 Alk Phos Isoenzyme #N/A

001628 Haptoglobin #N/A

001677 Fecal Fat, Qualitative #N/A

001685 Immunofixation, Serum #N/A

001693 Glycohemoglobin (GHb),Total #N/A

001701 5' Nucleotidase #N/A

001727 Phospholipids, Serum #N/A

001735 Thyroxine Binding Globulin #N/A

001768 Immunoglobulins A/G/M, Qn, Ser #N/A

001776 Immunoglobulin G, Qn, Serum #N/A

001784 Immunoglobulin A, Qn, Serum #N/A

001792 Immunoglobulin M, Qn, Serum #N/A

001800 Zinc, Plasma or Serum #N/A

001818 Glucose, Plasma #N/A

001834 Complement C4, Serum #N/A

001842 LD Isoenzymes #N/A

001859 CK+LD, Totals+Isoenzymes #N/A

001909 Alb+Prot #N/A

001917 G-6-PD, Quant, Blood and RBC #N/A

001925 HDL Cholesterol #N/A

001941 Complement, Total (CH50) #N/A

001958 GGT #N/A

001966 Leukocyte Alkaline Phos Score #N/A

001974 Thyroxine (T4) Free, Direct, S #N/A

001976 Thyroxine (T4) Free, Direct, S #N/A

001977 Thyroxine (T4) Free, Direct, S #N/A

001982 Alpha-1-Antitrypsin, Serum #N/A

002014 Folate (Folic Acid), Serum #N/A

002022 Glucose, Two-Hour Postprandial #N/A

002030 Aldolase #N/A

002071 Osmolality #N/A

002139 CEA #N/A

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002154 CK, Total+Isoenzymes, Serum #N/A

002170 Immunoglobulin E, Total #N/A

002188 Triiodothyronine (T3) #N/A

002253 AFP, Serum, Tumor Marker #N/A

002261 CA 19-9 #N/A

002295 Immunoglobulins A/E/G/M, Serum #N/A

002303 Cancer Antigen (CA) 125 #N/A

002311 Creatine Kinase (CK), MB/Total #N/A

002329 Urea Nitrogen Clearance #N/A

002402 Creatine, Serum #N/A

002626 HFP7+3AC #N/A

003004 Creatinine Clearance #N/A

003012 Creatinine, 24-Hour Urine #N/A

003038 Urinalysis, Routine #N/A

003053 Porphobilinogen, Qn, Random Ur #N/A

003079 Myoglobin, Urine #N/A

003103 Porphobilinogen, Qn, 24-Hr Ur #N/A

003129 Prot+CreatU (Random) #N/A

003160 Chloride, 24 hr Urine #N/A

003178 Sodium, 24 hr Urine #N/A

003186 Potassium, 24 hr Urine #N/A

003194 Porphyrins, Qn, 24 Hr Ur. #N/A

003228 Bile, Qualitative, Urine #N/A

003251 Phosphorus, 24 hr Urine #N/A

003269 Calcium, 24Hr Urine #N/A

003277 Protein Total, Qn, 24-Hr Urine #N/A

003293 Amylase, Urine #N/A

003343 Copper, Urine #N/A

003368 Protein Electro, 24-Hour Urine #N/A

003376 Glucose, Quantitative, Urine #N/A

003400 Magnesium, Urine #N/A

003418 Uric Acid, 24 hr Urine #N/A

003442 Osmolality, Urine #N/A

003467 IFE+Protein Electro, 24-Hr Ur #N/A

003475 Creatine, 24-Hour Urine #N/A

003715 PE(Rfx IFE), Random Ur #N/A

003772 Urinalysis, Complete #N/A

003855 Creatine+Creatinine, 24-Hr Ur #N/A

003921 Urinalysis (No Micro) Waived #N/A

003970 Oxalate, Quant, 24-Hour Urine #N/A

004020 DHEA-Sulfate #N/A

004036 Pregnancy Test, Urine #N/A

004044 Metanephrines, Pheochromocyt #N/A

004051 Cortisol #N/A

004069 5-HIAA,Quant.,24 Hr Urine #N/A

004100 DHEA, Serum #N/A

004143 Vanillylmandelic Acid, 24-Hr U #N/A

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004176 Catecholamines,Ur.,Free,24 Hr #N/A

004226 Testosterone, Serum #N/A

004234 Metanephrines, Frac, Qn, 24-Hr #N/A

004259 TSH #N/A

004275 Growth Hormone, Serum #N/A

004280 Tryptase #N/A

004283 Luteinizing Hormone(LH), S #N/A

004291 Aldosterone, Urine #N/A

004309 FSH, Serum #N/A

004317 Progesterone #N/A

004333 Insulin #N/A

004354 Aldosterone/Renin Ratio #N/A

004374 Aldosterone LCMS, Serum #N/A

004390 Gastrin, Serum #N/A

004416 hCG,Beta Subunit, Qnt, Serum #N/A

004432 Cortisol, Urinary Free #N/A

004440 ACTH, Plasma #N/A

004465 Prolactin #N/A

004515 Estradiol #N/A

004549 Estrogens, Total #N/A

004556 hCG,Beta Subunit,Qual,Serum #N/A

004598 Ferritin, Serum #N/A

004655 Vitamin B6, Plasma #N/A

004747 Prostatic Acid Phos, Serum #N/A

004770 Lactic Acid, Plasma #N/A

004804 Calcium, Ionized, Serum #N/A

004861 Viscosity, Serum #N/A

004887 Ketone Bodies, Serum #N/A

004895 Calcitonin, Serum #N/A

004937 Transferrin #N/A

004945 Ca+Creat+P+PTH Intact #N/A

005009 CBC With Differential/Platelet #N/A

005017 CBC, No Differential/Platelet #N/A

005025 WBC #N/A

005033 RBC #N/A

005041 Hemoglobin #N/A

005058 Hematocrit #N/A

005090 Differential WBC Count #N/A

005199 Prothrombin Time (PT) #N/A

005207 PTT, Activated #N/A

005215 Sedimentation Rate-Westergren #N/A

005223 Hgb Solubility #N/A

005231 Cell Ct, Synovial w/Crystals #N/A

005249 Platelet Count #N/A

005256 Cell Count, CSF #N/A

005280 Reticulocyte Count #N/A

005298 Eosinophil Count #N/A

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005300 Hematopath Consultation, Smear #N/A

005330 HB Solu + Rflx Frac #N/A

005355 Crystal,Synovial/Joint Fl #N/A

005595 Hemoglobin, Free, Plasma #N/A

005702 Blood Drawing #N/A

006015 Antibody Screen #N/A

006023 Antibody Identification #N/A

006031 Antistreptolysin O Ab #N/A

006049 ABO Grouping and Rho(D) Typing #N/A

006056 ABO Grouping #N/A

006064 Rh Factor #N/A

006072 RPR #N/A

006099 RPR #N/A

006189 Mononucleosis Test, Qual #N/A

006197 Rubella Antibodies, IgG #N/A

006213 Antibody Identification #N/A

006270 Coombs', Direct #N/A

006338 Antiextractable Nuclear Ag #N/A

006353 Cold Agglutinin Titer, Quant #N/A

006379 T pallidum Ab (FTA-Ab) #N/A

006395 Hep B Surface Ab #N/A

006445 VDRL, CSF #N/A

006452 Complement C3, Serum #N/A

006460 Rapid Plasma Reagin, Quant #N/A

006478 Toxoplasma gondii Ab, IgG, Qn #N/A

006486 Antiparietal Cell Antibody #N/A

006494 Cytomegalovirus (CMV) Ab, IgG #N/A

006502 Rheumatoid Arthritis Factor #N/A

006510 HBsAg Screen #N/A

006530 Hepatitis B Surf Ab Quant #N/A

006536 Mono Qual W/Rflx Qn #N/A

006551 Cryptococcus Antigen, Serum #N/A

006553 Cryptococcus Ag Titer #N/A

006619 Hep Be Ag #N/A

006627 C-Reactive Protein, Quant #N/A

006635 Hep Be Ab #N/A

006643 Actin (Smooth Muscle) Antibody #N/A

006650 Mitochondrial (M2) Antibody #N/A

006676 Thyroid Peroxidase (TPO) Ab #N/A

006684 Thyroid Antibodies #N/A

006692 Antithyroglobulin Ab #N/A

006694 Thyroglobulin, Serum #N/A

006718 Hep B Core Ab, Tot #N/A

006726 Hep A Ab, Total #N/A

006734 Hep A Ab, IgM #N/A

006841 Mucin Clot,Synovial Fl #N/A

006866 Rotavirus Ag, EIA #N/A

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006890 Bacterial Antigens #N/A

006924 HLA B 27 Disease Association #N/A

006926 HLA B5701 Test #N/A

006981 Autoimmune Profile #N/A

007012 Lacosamide #N/A

007034 Drug Screen (Blood or Serum) #N/A

007054 Ammonia, Plasma #N/A

007062 Volatiles, Blood #N/A

007153 Tobramycin Random, Serum #N/A

007161 Gentamicin Random, Serum #N/A

007162 Gentamicin Peak, Serum #N/A

007163 Gentamicin Trough, Serum #N/A

007183 Cyclosporine IA/IA Rebaseline #N/A

007187 Carbon Monoxide, Blood #N/A

007237 Ethanol, Urine #N/A

007260 Valproic Acid (Depakote)(R),S #N/A

007286 Cholinesterase, RBC #N/A

007336 Theophylline, Serum #N/A

007351 ALA Delta, Random Urine #N/A

007385 Digoxin, Serum #N/A

007393 Nortriptyline (Aventyl), Serum #N/A

007401 Phenytoin (Dilantin), Serum #N/A

007419 Carbamazepine(Tegretol), S #N/A

007468 Imipramine (Tofranil), Serum #N/A

007476 Amitriptyline (Elavil), Serum #N/A

007492 Heavy Metals Profile, Urine #N/A

007609 Doxepin (Sinequan), Serum #N/A

007625 Lead, Blood (Adult) #N/A

007629 Lead, Blood #N/A

007690 Tricyclic Antidepressants #N/A

007708 Lithium (Eskalith(R)), Serum #N/A

007740 Acetaminophen (Tylenol), S #N/A

007765 Desipramine, Serum #N/A

007773 Mercury, Urine #N/A

007781 Methadone (Dolophine), Serum #N/A

007823 Phenobarbital, Serum #N/A

007849 Salicylate, Serum #N/A

007856 Primidone (Mysoline(R)), Serum #N/A

007915 Zonisamide(Zonegran), Serum #N/A

007930 Clorazepate (Tranxene), Serum #N/A

007989 Diazepam (Valium), Serum #N/A

008003 Anaerobic and Aerobic Culture #N/A

008086 Urine Culture,Comprehensive #N/A

008087 Urine Culture, Comprehensive #N/A

008128 GC Culture Only #N/A

008136 Fungus Stain #N/A

008144 Stool Culture #N/A

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008169 Beta Strep Gp A Culture #N/A

008185 Parasite Exam, Blood #N/A

008201 Cytomegalovirus (CMV) Culture #N/A

008250 HSV Culture and Typing #N/A

008300 Blood Culture, Routine #N/A

008334 Genital Culture, Routine #N/A

008342 Upper Respiratory Culture #N/A

008458 Reference Bacterial Culture ID #N/A

008482 Fungus (Mycology) Culture #N/A

008540 Gram Stain #N/A

008557 Environmental Culture #N/A

008565 Chlamydia trachomatis Culture #N/A

008573 Viral Culture, General #N/A

008623 Ova + Parasite Exam #N/A

008629 Ova + Parasite Exam, Urine #N/A

008631 Pinworm Prep - Enterobius #N/A

008649 Aerobic Bacterial Culture #N/A

008656 White Blood Cells (WBC), Stool #N/A

008664 Organism ID, Bacteria #N/A

008680 Susceptibility, Aer + Anaerob #N/A

008847 Urine Culture, Routine #N/A

008848 Urine Culture, Routine #N/A

008900 Anaerobic Cult, Extend Incubat #N/A

008904 Anaerobic Culture #N/A

009001 Fine-Needle Aspiration #N/A

009068 Urine Cytology #N/A

009076 Sputum Cytology #N/A

009100 Pap Smear, 1 Slide #N/A

009126 Miscellaneous Smear Cytology #N/A

009134 Breast Discharge Cytology #N/A

009159 Miscellaneous Fluid Cytology #N/A

009160 Anal(Rectal) Cytology, LBP #N/A

009191 Pap Smear, 2 Slide #N/A

009209 Pap Smear, 1 sld w Mat Indx #N/A

010108 C-Peptide, Serum #N/A

010116 Angiotensin-Converting Enzyme #N/A

010165 Protoporphyrin, FEP/ZPP #N/A

010173 Beta-2 Microglobulin, Urine #N/A

010181 Beta-2 Microglobulin, Serum #N/A

010272 EBV Nuclear Antigen Ab, IgG #N/A

010280 EBV, Chronic/Active Infection #N/A

010314 Thyrotropin Receptor Ab, Serum #N/A

010322 Prostate-Specific Ag, Serum #N/A

010330 Bile Acids #N/A

010355 Trypsin #N/A

010363 IGF-1 #N/A

010389 Triiodothyronine,Free,Serum #N/A

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010390 T3Free #N/A

010405 Myoglobin, Serum #N/A

010413 Intrinsic Factor Abs, Serum #N/A

010447 ADH #N/A

010540 IGF-1 with Z-Score #N/A

010777 Enterovirus Antibodies Profile #N/A

010801 AFP, Serum, Open Spina Bifida #N/A

011254 pH, Body Fluid #N/A

012005 RPR, Rfx Qn RPR/Confirm TP #N/A

012021 RPR Qn+TP Abs #N/A

012518 Antihistone Antibodies #N/A

012580 Antichromatin Antibodies #N/A

012708 Sjogren's Ab, Anti-SS-A/-SS-B #N/A

012898 Uric Acid, Urine #N/A

013037 pH, Urine #N/A

013326 Sodium, Urine #N/A

013334 Potassium, Urine #N/A

013656 Chloride, Urine #N/A

013664 Protein,Total,Urine #N/A

013672 Creatinine, Urine #N/A

013706 Calcium, Random Urine #N/A

014086 Platelet Antibody, Serum #N/A

014102 Platelet Autoantibody Panel #N/A

015040 Antithrombin Activity #N/A

015173 Differential/Total WBC Count #N/A

015271 Lyme IgG/IgM Ab #N/A

015594 Antithrombin III, Func/Immunol #N/A

015610 PTH, Intact #N/A

016022 Cryptococcus Ag Titer #N/A

016123 ENA+DNA/DS+Sjorgen's #N/A

016360 Smith Antibodies #N/A

016370 RPR Titer+TP Abs Reflex #N/A

016592 Rocky Mtn Spotted Fev, IgG, Qn #N/A

016667 Rocky Mtn Spotted Fever, IgM #N/A

016865 Citric Acid (Citrate), Urine #N/A

016881 Hep B Core Ab, IgM #N/A

016931 Prealbumin #N/A

017319 AFP Tetra #N/A

017422 Add On: hCG,uE3,Inhibin #N/A

017500 First Trimester Screen w/NT #N/A

017509 Vitamin A, Serum #N/A

017996 Ethanol, Blood #N/A

018705 Antiscleroderma-70 Antibodies #N/A

018788 Streptococcus pneumoniae Ag #N/A

019497 Glucose, Body Fluid #N/A

019588 Protein, Body Fluid #N/A

020313 CMP12+5AC #N/A

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020321 PT and PTT #N/A

021550 CMP12+7AC #N/A

023051 CMP12+6AC #N/A

024026 T4 and TSH #N/A

024141 ANA+RA Qn #N/A

024778 BUN+Creat #N/A

025239 Glu+Hb A1c #N/A

027011 Thyroid Profile II #N/A

027094 Amy+Lipase #N/A

027623 CMP12+LP+6AC #N/A

028142 CBC, Platelet, No Differential #N/A

028480 FSH and LH #N/A

028498 Cortisol (3 Specimens) #N/A

028928 Hepatitis A (Prof V) #N/A

030387 Prenatal Panel I/without HBsAg #N/A

030452 Uric A+ANA+CRP+RF Qn #N/A

030577 Anemia Profile A #N/A

030601 CMP12+5AC #N/A

030825 Fe+TIBC+Fer #N/A

030932 CMP12+LP+6AC+CBC/D/Plt #N/A

031088 Hgb+Hct #N/A

031138 Amenorrhea Profile #N/A

032268 CMP12+LP+TP+TSH+6AC #N/A

033852 C4+C3 #N/A

033969 LP without VLDL+Chol/HDL+CH... #N/A

035774 HBsAb+Ag #N/A

037184 HBcAb+HBsAb+Ag #N/A

038091 Fe+TIBC+Fer+B12+Folic #N/A

038109 Prenat Infect Dis Ab, IgG, Qn #N/A

038120 Prenat Infect Dis Ab, IgG, Qn #N/A

038158 Lead Standard Profile, Blood #N/A

042077 Anemia Profile B #N/A

042100 Thyroglobulin with Anti-TG Ab #N/A

042580 Heavy Metals Profile I, Blood #N/A

043083 Uric A+RA Qn+CRP+ASO #N/A

045120 Uric A+ESR-Wes+ANA+RA Qn+CR... #N/A

045849 Hepatitis Pt Mgmnt (Prof III) #N/A

046300 Lactose Tolerance Test #N/A

046557 Antidiuretic Hormone Profile #N/A

048827 CMP12+LP+TP+TSH+6AC+CBC/D/Plt #N/A

052019 Chromosome, Blood, Routine #N/A

052373 Scleroderma Diagnostic Profile #N/A

054130 Glucose/Insulin Resp (5 Spec) #N/A

054601 Ca+PTH Intact #N/A

054619 LUPUS PROFILE #N/A

056499 Systemic Lupus Profile A #N/A

058008 Rh-hr Genotype w/ABO Grouping #N/A

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058099 Calcium+Calcium, Ionized #N/A

058495 Measles/Mumps/Rubella Immunity #N/A

058503 Respiratory Infection Prof A #N/A

058537 HAV/HBV Immune Status (Pro IV) #N/A

058545 Hepatitis B Virus (Profile VI) #N/A

058552 HAV/HBV (Profile VII) #N/A

058560 Hepatitis, Diagnostic (Prof I) #N/A

058867 CMP12+8AC #N/A

062448 Allergen Profile, Mold #N/A

062463 Seasonal Allrgns, Fall--Weed #N/A

062471 Seasonal Allrgns, Summer-Grass #N/A

062695 Allergen Profile, Shellfish #N/A

067108 C001-IgE Penicillin G #N/A

067116 C002-IgE Penicillin V #N/A

067710 Hymenoptera Profile #N/A

070001 Testosterone, Serum, LC/MS/MS #N/A

070032 Zinc, Whole Blood #N/A

070034 Iodine, Serum or Plasma #N/A

070038 Testosterone, F Eqlib+T LC/MS #N/A

070085 17-OH Progesterone LCMS #N/A

070104 Reverse T3, Serum #N/A

070115 Vitamin B3 (Niacin+Metabolite) #N/A

070195 Testosterone, Free+Total LC/MS #N/A

070282 Testosterone,Free+Weakly Bound #N/A

070326 Vancomycin Random, Serum #N/A

070327 Vancomycin Peak, Serum #N/A

070328 Vancomycin Trough, Serum #N/A

070340 17-OH P/Creat Ratio, Urine #N/A

070409 Cannabinoid/Creatinine Ratio #N/A

070466 Chain-of-Custody Protocol #N/A

070482 Haloperidol (Haldol(R)) Serum #N/A

070706 Phenytoin,Free and Total,Serum #N/A

070748 Carbamazepine, Free, Serum #N/A

070763 Phenytoin, Free, Serum #N/A

070789 Free Valproic Acid (Depakote) #N/A

071159 LSD, Urine #N/A

071175 071175 7 Drug-Unb #N/A

071282 Amphetamine Confirmation, Ur #N/A

071290 Barbiturate Confirmation, Ur #N/A

071308 Benzodiazepine Confirmation,Ur #N/A

071316 Cannabinoid Confirmation, Ur #N/A

071318 MDMA Confirmation #N/A

071324 Cocaine Metabolite Confirm,Ur #N/A

071456 Opiate Confirmation, Urine #N/A

071464 Phencyclidine, Confirm, Urine #N/A

071522 Chromium, Plasma #N/A

071526 Hydrocodone and Metabolite #N/A

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071532 Morphine #N/A

071538 Oxycodone and Metabolite #N/A

071548 Aluminum, Plasma/Serum #N/A

071555 Aluminum, Urine #N/A

071688 Trazodone, Serum #N/A

071712 Clonazepam (Klonopin(R)),Serum #N/A

071910 071910 7 Drug-Scr #N/A

072132 Chlorpromazine, Serum #N/A

072306 072306 7+Alc-Scr #N/A

074000 Zolpidem (Ambien), Urine #N/A

074021 074021 9 Drug-Scr #N/A

074401 Amphetamine Screen, Urine #N/A

074419 Barbiturate Screen, Urine #N/A

074427 Benzodiazepine Screen, Urine #N/A

074435 Cannabinoid, Qual, Urine #N/A

074567 Propoxyphene Confirmation, Ur #N/A

080176 Hemoglobin, Free, Qual, Urine #N/A

080465 Protein C Antigen #N/A

080713 Lysozyme, Serum #N/A

081000 Vitamin E, Serum #N/A

081091 Calcitriol(1,25 di-OH Vit D) #N/A

081786 Testosterone, Free/Tot Equilib #N/A

081893 Fatty Acids, Free (Nonester) #N/A

081950 Vitamin D, 25-Hydroxy #N/A

082024 Antiadrenal Antibodies, Quant #N/A

082345 T pallidum Screening Cascade #N/A

082370 Treponema pallidum Antibodies #N/A

082553 Allyl Alcohol, Blood #N/A

082891 Cryptococcus Antibodies, Quant #N/A

083824 Panel 083824 #N/A

083850 Panel 083850 #N/A

083860 HIV 1/2 Ab Differentiation #N/A

083870 Panel 083870 #N/A

083885 Rabies Neut.Abs Titrat.(RFFIT) #N/A

083904 Panel 083904 #N/A

083935 Panel 083935 #N/A

083940 HIV 1/2 Ab Differentiation #N/A

083950 RNA Qualitative #N/A

083955 Panel 083955 #N/A

083988 HIV 1/2 Supplemental Ab Test #N/A

083989 Panel 083989 #N/A

084152 Catecholamines, Plasma #N/A

084715 von Willebrand Profile #N/A

085902 AChR Binding Abs, Serum #N/A

085910 Antimyocardial Antibodies, Qn #N/A

086007 Acetylcholine Receptor Ab, All #N/A

086122 Myasthenia Gravis Panel III #N/A

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086207 C difficile Toxins A+B, EIA #N/A

086249 Factor V Activity #N/A

086264 Factor VIII Activity #N/A

086330 Factor XIII #N/A

086884 Ureaplasma/Mycoplasma hominis #N/A

088161 AFB Antibiotic Suscep #N/A

090365 Glucose Tolerance (4 Sp Blood) #N/A

090373 Glucose Tolerance (5 Sp Blood) #N/A

091108 HBV Follow-Up (Profile XII) #N/A

091454 Fungal Antibodies, Quant #N/A

095588 Glucose Tolerance (3 Sp Blood) #N/A

096180 Chlamydia Antibodies, IgG #N/A

096206 Varicella-Zoster V Ab, IgG #N/A

096230 EBV Ab VCA, IgG #N/A

096248 EBV Early Antigen Ab, IgG #N/A

096289 Anti-DNase B Strep Antibodies #N/A

096339 Anti-dsDNA Antibodies #N/A

096354 ALA Delta, 24-Hour Urine #N/A

096487 Influenza A/B Ab, Quant #N/A

096537 Rubella Antibodies, IgM #N/A

096552 Mumps Antibodies, IgG #N/A

096560 Rubeola Antibodies, IgG #N/A

096651 Toxoplasma gondii Ab,IgM,Qn #N/A

096669 Poliovirus Antibodies #N/A

096727 Cytomegalovirus (CMV) Ab, IgM #N/A

096735 EBV Ab VCA, IgM #N/A

096776 Varicella-Zoster Ab, IgM #N/A

096834 T-Lymphocyte CD3 Cells #N/A

096917 T + B-Lymphocyte Differential #N/A

096925 T-Lymphocyte Helper/Suppressor #N/A

097279 Uric A+ANA+RA Qn+CRP+ASO #N/A

098418 HBV Core Ab, IgG/IgM Diff #N/A

100156 LD, Body Fluid #N/A

100768 Glom Filt Rate, Estimated #N/A

100800 Fructosamine #N/A

101000 Gestational 2 hour GTT #N/A

101200 Glucose (2 Spec, WHO) Toler,S #N/A

102004 Gestational Glucose Tolerance #N/A

102053 Gestational Glucose (X3) #N/A

102087 Glucose Hemocue Waived #N/A

102277 Gest. Diabetes 1-Hr Screen #N/A

102525 Hgb A1c with eAG Estimation #N/A

104000 Cortisol, AM/PM #N/A

104018 Cortisol - AM #N/A

104026 Cortisol - PM #N/A

112185 Arterial Blood Gas #N/A

114041 Ab Scr+Antibody ID #N/A

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115055 Eosinophil, Urine #N/A

115188 D-Dimer #N/A

115300 CBC+Platelet+Hem Review #N/A

115345 Platelet Count on Citrated Bld #N/A

115402 FDP, Plasma #N/A

115907 CBC/Differential (No Platelet) #N/A

116087 Total Neutrophil Count #N/A

117004 PTT-LA Mix #N/A

117008 Hexagonal Phase Phospholipid #N/A

117020 Hexagonal Phase Phospholipid #N/A

117040 PTT-LA Mix #N/A

117054 Lupus Anticoagulant Comp #N/A

117101 Heparin Anti-Xa #N/A

117199 aPTT Mixing Studies #N/A

117705 Protein C-Functional #N/A

117726 Thrombotic Risk Profile II #N/A

117754 Protein S Panel #N/A

117762 Activated Protein C Resistance #N/A

117788 Prolonged PT #N/A

117796 Prolonged APTT #N/A

117887 Dilute Russell's Viper Venom #N/A

117892 Lupus Anticoagulant Reflex #N/A

117912 dRVVT Mix #N/A

117923 dRVVT Confirm #N/A

120089 Serotonin, Whole Blood #N/A

120188 Lipoprotein (a) #N/A

120204 Serotonin, Serum #N/A

120220 C1 Esterase Inhibitor, Func #N/A

120253 Homovanillic Acid, 24-Hr Urine #N/A

120256 IFE, PE and FLC, Serum #N/A

120295 LDL Cholesterol (Direct) #N/A

120691 Calculi, Urinary, with Photo #N/A

120766 C-Reactive Protein, Cardiac #N/A

120790 Calculi, Urinary #N/A

120816 Creatine Kinase (CK), MB #N/A

120832 Troponin I #N/A

120880 Hemoglobin Frac.w/o Solubility #N/A

120956 Cryoglobulin, Ql, Serum #N/A

120980 Porphyrins, Qn, Random U #N/A

121020 Hgb A2, Quant #N/A

121137 Free K+L Lt Chains,Qn,S #N/A

121155 Free K+L Lt Chains,Qn,S Serial #N/A

121178 Vitamin B1 (Thiamine), Plasma #N/A

121186 Vitamin B1 (Thiamine), Blood #N/A

121200 Vitamin K1 #N/A

121210 PE and FLC, Serum #N/A

121228 Free K+L Lt Chains,Qn,Ur #N/A

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121679 Hgb Frac. Profile #N/A

121806 Metanephrines, Frac., Pl. Free #N/A

122101 Hgb Frac. w/o Solubility #N/A

122390 IFE and PE, Random Urine #N/A

123014 C3d Immune Complexes #N/A

123016 Lactoferrin, Fecal, Quant. #N/A

123018 PE+Interp(Rfx IFE), 24-Hr U #N/A

123026 PE+Interp(Rfx IFE),S #N/A

123034 Immunofixation, Urine #N/A

123049 IgA, Subclasses (1-2) #N/A

123050 IgA, Subclass 1 #N/A

123055 PE+Interp(Rfx IFE+FLC), S #N/A

123208 VMA, Random Urine #N/A

123220 Vitamin B2, Whole Blood #N/A

123234 Pancreatic Elastase, Fecal #N/A

123255 Calprotectin, Fecal #N/A

123299 Norepinephrine, Plasma #N/A

123377 Myelin Basic Protein #N/A

123482 Lipoprotein Analysis, by NMR #N/A

123489 NMR LipoProf noLp+Graph #N/A

123638 NMR LipoProf wSubCls+Graph #N/A

123810 NMR LipoProf+Graph #N/A

123836 Lipid Cascade w Graph #N/A

126120 PTH, LIAB #N/A

130005 Creatinine, Urine, 12hr #N/A

130021 Protein, Urine 12-Hr #N/A

132209 Stone Analysis #N/A

138307 Norovirus, RT-PCR #N/A

138313 VZV Real Time PCR #N/A

138529 Human Herpes Virus Type 6 IgM #N/A

138537 Poliovirus Immune Status #N/A

138651 HSV 1/2 PCR #N/A

138658 Panel 138658 #N/A

138685 Lyme (B. burgdorferi) PCR #N/A

138741 DONOR ABO Group/Rho(D) Type #N/A

138820 DONOR HBsAg Confirmation #N/A

138842 West Nile Virus Antibody,Serum #N/A

138931 DONOR Panel 138931 Rflx to WB #N/A

138981 DONOR Panel 138981 WB #N/A

139149 CMV Quant DNA PCR (Plasma) #N/A

139350 RNA Qualitative #N/A

139450 RNA Qualitative #N/A

139730 Donor Panel 139730 #N/A

140045 Ovarian Malignancy Risk-ROMA #N/A

140050 Microalbumin, 24 hr Urine #N/A

140053 Microalbumin, Timed Urine #N/A

140080 Galectin-3 with BNP #N/A

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140103 Testosterone,Free and Total #N/A

140244 Estradiol, Sensitive #N/A

140277 Erythropoietin (EPO), Serum #N/A

140285 Microalb/Creat Ratio, Randm Ur #N/A

140293 CA 27.29 #N/A

140318 Thyroglobulin, Serum,(New) #N/A

140320 Thyroglobulin,Quant Rebaseline #N/A

140533 Proinsulin #N/A

140609 NGI HCV UltraQual #N/A

140612 NGI HCV SuperQuant #N/A

140622 NGI HBV UltraQual #N/A

140639 NGI HCV QuantaSure #N/A

140659 HCV Antibody #N/A

140674 PSA, Complexed #N/A

140707 Pregnenolone, MS #N/A

140723 PSA Ultra. W/Serial Monitor #N/A

140749 Thyroid Stim Immunoglobulin #N/A

140761 Cortisol, ACTH Stimulation #N/A

140810 NGI HBV SuperQuant #N/A

140822 IGF-BP1 #N/A

140848 Chromogranin A #N/A

140889 B-Type Natriuretic Peptide #N/A

141093 N-Telopeptide, Urine #N/A

141300 AFP with AFP-L3% #N/A

141598 Insulin Antibodies #N/A

141770 IGF-2 #N/A

142005 Galectin-3 with proBNP #N/A

143000 proBNP #N/A

143008 GAD-65 Autoantibody #N/A

143255 Testosterone,Free+Weakly Bound #N/A

143305 Soluble Transferrin Receptor #N/A

143404 Cancer Antigen (CA) 15-3 #N/A

144006 Vitamin A and E #N/A

144014 Vitamin A, E, Beta Carotene #N/A

144028 HCV reflex to Quant RT PCR #N/A

144045 HCV Antibody reflex to NAA #N/A

144065 HCV Ab w/Rflx to Verification #N/A

144075 HCV Ab Verification #N/A

144090 HCV Antibody Verification #N/A

144733 CA 125 in the Presence of HAMA #N/A

144980 Testosterone, Free, Direct #N/A

149997 Microalbumin, Random Urine #N/A

155002 Diff Slide Preparation #N/A

160014 ENA+DNA/DS+Antich+Centro+Jo... #N/A

160093 ENA+DNA/DS+SCL-70+SjoSSA+Sj... #N/A

160151 Anti-dsDNA Antibodies #N/A

160152 Smith Antibodies #N/A

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160153 Smith/RNP Antibodies #N/A

160154 Antichromatin Antibodies #N/A

160155 RNP Antibodies #N/A

160156 Sjogren's Anti-SS-A #N/A

160157 Sjogren's Anti-SS-B #N/A

160158 Antiscleroderma-70 Antibodies #N/A

160218 Rubeola Antibodies, IgM #N/A

160325 Lyme, Total Ab Test/Reflex #N/A

160333 Lyme, IgM, Early Test/Reflex #N/A

160499 Mumps Antibodies, IgM #N/A

160507 IgG, Subclass 1 #N/A

160721 Antipancreatic Islet Cells #N/A

160747 Cryptococcus Antigen, CSF #N/A

161000 Panel 161000 #N/A

161422 Anti-DNA(SS)IgG, Ab, Qn #N/A

161653 Lyme/Syphilis Ab Diff Profile #N/A

161802 Anticardiolipin Ab, IgG/M, Qn #N/A

161810 Anticardiolipin Ab, IgG, Qn #N/A

161828 Anticardiolipin Ab, IgM, Qn #N/A

161836 Anticardiolipin Ab, IgA, Qn #N/A

161950 Anticardiolip Ab, IgA/G/M, Qn #N/A

161992 Lyme Disease Ab, Quant, IgM #N/A

162040 Western Equine Enceph Ab, IgG #N/A

162045 IBD Expanded Panel #N/A

162164 RNA, b-DNA, Quant #N/A

162222 Panel 162222 #N/A

162289 H. pylori, IgG Abs #N/A

162388 Antineutrophil Cytoplasmic Ab #N/A

163014 Herpes Simplex Virus I/II, IgG #N/A

163048 Parvovirus B19, IgG #N/A

163147 HSV Type 2-Specific Ab, IgG #N/A

163154 Parvovirus B19, IgM #N/A

163162 Bartonella Antibody Panel #N/A

163170 Helicobacter pylori, IgA #N/A

163204 Helicobacter pylori, IgM Ab #N/A

163253 Tetanus/Diphtheria Ab #N/A

163303 Parvovirus B19, Human, IgG/IgM #N/A

163402 Gliadin IgG/IgA Ab Prof, EIA #N/A

163550 Panel 163550 #N/A

163600 Lyme, Western Blot, Serum #N/A

163601 Lyme, Western Blot, Serum #N/A

163683 H pylori, IgM, IgG, IgA Ab #N/A

163758 Mycoplasma pneu. IgG/IgM Abs #N/A

163840 Antimyeloperoxidase (MPO) Abs #N/A

163857 Antiproteinase 3 (PR-3) Abs #N/A

163873 ANCA Panel #N/A

163915 Beta-2 Glycoprotein I Ab,G,A,M #N/A

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163980 Liver-Kidney Microsomal Ab #N/A

164000 Strongyloides IgG Antibody #N/A

164020 HSV I/II, IgG/Rfx Type II IgG #N/A

164065 Rheumatoid Arthritis Profile #N/A

164075 Bartonella henselae IgG/M #N/A

164245 RA Expanded Profile #N/A

164277 HTLV-I/II Antibodies, Qual. #N/A

164301 Coccidioides Abs, Qn, DID #N/A

164319 Histoplasma Abs, Qn, DID #N/A

164517 Protein S-Antigen #N/A

164525 Protein S-Functional #N/A

164541 B pertussis IgG/M/A Ab #N/A

164608 Brucella Antibody IgG, EIA #N/A

164616 Legionella pneumophila Abs. #N/A

164624 Brucella Antibody IgM, EIA #N/A

164640 t-Transglutaminase (tTG) IgA #N/A

164657 Saccharomyces cerevisiae Panel #N/A

164708 Panel 164708 #N/A

164750 Procalcitonin #N/A

164806 HSV, IgM I/II Combination #N/A

164814 Anti-Centromere B Antibodies #N/A

164830 Inflammatory Bowel Disease-IBD #N/A

164855 Antinuclear Antibodies Direct #N/A

164863 ANA w/Reflex if Positive #N/A

164880 Antinuclear Ab Reflex Cascade #N/A

164897 HSV Type 1-Specific Ab, IgG #N/A

164905 HSV 1 and 2-Specific Ab, IgG #N/A

164913 HSV I/II IgG Rflx I-II Type Sp #N/A

164914 CCP Antibodies IgG/IgA #N/A

164947 Antinuclear Antibodies, IFA #N/A

164962 ANA w/Reflex #N/A

164988 t-Transglutaminase (tTG) IgG #N/A

164996 Endomysial Antibody IgA #N/A

165092 ANA Comprehensive Panel #N/A

165105 Endomysial Ab IgA w/Reflex #N/A

165118 Celiac Disease Ab Screen w/Rfx #N/A

165126 Celiac Disease Comprehensive #N/A

165134 Celiac Disease II #N/A

165142 Celiac Disease Panel #N/A

165180 HSV 1 and 2 IgM Abs, Indirect #N/A

167015 Apolipoprotein B #N/A

167082 Celiac Disease HLA DQ Assoc. #N/A

167116 HLA A,B,C (IR) #N/A

167267 HLA-A (IR) #N/A

167292 HLA-B (IR) #N/A

167316 HLA-C (IR) #N/A

180010 Candida 6 Species Profile, NAA #N/A

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180021 NuSwab Vaginitis Plus (VG+) #N/A

180026 Vaginitis/Vaginosis, DNA Probe #N/A

180033 Candida 4 Species Profile, NAA #N/A

180039 NuSwab Vaginitis (VG) #N/A

180043 NuSwab BV and Candida, NAA #N/A

180049 Ct Ng M genitalium NAA, Urine #N/A

180055 C albicans + C glabrata, NAA #N/A

180060 Bacterial Vaginosis, NAA #N/A

180066 NuSwab VG+, HSV #N/A

180071 NuSwab VG, HSV #N/A

180089 Genital Mycoplasmas NAA, Swab #N/A

180098 Chlamydia/GC Amplification #N/A

180141 Campylobacter Culture #N/A

180307 Culture of Dialysis Water #N/A

180448 C difficile, Cytotoxin B #N/A

180764 H. pylori Stool Ag, EIA #N/A

180786 Strep Gp A Direct, DNA Probe #N/A

180794 Strep Gp B Cult/Probe+Rflx #N/A

180797 Strep Gp B Susceptibility #N/A

180798 Strep Gp B Susceptibility #N/A

180802 Body Fluid Culture, Sterile #N/A

180803 Aerobic Cult, Extend Incubat #N/A

180810 Lower Respiratory Culture #N/A

180812 Bacterial Antigens #N/A

180828 Water Culture #N/A

180836 H. pylori Breath Test #N/A

180844 O+P Exam, PVA Only #N/A

180851 O+P Exam, Formalin Only #N/A

180901 Wet Prep #N/A

182196 Occult Blood, Gastric Fluid #N/A

182204 Giardia lamblia Ag, EIA #N/A

182212 Organism Identification, Yeast #N/A

182246 L. pneumophila Serogp 1 Ur Ag #N/A

182261 Aerobe ID + Suscept #N/A

182295 Influenza A Ag, EIA #N/A

182337 Dermatophyte Only, Culture #N/A

182352 Gram Stain w/Sputum Cult Rflx #N/A

182354 Sputum Culture #N/A

182360 Vancomycin-Resist Enterococcus #N/A

182378 Cryptosporidium/Isospora Smear #N/A

182402 AFB Culture and Smear,Broth #N/A

182410 Stool Culture, Yersinia Only #N/A

182493 Vaginal Yeast Culture #N/A

182675 AFB Cult/Smear, Broth, Suscep #N/A

182709 BV+Yeast Culture #N/A

182717 BV+Trich NAA+Yeast Culture #N/A

182725 BV+Ct/Ng/Tv NAA+Yeast Culture #N/A

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182776 Yeast Only, Culture #N/A

182782 Customer Request Culture #N/A

182786 ID 3 #N/A

182808 Susceptibility, Gram Pos Rods #N/A

182877 QuantiFERON In Tube #N/A

182931 Susceptibility, Haemophilus #N/A

182949 Occult Blood, Fecal, IA #N/A

183009 Streptococcus pneumoniae Ag #N/A

183016 Cryptococcus Antigen, CSF #N/A

183020 Cryptosporidium EIA #N/A

183025 Cryptococcus Antigen, Serum #N/A

183036 Cryptococcus Ag Titer, Serum #N/A

183048 Crypto Ag, CSF, Rebaseline #N/A

183050 Cryptococcus Ag, Titer, Serum #N/A

183060 Crypto Ag, Serum, Rebaseline #N/A

183111 Anaerobic/Aerobic/Gram Stain #N/A

183145 Cyclospora Smear, Stool #N/A

183156 Concentration #N/A

183157 Tissue Grind/Digestion/Decon #N/A

183160 Ct, Ng, Trich vag by NAA #N/A

183194 Chlamydia/GC Amplification #N/A

183244 QuantiFERON Client Incubated #N/A

183467 MRSA Screening Culture #N/A

183558 Giardia/Cryptosporidium EIA #N/A

183616 Chlamydia/GC NAA, Confirmation #N/A

183620 C. trachomatis NAA, Confirm #N/A

183624 N. gonorrhoeae NAA, Confirm #N/A

183641 Mtb NAA+AFB Smear/Cult/ID #N/A

183753 Acid Fast Smear+Culture #N/A

183764 Acid Fast Smear+Culture W/Rflx #N/A

183809 Strep Gp B Susceptibility #N/A

183988 C difficile Toxin Gene NAA #N/A

185009 Virus, Varicella Zoster Ag,DFA #N/A

186023 Viral Culture,Rapid,Influenza #N/A

186056 Viral Culture,Rapid,Lesion #N/A

186064 Influenza A+B Ag, EIA #N/A

186072 HSV Culture Without Typing #N/A

186205 Influenza A, H1N1, RT PCR #N/A

186221 Influenza A and B, RT PCR #N/A

186239 Viral Cul, Rapid Flu Rfx H1N1 #N/A

186243 Influenza A, H1N1, RT PCR #N/A

186288 Influenza A/B Ag, EIA W/Reflex #N/A

188035 Herpes Simplex Virus, PCR #N/A

188045 C difficile Toxigenic Culture #N/A

188047 Cytotoxin B Production #N/A

188052 Trich vag by NAA #N/A

188056 HSV NAA #N/A

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188065 Ct Ng HSV by NAA #N/A

188070 Ct Ng TV HSV by NAA #N/A

188078 Chlamydia trachomatis, NAA #N/A

188080 Chlamydia, Conjunctiva, NAA #N/A

188086 Neisseria gonorrhoeae, NAA #N/A

188110 Giardia, EIA, Ova/Parasite #N/A

188128 Strep Gp B Cult/DNA Probe #N/A

188130 Strep Gp B Culture #N/A

188132 Strep Gp B NAA #N/A

188135 Strep Gp B Culture+Rflx #N/A

188139 Strep Gp B NAA+Rflx #N/A

188177 Gram Stn+Lower Resp Cult #N/A

188243 Fungus Culture With Stain #N/A

188284 Gram Stain/Body Fluid Culture #N/A

188540 M tuberculosis, PCR/Culture #N/A

188672 Ct/GC NAA, Rectal #N/A

188698 Ct/GC NAA, Pharyngeal #N/A

188706 Ct NAA, Rectal #N/A

188714 Ct NAA, Pharyngeal #N/A

188730 GC NAA, Rectal #N/A

188748 GC NAA, Pharyngeal #N/A

192005 Pap Lb (Liquid-based) #N/A

192047 Pap Lb, rfx HPV ASCU #N/A

192096 Pap Lb, w Mat Indx #N/A

192104 Pap Lb, Ct-Ng, rfx HPV all #N/A

192112 Pap Lb, Ct-Ng, rfx HPV ASCU #N/A

192120 Pap Lb, Ct-Ng #N/A

192138 Pap Lb, Ct #N/A

192146 Pap Lb, Ct-Ng, HPV-hr #N/A

192153 Pap IG, Ct-Ng, HPV-hr #N/A

192197 PapLb, HPV, rfx16/18 #N/A

192504 Pap Lb, Ct-Ng TV rfx HPV all #N/A

192512 Pap Lb, Ct-Ng TV rfx HPV ASCU #N/A

192520 Pap Lb, Ct-Ng TV #N/A

192546 Pap Lb, Ct-Ng TV HPV-hr #N/A

192555 Change IG Pap to LB Pap #N/A

192560 PapLb, CtNgTv, HPV, rfx16/18 #N/A

192630 Pap Lb, rfx HPV all pth #N/A

193000 Pap IG (Image Guided) #N/A

193130 Pap Lb, Ct, rfx HPV ASCU #N/A

193148 Pap Lb, Ct, rfx HPV all pth #N/A

193924 Pap Lb, Ct-Ng, HPV-h+lr #N/A

193960 Pap IG, Ct, HPV-hr #N/A

193970 Pap Lb, Ng #N/A

194027 Pap IG, Ct-Ng, rfx HPV ASCU #N/A

194074 Pap IG, rfx HPV ASCU #N/A

195050 Pap Lb, HPV-hr #N/A

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195677 Pap IG, Ct, rfx HPV ASCU #N/A

196210 IGP, cobasHPV16/18 #N/A

196215 IGP, CtNg, cobasHPV16/18 #N/A

196220 IGP, CtNgTv, cobasHPV16/18 #N/A

196250 Pap IG, rfx HPV all pth #N/A

196402 Pap IG, Ct-Ng #N/A

196502 Pap IG, Ct-Ng TV #N/A

196527 Pap IG, Ct-Ng TV rfx HPV ASCU #N/A

196553 Pap IG, Ct-Ng TV HPV-hr #N/A

196565 Pap IG, Ct-Ng, rfx HPV all #N/A

196595 Pap IG, Ct-Ng TV rfx HPV all #N/A

196599 Pap IG, Ct-Ng TV HPV 16&18 #N/A

196605 PapIG,Ct-Ng TV rfxHPVall 16&18 #N/A

197012 Pap Lb,Ct-Ng,rfxHPV ASCU 16&18 #N/A

197014 Pap Lb, Ct-Ng,rfxHPV all 16&18 #N/A

197017 PapLb, CtNg, HPV, rfx16/18 #N/A

197070 Pap Lb, HPV-h+lr #N/A

197102 Pap IG, Ct-Ng,rfxHPV all 16&18 #N/A

197116 Pap IG, rfx HPV all pth 16&18 #N/A

197117 Pap IG,Ct-Ng,rfxHPV ASCU 16&18 #N/A

197124 PapIG, CtNg, HPV, rfx 16/18 #N/A

197132 Pap IG, rfx HPV ASCU,16/18 #N/A

197146 PapIG, HPV, rfx 16/18 #N/A

197676 Pap IG, Ct #N/A

198190 Pap IG, HPV-h+lr #N/A

198300 Pap IG, HSV 1/2 NAA #N/A

198305 Pap IG, Ct-Ng TV HSV HPV 16/18 #N/A

198310 Pap IG, Ct-Ng HSV 1/2 PCR #N/A

198315 Pap IG, Ct-Ng TV HSV 1/2 PCR #N/A

198320 Pap IG, Ct-Ng HSV HPV 16/18 #N/A

198325 Pap IG, HSV, HPV rfx HPV 16/18 #N/A

198330 PapIG, CtNgTVHSV, rfxHPVal #N/A

198335 PapIG, CtNgTvHSV rfxHPV ASCU #N/A

198340 PapIG, CtNgHSV, rfxHPVall #N/A

198345 Pap IG, CtNgHSV, rfxHPV ASCU #N/A

198350 PapIG, HSV rfxHPVall #N/A

198355 Pap IG, HSV, rfxHPV ASCU #N/A

198888 Pap IG, Ct, rfx HPV all pth #N/A

199123 Pap IG, HPV-hr #N/A

199305 IGP, Aptima HPV, rfx 16/18,45 #N/A

199310 IGP,CtNg,AptimaHPV,rfx16/18,45 #N/A

199315 IGP,CtNgTv,Apt HPV,rfx16/18,45 #N/A

199320 IGP, CtNg, rfx Aptima HPV ASCU #N/A

199400 IGP,rfxHPVpath+rfxQS #N/A

199405 IGP,CtNg,rfxHPVpath+rfxQS #N/A

199410 IGP,CtNgTv,rfxHPVpath+rfxQS #N/A

199425 IGP,CtNgTv,HPV rfx16/18+rfxQS #N/A

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200477 HBeAb+Ag #N/A

202945 Prenatal Profile I #N/A

203430 CMP12+6AC #N/A

203752 Systemic Lupus Profile B #N/A

204511 RA Qn+SjoSSA+SjoSSB #N/A

204529 Rheumatic Fever Profile #N/A

205500 Bilirubin Fraction, Neonatal #N/A

207631 Sulfapyridine #N/A

210849 CMP14+Lipid+5AC #N/A

211193 Glucose Tolerance (3 Sp Bl/Ur) #N/A

211425 Glucose Tolerance Prof (4 Sp) #N/A

211581 Prenat Infect Dis Ab, IgM, Qn #N/A

213561 Toxoplasma Abs IgG/IgM #N/A

213660 Insulin and C-Peptide, Serum #N/A

215996 Cell Ct, Synovial w/o Crystals #N/A

216010 Apo A1 + B + Ratio #N/A

216655 EBV Acute Infection Antibodies #N/A

220955 Burkholderia Pseudom. Ab, IFA #N/A

221010 Lipid Panel w/ Chol/HDL Ratio #N/A

221051 Rub Ab(IgG/M)+ToxoAb(IgG/M)... #N/A

221085 CMV Abs IgG/IgM #N/A

221214 CMP12+8AC #N/A

223586 Lyme Ab, Total/IgM Responses #N/A

224576 TSH+Free T4 #N/A

225920 Protein Elec + Interp, Serum #N/A

233783 CBC/D/Plt+RPR+UA+Rh+ABO+Rub... #N/A

234419 Myasthenia Gravis Evaluation #N/A

235010 Lipid Panel With LDL/HDL Ratio #N/A

235011 Lipid Panel with LDL/HDL Ratio #N/A

235036 Lipoprotein Phenotyping #N/A

235945 Varicella Zoster Abs, IgG/IgM #N/A

236000 CreatU+Prot U #N/A

237842 HFP7+2AC #N/A

239822 Glucose (2 Spec) Tolerance, S #N/A

242545 CMP12+6AC+CBC/D/Plt #N/A

243766 Rub Ab+VarAb+RubeoAb+MumIgG #N/A

244681 RPR+Rh+ABO+Rub Ab+Ab Scr+CB... #N/A

250555 Antiphospholipid Syndrome Prof #N/A

252816 Galactosemia: GALT #N/A

252823 Beta Thalassemia: HBB #N/A

255505 HBV/HCV (Profile VIII) #N/A

257113 HP5+HAVIgM+HBcIgM+HBeAb+Ag #N/A

257188 HP4 #N/A

257238 HP5+HAVIgM+HBcIgM #N/A

257451 ALT+AST+TBili #N/A

258004 Lyme Ab/Western Blot Reflex #N/A

261511 Prot Electro Interp, 24-Hr Ur #N/A

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265389 HBV Vaccine Follow-Up (Pro XI) #N/A

266015 Folate, RBC #N/A

272902 CMP12+TP+TSH+7AC+CBC/D/Plt+... #N/A

275180 Fe+CBC/D/Plt+TIBC+Fer+CRP #N/A

276024 Creat Clearance, Normalized #N/A

282020 CBC/D/Plt+RPR+Rh+ABO+Rub Ab... #N/A

283655 Protein C Deficiency Profile #N/A

284452 Hepatitis D Total #N/A

285700 Folate, RBC and Serum #N/A

286161 Catecholamine+VMA, 24-Hr Urine #N/A

300321 Prl+FSH+LH+Prog+hCG Ql #N/A

300327 CMP12+8AC+Mg+TIBC #N/A

301021 HBcAb+M+HBsAb+HCVAb #N/A

301622 CMP12+7AC+Mg #N/A

302085 Comp. Metabolic Panel (12) #N/A

302832 Glu+CBC/D/Plt+RPR+UA+Sickle #N/A

302857 Glu+CBC/D/Plt+RPR+UA #N/A

303476 Glu+CBC/D/Plt+Sickle #N/A

303560 CMP12+8AC #N/A

303744 HP5 #N/A

303750 CMP14+4AC #N/A

303754 Electrolyte Panel #N/A

303755 Hepatic Function Panel (6) #N/A

303756 Lipid Panel #N/A

303758 Basic Metabolic Panel (7) #N/A

303785 CMP12+LP+TP+TSH+5AC+CBC/D/P... #N/A

304148 CMP12+1AC #N/A

308336 Rub Ab+ToxoAb+CMV Ab+CMVIgM... #N/A

310700 CMP13+2AC #N/A

310900 Comp. Metabolic Panel (13) #N/A

311779 CMP12+8AC+CBC/D/Plt #N/A

312264 CMP12+LP+6AC+CBC/D/Plt+TSH+Fer #N/A

313700 Gestational Glucose (X2) #N/A

314903 CMP13+LP+TP+TSH+2AC+CBC/D/P... #N/A

314918 CMP13+LP+2AC+CBC/D/Plt #N/A

315388 CMP14+LP+5AC+TIBC #N/A

315423 CMP12+LP+TP+TSH+6AC+CBC/D/Plt #N/A

315652 CMP12+TP+TSH+8AC+CBC/D/Plt+... #N/A

315865 AlP+ALT+AST+TBili+Uric A+CB... #N/A

315874 CMP14+LP+6AC #N/A

316203 Catecholamines,Ur.,Free,Random #N/A

316205 5-HIAA Qn,Random Urine #N/A

316280 CMP13+CBC/D/Plt+RPR+Mg+TSH #N/A

316370 HFP+2AC+CBC/D/Plt+CreatCx+P... #N/A

316566 ALT+AST+Creat+Uric A+Hgb+Plt #N/A

317222 UREA and Creatinine, 24-Hr Ur #N/A

322000 Comp. Metabolic Panel (14) #N/A

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322458 BMP8+LP+1AC+Hb A1c #N/A

322744 Hepatitis Panel (4) #N/A

322755 Hepatic Function Panel (7) #N/A

322758 Basic Metabolic Panel (8) #N/A

322777 Renal Panel (10) #N/A

330015 Thyroid Cascade Profile #N/A

330018 Thyroid Peroxidase (TPO) Ab #N/A

331258 CMP14+1AC+TSH+PTT+Sickle+PT... #N/A

332158 AlP+ALT+AST+Creat+TBili+Uri... #N/A

332215 TSH+Prl+FSH+LH+DHEA-S+hCG Q... #N/A

332403 CMP12+LP+6AC+CBC/D/Plt #N/A

333126 CMP14+LP+1AC #N/A

333427 Microscopic Examination #N/A

334943 CMP14+eGFR #N/A

334971 Celiac Disease Antibody Screen #N/A

334993 CMP14+TP+7AC #N/A

335362 BMP8+eGFR #N/A

337036 CMP14+LP+CBC/D/Plt+Prl+Test... #N/A

341109 RPR+Rh+ABO+Rub Ab+Ab Scr+CB... #N/A

341142 Celiac Disease Complete Panel #N/A

341776 ANA #N/A

343925 LP+Non-HDL Cholesterol #N/A

347692 AlP+ALT+AST+Creat+Glu+TBili... #N/A

347845 CMP14+5AC #N/A

348532 CMP12+LP+6AC+CBC/D/Plt+RPR+... #N/A

349829 TSH Rfx on Abnormal to Free T4 #N/A

350512 CBC+Hematology Review #N/A

354415 Rubella+Rubeola+VZ #N/A

354928 Protein Electro, Random Urine #N/A

360495 CMP12+9AC #N/A

361446 CMP14+LP+6AC+CBC/D/Plt+RPR+... #N/A

361946 Lipid Cascade #N/A

361959 LDL Cholesterol (Direct) #N/A

362165 CMP14+2AC+CEA+CA125 #N/A

363676 Lipid Cascade w/Rflx to ApoliB #N/A

368878 HFP7+2AC #N/A

368894 ANA+ENA+C3+C4+DNA/DS+Card(I... #N/A

371184 CBC/D/Plt+RPR+Rh+ABO+Rub Ab... #N/A

371643 CMP12+LP+6AC+CBC/D/Plt+TSH+... #N/A

371653 CBC+TestT+DHEA S+Prog+E2+Te... #N/A

371841 CMP14+LP+Uric A+CBC/D/Plt+E... #N/A

371862 GG1hr+RPR+Ab Scr+CBC/Plt+HB... #N/A

375268 Alb+AST+Fe+Prot+PT+Plt #N/A

376426 CMP14+8AC #N/A

377036 UA/M w/rflx Culture, Routine #N/A

377200 UA/M w/rflx Culture, Comp #N/A

384715 von Willebrand Profile #N/A

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450020 Cystic Fibrosis Mutation 97 #N/A

480004 Alkaline Phosphatase (Serial) #N/A

480012 AFP, Tumor Marker (Serial) #N/A

480038 hCG, Beta Subunit, Qn (Serial) #N/A

480061 CA 125, Serum (Serial) #N/A

480095 CEA (Serial Monitor) #N/A

480111 Ferritin, Serum (Serial) #N/A

480145 PSA, Serum (Serial Monitor) #N/A

480277 ER/PR,Immunohistochem,Paraffin #N/A

480293 CA 27.29 (Serial Monitor) #N/A

480300 AFP-L3% (Serial Monitor) #N/A

480533 Cystic Fibrosis Profile #N/A

480640 PSA (Reflex To Free) (Serial) #N/A

480701 Cystic Fibrosis Mutation 97 #N/A

480772 PSA Total (Reflex To Free) #N/A

480848 %fPSA Reflex #N/A

480947 PSA Total+% Free #N/A

483248 HER-2/CEP17 FISH #N/A

483404 CA 15-3 (Serial Monitor) #N/A

485029 Leukemia/Lymphoma Monitor Prof #N/A

485086 Pancreatic CA Monitor Profile #N/A

485151 Testicular Cancer Monitor Prof #N/A

485199 Prothrombin Time (PT), Serial #N/A

489111 Flow Marker, First #N/A

489112 Flow Markers X 3 #N/A

489120 Flow Markers X 4 #N/A

489128 Flow Markers X28 #N/A

489138 Flow Markers X 5 #N/A

489146 Flow Markers X 10 #N/A

489153 Flow Markers X 15 #N/A

489179 Flow Markers X 20 #N/A

489200 JAK2 Mutation Analysis, Qual #N/A

489316 Flow Interp 16 or more #N/A

500016 Prothrombin Fragment 1+2 MoAb #N/A

500070 Lupus Anticoagulant Panel #N/A

500116 Vitamin D 25-Hydroxy, D2 + D3 #N/A

500161 DHEA-Sulfate, Serum #N/A

500187 Heparin Cofactor II #N/A

500196 Factor VIII Antigen #N/A

500306 HPV, high+low-risk #N/A

500324 Macroprolactin #N/A

500463 Prt C Activity (Chromogenic) #N/A

500555 Anti-Thyroglobulin Antibodies #N/A

500557 Prolactin, Serum (ICMA) #N/A

500711 Lupus Anticoag/Cardiolipin Ab #N/A

501819 Transferrin Saturation #N/A

502280 FSH, Pediatric #N/A

Page 78: Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS ... - 04093 labcorp pricing sheet 2015...Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 -

502286 Luteinizing Hormone, Pediatric #N/A

502421 Gonadotropin Releasing Hormone #N/A

502515 TestT+LH+DHEA S+E2+TestF+E1... #N/A

503380 PTHrP (PTH-Related Peptide) #N/A

503600 FT3 Dialysis MS #N/A

503610 Beta-Hydroxybutyrate #N/A

503850 Platelet Antibody Profile #N/A

503853 Factor V Leiden Reflex to R2 #N/A

503880 Thyroglobulin (TG-RIA) #N/A

504115 25-Hydroxyvitamin D LCMS D2+D3 #N/A

505008 Helper T-Lymph-CD4 #N/A

505271 CD4/CD8 Ratio Profile #N/A

507301 HPV, high-risk #N/A

507310 HPV, high-risk #N/A

507385 HPV, cobas high-risk/16/18 #N/A

507405 HPV, low volume rfx #N/A

507460 HPV Genotype, 16/18 #N/A

507800 HPV Aptima #N/A

507810 HPV Genotypes 16/18,45 #N/A

507815 HPV, 16/18,45 #N/A

507820 HPV Genotypes 16/18,45 #N/A

508005 cobas HPV, Rectal #N/A

510750 Thiopurine Methyltransferase #N/A

511154 Factor V Leiden Mutation #N/A

511162 Factor II, DNA Analysis #N/A

511172 Alpha-Thalassemia #N/A

511230 Cytochrome P450 2D6 Genotyping #N/A

511238 MTHFR #N/A

511345 Hered.Hemochromatosis, DNA #N/A

513002 Alk Phosphatase, Bone Specific #N/A

513160 Alk Phosphatase, Bone Specific #N/A

550020 HPV Genotyping, PCR #N/A

550066 HCV RNA Qn (Graph) Rfx NS3/4A #N/A

550070 HCV RT-PCR, Quant (Graph) #N/A

550071 HCV Real-Time, PCR, Quant #N/A

550072 HCV RNA PCR Qn Rfx NS3/4A #N/A

550080 HCV RT-PCR, Quant (Non-Graph) #N/A

550087 M tuberculosis Detection, PCR #N/A

550090 HCV RNA by PCR, Qn Rfx Geno #N/A

550100 HCV RNA by PCR, Qn Rfx Geno #N/A

550123 HCV FibroSure #N/A

550146 HCV RNA, PCR, Ql (Quant Rflx) #N/A

550250 RNA,PCR(Graph)rfx/PS Int #N/A

550296 HCV RT-PCR, Quant #N/A

550312 HCV Real-Time, PCR, Quant #N/A

550400 HCV RNA, PCR, Qualitative #N/A

550420 RNA, Real Time PCR (Graph) #N/A

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550422 RNA, PCR (Graph) rfx/Geno #N/A

550423 RNA, PCR (Graph) rfx/GenoPLUS #N/A

550430 RNA, Real Time PCR (Non-Graph) #N/A

550432 RNA, PCR (NonGraph) rfx/Geno #N/A

550433 RNA,PCR (NonGra) rfx/GenoPLUS #N/A

550450 RNA, PCR (NonGraph) rfx/PSGT #N/A

550466 Quant, RNA PCR #N/A

550470 RNA, PCR (NonGraph) rfx/PS #N/A

550475 HCV Genotyping Non Reflex #N/A

550481 Hepatitis C Genotype #N/A

550486 Hepatitis C Genotype #N/A

550503 Quant, RNA PCR #N/A

550504 Quant, RNA PCR #N/A

550510 RNA, PCR (Graph) rfx/PSGT #N/A

550515 HCV RT-PCR, Quant #N/A

550520 RNA, PCR (Graph) rfx/PS #N/A

550522 RNA, PCR (Graph) rfx/Geno EDI #N/A

550538 Rfx to GenoSure(R) HCV NS3/4A #N/A

550539 Rfx to GenoSure(R) HCV NS3/4A #N/A

550555 HCV Genotype Reflex NS3/4A #N/A

550563 Rfx to GenoSure(R) HCV NS3/4A #N/A

550630 RNA, PCR(Graph)rfx/GenoPRI #N/A

550713 HCV RNA NAA Qualitative #N/A

550757 informaSeq(SM) with Y Analysis #N/A

550825 HCV NAA Qualitative (rfx Geno) #N/A

550840 HCV RNA NAA Qual rfx to Quant #N/A

550850 HCV RNA NAA Qualitative #N/A

550880 RealTime Abbott #N/A

551242 HCV RNA Det Ql Rfx Gen #N/A

551300 HCV RealTime Abbott #N/A

551319 Quant, RNA PCR #N/A

551610 HBV Real-Time PCR, Quant #N/A

551619 HIV GenoSure(R) MG #N/A

551620 HBV RT PCR, Quant (Graph) #N/A

551624 HIV GenoSure(R) MG #N/A

551689 Virtual Phenotype #N/A

551690 PhenoSense GT (TM) #N/A

551704 GenoSure PRIme(R) #N/A

551707 GenoSure PRIme(R) #N/A

551734 HIVDNASeq PRRT #N/A

551743 HIVDNASeq PRRT Interp #N/A

551781 HIV GSArchive #N/A

551782 HIV GSArchive Interp #N/A

551800 PhenoSense(R) #N/A

551874 HIV GenoSure(R) Integrase #N/A

551887 RNA, b-DNA, Quant, Non-Graph #N/A

600973 Allergen Panel, Food-Berry #N/A

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600999 Allergen Profile, Food-Legume #N/A

601013 Allergen Profile, Food-Fish #N/A

601823 Allergen Profile, Vegetable II #N/A

601831 Allergen Profile, Vegetable I #N/A

601856 Allergen Profile, Food-Milk #N/A

601872 Allergen Profile, Food-Fruit #N/A

602284 Allergen Profile, Food-Meat #N/A

602292 Allergens(4) #N/A

602421 Allergens (4) Foods #N/A

602451 F013-IgE Peanut #N/A

602452 F001-IgE Egg White #N/A

602453 F002-IgE Milk #N/A

602454 E001-IgE Cat Dander #N/A

602456 E005-IgE Dog Dander #N/A

602457 F014-IgE Soybean #N/A

602459 F004-IgE Wheat #N/A

602460 F008-IgE Corn #N/A

602462 M002-IgE Cladosporium #N/A

602463 W001-IgE Ragweed, Short #N/A

602464 G002-IgE Bermuda Grass #N/A

602465 F003-IgE Codfish #N/A

602467 D001-IgE D pteronyssinus #N/A

602468 F025-IgE Tomato #N/A

602470 F201-IgE Pecan Nut #N/A

602472 F033-IgE Orange #N/A

602473 F024-IgE Shrimp #N/A

602475 D002-IgE D farinae Mite #N/A

602476 T008-IgE Elm, American #N/A

602478 F338-IgE Scallop #N/A

602480 T007-IgE Oak, White #N/A

602481 I100-IgE Cockroach, American #N/A

602484 W014-IgE Pigweed, Rough #N/A

602485 F010-IgE Sesame Seed #N/A

602486 F203-IgE Pistachio Nut #N/A

602487 F075-IgE Egg (Yolk) #N/A

602491 T006-IgE Cedar, Mountain #N/A

602492 F093-IgE Chocolate/Cacao #N/A

602493 F023-IgE Crab #N/A

602494 T010-IgE Walnut #N/A

602495 F080-IgE Lobster #N/A

602497 F079-IgE Gluten #N/A

602498 F026-IgE Pork #N/A

602500 F083-IgE Chicken #N/A

602501 F236-IgE Whey #N/A

602503 G010-IgE Johnson Grass #N/A

602506 G006-IgE Timothy Grass #N/A

602507 F041-IgE Salmon #N/A

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602509 F027-IgE Beef #N/A

602510 F040-IgE Tuna #N/A

602511 F009-IgE Rice #N/A

602512 F036-IgE Coconut #N/A

602513 F044-IgE Strawberry #N/A

602517 F012-IgE Green Pea #N/A

602518 T014-IgE Cottonwood #N/A

602519 F047-IgE Garlic #N/A

602521 F031-IgE Carrot #N/A

602523 F204-IgE Trout #N/A

602525 F015-IgE White Bean #N/A

602528 F245-IgE Egg, Whole #N/A

602529 F207-IgE Clam #N/A

602530 F256-IgE Walnut #N/A

602531 W006-IgE Mugwort #N/A

602536 W009-IgE Plantain, English #N/A

602537 W010-IgE Lamb's Quarter #N/A

602539 F414-IgE Tilapia #N/A

602542 W018-IgE Sheep Sorrel #N/A

602546 H002-IgE House Dust(Hollister) #N/A

602548 M005-IgE Candida albican #N/A

602553 F007-IgE Oat #N/A

602555 M011-IgE Rhizopus nigrica #N/A

602560 M009-IgE Fusarium monilif #N/A

602561 M008-IgE Helminthosporium #N/A

602567 F045-IgE Yeast, Baker's #N/A

602673 O001-IgE Cotton Lint #N/A

602684 E003-IgE Horse Dander #N/A

602688 E070-IgE Goose Feathers #N/A

602699 E081-IgE Sheep epithelia #N/A

602703 E085-IgE Chicken Feathers #N/A

602704 E086-IgE Duck Feathers #N/A

602708 E089-IgE Turkey Feathers #N/A

602718 F329-IgE Watermelon #N/A

602720 F042-IgE Haddock #N/A

602723 F048-IgE Onion #N/A

602724 F049-IgE Apple #N/A

602725 F050-IgE Mackerel #N/A

602726 F054-IgE Sweet Potato #N/A

602728 F415-IgE Walleye Pike #N/A

602732 F081-IgE Cheese, Cheddar Type #N/A

602734 F084-IgE Kiwi Fruit #N/A

602735 F085-IgE Celery #N/A

602736 F086-IgE Parsley #N/A

602737 F087-IgE Melon #N/A

602739 F089-IgE Mustard #N/A

602742 F092-IgE Banana #N/A

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602743 F094-IgE Pear #N/A

602744 F095-IgE Peach #N/A

602756 F342-IgE Olive, Black #N/A

602757 F319-IgE Red Beet #N/A

602759 F147-IgE Flounder #N/A

602760 F263-IgE Green Bell Pepper #N/A

602765 F182-IgE Lima Bean #N/A

602770 F210-IgE Pineapple #N/A

602773 F212-IgE Mushroom #N/A

602775 F214-IgE Spinach #N/A

602776 F215-IgE Lettuce #N/A

602777 F216-IgE Cabbage #N/A

602779 F218-IgE Paprika #N/A

602780 F344-IgE Sage, Salvia #N/A

602781 F220-IgE Cinnamon #N/A

602782 F221-IgE Coffee #N/A

602786 F225-IgE Pumpkin #N/A

602793 F234-IgE Vanilla #N/A

602794 F235-IgE Lentil #N/A

602796 F242-IgE Bing Cherry #N/A

602798 F244-IgE Cucumber #N/A

602802 F259-IgE Grape #N/A

602803 F260-IgE Broccoli #N/A

602806 F262-IgE Eggplant #N/A

602807 F265-IgE Cumin #N/A

602816 F278-IgE Bayleaf (Laurel) #N/A

602817 F279-IgE Chili Pepper #N/A

602818 F280-IgE Black Pepper #N/A

602822 F283-IgE Oregano #N/A

602823 F284-IgE Turkey #N/A

602824 F287-IgE Kidney Bean #N/A

602829 F296-IgE Carob Bean #N/A

602835 F309-IgE Chick Pea #N/A

602838 F315-IgE Green Bean #N/A

602845 F369-IgE Catfish #N/A

602857 F381-IgE Red Snapper #N/A

602858 F384-IgE Whitefish #N/A

602860 FX02-IgE Food Mix (Seafoods) #N/A

602864 K071-IgE Castor Bean #N/A

602874 G014-IgE Oat, Cultivated #N/A

602886 I001-IgE Honeybee #N/A

602887 I002-IgE Hornet, White Face #N/A

602889 I003-IgE Yellow Jacket #N/A

602890 I004-IgE Paper Wasp #N/A

602891 I005-IgE Hornet, Yellow #N/A

602897 I205-IgE Bumblebee #N/A

602918 M024-IgE Stachybotrys atra #N/A

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602927 T015-IgE Ash, White #N/A

602936 T003-IgE Common Silver Birch #N/A

602948 T011-IgE Maple Leaf Sycamore #N/A

602966 W005-IgE Wormwood #N/A

602970 W013-IgE Cocklebur #N/A

602983 F004W-IgE Wheat #N/A

602989 Food Allergy Profile #N/A

603203 Allergens(92) Foods #N/A

603857 IgE Food Basic w/Component Rfx #N/A

603916 IgE Peanut w/Component Reflex #N/A

603927 IgE Milk w/ Component Reflex #N/A

603940 IgE Egg White w/Component Rflx #N/A

607523 Allergens(10) #N/A

648014 Allergen Profile, Food-Basic #N/A

649749 Allergen Profile, Mini-Panel #N/A

650390 K082-IgE Latex #N/A

660423 Allergen Profile, Basic Food #N/A

660670 Hypersensitivity Pneumonitis #N/A

665349 IgE+Latex #N/A

670797 Allergens(5) #N/A

671871 Hymenoptera Profile 2 #N/A

671926 Allergens(7) #N/A

672208 Allergens(9) #N/A

672486 Allergen Profile, Ragweed Plus #N/A

672489 Allergens(9) #N/A

676528 Allergens, Zone 2 #N/A

676536 Allergens, Zone 3 #N/A

700068 Amino Acid Profile, Qn, Plasma #N/A

700070 Methadone Confirmation, Urine #N/A

700140 Amino Acid Profile, Qn, Urine #N/A

700195 Cystine, Quant. 24 hr Urine #N/A

700248 Tacrolimus (FK506), Blood #N/A

701869 Cannabinoid Screen, Urine #N/A

704411 704411 5 Drug-Unbund #N/A

706200 Heavy Metals Profile II, Blood #N/A

706440 Clozapine (Clozaril), Serum #N/A

706465 Clomipramine, Serum #N/A

706499 Valproic Acid (Total+Free) #N/A

706500 Carnitine, Total and Free #N/A

706501 Carnitine, Total #N/A

706557 Cyclosporine, Blood #N/A

706705 Amiodarone (Cordarone), Serum #N/A

706838 Fluoxetine (Prozac(R)), Serum #N/A

706887 Fluphenazine (Prolixin(R)), S #N/A

706961 Methylmalonic Acid, Serum #N/A

706994 Homocyst(e)ine, Plasma #N/A

707013 Amphetamines Confirm, Urine #N/A

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707031 Cocaine Metabolite Confirm #N/A

707033 Opiates Confirm, Urine #N/A

707052 MDMA Confirm, Urine #N/A

707080 Drug Abuse, HHS/DOT - Unbund #N/A

707100 D/L Methamphetamine #N/A

708008 PSC Specimen Collection #N/A

708080 Drug Abuse, HHS/DOT-Bund #N/A

708120 Drug Abuse, HHS/DOT - Bund #N/A

711034 Tacrolimus by Immunoassay #N/A

712562 Cannabinoid Confirmation, Ur #N/A

712570 Opiates Conf (GC/MS) #N/A

712588 Phencyclidine Confirmation, Ur #N/A

713751 Opiates GC/MS, Urine #N/A

716159 6-Acetylmorphine, Conf #N/A

716167 Ethanol, Urine #N/A

716285 Topiramate (Topamax), Serum #N/A

716290 Homocysteine, Urine #N/A

716365 Methylmalonic Acid, Urine #N/A

716563 Risperidone (Risperdal(R)), S #N/A

716720 Organic Acid Analysis, Urine #N/A

716795 Mycophenolic Acid and Metabo. #N/A

716803 Carbamazepine-10,11 Epoxide #N/A

716811 Gabapentin (Neurontin), Serum #N/A

716928 Oxcarbazepine (Trileptal),S #N/A

716936 Levetiracetam (Keppra), S #N/A

716944 Lamotrigine (Lamictal), Serum #N/A

717009 Lead, Blood (Pediatric) #N/A

717033 Lead/Protoporphyrin, Pediatric #N/A

717330 Amikacin , Serum, Peak/Trough #N/A

722118 MDMA #N/A

724542 Pb+As U+Hg U+FEP #N/A

725788 725788 7 Drug-Unbund #N/A

726778 726778 7+Alc-Unbund #N/A

733071 Opiates GC/MS Retest #N/A

733339 733339 10+Alc-Scr #N/A

733690 733690 12+Oxycodone+Crt-Scr #N/A

733692 733692 9+Oxycodone+Crt-Scr #N/A

733694 733694 9+Alc+Crt-Scr #N/A

733726 733726 13+Oxycodone+Crt-Scr #N/A

733848 733848 9+Alc+Crt-Scr #N/A

734349 734349 3 Drug-Scr #N/A

734351 734351 5 Drug-Scr #N/A

734352 734352 6 Drug-Scr #N/A

734353 734353 7 Drug-Scr #N/A

737000 Methadone (GC/MS), Urine #N/A

737620 Oxycodone/Oxymorphone (GC/MS) #N/A

737630 Oxycodone/Oxymorphone, Urine #N/A

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737637 Oxycodone/Oxymorphone, Urine #N/A

737638 Oxycodone/Oxymorphone, Urine #N/A

737640 Oxycodone/Oxymorphone (GC/MS) #N/A

737641 Oxycodone/Oxymorphone (GC/MS) #N/A

737648 Oxycodone/Oxymorphone, Urine #N/A

737693 Amphetamine, Urine #N/A

737735 Cannabinoid (GC/MS), Urine #N/A

737752 Cocaine (GC/MS), Urine #N/A

737834 Opiates Confirmation, Urine #N/A

737846 Opiates Confirmation, Urine #N/A

737892 Amphetamines (GC/MS), Urine #N/A

737921 737921 12+Oxycodone+Crt-Unbund #N/A

761050 Meperidine/Normep (GC/MS), U #N/A

761141 Fentanyl, Urine #N/A

761153 Buprenorphine, Urine #N/A

763400 Buprenorphine, Urine #N/A

763401 Buprenorphine LC/MS/MS #N/A

763824 763824 12+Oxycodone+Crt-Unbund #N/A

763897 Oxycodone/Oxymorphone Confirm #N/A

763910 Benzodiazepines Confirm, Urine #N/A

764024 Carisoprodol/Meprobamate, Ur #N/A

764060 Benzodiazepines Confirm, Urine #N/A

764130 Buprenorphine, Urine #N/A

764227 764227 9+Oxyco+Crt-Unbund #N/A

764365 Tramadol #N/A

764400 Buprenorphine Confirm, Urine #N/A

764875 Drug Profile 764875 #N/A

764883 764883 11+Oxyco+Alc+Crt-Bund #N/A

764888 764888 10+Oxyco+Alc+Crt-Bund #N/A

764928 764928 11+Oxycodone+Crt-Bund #N/A

765000 765000 11+Oxyco+Alc+Crt-Bund #N/A

765204 765204 15+Oxyco-Bund+Bup-Scr #N/A

765507 765507 9+MDMA+Oxyco+Crt-Bund #N/A

766550 Drug Profile, Blood (5 Drugs) #N/A

767640 Opiates (GC/MS), Blood #N/A

768431 768431 10+Oxycodone+Crt-Bund #N/A

770565 Cocaine(Metab.)Screen, Urine #N/A

770628 770628 7 Drug-Scr #N/A

770701 Drug Scrn, Treatment Center #N/A

772012 DRUG PROFILE 772012 #N/A

772111 772111 9+Alc+Crt-Scr #N/A

772236 772236 8+Alc-Scr #N/A

780400 Oral Fluid Drug Analysis #N/A

788243 788243 10+Alc-Bund #N/A

788423 788423 7 Drug-Bund #N/A

788583 788583 10+Crt-Bund #N/A

788877 CreatU+pH U+Specific Gravity #N/A

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788878 788878 9+MDMA-Bund #N/A

788890 Adulteration (Dilution), Urine #N/A

788923 Specific Gravity #N/A

788927 Creatinine, Urine #N/A

788941 788941 7+MDMA-Bund #N/A

789034 789034 7+Crt-Bund #N/A

789888 789888 6+MDMA+Crt-Bund #N/A

790034 790034 9+MDMA+Crt-Bund #N/A

790350 Mephedrone, MDPV, Methylone #N/A

790390 Drugs of Abuse Screen,11 Serum #N/A

790394 Gabapentin, Urine #N/A

790430 Drugs of Abuse Screen, 10 WB #N/A

790560 Heroin, Serum/Plasma/WB #N/A

790600 Compliance Drug Analysis, Ur #N/A

790621 Opiates, Unconjugated Exp. WB #N/A

790738 Synthetic Cannabinoids, Conf #N/A

790742 Synthetic Cannabinoids, Urine #N/A

790856 Paliperidone, Serum #N/A

790890 PCB Serum w/rfx to Confir #N/A

791194 Comprehensive Drug Analysis,Ur #N/A

791566 Cannabinoid Analysis, WB #N/A

791570 Blood Drugs of Abuse 6, WB #N/A

791588 Amphetamine Analysis, WB #N/A

791590 Blood Drugs of Abuse 8, WB #N/A

791632 Drugs of Abuse Scr ONLY, 10,WB #N/A

791706 Bld Drugs of Abuse, 7, WB #N/A

791710 Benzodiazepine Confirm, QT, WB #N/A

791718 THC (Tetrahydrocannabinol), W #N/A

791742 791742 10+Oxycodone+Alc-Bund #N/A

794370 Drug Profile, Ur, 9 Drugs #N/A

794388 794388 7 Drug-Bund #N/A

794902 Specific Gravity #N/A

798067 Ethyl Glucuronide, Urine #N/A

798419 Benzodiazepines GC/MS Retest #N/A

799007 799007 7 Drug-Bund #N/A

799452 799452 5 Drug-Bund #N/A

803301 Hydrocodone + Metabolites, U #N/A

804500 VAP Cholesterol Profile #N/A

805891 Coriander/Cilantro IgE #N/A

805904 Venom European Hornet IgE #N/A

805922 Sardine, Pilchard IgE #N/A

805979 Tilapia IgE #N/A

806021 Tarragon IgE #N/A

806054 Marjoram IgE #N/A

806130 Venom Paper Wasp IgE #N/A

806443 Ketone Bodies Panel, S/P #N/A

806698 Hair Standard #N/A

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808374 Naproxen (Aleve,Naprosyn,Ana.) #N/A

808377 Mercaptopurine (6-MP,Purin.) #N/A

808404 Quetiapine (Seroquel) #N/A

808462 Ibuprofen, Serum/Plasma #N/A

808933 Solvent Inhalants Panel, WB #N/A

808966 Paraneoplastic Profile II #N/A

809623 Pregabalin, Urine #N/A

809671 Aripiprazole #N/A

811338 Azathioprine (Imuran) #N/A

811394 Mineral Profile (7), RBC's #N/A

811513 Olanzapine (Zyprexa) #N/A

811903 Clonazepam, Ur as Metabolite #N/A

812238 Harmony with XY Analysis #N/A

814483 Bartonella + Bact. Aerobic #N/A

816212 Hair Drug Screen 9 Panel #N/A

816767 Pneumococcal IM (14 Serotype) #N/A

816853 Sugar Cane IgE* #N/A

823203 Histoplasma Antigen, Urine #N/A

823239 Porphyrins, Total Plasma #N/A

823263 Francisella tularensis Abs #N/A

823331 Hepatitis E IgM #N/A

823334 Hepatitis E IgG #N/A

826359 Jalapeno Pepper, IgE #N/A

826700 Black Bean IgE #N/A

827632 PBG Deaminase, Erythrocytes #N/A

828391 Dengue Fever Ab #N/A

828395 Dengue Fever Virus Ab, IgM #N/A

828470 Dengue Fever Virus Ab, IgG #N/A

828735 Trypanosoma Cruzi Ab, IgM #N/A

828737 Trypanosoma Cruzi Ab IgG #N/A

828755 Strongyloides Ab IgG, ELISA #N/A

829044 Huntington Disease Mutation #N/A

831000 Rheumatoid Factor (RF), IgA #N/A

842104 Tiagabine (Gabitril) #N/A

847525 Ziprasidone (Geodon,Zeldox) #N/A

850601 Blood-SMR,Periph;Int/Phy 1st #N/A

875194 Leucine Aminopeptidase, Serum #N/A

881411 Physician Read Pap #N/A

883001 88300 Surgical Pathology #N/A

883041 88304 Surgical Path-1st Site #N/A

883042 88304 Surgical Path-2nd Site #N/A

883051 88305 Surg Path-1st Site #N/A

883052 88305 Surg Path-2nd Site #N/A

883053 88305 Surg Path-3rd Site #N/A

883054 88305 Surg Path-4th Site #N/A

883055 88305 Surg Path-5th Site #N/A

883056 88305 Surg Path-6th Site #N/A

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883057 88305 Surg Path-7th Site #N/A

883058 88305 Surg Path-8th Site #N/A

883071 88307 Surgical Pathology #N/A

883072 88307 Surgical Pathology #N/A

883073 88307 Surgical Pathology #N/A

883121 Spec-Stain,GRP I-Micro 1st #N/A

883122 Spec-Stain,GRP I-Micro 2nd #N/A

883123 Spec-Stain;GRP I-Micro 3rd #N/A

883124 Spec-Stain;GRP I-Micro 4th #N/A

883125 Spec-Stain;GRP I-Micro 5th #N/A

883131 Spec-Stain,GRP II-All-Oth 1st #N/A

883132 Spec-Stain,GRP II-All-Oth 2nd #N/A

883211 Consul+Rep/Ref Slides 1st Site #N/A

883421 Immunohistochem, 1st Antibody #N/A

883422 Immunohistochem, 2nd Antibody #N/A

883423 Immunohistochem, 3rd Antibody #N/A

883431 1st addtl IHC Ab per slide #N/A

883432 2nd addtl IHC Ab per slide #N/A

883433 3rd addtl IHC Ab per slide #N/A

884000 NMR LipoProfile w/IR Markers #N/A

884247 NMR LipoProfile #N/A

884280 Lipoprotein Analysis, by NMR #N/A

884318 Lipoprotein Analysis by NMR #N/A

910339 Litholink CMP14+P #N/A

977709 CBC/Diff Ambiguous Default #N/A

995407 Hourly Phlebotomy Coverage Fee #N/A

C90139 CVS Chrom Analysis 88235 #N/A

C90140 Chromosome Blood Routine 88230 #N/A

C90142 Chrom Analy 5 Cell 1 Karyo #N/A

C90145 Count 15-20 cells, 2 Karyotype #N/A

C90149 Chromosome Amniotic Fluid #N/A

M90001 MIC Organism #1 #N/A

M90002 MIC Organism #2 #N/A

M90003 MIC Organism #3 #N/A

P20061 IHC 1st AB Stain x1 PROF #N/A

P20062 IHC 1st AB Stain x2 PROF #N/A

P20063 IHC 1st AB Stain x3 PROF #N/A

P20064 IHC 1st AB Stain x4 PROF #N/A

P20065 IHC 1st AB Stain x5 PROF #N/A

P20066 IHC 1st AB Stain x6 PROF #N/A

P20067 IHC 1st AB Stain x7 PROF #N/A

P20068 IHC 1st AB Stain x8 PROF #N/A

P20069 IHC 1st AB Stain x9 PROF #N/A

P20070 IHC 1st AB Stain x10 PROF #N/A

P20071 IHC 1st AB Stain x11 PROF #N/A

P20072 IHC 1st AB Stain x12 PROF #N/A

P20073 IHC 1st AB Stain x13 PROF #N/A

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P20074 IHC 1st AB Stain x14 PROF #N/A

P20075 IHC 1st AB Stain x15 PROF #N/A

P20076 IHC 1st AB Stain x16 PROF #N/A

P20077 IHC 1st AB Stain x17 PROF #N/A

P20078 IHC 1st AB Stain x18 PROF #N/A

P20079 IHC 1st AB Stain x19 PROF #N/A

P20080 IHC 1st AB Stain x20 PROF #N/A

P20081 IHC 1st AB Stain x21 PROF #N/A

P20082 IHC 1st AB Stain x22 PROF #N/A

P20083 IHC 1st AB Stain x23 PROF #N/A

P20084 IHC 1st AB Stain x24 PROF #N/A

P20085 IHC 1st AB Stain x25 PROF #N/A

P20086 IHC 1st AB Stain x26 PROF #N/A

P20087 IHC 1st AB Stain x27 PROF #N/A

P20088 IHC 1st AB Stain x28 PROF #N/A

P20089 IHC 1st AB Stain x29 PROF #N/A

P20090 IHC 1st AB Stain x30 PROF #N/A

P20291 IHC X1 RUO Prof #N/A

P20292 IHC X2 RUO Prof #N/A

P20293 IHC X3 RUO Prof #N/A

P20294 IHC X4 RUO Prof #N/A

P20295 IHC X5 RUO Prof #N/A

P20296 IHC X6 RUO Prof #N/A

P20297 IHC X7 RUO Prof #N/A

P20298 IHC X8 RUO Prof #N/A

P20299 IHC X9 RUO Prof #N/A

P20310 IHC X10 RUO Prof #N/A

P20321 Add'l IHC Per Slide X1 Prof #N/A

P20401 IHC ea Addl x1 RUO PROF #N/A

P20402 IHC ea Addl x2 RUO PROF #N/A

P20403 IHC ea Addl x3 RUO PROF #N/A

P20404 IHC ea Addl x4 RUO PROF #N/A

P20405 IHC ea Addl x5 RUO PROF #N/A

P20406 IHC ea Addl x6 RUO PROF #N/A

P20407 IHC ea Addl x7 RUO PROF #N/A

P20408 IHC ea Addl x8 RUO PROF #N/A

P20409 IHC ea Addl x9 RUO PROF #N/A

P20410 IHC ea Addl x10 RUO PROF #N/A

P20530 IHC ea addl AB Stain x1 PROF #N/A

P20531 IHC ea addl AB Stain x2 PROF #N/A

P20532 IHC ea addl AB Stain x3 PROF #N/A

P20533 IHC ea addl AB Stain x4 PROF #N/A

P20534 IHC ea addl AB Stain x5 PROF #N/A

P20535 IHC ea addl AB Stain x6 PROF #N/A

P20536 IHC ea addl AB Stain x7 PROF #N/A

P20537 IHC ea addl AB Stain x8 PROF #N/A

P20538 IHC ea addl AB Stain x9 PROF #N/A

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P20539 IHC ea addl AB Stain x10 PROF #N/A

P20540 IHC ea addl AB Stain x11 PROF #N/A

P20541 IHC ea addl AB Stain x12 PROF #N/A

P20542 IHC ea addl AB Stain x13 PROF #N/A

P20543 IHC ea addl AB Stain x14 PROF #N/A

P20544 IHC ea addl AB Stain x15 PROF #N/A

P20545 IHC ea addl AB Stain x16 PROF #N/A

P20546 IHC ea addl AB Stain x17 PROF #N/A

P20547 IHC ea addl AB Stain x18 PROF #N/A

P20548 IHC ea addl AB Stain x19 PROF #N/A

P20549 IHC ea addl AB Stain x20 PROF #N/A

P20550 IHC ea addl AB Stain x21 PROF #N/A

P20551 IHC ea addl AB Stain x22 PROF #N/A

P20552 IHC ea addl AB Stain x23 PROF #N/A

P20553 IHC ea addl AB Stain x24 PROF #N/A

P20554 IHC ea addl AB Stain x25 PROF #N/A

P20555 IHC ea addl AB Stain x26 PROF #N/A

P20556 IHC ea addl AB Stain x27 PROF #N/A

P20557 IHC ea addl AB Stain x28 PROF #N/A

P20558 IHC ea addl AB Stain x29 PROF #N/A

P20559 IHC ea addl AB Stain x30 PROF #N/A

P30001 IHC Multiplex x1 Prof #N/A

P30002 IHC Multiplex x2 Prof #N/A

P30003 IHC Multiplex x3 Prof #N/A

P30004 IHC Multiplex x4 Prof #N/A

P30005 IHC Multiplex x5 Prof #N/A

P30006 IHC Multiplex x6 Prof #N/A

P30007 IHC Multiplex x7 PROF #N/A

P30008 IHC Multiplex x8 Prof #N/A

P30009 IHC Multiplex x9 Prof #N/A

P30010 IHC Multiplex x10 Prof #N/A

P30111 IHC Multiplex x11 Prof #N/A

P30112 IHC Multiplex x12 Prof #N/A

P83001 Level I;Gross Only 1st (Prof) #N/A

P83041 Level III Surg Path 1st (Prof) #N/A

P83042 Level III Surg Path 2nd (Prof) #N/A

P83051 88305 Prof Comp-1st Site #N/A

P83052 88305 Prof Comp-2nd Site #N/A

P83053 88305 Prof Comp-3rd Site #N/A

P83054 88305 Prof Comp-4th Site #N/A

P83055 88305 Prof Comp-5th Site #N/A

P83056 88305 Prof Comp-6th Site #N/A

P83057 88305 Prof Comp-7th Site #N/A

P83058 88305 Prof Comp-8th Site #N/A

P83071 Level V Surg Path 1st (Prof) #N/A

P83072 Level V Surg Path 2nd (Prof) #N/A

P83121 Spec Stn;Grp I Micro 1st(Prof) #N/A

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P83421 88342-Prof Comp 1st Antibody #N/A

P83422 88342-Prof Comp 2nd Antibody #N/A

P83423 88342-Prof Comp 3rd Antibody #N/A

P83431 PC 1st addtl IHC Ab per slide #N/A

P83432 PC 2nd addtl IHC Ab per slide #N/A

P83433 PC 3rd addtl IHC Ab per slide #N/A

P83501 Prof Only Prostate Biopsy x1 #N/A

P83502 Prof Only Prostate Biopsy x2 #N/A

P83503 Prof Only Prostate Biopsy x3 #N/A

P83504 Prof Only Prostate Biopsy x4 #N/A

P83505 Prof Only Prostate Biopsy x5 #N/A

P83506 Prof Only Prostate Biopsy x6 #N/A

P83507 Prof Only Prostate Biopsy x7 #N/A

P83508 Prof Only Prostate Biopsy x8 #N/A

P83509 Prof Only Prostate Biopsy x9 #N/A

P83510 Prof Only Prostate Biopsy x10 #N/A

P83511 Prof Only Prostate Biopsy x11 #N/A

P83512 Prof Only Prostate Biopsy x12 #N/A

P83513 Prof Only Prostate Biopsy x13 #N/A

P83514 Prof Only Prostate Biopsy x14 #N/A

P83515 Prof Only Prostate Biopsy x15 #N/A

P83516 Prof Only Prostate Biopsy x16 #N/A

P83517 Prof Only Prostate Biopsy x17 #N/A

P83518 Prof Only Prostate Biopsy x18 #N/A

P83519 Prof Only Prostate Biopsy x19 #N/A

P83520 Prof Only Prostate Biopsy x20 #N/A

P83521 Prof Only Prostate Biopsy x21 #N/A

P83522 Prof Only Prostate Biopsy x22 #N/A

P83523 Prof Only Prostate Biopsy x23 #N/A

P83524 Prof Only Prostate Biopsy x24 #N/A

P83525 Prof Only Prostate Biopsy x25 #N/A

P83526 Prof Only Prostate Biopsy x26 #N/A

P83527 Prof Only Prostate Biopsy x27 #N/A

P83528 Prof Only Prostate Biopsy x28 #N/A

P83529 Prof Only Prostate Biopsy x29 #N/A

P83530 Prof Only Prostate Biopsy x30 #N/A

P83531 Prof Only Prostate Biopsy x31 #N/A

P83532 Prof Only Prostate Biopsy x32 #N/A

P83533 Prof Only Prostate Biopsy x33 #N/A

P83534 Prof Only Prostate Biopsy x34 #N/A

P83535 Prof Only Prostate Biopsy x35 #N/A

P83536 Prof Only Prostate Biopsy x36 #N/A

P83537 Prof Only Prostate Biopsy x37 #N/A

P83538 Prof Only Prostate Biopsy x38 #N/A

P83539 Prof Only Prostate Biopsy x39 #N/A

P83540 Prof Only Prostate Biopsy x40 #N/A

R83501 Prostate Biopsy x1 #N/A

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R83502 Prostate Biopsy x2 #N/A

R83503 Prostate Biopsy x3 #N/A

R83504 Prostate Biopsy x4 #N/A

R83505 Prostate Biopsy x5 #N/A

R83506 Prostate Biopsy x6 #N/A

R83507 Prostate Biopsy x7 #N/A

R83508 Prostate Biopsy x8 #N/A

R83509 Prostate Biopsy x9 #N/A

R83510 Prostate Biopsy x10 #N/A

R83511 Prostate Biopsy x11 #N/A

R83512 Prostate Biopsy x12 #N/A

R83513 Prostate Biopsy x13 #N/A

R83514 Prostate Biopsy x14 #N/A

R83515 Prostate Biopsy x15 #N/A

R83516 Prostate Biopsy x16 #N/A

R83517 Prostate Biopsy x17 #N/A

R83518 Prostate Biopsy x18 #N/A

R83519 Prostate Biopsy x19 #N/A

R83520 Prostate Biopsy x20 #N/A

R83521 Prostate Biopsy x21 #N/A

R83522 Prostate Biopsy x22 #N/A

R83523 Prostate Biopsy x23 #N/A

R83524 Prostate Biopsy x24 #N/A

R83525 Prostate Biopsy x25 #N/A

R83526 Prostate Biopsy x26 #N/A

R83527 Prostate Biopsy x27 #N/A

R83528 Prostate Biopsy x28 #N/A

R83529 Prostate Biopsy x29 #N/A

R83530 Prostate Biopsy x30 #N/A

R83531 Prostate Biopsy x31 #N/A

R83532 Prostate Biopsy x32 #N/A

R83533 Prostate Biopsy x33 #N/A

R83534 Prostate Biopsy x34 #N/A

R83535 Prostate Biopsy x35 #N/A

R83536 Prostate Biopsy x36 #N/A

R83537 Prostate Biopsy x37 #N/A

R83538 Prostate Biopsy x38 #N/A

R83539 Prostate Biopsy x39 #N/A

R83540 Prostate Biopsy x40 #N/A

S00001 Sensitivity Organism #1 #N/A

S00002 Sensitivity Organism #2 #N/A

S00003 Sensitivity Organism #3 #N/A

S00004 Sensitivity Organism #4 #N/A

T20061 Immunohistochem X1 Tech #N/A

T20062 Immunohistochem X2 Tech #N/A

T20063 Immunohistochem X3 Tech #N/A

T20064 Immunohistochem X4 Tech #N/A

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T20065 Immunohistochem X5 Tech #N/A

T20066 Immunohistochem X6 Tech #N/A

T20067 Immunohistochem X7 Tech #N/A

T20068 Immunohistochem X8 Tech #N/A

T20069 Immunohistochem X9 Tech #N/A

T20070 Immunohistochem X10 Tech #N/A

T20071 Immunohistochem X11 Tech #N/A

T20072 Immunohistochem X12 Tech #N/A

T20073 Immunohistochem X13 Tech #N/A

T20074 Immunohistochem X14 Tech #N/A

T20075 Immunohistochem X15 Tech #N/A

T20076 Immunohistochem X16 Tech #N/A

T20077 Immunohistochem X17 Tech #N/A

T20078 Immunohistochem X18 Tech #N/A

T20079 Immunohistochem X19 Tech #N/A

T20080 Immunohistochem X20 Tech #N/A

T20081 IHC 1st AB Stain x21 TECH #N/A

T20082 Immunohistochem X22 Tech #N/A

T20083 IHC 1st AB Stain x23 TECH #N/A

T20084 IHC 1st AB Stain x24 TECH #N/A

T20085 Immunohistochem X25 Tech #N/A

T20086 IHC 1st AB Stain x26 TECH #N/A

T20087 IHC 1st AB Stain x27 TECH #N/A

T20088 IHC 1st AB Stain x28 TECH #N/A

T20089 IHC 1st AB Stain x29 TECH #N/A

T20090 Immunohistochem X30 Tech #N/A

T20291 IHC X1 RUO Tech #N/A

T20292 IHC X2 RUO Tech #N/A

T20293 IHC X3 RUO Tech #N/A

T20294 IHC X4 RUO Tech #N/A

T20295 IHC X5 RUO Tech #N/A

T20296 IHC X6 RUO Tech #N/A

T20297 IHC X7 RUO Tech #N/A

T20298 IHC X8 RUO Tech #N/A

T20299 IHC X9 RUO Tech #N/A

T20310 IHC X10 RUO Tech #N/A

T20321 Add'l IHC Per Slide X1 Tech #N/A

T20401 IHC ea Addl x1 RUO TECH #N/A

T20402 IHC ea Addl x2 RUO TECH #N/A

T20403 IHC ea Addl x3 RUO TECH #N/A

T20404 IHC ea Addl x4 RUO TECH #N/A

T20405 IHC ea Addl x5 RUO TECH #N/A

T20406 IHC ea Addl x6 RUO TECH #N/A

T20407 IHC ea Addl x7 RUO TECH #N/A

T20408 IHC ea Addl x8 RUO TECH #N/A

T20409 IHC ea Addl x9 RUO TECH #N/A

T20410 IHC ea Addl x10 RUO TECH #N/A

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T20530 IHC ea addl AB Stain x1 TECH #N/A

T20531 IHC ea addl AB Stain x2 TECH #N/A

T20532 IHC ea addl AB Stain x3 TECH #N/A

T20533 IHC ea addl AB Stain x4 TECH #N/A

T20534 IHC ea addl AB Stain x5 TECH #N/A

T20535 IHC ea addl AB Stain x6 TECH #N/A

T20536 IHC ea addl AB Stain x7 TECH #N/A

T20537 IHC ea addl AB Stain x8 TECH #N/A

T20538 IHC ea addl AB Stain x9 TECH #N/A

T20539 IHC ea addl AB Stain x10 TECH #N/A

T20540 IHC ea addl AB Stain x11 TECH #N/A

T20541 IHC ea addl AB Stain x12 TECH #N/A

T20542 IHC ea addl AB Stain x13 TECH #N/A

T20543 IHC ea addl AB Stain x14 TECH #N/A

T20544 IHC ea addl AB Stain x15 TECH #N/A

T20545 IHC ea addl AB Stain x16 TECH #N/A

T20546 IHC ea addl AB Stain x17 TECH #N/A

T20547 IHC ea addl AB Stain x18 TECH #N/A

T20548 IHC ea addl AB Stain x19 TECH #N/A

T20549 IHC ea addl AB Stain x20 TECH #N/A

T20550 IHC ea addl AB Stain x21 TECH #N/A

T20551 IHC ea addl AB Stain x22 TECH #N/A

T20552 IHC ea addl AB Stain x23 TECH #N/A

T20553 IHC ea addl AB Stain x24 TECH #N/A

T20554 IHC ea addl AB Stain x25 TECH #N/A

T20555 IHC ea addl AB Stain x26 TECH #N/A

T20556 IHC ea addl AB Stain x27 TECH #N/A

T20557 IHC ea addl AB Stain x28 TECH #N/A

T20558 IHC ea addl AB Stain x29 TECH #N/A

T20559 IHC ea addl AB Stain x30 TECG #N/A

T30001 IHC Multiplex x1 Tech #N/A

T30002 IHC Multiplex x2 Tech #N/A

T30003 IHC Multiplex x3 Tech #N/A

T30004 IHC Multiplex x4 Tech #N/A

T30005 IHC Multiplex x5 Tech #N/A

T30006 IHC Multiplex x6 Tech #N/A

T30007 IHC Multiplex x7 Tech #N/A

T30008 IHC Multiplex x8 Tech #N/A

T30009 IHC Multiplex x9 Tech #N/A

T30010 IHC Multiplex x10 Tech #N/A

T30111 IHC Multiplex x11 Tech #N/A

T30112 IHC Multiplex x12 Tech #N/A

T83001 88300 Tech Comp-1st Site #N/A

T83041 88304 Tech Comp-1st Site #N/A

T83042 88304 Tech Comp-2nd Site #N/A

T83051 88305 Tech Comp-1st Site #N/A

T83052 88305 Tech Comp-2nd Site #N/A

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T83053 88305 Tech Comp-3rd Site #N/A

T83054 88305 Tech Comp-4th Site #N/A

T83056 88305 Tech Comp-6th Site #N/A

T83057 88305 Tech Comp-7th Site #N/A

T83058 88305 Tech Comp-8th Site #N/A

T83071 88307 Tech Comp-1st Site #N/A

T83072 88307 Tech Comp-2nd Site #N/A

T83121 88312 Tech Comp-1st Stain #N/A

T83421 88342 Tech Comp-1st Antibody #N/A

T83422 88342 Tech Comp-2nd Antibody #N/A

T83423 88342 Tech Comp-3rd Antibody #N/A

T83431 TC 1st addtl IHC Ab per slide #N/A

T83432 TC 2nd addtl IHC Ab per slide #N/A

T83433 TC 3rd addtl IHC Ab per slide #N/A

T83501 Tech Only Prostate Biopsy x1 #N/A

T83502 Tech Only Prostate Biopsy x2 #N/A

T83503 Tech Only Prostate Biopsy x3 #N/A

T83504 Tech Only Prostate Biopsy x4 #N/A

T83505 Tech Only Prostate Biopsy x5 #N/A

T83506 Tech Only Prostate Biopsy x6 #N/A

T83507 Tech Only Prostate Biopsy x7 #N/A

T83508 Tech Only Prostate Biopsy x8 #N/A

T83509 Tech Only Prostate Biopsy x9 #N/A

T83510 Tech Only Prostate Biopsy x10 #N/A

T83511 Tech Only Prostate Biopsy x11 #N/A

T83512 Tech Only Prostate Biopsy x12 #N/A

T83513 Tech Only Prostate Biopsy x13 #N/A

T83514 Tech Only Prostate Biopsy x14 #N/A

T83515 Tech Only Prostate Biopsy x15 #N/A

T83516 Tech Only Prostate Biopsy x16 #N/A

T83517 Tech Only Prostate Biopsy x17 #N/A

T83518 Tech Only Prostate Biopsy x18 #N/A

T83519 Tech Only Prostate Biopsy x19 #N/A

T83520 Tech Only Prostate Biopsy x20 #N/A

T83521 Tech Only Prostate Biopsy x21 #N/A

T83522 Tech Only Prostate Biopsy x22 #N/A

T83523 Tech Only Prostate Biopsy x23 #N/A

T83524 Tech Only Prostate Biopsy x24 #N/A

T83525 Tech Only Prostate Biopsy x25 #N/A

T83526 Tech Only Prostate Biopsy x26 #N/A

T83527 Tech Only Prostate Biopsy x27 #N/A

T83528 Tech Only Prostate Biopsy x28 #N/A

T83529 Tech Only Prostate Biopsy x29 #N/A

T83530 Tech Only Prostate Biopsy x30 #N/A

T83531 Tech Only Prostate Biopsy x31 #N/A

T83532 Tech Only Prostate Biopsy x32 #N/A

T83533 Tech Only Prostate Biopsy x33 #N/A

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T83534 Tech Only Prostate Biopsy x34 #N/A

T83535 Tech Only Prostate Biopsy x35 #N/A

T83536 Tech Only Prostate Biopsy x36 #N/A

T83537 Tech Only Prostate Biopsy x37 #N/A

T83538 Tech Only Prostate Biopsy x38 #N/A

T83539 Tech Only Prostate Biopsy x39 #N/A

T83540 Tech Only Prostate Biopsy x40 #N/A

W20061 IHC 1st AB Stain x1 GLBL #N/A

W20062 IHC 1st AB Stain x2 GLBL #N/A

W20063 IHC 1st AB Stain x3 GLBL #N/A

W20064 Immunohistochem X4 Global #N/A

W20065 Immunohistochem X5 Global #N/A

W20066 IHC 1st AB Stain x6 GLBL #N/A

W20067 IHC 1st AB Stain x7 GLBL #N/A

W20068 IHC 1st AB Stain x8 GLBL #N/A

W20069 IHC 1st AB Stain x9 GLBL #N/A

W20070 IHC 1st AB Stain x10 GLBL #N/A

W20071 IHC 1st AB Stain x11 GLBL #N/A

W20072 Immunohistochem X12 Global #N/A

W20073 IHC 1st AB Stain x13 GLBL #N/A

W20074 Immunohistochem X14 Global #N/A

W20075 IHC 1st AB Stain x15 GLBL #N/A

W20076 IHC 1st AB Stain x16 GLBL #N/A

W20077 Immunohistochem X17 Global #N/A

W20078 IHC 1st AB Stain x18 GLBL #N/A

W20079 IHC 1st AB Stain x19 GLBL #N/A

W20080 IHC 1st AB Stain x20 GLBL #N/A

W20081 IHC 1st AB Stain x21 GLBL #N/A

W20082 IHC 1st AB Stain x22 GLBL #N/A

W20083 IHC 1st AB Stain x23 GLBL #N/A

W20084 IHC 1st AB Stain x24 GLBL #N/A

W20085 IHC 1st AB Stain x25 GLBL #N/A

W20086 IHC 1st AB Stain x26 GLBL #N/A

W20087 IHC 1st AB Stain x27 GLBL #N/A

W20088 IHC 1st AB Stain x28 GLBL #N/A

W20089 IHC 1st AB Stain x29 GLBL #N/A

W20090 IHC 1st AB Stain x30 GLBL #N/A

W20291 IHC X1 RUO Global #N/A

W20292 IHC X2 RUO Global #N/A

W20293 IHC X3 RUO Global #N/A

W20294 IHC X4 RUO Global #N/A

W20295 IHC X5 RUO Global #N/A

W20296 IHC X6 RUO Global #N/A

W20297 IHC X7 RUO Global #N/A

W20298 IHC X8 RUO Global #N/A

W20299 IHC X9 RUO Global #N/A

W20310 IHC X10 RUO Global #N/A

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W20321 Add'l IHC Per Slide X1 Glbl #N/A

W20401 IHC ea Addl x1 RUO GLBL #N/A

W20402 IHC ea Addl x2 RUO GLBL #N/A

W20403 IHC ea Addl x3 RUO GLBL #N/A

W20404 IHC ea Addl x4 RUO GLBL #N/A

W20405 IHC ea Addl x5 RUO GLBL #N/A

W20406 IHC ea Addl x6 RUO GLBL #N/A

W20407 IHC ea Addl x7 RUO GLBL #N/A

W20408 IHC ea Addl x8 RUO GLBL #N/A

W20409 IHC ea Addl x9 RUO GLBL #N/A

W20410 IHC ea Addl x10 RUO GLBL #N/A

W20530 IHC ea addl AB Stain x1 GLBL #N/A

W20531 IHC ea addl AB Stain x2 GLBL #N/A

W20532 IHC ea addl AB Stain x3 GLBL #N/A

W20533 IHC ea addl AB Stain x4 GLBL #N/A

W20534 IHC ea addl AB Stain x5 GLBL #N/A

W20535 IHC ea addl AB Stain x6 GLBL #N/A

W20536 IHC ea addl AB Stain x7 GLBL #N/A

W20537 IHC ea addl AB Stain x8 GLBL #N/A

W20538 IHC ea addl AB Stain x9 GLBL #N/A

W20539 IHC ea addl AB Stain x10 GLBL #N/A

W20540 IHC ea addl AB Stain x11 GLBL #N/A

W20541 IHC ea addl AB Stain x12 GLBL #N/A

W20542 IHC ea addl AB Stain x13 GLBL #N/A

W20543 IHC ea addl AB Stain x14 GLBL #N/A

W20544 IHC ea addl AB Stain x15 GLBL #N/A

W20545 IHC ea addl AB Stain x16 GLBL #N/A

W20546 IHC ea addl AB Stain x17 GLBL #N/A

W20547 IHC ea addl AB Stain x18 GLBL #N/A

W20548 IHC ea addl AB Stain x19 GLBL #N/A

W20549 IHC ea addl AB Stain x20 GLBL #N/A

W20550 IHC ea addl AB Stain x21 GLBL #N/A

W20551 IHC ea addl AB Stain x22 GLBL #N/A

W20552 IHC ea addl AB Stain x23 GLBL #N/A

W20553 IHC ea addl AB Stain x24 GLBL #N/A

W20554 IHC ea addl AB Stain x25 GLBL #N/A

W20555 IHC ea addl AB Stain x26 GLBL #N/A

W20556 IHC ea addl AB Stain x27 GLBL #N/A

W20557 IHC ea addl AB Stain x28 GLBL #N/A

W20558 IHC ea addl AB Stain x29 GLBL #N/A

W20559 IHC ea addl AB Stain x30 GLBL #N/A

W30001 IHC Multiplex X1 Gbl #N/A

W30002 IHC Multiplex X2 Gbl #N/A

W30003 IHC Multiplex X3 Gbl #N/A

W30004 IHC Multiplex X4 Gbl #N/A

W30005 IHC Multiplex X5 Gbl #N/A

W30006 IHC Multiplex X6 Gbl #N/A

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W30007 IHC Multiplex X7 Gbl #N/A

W30008 IHC Multiplex X8 Gbl #N/A

W30009 IHC Multiplex X9 Gbl #N/A

W30010 IHC Multiplex X10 Gbl #N/A

W30111 IHC Multiplex X11 Gbl #N/A

W30112 IHC Multiplex X12 Gbl #N/A

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TEST_NUMBERTEST_NAMEPRICE_REGION___LABPRICE_SCALETEST_DISC_SWPROCEDURE_CLASSBOOK_PRICEACTIVE_DELETE_SWDRCTY_OF_SERV_SW

000273 CMP12+6AC R1 1 Y GN 32.25 A N

000455 Thyroid Panel R1 1 Y RI 61.25 A Y

000505 HFP7+3AC R1 1 Y AC 31.5 A N

000604 Cl+K+Na R1 1 Y AC 28 A N

000620 Thyroid Panel With TSH R1 1 Y RI 137.5 A Y

000703 Renin Activity and AldosteroneR1 1 N RI 255.75 A Y

000810 Vitamin B12 and Folate R1 1 Y RI 157.75 A Y

001016 Calcium, Serum R1 1 Y AC 27 A Y

001024 Phosphorus, Serum R1 1 Y AC 27 A Y

001032 Glucose, Serum R1 1 Y AC 27 A Y

001040 BUN R1 1 Y AC 27 A Y

001057 Uric Acid, Serum R1 1 Y AC 27 A Y

001065 Cholesterol, Total R1 1 Y AC 27 A Y

001073 Protein, Total, Serum R1 1 Y AC 27 A Y

001081 Albumin, Serum R1 1 Y AC 27 A Y

001099 Bilirubin, Total R1 1 Y AC 27 A Y

001107 Alkaline Phosphatase, S R1 1 Y AC 27 A Y

001115 LDH R1 1 Y AC 27 A Y

001123 AST (SGOT) R1 1 Y AC 27 A Y

001149 Thyroxine (T4) R1 1 Y RI 30.5 A Y

001156 T3 Uptake R1 1 Y RI 30.75 A Y

001172 Triglycerides R1 1 Y AC 27 A Y

001180 Potassium, Serum R1 1 Y AC 27 A Y

001198 Sodium, Serum R1 1 Y AC 27 A Y

001206 Chloride, Serum R1 1 Y AC 27 A Y

001214 Bilirubin, Total/Direct, SerumR1 1 Y AC 27.5 A Y

001222 Bilirubin, Direct R1 1 Y AC 27 A Y

001255 Glucose Fasting and 2hr R1 1 Y MC 54 A N

001321 Iron and TIBC R1 1 Y AC 54 A Y

001339 Iron, Serum R1 1 Y AC 27 A Y

001354 Fecal Fat, Quantitative R1 1 N SC 125.25 A Y

001362 Creatine Kinase,Total,Serum R1 1 Y AC 27 A Y

001370 Creatinine, Serum R1 1 Y AC 27 A Y

001396 Amylase, Serum R1 1 Y AC 37.25 A Y

001404 Lipase, Serum R1 1 Y AC 37.25 A Y

001453 Hemoglobin A1c R1 1 Y AC 50.75 A Y

001479 Vitamin C R1 1 N SC 75.75 A Y

001487 Protein Electro.,S R1 1 N SC 67.75 A Y

001495 IFE and PE, Serum R1 1 N SC 280.25 A Y

001496 Immunofixation Reflex, Serum R1 1 N SC 212.5 A N

001503 Vitamin B12 R1 1 Y RI 87 A Y

001529 Carotene, Beta R1 1 N SC 87.75 A Y

001537 Magnesium, Serum R1 1 Y AC 36.25 A Y

001545 ALT (SGPT) R1 1 Y AC 27 A Y

001560 Ceruloplasmin R1 1 Y AC 56.5 A Y

001578 Carbon Dioxide, Total R1 1 Y AC 27 A Y

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001586 Copper, Serum R1 1 N TX 81.25 A Y

001594 Cryoglobulin, Ql, Serum, Rflx R1 1 N SC 29.75 A Y

001610 Fibrinogen Activity R1 1 N HE 75 A Y

001612 Alk Phos Isoenzyme R1 1 N SC 89.75 A Y

001628 Haptoglobin R1 1 Y AC 83 A Y

001677 Fecal Fat, Qualitative R1 1 N SC 81 A Y

001685 Immunofixation, Serum R1 1 N SC 212.5 A Y

001693 Glycohemoglobin (GHb),Total R1 1 N SC 50.75 A N

001701 5' Nucleotidase R1 1 N SC 95.75 A Y

001727 Phospholipids, Serum R1 1 N SC 58.25 A Y

001735 Thyroxine Binding Globulin R1 1 Y RI 98.5 A Y

001768 Immunoglobulins A/G/M, Qn, SerR1 1 Y AC 141.75 A Y

001776 Immunoglobulin G, Qn, Serum R1 1 Y AC 47.25 A Y

001784 Immunoglobulin A, Qn, Serum R1 1 Y AC 47.25 A Y

001792 Immunoglobulin M, Qn, Serum R1 1 Y AC 47.25 A Y

001800 Zinc, Plasma or Serum R1 1 N TX 74 A Y

001818 Glucose, Plasma R1 1 Y AC 27 A Y

001834 Complement C4, Serum R1 1 Y AC 66.5 A Y

001842 LD Isoenzymes R1 1 N SC 80 A Y

001859 CK+LD, Totals+Isoenzymes R1 1 N SC 153.5 A Y

001909 Alb+Prot R1 1 Y AC 27.5 A N

001917 G-6-PD, Quant, Blood and RBC R1 1 N SC 86.5 A Y

001925 HDL Cholesterol R1 1 Y AC 49.5 A Y

001941 Complement, Total (CH50) R1 1 N SC 102.75 A Y

001958 GGT R1 1 Y AC 27 A Y

001966 Leukocyte Alkaline Phos Score R1 1 N HE 61.5 A Y

001974 Thyroxine (T4) Free, Direct, SR1 1 Y RI 82.5 A Y

001976 Thyroxine (T4) Free, Direct, SR1 1 Y RI 82.5 A N

001977 Thyroxine (T4) Free, Direct, SR1 1 Y RI 82.5 A N

001982 Alpha-1-Antitrypsin, Serum R1 1 Y AC 72.5 A Y

002014 Folate (Folic Acid), Serum R1 1 Y RI 70.75 A Y

002022 Glucose, Two-Hour PostprandialR1 1 Y MC 27 A Y

002030 Aldolase R1 1 N SC 59.25 A Y

002071 Osmolality R1 1 Y RI 55 A Y

002139 CEA R1 1 Y RI 86 A Y

002154 CK, Total+Isoenzymes, Serum R1 1 N SC 73.5 A Y

002170 Immunoglobulin E, Total R1 1 Y AL 81.25 A Y

002188 Triiodothyronine (T3) R1 1 Y RI 93.25 A Y

002253 AFP, Serum, Tumor Marker R1 1 Y RI 76.25 A Y

002261 CA 19-9 R1 1 N RI 119.5 A Y

002295 Immunoglobulins A/E/G/M, SerumR1 1 Y AC 223 A Y

002303 Cancer Antigen (CA) 125 R1 1 Y RI 122.75 A Y

002311 Creatine Kinase (CK), MB/TotalR1 1 N RI 164.5 A Y

002329 Urea Nitrogen Clearance R1 1 Y AC 57.75 A Y

002402 Creatine, Serum R1 1 N SC 40.25 A Y

002626 HFP7+3AC R1 1 Y GN 26 A N

003004 Creatinine Clearance R1 1 Y AC 63 A Y

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003012 Creatinine, 24-Hour Urine R1 1 Y AC 36 A Y

003038 Urinalysis, Routine R1 1 Y UR 21.5 A Y

003053 Porphobilinogen, Qn, Random UrR1 1 N SC 83.5 A Y

003079 Myoglobin, Urine R1 1 N RI 109.25 A Y

003103 Porphobilinogen, Qn, 24-Hr Ur R1 1 N SC 83.5 A Y

003129 Prot+CreatU (Random) R1 1 Y AC 65.25 A Y

003160 Chloride, 24 hr Urine R1 1 Y AC 28.5 A Y

003178 Sodium, 24 hr Urine R1 1 Y AC 28.5 A Y

003186 Potassium, 24 hr Urine R1 1 Y AC 29.25 A Y

003194 Porphyrins, Qn, 24 Hr Ur. R1 1 N SC 98.25 A Y

003228 Bile, Qualitative, Urine R1 1 Y UR 37.25 A Y

003251 Phosphorus, 24 hr Urine R1 1 Y AC 29.25 A Y

003269 Calcium, 24Hr Urine R1 1 Y AC 28.5 A Y

003277 Protein Total, Qn, 24-Hr UrineR1 1 Y AC 29.25 A Y

003293 Amylase, Urine R1 1 Y MC 37.25 A Y

003343 Copper, Urine R1 1 N TX 81.25 A Y

003368 Protein Electro, 24-Hour UrineR1 1 N SC 132.75 A Y

003376 Glucose, Quantitative, Urine R1 1 Y AC 27 A Y

003400 Magnesium, Urine R1 1 N TX 31.5 A Y

003418 Uric Acid, 24 hr Urine R1 1 Y AC 29.25 A Y

003442 Osmolality, Urine R1 1 Y RI 55 A Y

003467 IFE+Protein Electro, 24-Hr Ur R1 1 N SC 301.5 A Y

003475 Creatine, 24-Hour Urine R1 1 N SC 40.25 A Y

003715 PE(Rfx IFE), Random Ur R1 1 N SC 132.75 A Y

003772 Urinalysis, Complete R1 1 Y UR 26 A Y

003855 Creatine+Creatinine, 24-Hr Ur R1 1 N SC 76.25 A Y

003921 Urinalysis (No Micro) Waived R1 1 Y UR 20 A N

003970 Oxalate, Quant, 24-Hour Urine R1 1 N SC 74 A Y

004020 DHEA-Sulfate R1 1 N RI 110.25 A Y

004036 Pregnancy Test, Urine R1 1 N SE 50.75 A Y

004044 Metanephrines, Pheochromocyt R1 1 N TX 219.5 A Y

004051 Cortisol R1 1 N RI 80 A Y

004069 5-HIAA,Quant.,24 Hr Urine R1 1 N TX 71.5 A Y

004100 DHEA, Serum R1 1 N RI 181.75 A Y

004143 Vanillylmandelic Acid, 24-Hr UR1 1 N TX 75.25 A Y

004176 Catecholamines,Ur.,Free,24 Hr R1 1 N TX 152 A Y

004226 Testosterone, Serum R1 1 Y RI 128.5 A Y

004234 Metanephrines, Frac, Qn, 24-HrR1 1 N TX 183.5 A Y

004259 TSH R1 1 Y RI 76.25 A Y

004275 Growth Hormone, Serum R1 1 Y RI 84.5 A Y

004280 Tryptase R1 1 N RI 146 A Y

004283 Luteinizing Hormone(LH), S R1 1 Y RI 85.75 A Y

004291 Aldosterone, Urine R1 1 N RI 193.75 A Y

004309 FSH, Serum R1 1 Y RI 88 A Y

004317 Progesterone R1 1 Y RI 110.75 A Y

004333 Insulin R1 1 Y RI 59 A Y

004354 Aldosterone/Renin Ratio R1 1 N RI 255.75 A Y

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004374 Aldosterone LCMS, Serum R1 1 N RI 141 A Y

004390 Gastrin, Serum R1 1 N RI 78.5 A Y

004416 hCG,Beta Subunit, Qnt, Serum R1 1 Y RI 100 A Y

004432 Cortisol, Urinary Free R1 1 N TX 146.75 A Y

004440 ACTH, Plasma R1 1 N RI 171.75 A Y

004465 Prolactin R1 1 Y RI 110.75 A Y

004515 Estradiol R1 1 Y RI 144.25 A Y

004549 Estrogens, Total R1 1 N RI 122.75 A Y

004556 hCG,Beta Subunit,Qual,Serum R1 1 Y RI 91.5 A Y

004598 Ferritin, Serum R1 1 Y RI 62.75 A Y

004655 Vitamin B6, Plasma R1 1 N SC 158.5 A Y

004747 Prostatic Acid Phos, Serum R1 1 Y RI 74 A Y

004770 Lactic Acid, Plasma R1 1 Y AC 74 A Y

004804 Calcium, Ionized, Serum R1 1 Y RI 75.25 A Y

004861 Viscosity, Serum R1 1 N SC 72.5 A Y

004887 Ketone Bodies, Serum R1 1 N XX 44.5 A N

004895 Calcitonin, Serum R1 1 N RI 175.5 A Y

004937 Transferrin R1 1 Y AC 67.25 A Y

004945 Ca+Creat+P+PTH Intact R1 1 Y GN 164.5 A N

005009 CBC With Differential/PlateletR1 1 Y HE 25.75 A Y

005017 CBC, No Differential/Platelet R1 1 Y HE 25.25 A N

005025 WBC R1 1 Y HE 24.5 A Y

005033 RBC R1 1 Y HE 24.5 A Y

005041 Hemoglobin R1 1 Y HE 24.5 A Y

005058 Hematocrit R1 1 Y HE 24.5 A Y

005090 Differential WBC Count R1 1 Y HE 24.25 A N

005199 Prothrombin Time (PT) R1 1 Y HE 30 A Y

005207 PTT, Activated R1 1 Y HE 36 A Y

005215 Sedimentation Rate-Westergren R1 1 Y HE 24.75 A Y

005223 Hgb Solubility R1 1 N SC 67.75 A Y

005231 Cell Ct, Synovial w/Crystals R1 1 N HE 122.25 A Y

005249 Platelet Count R1 1 Y HE 24.5 A Y

005256 Cell Count, CSF R1 1 N HE 55.5 A Y

005280 Reticulocyte Count R1 1 Y HE 29.75 A Y

005298 Eosinophil Count R1 1 Y HE 24.5 A Y

005300 Hematopath Consultation, SmearR1 1 N HE 70.25 A Y

005330 HB Solu + Rflx Frac R1 1 N SC 67.75 A Y

005355 Crystal,Synovial/Joint Fl R1 1 N HE 66.75 A Y

005595 Hemoglobin, Free, Plasma R1 1 N SC 75.25 A Y

005702 Blood Drawing R1 1 N VN 20 A N

006015 Antibody Screen R1 1 Y BB 30.5 A Y

006023 Antibody Identification R1 1 N BB 87 A N

006031 Antistreptolysin O Ab R1 1 Y SE 41.5 A Y

006049 ABO Grouping and Rho(D) TypingR1 1 Y BB 60.25 A Y

006056 ABO Grouping R1 1 Y BB 30.25 A Y

006064 Rh Factor R1 1 Y BB 30 A Y

006072 RPR R1 1 Y SE 27.5 A Y

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006099 RPR R1 1 Y SE 27.5 A N

006189 Mononucleosis Test, Qual R1 1 Y SE 50.75 A Y

006197 Rubella Antibodies, IgG R1 1 Y SE 54.5 A Y

006213 Antibody Identification R1 1 N BB 87 A Y

006270 Coombs', Direct R1 1 N BB 35.25 A Y

006338 Antiextractable Nuclear Ag R1 1 N SE 206.5 A Y

006353 Cold Agglutinin Titer, Quant R1 1 Y SE 74 A Y

006379 T pallidum Ab (FTA-Ab) R1 1 Y SE 79.75 A Y

006395 Hep B Surface Ab R1 1 Y HT 70.25 A Y

006445 VDRL, CSF R1 1 N SE 53.25 A Y

006452 Complement C3, Serum R1 1 Y AC 66.5 A Y

006460 Rapid Plasma Reagin, Quant R1 1 Y SE 27.5 A Y

006478 Toxoplasma gondii Ab, IgG, Qn R1 1 N SE 73.25 A Y

006486 Antiparietal Cell Antibody R1 1 N SE 98.5 A Y

006494 Cytomegalovirus (CMV) Ab, IgG R1 1 N SE 92 A Y

006502 Rheumatoid Arthritis Factor R1 1 Y SE 33.5 A Y

006510 HBsAg Screen R1 1 Y HT 59.5 A Y

006530 Hepatitis B Surf Ab Quant R1 1 Y HT 70.25 A Y

006536 Mono Qual W/Rflx Qn R1 1 Y SE 50.75 A Y

006551 Cryptococcus Antigen, Serum R1 1 N XX 90.75 A N

006553 Cryptococcus Ag Titer R1 1 N SE 90.75 A N

006619 Hep Be Ag R1 1 N HT 62.75 A Y

006627 C-Reactive Protein, Quant R1 1 Y SE 52.25 A Y

006635 Hep Be Ab R1 1 N HT 62.75 A Y

006643 Actin (Smooth Muscle) AntibodyR1 1 N SE 98.5 A Y

006650 Mitochondrial (M2) Antibody R1 1 N SE 98.5 A Y

006676 Thyroid Peroxidase (TPO) Ab R1 1 Y RI 66 A Y

006684 Thyroid Antibodies R1 1 N RI 150.5 A Y

006692 Antithyroglobulin Ab R1 1 N RI 84.5 A Y

006694 Thyroglobulin, Serum R1 1 N RI 99 A N

006718 Hep B Core Ab, Tot R1 1 Y HT 77.5 A Y

006726 Hep A Ab, Total R1 1 Y HT 73.5 A Y

006734 Hep A Ab, IgM R1 1 Y HT 77.25 A Y

006841 Mucin Clot,Synovial Fl R1 1 N HE 22.75 A Y

006866 Rotavirus Ag, EIA R1 1 N VX 116.75 A Y

006890 Bacterial Antigens R1 1 N MZ 602 A Y

006924 HLA B 27 Disease Association R1 1 N HA 170 A Y

006926 HLA B5701 Test R1 1 N HA 143.75 A Y

006981 Autoimmune Profile R1 1 N GN 206 A Y

007012 Lacosamide R1 1 N TX 186.75 A Y

007034 Drug Screen (Blood or Serum) R1 1 N TX 200 A Y

007054 Ammonia, Plasma R1 1 Y AC 98.25 A Y

007062 Volatiles, Blood R1 1 N TX 86.25 A Y

007153 Tobramycin Random, Serum R1 1 Y TX 92 A N

007161 Gentamicin Random, Serum R1 1 Y TX 90 A N

007162 Gentamicin Peak, Serum R1 1 Y TX 90 A Y

007163 Gentamicin Trough, Serum R1 1 Y TX 90 A Y

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007183 Cyclosporine IA/IA Rebaseline R1 1 N XX 141 A N

007187 Carbon Monoxide, Blood R1 1 N TX 88.5 A Y

007237 Ethanol, Urine R1 1 N TX 67.75 A Y

007260 Valproic Acid (Depakote)(R),S R1 1 Y TX 98.25 A Y

007286 Cholinesterase, RBC R1 1 N SC 76.75 A Y

007336 Theophylline, Serum R1 1 Y TX 83.5 A Y

007351 ALA Delta, Random Urine R1 1 N SC 198.25 A Y

007385 Digoxin, Serum R1 1 Y RI 77.5 A Y

007393 Nortriptyline (Aventyl), SerumR1 1 N TX 129 A Y

007401 Phenytoin (Dilantin), Serum R1 1 Y TX 76.25 A Y

007419 Carbamazepine(Tegretol), S R1 1 Y TX 98.25 A Y

007468 Imipramine (Tofranil), Serum R1 1 N TX 120.25 A Y

007476 Amitriptyline (Elavil), Serum R1 1 N TX 127.25 A Y

007492 Heavy Metals Profile, Urine R1 1 N TX 257.5 A Y

007609 Doxepin (Sinequan), Serum R1 1 N TX 120.25 A Y

007625 Lead, Blood (Adult) R1 1 N TX 61 A Y

007629 Lead, Blood R1 1 Y TX 61 A N

007690 Tricyclic Antidepressants R1 1 N TX 110.75 A Y

007708 Lithium (Eskalith(R)), Serum R1 1 Y TX 51.75 A Y

007740 Acetaminophen (Tylenol), S R1 1 N TX 98.25 A Y

007765 Desipramine, Serum R1 1 N TX 130 A Y

007773 Mercury, Urine R1 1 N TX 116.75 A Y

007781 Methadone (Dolophine), Serum R1 1 N TX 116.75 A Y

007823 Phenobarbital, Serum R1 1 Y TX 86.25 A Y

007849 Salicylate, Serum R1 1 N TX 82.5 A Y

007856 Primidone (Mysoline(R)), SerumR1 1 N TX 180.75 A Y

007915 Zonisamide(Zonegran), Serum R1 1 N TX 102.25 A Y

007930 Clorazepate (Tranxene(R)), S R1 1 N TX 110.75 A Y

007989 Diazepam (Valium), Serum R1 1 N TX 116.75 A Y

008003 Anaerobic and Aerobic Culture R1 1 N MI 198.5 A Y

008086 Urine Culture,Comprehensive R1 1 N MI 82.5 A Y

008087 Urine Culture, Comprehensive R1 1 N MI 82.5 A N

008128 GC Culture Only R1 1 N MI 37.25 A Y

008136 Fungus Stain R1 1 N MI 55 A Y

008144 Stool Culture R1 1 N MI 163.25 A Y

008169 Beta Strep Gp A Culture R1 1 N MZ 37.25 A Y

008185 Parasite Exam, Blood R1 1 N HE 98.25 A Y

008201 Cytomegalovirus (CMV) Culture R1 1 N VI 168 A Y

008250 HSV Culture and Typing R1 1 N VI 127.25 A Y

008300 Blood Culture, Routine R1 1 N MI 63.5 A Y

008334 Genital Culture, Routine R1 1 N MI 65.25 A Y

008342 Upper Respiratory Culture R1 1 N MI 65.25 A Y

008458 Reference Bacterial Culture IDR1 1 N MI 137.5 A Y

008482 Fungus (Mycology) Culture R1 1 N MI 83.75 A Y

008540 Gram Stain R1 1 N MI 37.25 A Y

008557 Environmental Culture R1 1 N MI 45.75 A Y

008565 Chlamydia trachomatis Culture R1 1 N VI 118.25 A Y

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008573 Viral Culture, General R1 1 N VI 239 A Y

008623 Ova + Parasite Exam R1 1 N MI 75.25 A Y

008629 Ova + Parasite Exam, Urine R1 1 N MZ 75.25 A Y

008631 Pinworm Prep - Enterobius R1 1 N MZ 40 A Y

008649 Aerobic Bacterial Culture R1 1 N MI 65.25 A Y

008656 White Blood Cells (WBC), StoolR1 1 N MI 48.75 A Y

008664 Organism ID, Bacteria R1 1 N MI 82.75 A Y

008680 Susceptibility, Aer + Anaerob R1 1 N MI 82.25 A Y

008847 Urine Culture, Routine R1 1 N MI 60 A Y

008848 Urine Culture, Routine R1 1 N MI 60 A N

008900 Anaerobic Cult, Extended IncubR1 1 N MI 133.25 A Y

008904 Anaerobic Culture R1 1 N MI 133.25 A Y

009001 Fine-Needle Aspiration R1 1 N CY 184 A Y

009068 Urine Cytology R1 1 N CY 133 A Y

009076 Sputum Cytology R1 1 N CY 114 A Y

009100 Pap Smear, 1 Slide R1 1 N CY 40 A Y

009126 Miscellaneous Smear Cytology R1 1 N CY 113.5 A Y

009134 Breast Discharge Cytology R1 1 N CY 113.5 A Y

009159 Miscellaneous Fluid Cytology R1 1 N CY 133 A Y

009160 Anal(Rectal) Cytology, LBP R1 1 N CY 133 A Y

009191 Pap Smear, 2 Slide R1 1 N CY 80 A Y

009209 Pap Smear, 1 sld w Mat Indx R1 1 N CY 45 A Y

010108 C-Peptide, Serum R1 1 N RI 94.5 A Y

010116 Angiotensin-Converting Enzyme R1 1 N SC 81.25 A Y

010165 Protoporphyrin, FEP/ZPP R1 1 N TX 76.25 A Y

010173 Beta-2 Microglobulin, Urine R1 1 N RI 125.25 A Y

010181 Beta-2 Microglobulin, Serum R1 1 N RI 104.5 A Y

010272 EBV Nuclear Antigen Ab, IgG R1 1 N SE 87.25 A Y

010280 EBV, Chronic/Active Infection R1 1 Y SE 261.75 A Y

010314 Thyrotropin Receptor Ab, SerumR1 1 N RI 165 A Y

010322 Prostate-Specific Ag, Serum R1 1 Y RI 87.5 A Y

010330 Bile Acids R1 1 N SC 67.75 A Y

010355 Trypsin R1 1 N RI 154.25 A Y

010363 IGF-1 R1 1 N RI 196.5 A Y

010389 Triiodothyronine,Free,Serum R1 1 Y RI 157.5 A Y

010390 T3Free R1 1 Y RI 157.5 A N

010405 Myoglobin, Serum R1 1 N RI 109.25 A Y

010413 Intrinsic Factor Abs, Serum R1 1 N RI 114.25 A Y

010447 ADH R1 1 N RI 233 A Y

010540 IGF-1 with Z-Score R1 1 N RI 196.5 A Y

010777 Enterovirus Antibodies ProfileR1 1 N SE 328.75 A Y

010801 AFP, Serum, Open Spina Bifida R1 1 N MA 81.75 A Y

011254 pH, Body Fluid R1 1 N SC 49.25 A Y

012005 RPR, Rfx Qn RPR/Confirm TP R1 1 Y SE 27.5 A Y

012021 RPR Qn+TP Abs R1 1 Y SE 107.25 A N

012518 Antihistone Antibodies R1 1 N SE 103.25 A Y

012580 Antichromatin Antibodies R1 1 N SE 103.25 A Y

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012708 Sjogren's Ab, Anti-SS-A/-SS-B R1 1 N SE 206.5 A Y

012898 Uric Acid, Urine R1 1 Y AC 29.25 A N

013037 pH, Urine R1 1 N SC 49.25 A Y

013326 Sodium, Urine R1 1 Y AC 28.5 A Y

013334 Potassium, Urine R1 1 Y AC 28.5 A N

013656 Chloride, Urine R1 1 Y AC 28.5 A N

013664 Protein,Total,Urine R1 1 Y AC 29.25 A Y

013672 Creatinine, Urine R1 1 Y AC 36 A Y

013706 Calcium, Random Urine R1 1 Y AC 28.5 A N

014086 Platelet Antibody, Serum R1 1 N FA 606.75 A Y

014102 Platelet Autoantibody Panel R1 1 N FA 266.75 A Y

015040 Antithrombin Activity R1 1 N FA 170 A Y

015173 Differential/Total WBC Count R1 1 Y HE 24.75 A Y

015271 Lyme IgG/IgM Ab R1 1 N XX 113 A N

015594 Antithrombin III, Func/ImmunolR1 1 N FA 330 A Y

015610 PTH, Intact R1 1 Y RI 136.5 A Y

016022 Cryptococcus Ag Titer R1 1 N XX 90.75 A N

016123 ENA+DNA/DS+Sjorgen's R1 1 N SE 516.25 A N

016360 Smith Antibodies R1 1 N SE 103.25 A N

016370 RPR Titer+TP Abs Reflex R1 1 Y XX 107.25 A N

016592 Rocky Mtn Spotted Fev, IgG, QnR1 1 N SE 120.25 A Y

016667 Rocky Mtn Spotted Fever, IgM R1 1 N SE 120.25 A Y

016865 Citric Acid (Citrate), Urine R1 1 N SC 167.75 A Y

016881 Hep B Core Ab, IgM R1 1 Y HT 80 A Y

016931 Prealbumin R1 1 Y AC 80.5 A Y

017319 AFP Tetra R1 1 N MA 348.75 A Y

017422 Add On: hCG,uE3,Inhibin R1 1 N MA 267 A N

017500 First Trimester Screen w/NT R1 1 N MA 257 A Y

017509 Vitamin A, Serum R1 1 N SC 91.5 A Y

017996 Ethanol, Blood R1 1 N TX 88.5 A Y

018705 Antiscleroderma-70 Antibodies R1 1 N SE 103.25 A Y

018788 Streptococcus pneumoniae Ag R1 1 N MZ 150 A Y

019497 Glucose, Body Fluid R1 1 Y AC 27 A Y

019588 Protein, Body Fluid R1 1 Y AC 27 A Y

020313 CMP12+5AC R1 1 Y GN 31.5 A N

020321 PT and PTT R1 1 Y HE 66 A Y

021550 CMP12+7AC R1 1 Y AC 33 A N

023051 CMP12+6AC R1 1 Y GN 32.25 A N

024026 T4 and TSH R1 1 Y RI 106.75 A Y

024141 ANA+RA Qn R1 1 Y SE 102.75 A N

024778 BUN+Creat R1 1 Y GN 27.5 A N

025239 Glu+Hb A1c R1 1 Y MC 77.75 A N

027011 Thyroid Profile II R1 1 Y RI 230.75 A Y

027094 Amy+Lipase R1 1 Y MC 74.5 A N

027623 CMP12+LP+6AC R1 1 Y GN 86 A N

028142 CBC, Platelet, No DifferentialR1 1 Y HE 25.5 A Y

028480 FSH and LH R1 1 Y RI 173.75 A Y

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028498 Cortisol (3 Specimens) R1 1 N RI 240 A Y

028928 Hepatitis A (Prof V) R1 1 Y HT 150.75 A Y

030387 Prenatal Panel I/without HBsAgR1 1 Y GN 198.5 A Y

030452 Uric A+ANA+CRP+RF Qn R1 1 Y GN 182 A N

030577 Anemia Profile A R1 1 Y GN 109.5 A Y

030601 CMP12+5AC R1 1 Y GN 31.5 A N

030825 Fe+TIBC+Fer R1 1 Y GN 116.75 A N

030932 CMP12+LP+6AC+CBC/D/Plt R1 1 Y GN 111.75 A N

031088 Hgb+Hct R1 1 Y HE 24.75 A N

031138 Amenorrhea Profile R1 1 Y RI 284.5 A Y

032268 CMP12+LP+TP+TSH+6AC R1 1 Y GN 223.5 A N

033852 C4+C3 R1 1 Y AC 133 A N

033969 LP without VLDL+Chol/HDL+CH...R1 1 Y AC 77 A N

035774 HBsAb+Ag R1 1 Y HT 113.75 A N

037184 HBcAb+HBsAb+Ag R1 1 Y HT 181.75 A N

038091 Fe+TIBC+Fer+B12+Folic R1 1 Y GN 272.5 A N

038109 Prenat Infect Dis Ab, IgG, Qn R1 1 N XX 299.25 A N

038120 Prenat Infect Dis Ab, IgG, Qn R1 1 N SE 400.75 A Y

038158 Lead Standard Profile, Blood R1 1 N TX 137.25 A Y

042077 Anemia Profile B R1 1 Y GN 328 A Y

042100 Thyroglobulin with Anti-TG Ab R1 1 N RI 84.5 A Y

042580 Heavy Metals Profile I, Blood R1 1 N TX 304.25 A Y

043083 Uric A+RA Qn+CRP+ASO R1 1 Y GN 154.25 A N

045120 Uric A+ESR-Wes+ANA+RA Qn+CR...R1 1 Y GN 248.25 A N

045849 Hepatitis Pt Mgmnt (Prof III) R1 1 Y HT 183.25 A Y

046300 Lactose Tolerance Test R1 1 Y MC 135 A Y

046557 Antidiuretic Hormone Profile R1 1 N RI 288 A Y

048827 CMP12+LP+TP+TSH+6AC+CBC/D/Plt R1 1 Y GN 249.25 A N

052019 Chromosome, Blood, Routine R1 1 N XX 674 A N

052373 Scleroderma Diagnostic ProfileR1 1 N SE 172.5 A Y

054130 Glucose/Insulin Resp (5 Spec) R1 1 Y RI 430 A N

054601 Ca+PTH Intact R1 1 Y RI 163.5 A Y

054619 LUPUS PROFILE R1 1 N SE 303.75 A N

056499 Systemic Lupus Profile A R1 1 N SE 653 A Y

058008 Rh-hr Genotype w/ABO Grouping R1 1 N BB 51.5 A Y

058099 Calcium+Calcium, Ionized R1 1 Y GN 87.25 A N

058495 Measles/Mumps/Rubella ImmunityR1 1 N SE 202.25 A Y

058503 Respiratory Infection Prof A R1 1 N SE 545.5 A Y

058537 HAV/HBV Immune Status (Pro IV)R1 1 Y HT 298.5 A Y

058545 Hepatitis B Virus (Profile VI)R1 1 Y HT 412.75 A Y

058552 HAV/HBV (Profile VII) R1 1 Y HT 561.75 A Y

058560 Hepatitis, Diagnostic (Prof I)R1 1 Y HT 216.75 A Y

058867 CMP12+8AC R1 1 Y GN 36.5 A N

062448 Allergen Profile, Mold R1 1 N AL 291 A Y

062463 Seasonal Allrgns, Fall--Weed R1 1 N AL 315.25 A Y

062471 Seasonal Allrgns, Summer-GrassR1 1 N AL 242.5 A Y

062695 Allergen Profile, Shellfish R1 1 N AL 145.5 A Y

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067108 C001-IgE Penicillin G R1 1 N AL 19.75 A Y

067116 C002-IgE Penicillin V R1 1 N AL 19.75 A Y

067710 Hymenoptera Profile R1 1 N AL 121.25 A Y

070001 Testosterone, Total, LC/MS R1 1 N RI 150 A Y

070032 Zinc, Whole Blood R1 1 N TX 92.5 A Y

070034 Iodine, Serum or Plasma R1 1 N TX 61.5 A Y

070038 Testosterone, F Eqlib+T LC/MS R1 1 N RI 311 A Y

070085 17-OH Progesterone LCMS R1 1 N RI 121.75 A Y

070104 Reverse T3, Serum R1 1 N RI 196.5 A Y

070115 Vitamin B3 (Niacin+Metabolite)R1 1 N RI 310 A Y

070195 Testosterone, Free+Total LC/MSR1 1 N RI 315.75 A Y

070282 Testosterone,F/WklyBd+T LC/MS R1 1 N RI 315 A Y

070326 Vancomycin Random, Serum R1 1 Y TX 92 A N

070327 Vancomycin Peak, Serum R1 1 Y TX 92 A Y

070328 Vancomycin Trough, Serum R1 1 Y TX 92 A Y

070340 17-OH P/Creat Ratio, Urine R1 1 N RI 246.5 A Y

070409 Cannabinoid/Creatinine Ratio R1 1 N TX 69.25 A Y

070466 Chain-of-Custody Protocol R1 1 N TX 4.25 A Y

070482 Haloperidol (Haldol(R)) Serum R1 1 N TX 147.5 A Y

070706 Phenytoin,Free and Total,SerumR1 1 N TX 201.75 A Y

070748 Carbamazepine, Free, Serum R1 1 N TX 134.5 A Y

070763 Phenytoin, Free, Serum R1 1 N TX 125.5 A Y

070789 Free Valproic Acid (Depakote) R1 1 N TX 118.75 A Y

071159 LSD, Urine R1 1 N TX 77.75 A Y

071175 071175 7 Drug-Unb R1 1 N TX 63 A N

071282 Amphetamine Confirmation, Ur R1 1 N TX 119.5 A Y

071290 Barbiturate Confirmation, Ur R1 1 N TX 119.5 A Y

071308 Benzodiazepine Confirmation,UrR1 1 N TX 119.5 A Y

071316 Cannabinoid Confirmation, Ur R1 1 N TX 119.5 A Y

071318 MDMA Confirmation, Urine R1 1 N TX 119.5 A Y

071324 Cocaine Metabolite Confirm,Ur R1 1 N TX 119.5 A Y

071456 Opiate Confirmation, Urine R1 1 N TX 119.5 A Y

071464 Phencyclidine, Confirm, Urine R1 1 N TX 119.5 A Y

071522 Chromium, Plasma R1 1 N TX 110.75 A Y

071526 Hydrocodone and Metabolite R1 1 N TX 111 A Y

071532 Morphine R1 1 N TX 111 A Y

071538 Oxycodone and Metabolite R1 1 N TX 111 A Y

071548 Aluminum, Plasma/Serum R1 1 N TX 120.25 A Y

071555 Aluminum, Urine R1 1 N TX 86.25 A Y

071688 Trazodone, Serum R1 1 N TX 116.75 A Y

071712 Clonazepam (Klonopin(R)),SerumR1 1 N TX 116.75 A Y

071910 071910 7 Drug-Scr R1 1 N TX 63 A N

072132 Chlorpromazine, Serum R1 1 N TX 133.75 A Y

072306 072306 7+Alc-Scr R1 1 N TX 66.25 A N

074000 Zolpidem (Ambien), Urine R1 1 N TX 140.75 A N

074021 074021 9 Drug-Scr R1 1 N TX 76 A N

074401 Amphetamine Screen, Urine R1 1 N TX 24 A Y

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074419 Barbiturate Screen, Urine R1 1 N TX 24 A Y

074427 Benzodiazepine Screen, Urine R1 1 N TX 24 A Y

074435 Cannabinoid, Qual, Urine R1 1 N TX 24 A Y

074567 Propoxyphene Confirmation, Ur R1 1 N TX 119.5 A Y

080176 Hemoglobin, Free, Qual, Urine R1 1 N HE 26 A Y

080465 Protein C Antigen R1 1 N FA 153.5 A Y

080713 Lysozyme, Serum R1 1 N SC 98.25 A Y

081000 Vitamin E, Serum R1 1 N SC 83 A Y

081091 Calcitriol(1,25 di-OH Vit D) R1 1 N RI 245.25 A Y

081786 Testosterone, Free/Tot EquilibR1 1 N RI 289.5 A Y

081893 Fatty Acids, Free (Nonester) R1 1 N SC 91 A Y

081950 Vitamin D, 25-Hydroxy R1 1 N RI 192.75 A Y

082024 Antiadrenal Antibodies, Quant R1 1 N SE 101 A Y

082345 T pallidum Screening Cascade R1 1 Y SE 79.75 A Y

082370 Treponema pallidum Antibodies R1 1 Y SE 79.75 A Y

082553 Allyl Alcohol, Blood R1 1 N SO 575.75 A N

082891 Cryptococcus Antibodies, QuantR1 1 N SE 115.5 A Y

083824 Panel 083824 R1 1 N SE 115.5 A Y

083850 Panel 083850 R1 1 N XX 115.5 A N

083860 HIV 1/2 Ab Differentiation R1 1 N SE 260 A N

083870 Panel 083870 R1 1 N SE 115.5 A N

083885 Rabies Neut.Abs Titrat.(RFFIT)R1 1 N SO 65 A N

083904 Panel 083904 R1 1 N SE 260 A Y

083935 Panel 083935 R1 1 N SE 140 A Y

083940 HIV 1/2 Ab Differentiation R1 1 N SE 260 A N

083950 RNA Qualitative R1 1 N VX 330 A N

083955 Panel 083955 R1 1 N SE 260 A Y

083988 HIV 1/2 Supplemental Ab Test R1 1 N XX 260 A N

083989 Panel 083989 R1 1 N SE 140 A N

084152 Catecholamines, Plasma R1 1 N SC 181.5 A Y

084715 von Willebrand Profile R1 1 N FA 535 A Y

085902 AChR Binding Abs, Serum R1 1 N RI 259.75 A Y

085910 Antimyocardial Antibodies, Qn R1 1 N SE 91.75 A Y

086007 Acetylcholine Receptor Ab, AllR1 1 N GN 700.5 A Y

086122 Myasthenia Gravis Panel III R1 1 N RI 576.75 A Y

086207 C difficile Toxins A+B, EIA R1 1 N MZ 107 A Y

086249 Factor V Activity R1 1 N FA 175 A Y

086264 Factor VIII Activity R1 1 N FA 175 A Y

086330 Factor XIII R1 1 N FA 175 A Y

086884 Ureaplasma/Mycoplasma hominis R1 1 N VI 122.75 A Y

088161 AFB Antibiotic Suscep R1 1 N MI 323.5 A Y

090365 Glucose Tolerance (4 Sp Blood)R1 1 Y MC 108 A N

090373 Glucose Tolerance (5 Sp Blood)R1 1 Y MC 135 A N

091108 HBV Follow-Up (Profile XII) R1 1 Y HT 253.5 A Y

091454 Fungal Antibodies, Quant R1 1 N SE 545.5 A Y

095588 Glucose Tolerance (3 Sp Blood)R1 1 Y MC 81 A N

096180 Chlamydia Antibodies, IgG R1 1 N SE 110.75 A Y

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096206 Varicella-Zoster V Ab, IgG R1 1 N SE 74 A Y

096230 EBV Ab VCA, IgG R1 1 N SE 87.25 A Y

096248 EBV Early Antigen Ab, IgG R1 1 N SE 87.25 A Y

096289 Anti-DNase B Strep Antibodies R1 1 N SC 114.25 A Y

096339 Anti-dsDNA Antibodies R1 1 N SE 103.25 A Y

096354 ALA Delta, 24-Hour Urine R1 1 N SC 198.25 A Y

096487 Influenza A/B Ab, Quant R1 1 N SE 152.5 A Y

096537 Rubella Antibodies, IgM R1 1 Y SE 98.25 A Y

096552 Mumps Antibodies, IgG R1 1 N SE 71.75 A Y

096560 Rubeola Antibodies, IgG R1 1 N SE 76 A Y

096651 Toxoplasma gondii Ab,IgM,Qn R1 1 N SE 108 A Y

096669 Poliovirus Antibodies R1 1 N SE 155.75 A Y

096727 Cytomegalovirus (CMV) Ab, IgM R1 1 N SE 92 A Y

096735 EBV Ab VCA, IgM R1 1 N SE 87.25 A Y

096776 Varicella-Zoster Ab, IgM R1 1 N SE 93.5 A Y

096834 T-Lymphocyte CD3 Cells R1 1 N IM 130.75 A N

096917 T + B-Lymphocyte Differential R1 1 N IM 443 A Y

096925 T-Lymphocyte Helper/SuppressorR1 1 N IM 358.5 A Y

097279 Uric A+ANA+RA Qn+CRP+ASO R1 1 Y GN 223.5 A N

098418 HBV Core Ab, IgG/IgM Diff R1 1 Y HT 157.5 A Y

100156 LD, Body Fluid R1 1 Y AC 27 A Y

100768 Glom Filt Rate, Estimated R1 1 Y AC 27 A Y

100800 Fructosamine R1 1 Y AC 40.75 A Y

101000 Gestational 2 hour GTT R1 1 Y AC 81 A Y

101200 Glucose (2 Spec, WHO) Toler,S R1 1 Y AC 54 A Y

102004 Gestational Glucose Tolerance R1 1 Y MC 108 A Y

102053 Gestational Glucose (X3) R1 1 Y MC 81 A N

102087 Glucose Hemocue Waived R1 1 Y AC 27 A N

102277 Gest. Diabetes 1-Hr Screen R1 1 Y MC 27 A Y

102525 Hgb A1c with eAG Estimation R1 1 Y AC 50.75 A Y

104000 Cortisol, AM/PM R1 1 N RI 160 A Y

104018 Cortisol - AM R1 1 N RI 80 A Y

104026 Cortisol - PM R1 1 N RI 80 A Y

112185 Arterial Blood Gas R1 1 N GN 122.75 A N

114041 Ab Scr+Antibody ID R1 1 N BB 87 A N

115055 Eosinophil, Urine R1 1 Y HE 47 A Y

115188 D-Dimer R1 1 N FA 165 A Y

115300 CBC+Platelet+Hem Review R1 1 N HE 51.5 A N

115345 Platelet Count on Citrated BldR1 1 Y HE 24.5 A Y

115402 FDP, Plasma R1 1 N FA 83.25 A Y

115907 CBC/Differential (No Platelet)R1 1 Y HE 25.5 A N

116087 Total Neutrophil Count R1 1 Y HE 24.75 A N

117004 PTT-LA Mix R1 1 N FA 89.75 A N

117008 Hexagonal Phase Phospholipid R1 1 N FA 140 A N

117020 Hexagonal Phase Phospholipid R1 1 N FA 140 A N

117040 PTT-LA Mix R1 1 N FA 89.75 A N

117054 Lupus Anticoagulant Comp R1 1 N FA 379.5 A Y

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117101 Heparin Anti-Xa R1 1 N FA 175 A Y

117199 aPTT Mixing Studies R1 1 N FA 221 A Y

117705 Protein C-Functional R1 1 N FA 150 A Y

117726 Thrombotic Risk Profile II R1 1 N GN 2559.25 A Y

117754 Protein S Panel R1 1 N FA 545 A Y

117762 Activated Protein C ResistanceR1 1 N FA 135 A Y

117788 Prolonged PT R1 1 N FA 797 A N

117796 Prolonged APTT R1 1 N FA 1062 A Y

117887 Dilute Russell's Viper Venom R1 1 N FA 90.75 A Y

117892 Lupus Anticoagulant Reflex R1 1 N FA 180.5 A Y

117912 dRVVT Mix R1 1 N FA 90.75 A N

117923 dRVVT Confirm R1 1 N FA 90.75 A N

120089 Serotonin, Whole Blood R1 1 N SC 221 A Y

120188 Lipoprotein (a) R1 1 N SC 100 A Y

120204 Serotonin, Serum R1 1 N SC 221 A Y

120220 C1 Esterase Inhibitor, Func R1 1 N SC 189 A Y

120253 Homovanillic Acid, 24-Hr UrineR1 1 N TX 88.5 A Y

120256 IFE, PE and FLC, Serum R1 1 N GN 525.5 A Y

120295 LDL Cholesterol (Direct) R1 1 Y AC 75.25 A Y

120691 Calculi, Urinary, with Photo R1 1 N KS 81.25 A Y

120766 C-Reactive Protein, Cardiac R1 1 Y RI 57.25 A Y

120790 Calculi, Urinary R1 1 N KS 70.25 A Y

120816 Creatine Kinase (CK), MB R1 1 N RI 137.5 A Y

120832 Troponin I R1 1 N RI 132.75 A Y

120880 Hemoglobin Frac.w/o SolubilityR1 1 N SC 98.25 A N

120956 Cryoglobulin, Ql, Serum R1 1 N SC 29.75 A N

120980 Porphyrins, Qn, Random U R1 1 N SC 98.25 A Y

121020 Hgb A2, Quant R1 1 N SC 98.25 A Y

121137 Free K+L Lt Chains,Qn,S R1 1 N AC 245.25 A Y

121155 Free K+L Lt Chains,Qn,S SerialR1 1 N AC 268.5 A Y

121178 Vitamin B1 (Thiamine), Plasma R1 1 N SC 98.25 A N

121186 Vitamin B1 (Thiamine), Blood R1 1 N SC 98.25 A Y

121200 Vitamin K1 R1 1 N SC 183.75 A Y

121210 PE and FLC, Serum R1 1 N GN 311.75 A Y

121228 Free K+L Lt Chains,Qn,Ur R1 1 N SC 245.25 A Y

121679 Hgb Frac. Profile R1 1 N SC 166 A Y

121806 Metanephrines, Frac., Pl. FreeR1 1 N TX 285.75 A Y

122101 Hgb Frac. w/o Solubility R1 1 N SC 98.25 A Y

122390 IFE and PE, Random Urine R1 1 N SC 301.5 A Y

123014 C3d Immune Complexes R1 1 N SC 153 A Y

123016 Lactoferrin, Fecal, Quant. R1 1 N SC 132.75 A Y

123018 PE+Interp(Rfx IFE), 24-Hr U R1 1 N SC 139.25 A Y

123026 PE+Interp(Rfx IFE),S R1 1 N SC 74.25 A Y

123034 Immunofixation, Urine R1 1 N SC 168.75 A Y

123049 IgA, Subclasses (1-2) R1 1 N SC 130.75 A Y

123050 IgA, Subclass 1 R1 1 N SC 41.75 A Y

123055 PE+Interp(Rfx IFE+FLC), S R1 1 N SC 74.25 A Y

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123208 VMA, Random Urine R1 1 N TX 110.75 A Y

123220 Vitamin B2, Whole Blood R1 1 N SC 174.5 A Y

123234 Pancreatic Elastase, Fecal R1 1 N SC 245 A Y

123255 Calprotectin, Fecal R1 1 N SC 200 A Y

123299 Norepinephrine, Plasma R1 1 N SC 181.5 A N

123377 Myelin Basic Protein, CSF R1 1 N SC 139.5 A Y

123482 Lipoprotein Analysis, by NMR R1 1 N SC 80.28 A N

123489 NMR LipoProf noLp+Graph R1 1 N SC 80.28 A Y

123638 NMR LipoProf wSubCls+Graph R1 1 N SC 99 A N

123810 NMR LipoProf+Graph R1 1 N SC 99 A Y

123836 Lipid Cascade w Graph R1 1 Y AC 77 A Y

126120 PTH, LIAB R1 1 N RI 136.5 A N

130005 Creatinine, Urine, 12hr R1 1 Y AC 36 A N

130021 Protein, Urine 12-Hr R1 1 Y AC 29.25 A N

132209 Stone Analysis R1 1 N KS 81.25 A N

138307 Norovirus, RT-PCR R1 1 N PC 254.25 A Y

138313 VZV Real Time PCR R1 1 N PC 402.5 A Y

138529 Human Herpes Virus Type 6 IgM R1 1 N SE 166.5 A Y

138537 Poliovirus Immune Status R1 1 N VX 292.75 A Y

138651 HSV 1/2 PCR R1 1 N PC 310 A Y

138658 Panel 138658 R1 1 N SE 225.5 A N

138685 Lyme (B. burgdorferi) PCR R1 1 N PC 487.25 A Y

138741 DONOR ABO Group/Rho(D) Type R1 1 N BB 60.25 A N

138820 DONOR HBsAg Confirmation R1 1 N HT 175 A N

138842 West Nile Virus Antibody,SerumR1 1 N SE 144.25 A Y

138931 DONOR Panel 138931 Rflx to WB R1 1 N SE 115.5 A N

138981 DONOR Panel 138981 WB R1 1 N SE 225.5 A N

139149 CMV Quant DNA PCR (Plasma) R1 1 N PC 367.5 A Y

139350 RNA Qualitative R1 1 N VX 330 A Y

139450 RNA Qualitative R1 1 N VX 330 A N

139730 Donor Panel 139730 R1 1 N GN 108.5 A N

140045 Ovarian Malignancy Risk-ROMA R1 1 N RI 434.25 A Y

140050 Microalbumin, 24 hr Urine R1 1 Y AC 66.5 A Y

140053 Microalbumin, Timed Urine R1 1 Y AC 66.5 A N

140080 Galectin-3 with BNP R1 1 N RI 333 A Y

140103 Testosterone,Free and Total R1 1 N RI 294.25 A Y

140244 Estradiol, Sensitive R1 1 N RI 181.75 A Y

140277 Erythropoietin (EPO), Serum R1 1 N RI 111.75 A Y

140285 Microalb/Creat Ratio, Randm UrR1 1 Y AC 102.5 A Y

140293 CA 27.29 R1 1 N RI 122.75 A Y

140318 Thyroglobulin, Serum,(New) R1 1 N RI 99 A N

140320 Thyroglobulin,Quant RebaselineR1 1 N XX 84.5 A N

140533 Proinsulin R1 1 N RI 229.25 A Y

140609 NGI HCV UltraQual R1 1 N PC 449 A N

140612 NGI HCV SuperQuant R1 1 N PC 449 A N

140622 NGI HBV UltraQual R1 1 N PC 448.25 A Y

140639 NGI HCV QuantaSure R1 1 N PC 647.75 A Y

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140659 HCV Antibody R1 1 Y HT 88 A Y

140674 PSA, Complexed R1 1 N RI 117 A Y

140707 Pregnenolone, MS R1 1 N RI 110 A Y

140723 PSA Ultra. W/Serial Monitor R1 1 N RI 161.75 A Y

140749 Thyroid Stim Immunoglobulin R1 1 N VX 270 A Y

140761 Cortisol, ACTH Stimulation R1 1 N RI 160 A Y

140810 NGI HBV SuperQuant R1 1 N PC 520.75 A Y

140822 IGF-BP1 R1 1 N RI 95 A Y

140848 Chromogranin A R1 1 N RI 198 A Y

140889 B-Type Natriuretic Peptide R1 1 N RI 183.75 A Y

141093 N-Telopeptide, Urine R1 1 N RI 77.5 A Y

141300 AFP with AFP-L3% R1 1 N RI 257.25 A Y

141598 Insulin Antibodies R1 1 Y RI 148 A Y

141770 IGF-2 R1 1 N RI 85 A Y

142005 Galectin-3 with proBNP R1 1 N RI 345 A Y

143000 proBNP R1 1 N RI 195 A Y

143008 GAD-65 Autoantibody R1 1 N RI 178.5 A Y

143255 Testosterone,Free+Weakly BoundR1 1 N RI 293.5 A Y

143305 Soluble Transferrin Receptor R1 1 N RI 153.5 A Y

143404 Cancer Antigen (CA) 15-3 R1 1 N RI 110.75 A Y

144006 Vitamin A and E R1 1 N SC 174.5 A Y

144014 Vitamin A, E, Beta Carotene R1 1 N SC 262.25 A Y

144028 HCV reflex to Quant RT PCR R1 1 N HT 88 A N

144045 HCV Antibody reflex to NAA R1 1 Y HT 88 A Y

144065 HCV Ab w/Rflx to Verification R1 1 Y HT 88 A Y

144075 HCV Ab Verification R1 1 N HT 386 A N

144090 HCV Antibody Verification R1 1 N HT 386 A Y

144733 CA 125 in the Presence of HAMAR1 1 N RI 153.25 A Y

144980 Testosterone, Free, Direct R1 1 N RI 165.75 A Y

149997 Microalbumin, Random Urine R1 1 Y AC 66.5 A Y

155002 Diff Slide Preparation R1 1 Y HE 12.75 A N

160014 ENA+DNA/DS+Antich+Centro+Jo...R1 1 N SE 929.25 A N

160093 ENA+DNA/DS+SCL-70+SjoSSA+Sj...R1 1 N SE 515.25 A N

160151 Anti-dsDNA Antibodies R1 1 N SE 103.25 A N

160152 Smith Antibodies R1 1 N SE 103.25 A N

160153 Smith/RNP Antibodies R1 1 N SE 103.25 A N

160154 Antichromatin Antibodies R1 1 N SE 103.25 A N

160155 RNP Antibodies R1 1 N SE 103.25 A N

160156 Sjogren's Anti-SS-A R1 1 N SE 103.25 A N

160157 Sjogren's Anti-SS-B R1 1 N SE 103.25 A N

160158 Antiscleroderma-70 Antibodies R1 1 N SE 103.25 A N

160218 Rubeola Antibodies, IgM R1 1 N SE 76 A Y

160325 Lyme, Total Ab Test/Reflex R1 1 N SE 113 A Y

160333 Lyme, IgM, Early Test/Reflex R1 1 N SE 113 A Y

160499 Mumps Antibodies, IgM R1 1 N SE 71.75 A Y

160507 IgG, Subclass 1 R1 1 N SC 104.75 A Y

160721 Antipancreatic Islet Cells R1 1 N SE 141 A Y

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160747 Cryptococcus Antigen, CSF R1 1 N XX 90.75 A N

161000 Panel 161000 R1 1 N SE 115.5 A N

161422 Anti-DNA(SS)IgG, Ab, Qn R1 1 N SE 110.75 A Y

161653 Lyme/Syphilis Ab Diff Profile R1 1 N SE 140.5 A Y

161802 Anticardiolipin Ab, IgG/M, Qn R1 1 Y FA 182 A Y

161810 Anticardiolipin Ab, IgG, Qn R1 1 N FA 91 A Y

161828 Anticardiolipin Ab, IgM, Qn R1 1 N FA 91 A Y

161836 Anticardiolipin Ab, IgA, Qn R1 1 N FA 91 A Y

161950 Anticardiolip Ab, IgA/G/M, Qn R1 1 Y FA 273 A Y

161992 Lyme Disease Ab, Quant, IgM R1 1 N XX 113 A N

162040 Western Equine Enceph Ab, IgG R1 1 N SE 94.5 A N

162045 IBD Expanded Panel R1 1 N SE 243 A Y

162164 RNA, b-DNA, Quant R1 1 N XX 439.5 A N

162222 Panel 162222 R1 1 N SE 115.5 A N

162289 H. pylori, IgG Abs R1 1 Y SE 97.25 A Y

162388 Antineutrophil Cytoplasmic Ab R1 1 N SE 201.25 A Y

163014 Herpes Simplex Virus I/II, IgGR1 1 N XX 80 A N

163048 Parvovirus B19, IgG R1 1 N SE 93.5 A N

163147 HSV Type 2-Specific Ab, IgG R1 1 N SE 107 A Y

163154 Parvovirus B19, IgM R1 1 N SE 93.5 A N

163162 Bartonella Antibody Panel R1 1 N SE 216 A Y

163170 Helicobacter pylori, IgA R1 1 Y SE 97.25 A Y

163204 Helicobacter pylori, IgM Ab R1 1 Y SE 97.25 A Y

163253 Tetanus/Diphtheria Ab R1 1 Y SE 187 A Y

163303 Parvovirus B19, Human, IgG/IgMR1 1 N SE 187 A Y

163402 Gliadin IgG/IgA Ab Prof, EIA R1 1 N SE 197 A N

163550 Panel 163550 R1 1 N SE 157.5 A Y

163600 Lyme, Western Blot, Serum R1 1 N SE 150 A Y

163601 Lyme, Western Blot, Serum R1 1 N SE 150 A N

163683 H pylori, IgM, IgG, IgA Ab R1 1 Y SE 291.75 A Y

163758 Mycoplasma pneu. IgG/IgM Abs R1 1 N SE 196.5 A Y

163840 Antimyeloperoxidase (MPO) Abs R1 1 N SE 138 A Y

163857 Antiproteinase 3 (PR-3) Abs R1 1 N SE 138 A Y

163873 ANCA Panel R1 1 N SE 477.25 A Y

163915 Beta-2 Glycoprotein I Ab,G,A,MR1 1 N FA 255 A Y

163980 Liver-Kidney Microsomal Ab R1 1 N SE 80 A Y

164000 Strongyloides IgG Antibody R1 1 N SE 92.25 A Y

164020 HSV I/II, IgG/Rfx Type II IgG R1 1 N XX 80 A N

164065 Rheumatoid Arthritis Profile R1 1 N SE 117 A Y

164075 Bartonella henselae IgG/M R1 1 N SE 216 A N

164245 RA Expanded Profile R1 1 N GN 194 A Y

164277 HTLV-I/II Antibodies, Qual. R1 1 N SE 93.5 A Y

164301 Coccidioides Abs, Qn, DID R1 1 N SE 104.5 A Y

164319 Histoplasma Abs, Qn, DID R1 1 N SE 109.25 A Y

164517 Protein S-Antigen R1 1 N FA 385 A Y

164525 Protein S-Functional R1 1 N FA 160 A Y

164541 B pertussis IgG/M/A Ab R1 1 N SE 398.25 A Y

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164608 Brucella Antibody IgG, EIA R1 1 N SE 80 A Y

164616 Legionella pneumophila Abs. R1 1 N SE 122.75 A Y

164624 Brucella Antibody IgM, EIA R1 1 N SE 80 A Y

164640 t-Transglutaminase (tTG) IgA R1 1 N SE 110 A Y

164657 Saccharomyces cerevisiae PanelR1 1 N SE 217.25 A Y

164708 Panel 164708 R1 1 N SE 115.5 A N

164750 Procalcitonin R1 1 N SE 261 A Y

164806 HSV, IgM I/II Combination R1 1 N SE 80 A Y

164814 Anti-Centromere B Antibodies R1 1 N SE 103.25 A Y

164830 Inflammatory Bowel Disease-IBDR1 1 N SE 418 A Y

164855 Antinuclear Antibodies Direct R1 1 Y SE 69.25 A Y

164863 ANA w/Reflex if Positive R1 1 Y SE 69.25 A Y

164880 Antinuclear Ab Reflex Cascade R1 1 Y SE 69.25 A Y

164897 HSV Type 1-Specific Ab, IgG R1 1 N SE 74 A Y

164905 HSV 1 and 2-Specific Ab, IgG R1 1 N SE 181 A Y

164913 HSV I/II IgG Rflx I-II Type SpR1 1 N XX 80 A N

164914 CCP Antibodies IgG/IgA R1 1 N SE 83.5 A Y

164947 Antinuclear Antibodies, IFA R1 1 Y SE 83 A Y

164962 ANA w/Reflex R1 1 Y SE 69.25 A Y

164988 t-Transglutaminase (tTG) IgG R1 1 N SE 98.5 A Y

164996 Endomysial Antibody IgA R1 1 N SE 101 A Y

165092 ANA Comprehensive Panel R1 1 N SE 929.25 A Y

165105 Endomysial Ab IgA w/Reflex R1 1 N SE 101 A N

165118 Celiac Disease Ab Screen w/RfxR1 1 N GN 255.75 A N

165126 Celiac Disease Comprehensive R1 1 N GN 542.25 A Y

165134 Celiac Disease II R1 1 N GN 345.25 A N

165142 Celiac Disease Panel R1 1 N GN 258.25 A Y

165180 HSV 1 and 2 IgM Abs, Indirect R1 1 N SE 96.5 A Y

167015 Apolipoprotein B R1 1 Y AC 59.25 A Y

167082 Celiac Disease HLA DQ Assoc. R1 1 N HA 490.75 A Y

167116 HLA A,B,C (IR) R1 1 N HA 600 A Y

167267 HLA-A (IR) R1 1 N HA 200 A Y

167292 HLA-B (IR) R1 1 N HA 200 A Y

167316 HLA-C (IR) R1 1 N HA 200 A Y

180010 Candida 6 Species Profile, NAAR1 1 N VX 607.5 A Y

180021 NuSwab Vaginitis Plus (VG+) R1 1 N VX 807.75 A Y

180026 Vaginitis/Vaginosis, DNA ProbeR1 1 N MZ 275.75 A Y

180033 Candida 4 Species Profile, NAAR1 1 N VX 405 A N

180039 NuSwab Vaginitis (VG) R1 1 N VX 580.25 A Y

180043 NuSwab BV and Candida, NAA R1 1 N VX 472.5 A Y

180049 Ct Ng M genitalium NAA, Urine R1 1 N VX 317.5 A Y

180055 C albicans + C glabrata, NAA R1 1 N VX 202.5 A Y

180060 Bacterial Vaginosis, NAA R1 1 N VX 270 A Y

180066 NuSwab VG+, HSV R1 1 N VX 1117.75 A Y

180071 NuSwab VG, HSV R1 1 N VX 890.25 A Y

180089 Genital Mycoplasmas NAA, Swab R1 1 N VX 270 A Y

180098 Chlamydia/GC Amplification R1 1 N VX 227.5 A N

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180141 Campylobacter Culture R1 1 N MI 50.75 A Y

180307 Culture of Dialysis Water R1 1 N MI 34 A Y

180448 C difficile, Cytotoxin B R1 1 N MI 120 A Y

180764 H. pylori Stool Ag, EIA R1 1 N MZ 183.75 A Y

180786 Strep Gp A Direct, DNA Probe R1 1 N MZ 65 A Y

180794 Strep Gp B Cult/Probe+Rflx R1 1 N XX 66.5 A N

180797 Strep Gp B Susceptibility R1 1 N MZ 35 A N

180798 Strep Gp B Susceptibility R1 1 N MZ 35 A N

180802 Body Fluid Culture, Sterile R1 1 N MI 89.75 A Y

180803 Aerobic Cult, Extended Incub R1 1 N MI 65.25 A Y

180810 Lower Respiratory Culture R1 1 N MI 65.25 A Y

180812 Bacterial Antigens R1 1 N MZ 602 A Y

180828 Water Culture R1 1 N MI 42.5 A N

180836 H. pylori Breath Test R1 1 N MZ 270 A Y

180844 O+P Exam, PVA Only R1 1 N MI 75 A N

180851 O+P Exam, Formalin Only R1 1 N MI 45.5 A N

180901 Wet Prep R1 1 N MI 40.75 A Y

182196 Occult Blood, Gastric Fluid R1 1 N MI 56 A N

182204 Giardia lamblia Ag, EIA R1 1 N MZ 90 A Y

182212 Organism Identification, YeastR1 1 N MI 96.5 A Y

182246 L. pneumophila Serogp 1 Ur Ag R1 1 N MI 99.25 A Y

182261 Aerobe ID + Suscept R1 1 N MI 82.75 A Y

182295 Influenza A Ag, EIA R1 1 N VX 122.5 A Y

182337 Dermatophyte Only, Culture R1 1 N MI 77 A Y

182352 Gram Stain w/Sputum Cult Rflx R1 1 N MZ 37.25 A Y

182354 Sputum Culture R1 1 N MI 65.25 A N

182360 Vancomycin-Resist EnterococcusR1 1 N MI 42 A Y

182378 Cryptosporidium/Isospora SmearR1 1 N MZ 75.75 A N

182402 AFB Culture and Smear,Broth R1 1 N MI 163.25 A N

182410 Stool Culture, Yersinia Only R1 1 N MI 50.75 A Y

182493 Vaginal Yeast Culture R1 1 N MZ 69 A Y

182675 AFB Cult/Smear, Broth, Suscep R1 1 N MI 163.25 A N

182709 BV+Yeast Culture R1 1 N MZ 201.75 A Y

182717 BV+Trich NAA+Yeast Culture R1 1 N GN 261.25 A Y

182725 BV+Ct/Ng/Tv NAA+Yeast Culture R1 1 N GN 484.75 A Y

182776 Yeast Only, Culture R1 1 N MI 81 A Y

182782 Customer Request Culture R1 1 N MZ 57.25 A N

182786 ID 3 R1 1 N MI 120 A N

182808 Susceptibility, Gram Pos Rods R1 1 N MZ 72.25 A N

182877 QuantiFERON In Tube R1 1 N MZ 189 A N

182931 Susceptibility, Haemophilus R1 1 N MZ 41.5 A N

182949 Occult Blood, Fecal, IA R1 1 N MZ 79 A Y

183009 Streptococcus pneumoniae Ag R1 1 N MZ 150 A Y

183016 Cryptococcus Antigen, CSF R1 1 N MZ 90.75 A Y

183020 Cryptosporidium EIA R1 1 N MZ 122.75 A Y

183025 Cryptococcus Antigen, Serum R1 1 N MZ 90.75 A Y

183036 Cryptococcus Ag Titer, Serum R1 1 N MZ 90.75 A N

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183048 Crypto Ag, CSF, Rebaseline R1 1 N MZ 90.75 A N

183050 Cryptococcus Ag, Titer, Serum R1 1 N MZ 90.75 A N

183060 Crypto Ag, Serum, Rebaseline R1 1 N MZ 90.75 A N

183111 Anaerobic/Aerobic/Gram Stain R1 1 N MI 235.75 A Y

183145 Cyclospora Smear, Stool R1 1 N MZ 81.25 A Y

183156 Concentration R1 1 N MZ 31.25 A N

183157 Tissue Grind/Digestion/Decon R1 1 N MZ 76.25 A N

183160 Ct, Ng, Trich vag by NAA R1 1 N MP 335.25 A Y

183194 Chlamydia/GC Amplification R1 1 N MP 227.5 A Y

183244 QuantiFERON Client Incubated R1 1 N MZ 189 A Y

183467 MRSA Screening Culture R1 1 N MZ 76.75 A Y

183558 Giardia/Cryptosporidium EIA R1 1 N MZ 212.75 A Y

183616 Chlamydia/GC NAA, ConfirmationR1 1 N MP 227.5 A Y

183620 C. trachomatis NAA, Confirm R1 1 N MP 160 A N

183624 N. gonorrhoeae NAA, Confirm R1 1 N MP 160 A N

183641 Mtb NAA+AFB Smear/Cult/ID R1 1 N MZ 426 A Y

183753 Acid Fast Smear+Culture R1 1 N MZ 132 A Y

183764 Acid Fast Smear+Culture W/RflxR1 1 N MZ 132 A Y

183809 Strep Gp B Susceptibility R1 1 N MZ 35 A N

183988 C difficile Toxin Gene NAA R1 1 N MZ 125 A Y

185009 Virus, Varicella Zoster Ag,DFAR1 1 N VX 97 A Y

186023 Viral Culture,Rapid,Influenza R1 1 N VI 129 A Y

186056 Viral Culture,Rapid,Lesion R1 1 N VI 289.75 A Y

186064 Influenza A+B Ag, EIA R1 1 N VX 226.5 A Y

186072 HSV Culture Without Typing R1 1 N VI 112.5 A Y

186205 Influenza A, H1N1, RT PCR R1 1 N MP 286 A Y

186221 Influenza A and B, RT PCR R1 1 N MP 286 A Y

186239 Viral Cul, Rapid Flu Rfx H1N1 R1 1 N VI 129 A Y

186243 Influenza A, H1N1, RT PCR R1 1 N MP 286 A N

186288 Influenza A/B Ag, EIA W/ReflexR1 1 Y VX 226.5 A N

188035 Herpes Simplex Virus, NAA R1 1 N MP 310 A N

188045 C difficile Toxigenic Culture R1 1 N MZ 67.75 A N

188047 Cytotoxin B Production R1 1 N MZ 120 A N

188052 Trich vag by NAA R1 1 N MP 107.75 A Y

188056 HSV NAA R1 1 N MP 310 A Y

188065 Ct Ng HSV by NAA R1 1 N MP 537.5 A Y

188070 Ct Ng TV HSV by NAA R1 1 N MP 645.25 A Y

188078 Chlamydia trachomatis, NAA R1 1 N MP 108.25 A Y

188080 Chlamydia, Conjunctiva, NAA R1 1 N VX 108.25 A Y

188086 Neisseria gonorrhoeae, NAA R1 1 N MP 119.25 A Y

188110 Giardia, EIA, Ova/Parasite R1 1 N MI 165.25 A Y

188128 Strep Gp B Cult/DNA Probe R1 1 N XX 66.5 A N

188130 Strep Gp B Culture R1 1 N MZ 78 A Y

188132 Strep Gp B NAA R1 1 N MZ 154 A Y

188135 Strep Gp B Culture+Rflx R1 1 N MZ 78 A Y

188139 Strep Gp B NAA+Rflx R1 1 N MZ 154 A Y

188177 Gram Stn+Lower Resp Cult R1 1 N MI 102.5 A N

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188243 Fungus Culture With Stain R1 1 N MI 138.75 A Y

188284 Gram Stain/Body Fluid Culture R1 1 N MI 127 A N

188540 M tuberculosis, PCR/Culture R1 1 N MI 422.75 A N

188672 Ct/GC NAA, Rectal R1 1 N MP 227.5 A Y

188698 Ct/GC NAA, Pharyngeal R1 1 N MP 227.5 A Y

188706 Ct NAA, Rectal R1 1 N MP 108.25 A Y

188714 Ct NAA, Pharyngeal R1 1 N MP 108.25 A Y

188730 GC NAA, Rectal R1 1 N MP 119.25 A Y

188748 GC NAA, Pharyngeal R1 1 N MP 119.25 A Y

192005 Pap Lb (Liquid-based) R1 1 N CY 74 A Y

192047 Pap Lb, rfx HPV ASCU R1 1 N CY 74 A Y

192096 Pap Lb, w Mat Indx R1 1 N CY 80.75 A Y

192104 Pap Lb, Ct-Ng, rfx HPV all R1 1 N CY 301.5 A Y

192112 Pap Lb, Ct-Ng, rfx HPV ASCU R1 1 N CY 301.5 A Y

192120 Pap Lb, Ct-Ng R1 1 N CY 301.5 A Y

192138 Pap Lb, Ct R1 1 N CY 182.25 A Y

192146 Pap Lb, Ct-Ng, HPV-hr R1 1 N CY 489.25 A Y

192153 Pap IG, Ct-Ng, HPV-hr R1 1 N CY 503.25 A Y

192197 PapLb, HPV, rfx16/18 R1 1 N CY 261.75 A Y

192504 Pap Lb, Ct-Ng TV rfx HPV all R1 1 N CY 398.25 A Y

192512 Pap Lb, Ct-Ng TV rfx HPV ASCU R1 1 N CY 398.25 A Y

192520 Pap Lb, Ct-Ng TV R1 1 N CY 398.25 A Y

192546 Pap Lb, Ct-Ng TV HPV-hr R1 1 N CY 586 A Y

192555 Change IG Pap to LB Pap R1 1 N CY 74 A N

192560 PapLb, CtNgTv, HPV, rfx16/18 R1 1 N CY 586 A Y

192630 Pap Lb, rfx HPV all pth R1 1 N CY 74 A Y

193000 Pap IG (Image Guided) R1 1 N CY 88 A Y

193130 Pap Lb, Ct, rfx HPV ASCU R1 1 N CY 182.25 A Y

193148 Pap Lb, Ct, rfx HPV all pth R1 1 N CY 182.25 A Y

193924 Pap Lb, Ct-Ng, HPV-h+lr R1 1 N CY 502.5 A N

193960 Pap IG, Ct, HPV-hr R1 1 N CY 384 A N

193970 Pap Lb, Ng R1 1 N CY 193.25 A N

194027 Pap IG, Ct-Ng, rfx HPV ASCU R1 1 N CY 315.5 A Y

194074 Pap IG, rfx HPV ASCU R1 1 N CY 88 A Y

195050 Pap Lb, HPV-hr R1 1 N CY 261.75 A Y

195677 Pap IG, Ct, rfx HPV ASCU R1 1 N CY 196.25 A Y

196210 IGP, cobasHPV16/18 R1 1 N CY 355.75 A Y

196215 IGP, CtNg, cobasHPV16/18 R1 1 N CY 583.25 A Y

196220 IGP, CtNgTv, cobasHPV16/18 R1 1 N CY 691 A Y

196250 Pap IG, rfx HPV all pth R1 1 N CY 88 A Y

196402 Pap IG, Ct-Ng R1 1 N CY 315.5 A Y

196502 Pap IG, Ct-Ng TV R1 1 N CY 412.25 A Y

196527 Pap IG, Ct-Ng TV rfx HPV ASCU R1 1 N CY 412.25 A Y

196553 Pap IG, Ct-Ng TV HPV-hr R1 1 N CY 600 A Y

196565 Pap IG, Ct-Ng, rfx HPV all R1 1 N CY 315.5 A Y

196595 Pap IG, Ct-Ng TV rfx HPV all R1 1 N CY 423.25 A Y

196599 PapIG, CtNgTv, HPV, rfx 16/18 R1 1 N CY 600 A Y

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196605 PapIG,CtNgTv,rfxHPVall,16/18 R1 1 N CY 412.25 A N

197012 PapLb,CtNg,rfxHPV ASCU, 16/18 R1 1 N CY 301.5 A Y

197014 PapLb, CtNg, rfxHPVall, 16/18 R1 1 N CY 301.5 A Y

197017 PapLb, CtNg, HPV, rfx16/18 R1 1 N CY 489.25 A Y

197070 Pap Lb, HPV-h+lr R1 1 N CY 275 A Y

197102 PapIG, CtNg, rfxHPVall, 16/18 R1 1 N CY 315.5 A Y

197116 PapIG, rfxHPVall, 16/18 R1 1 N CY 88 A Y

197117 Pap IG, CtNg,rfxHPV ASCU,16/18R1 1 N CY 315.5 A Y

197124 PapIG, CtNg, HPV, rfx 16/18 R1 1 N CY 503.25 A Y

197132 Pap IG, rfx HPV ASCU,16/18 R1 1 N CY 88 A Y

197146 PapIG, HPV, rfx 16/18 R1 1 N CY 275.75 A Y

197676 Pap IG, Ct R1 1 N CY 196.25 A Y

198190 Pap IG, HPV-h+lr R1 1 N CY 289 A Y

198300 Pap IG, HSV 1/2 NAA R1 1 N CY 398 A Y

198305 PapIG, CtNgTvHSV,HPV,rfx16/18 R1 1 N CY 921 A Y

198310 Pap IG, Ct-Ng HSV 1/2 NAA R1 1 N CY 625.5 A Y

198315 Pap IG, Ct-Ng TV HSV 1/2 NAA R1 1 N CY 733.25 A Y

198320 Pap IG, CtNgHSV,HPV, rfx16/18 R1 1 N CY 813.25 A Y

198325 Pap IG, HSV, HPV, rfx16/18 R1 1 N CY 585.75 A Y

198330 PapIG, CtNgTvHSV, rfxHPVall R1 1 N CY 733.25 A Y

198335 PapIG, CtNgTvHSV rfxHPV ASCU R1 1 N CY 733.25 A Y

198340 PapIG, CtNgHSV, rfxHPVall R1 1 N CY 625.5 A Y

198345 Pap IG, CtNgHSV, rfxHPV ASCU R1 1 N CY 625.5 A Y

198350 PapIG, HSV rfxHPVall R1 1 N CY 398 A Y

198355 Pap IG, HSV, rfxHPV ASCU R1 1 N CY 398 A Y

198888 Pap IG, Ct, rfx HPV all pth R1 1 N CY 196.25 A Y

199123 Pap IG, HPV-hr R1 1 N CY 275.75 A Y

199305 IGP, Aptima HPV, rfx 16/18,45 R1 1 N CY 275.75 A Y

199310 IGP,CtNg,AptimaHPV,rfx16/18,45R1 1 N CY 503.25 A Y

199315 IGP,CtNgTv,Apt HPV,rfx16/18,45R1 1 N CY 600 A Y

199320 IGP, CtNg, rfx Aptima HPV ASCUR1 1 N CY 315.5 A Y

199400 IGP,rfxHPVpath+rfxQS R1 1 N CY 88 A Y

199405 IGP,CtNg,rfxHPVpath+rfxQS R1 1 N CY 315.5 A Y

199410 IGP,CtNgTv,rfxHPVpath+rfxQS R1 1 N CY 423.25 A Y

199425 IGP,CtNgTv,HPV rfx16/18+rfxQS R1 1 N CY 611 A Y

200477 HBeAb+Ag R1 1 N HT 108.75 A N

202945 Prenatal Profile I R1 1 Y GN 258 A Y

203430 CMP12+6AC R1 1 Y GN 32.25 A N

203752 Systemic Lupus Profile B R1 1 N GN 374.75 A Y

204511 RA Qn+SjoSSA+SjoSSB R1 1 Y SE 210.75 A N

204529 Rheumatic Fever Profile R1 1 N GN 363.25 A Y

205500 Bilirubin Fraction, Neonatal R1 1 Y AC 27.5 A Y

207631 Sulfapyridine R1 1 N SO 208.5 A N

210849 CMP14+Lipid+5AC R1 1 Y GN 86.5 A N

211193 Glucose Tolerance (3 Sp Bl/Ur)R1 1 Y MC 145.5 A N

211425 Glucose Tolerance Prof (4 Sp) R1 1 Y GN 106 A N

211581 Prenat Infect Dis Ab, IgM, Qn R1 1 N SE 378.25 A Y

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213561 Toxoplasma Abs IgG/IgM R1 1 N SE 181.25 A N

213660 Insulin and C-Peptide, Serum R1 1 N RI 153.25 A Y

215996 Cell Ct, Synovial w/o CrystalsR1 1 N HE 55.5 A Y

216010 Apo A1 + B + Ratio R1 1 Y AC 118.5 A Y

216655 EBV Acute Infection AntibodiesR1 1 Y SE 349 A Y

220955 Burkholderia Pseudom. Ab, IFA R1 1 N SO 251.25 A N

221010 Lipid Panel w/ Chol/HDL Ratio R1 1 Y AC 77 A Y

221051 Rub Ab(IgG/M)+ToxoAb(IgG/M)...R1 1 N XX 678 A N

221085 CMV Abs IgG/IgM R1 1 N SE 184 A N

221214 CMP12+8AC R1 1 Y AC 34.25 A N

223586 Lyme Ab, Total/IgM Responses R1 1 N XX 226 A N

224576 TSH+Free T4 R1 1 Y RI 158.75 A Y

225920 Protein Elec + Interp, Serum R1 1 N SC 74.25 A Y

233783 CBC/D/Plt+RPR+UA+Rh+ABO+Rub...R1 1 N GN 395 A N

234419 Myasthenia Gravis Evaluation R1 1 N GN 317 A Y

235010 Lipid Panel With LDL/HDL RatioR1 1 Y AC 77 A Y

235011 Lipid Panel with LDL/HDL RatioR1 1 Y AC 77 A N

235036 Lipoprotein Phenotyping R1 1 N GN 93 A Y

235945 Varicella Zoster Abs, IgG/IgM R1 1 N SE 167.5 A N

236000 CreatU+Prot U R1 1 Y AC 65.25 A N

237842 HFP7+2AC R1 1 Y AC 31 A N

239822 Glucose (2 Spec) Tolerance, S R1 1 Y MC 54 A N

242545 CMP12+6AC+CBC/D/Plt R1 1 Y GN 54.75 A N

243766 Rub Ab+VarAb+RubeoAb+MumIgG R1 1 N SE 276.25 A N

244681 RPR+Rh+ABO+Rub Ab+Ab Scr+CB...R1 1 Y GN 257.75 A N

250555 Antiphospholipid Syndrome ProfR1 1 N FA 374.75 A N

252816 Galactosemia: GALT R1 1 N MG 680 A Y

252823 Beta Thalassemia: HBB R1 1 N MG 735 A Y

255505 HBV/HCV (Profile VIII) R1 1 N HT 500.75 A Y

257113 HP5+HAVIgM+HBcIgM+HBeAb+Ag R1 1 N HT 649.75 A N

257188 HP4 R1 1 Y HT 304.75 A N

257238 HP5+HAVIgM+HBcIgM R1 1 Y HT 526 A N

257451 ALT+AST+TBili R1 1 Y AC 22.5 A N

258004 Lyme Ab/Western Blot Reflex R1 1 N SE 226 A Y

261511 Prot Electro+Interp, 24-Hr Ur R1 1 N SC 139.25 A Y

265389 HBV Vaccine Follow-Up (Pro XI)R1 1 Y HT 70.25 A Y

266015 Folate, RBC R1 1 Y GN 137.5 A Y

272902 CMP12+TP+TSH+7AC+CBC/D/Plt+...R1 1 Y XX 218.5 A N

275180 Fe+CBC/D/Plt+TIBC+Fer+CRP R1 1 Y GN 165 A N

276024 Creat Clearance, Normalized R1 1 Y AC 63 A Y

282020 CBC/D/Plt+RPR+Rh+ABO+Rub Ab...R1 1 N GN 290 A N

283655 Protein C Deficiency Profile R1 1 N FA 303.5 A Y

284452 Hepatitis D Total R1 1 N SO 64.5 A N

285700 Folate, RBC and Serum R1 1 Y GN 208.25 A Y

286161 Catecholamine+VMA, 24-Hr UrineR1 1 N TX 227.25 A Y

300321 Prl+FSH+LH+Prog+hCG Ql R1 1 Y RI 411.5 A N

300327 CMP12+8AC+Mg+TIBC R1 1 Y GN 87.75 A N

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301021 HBcAb+M+HBsAb+HCVAb R1 1 Y HT 268 A N

301622 CMP12+7AC+Mg R1 1 Y GN 64.75 A N

302085 Comp. Metabolic Panel (12) R1 1 Y AC 32.5 A N

302832 Glu+CBC/D/Plt+RPR+UA+Sickle R1 1 N GN 145.75 A N

302857 Glu+CBC/D/Plt+RPR+UA R1 1 Y GN 86.25 A N

303476 Glu+CBC/D/Plt+Sickle R1 1 N GN 103.25 A N

303560 CMP12+8AC R1 1 Y GN 34.25 A N

303744 HP5 R1 1 Y HT 368.75 A N

303750 CMP14+4AC R1 1 Y GN 32.25 A N

303754 Electrolyte Panel R1 1 Y AC 28.5 A Y

303755 Hepatic Function Panel (6) R1 1 Y GN 29.5 A N

303756 Lipid Panel R1 1 Y AC 77 A Y

303758 Basic Metabolic Panel (7) R1 1 Y GN 30 A N

303785 CMP12+LP+TP+TSH+5AC+CBC/D/P...R1 1 Y GN 328.25 A N

304148 CMP12+1AC R1 1 Y AC 28 A N

308336 Rub Ab+ToxoAb+CMV Ab+CMVIgM...R1 1 N SE 677.5 A N

310700 CMP13+2AC R1 1 Y AC 29.75 A N

310900 Comp. Metabolic Panel (13) R1 1 Y AC 33 A N

311779 CMP12+8AC+CBC/D/Plt R1 1 Y GN 62.25 A N

312264 CMP12+LP+6AC+CBC/D/Plt+TSH+FerR1 1 Y GN 218 A N

313700 Gestational Glucose (X2) R1 1 Y MC 54 A N

314903 CMP13+LP+TP+TSH+2AC+CBC/D/P...R1 1 Y GN 214 A N

314918 CMP13+LP+2AC+CBC/D/Plt R1 1 Y GN 93.25 A N

315388 CMP14+LP+5AC+TIBC R1 1 Y AC 101.25 A N

315423 CMP12+LP+TP+TSH+6AC+CBC/D/Plt R1 1 Y GN 216.75 A N

315652 CMP12+TP+TSH+8AC+CBC/D/Plt+...R1 1 Y XX 433.5 A N

315865 AlP+ALT+AST+TBili+Uric A+CB...R1 1 Y GN 45.75 A N

315874 CMP14+LP+6AC R1 1 Y GN 75.25 A N

316203 Catecholamines,Ur.,Free,RandomR1 1 N TX 152 A Y

316205 5-HIAA Qn,Random Urine R1 1 N TX 107 A Y

316280 CMP13+CBC/D/Plt+RPR+Mg+TSH R1 1 Y GN 172.75 A N

316370 HFP+2AC+CBC/D/Plt+CreatCx+P...R1 1 Y GN 125.5 A N

316566 ALT+AST+Creat+Uric A+Hgb+Plt R1 1 Y GN 64 A N

317222 UREA and Creatinine, 24-Hr Ur R1 1 Y AC 66.75 A Y

322000 Comp. Metabolic Panel (14) R1 1 Y AC 33.5 A Y

322458 BMP8+LP+1AC+Hb A1c R1 1 Y GN 153.75 A N

322744 Hepatitis Panel (4) R1 1 Y HT 304.75 A Y

322755 Hepatic Function Panel (7) R1 1 Y AC 30 A Y

322758 Basic Metabolic Panel (8) R1 1 Y AC 30.5 A Y

322777 Renal Panel (10) R1 1 Y AC 31.5 A Y

330015 Thyroid Cascade Profile R1 1 Y RI 76.25 A Y

330018 Thyroid Peroxidase (TPO) Ab R1 1 Y RI 66 A N

331258 CMP14+1AC+TSH+PTT+Sickle+PT...R1 1 N GN 340.25 A N

332158 AlP+ALT+AST+Creat+TBili+Uri...R1 1 Y GN 46.25 A N

332215 TSH+Prl+FSH+LH+DHEA-S+hCG Q...R1 1 N RI 723 A N

332403 CMP12+LP+6AC+CBC/D/Plt R1 1 Y GN 96 A N

333126 CMP14+LP+1AC R1 1 Y AC 70.75 A N

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333427 Microscopic Examination R1 1 Y UR 19.25 A N

334943 CMP14+eGFR R1 1 Y AC 33.5 A N

334971 Celiac Disease Antibody ScreenR1 1 N GN 255.75 A N

334993 CMP14+TP+7AC R1 1 Y GN 88.75 A N

335362 BMP8+eGFR R1 1 Y AC 30.5 A N

337036 CMP14+LP+CBC/D/Plt+Prl+Test...R1 1 Y GN 531.5 A N

341109 RPR+Rh+ABO+Rub Ab+Ab Scr+CB...R1 1 N GN 335.75 A N

341142 Celiac Disease Complete Panel R1 1 N GN 464.25 A Y

341776 ANA R1 1 Y SE 69.25 A N

343925 LP+Non-HDL Cholesterol R1 1 Y AC 77 A Y

347692 AlP+ALT+AST+Creat+Glu+TBili...R1 1 Y GN 55.5 A N

347845 CMP14+5AC R1 1 Y AC 36 A N

348532 CMP12+LP+6AC+CBC/D/Plt+RPR+...R1 1 Y GN 192 A N

349829 TSH Rfx on Abnormal to Free T4R1 1 Y RI 76.25 A N

350512 CBC+Hematology Review R1 1 N HE 51.5 A N

354415 Rubella+Rubeola+VZ R1 1 N SE 179.25 A N

354928 Protein Electro, Random Urine R1 1 N SC 132.75 A Y

360495 CMP12+9AC R1 1 Y AC 35 A N

361446 CMP14+LP+6AC+CBC/D/Plt+RPR+...R1 1 Y GN 207.75 A N

361946 Lipid Cascade R1 1 Y AC 77 A Y

361959 LDL Cholesterol (Direct) R1 1 Y AC 75.25 A N

362165 CMP14+2AC+CEA+CA125 R1 1 Y GN 231.25 A N

363676 Lipid Cascade w/Rflx to ApoliBR1 1 Y AC 77 A Y

368878 HFP7+2AC R1 1 Y AC 25.5 A N

368894 ANA+ENA+C3+C4+DNA/DS+Card(I...R1 1 N GN 841.75 A N

371184 CBC/D/Plt+RPR+Rh+ABO+Rub Ab...R1 1 N GN 511.75 A N

371643 CMP12+LP+6AC+CBC/D/Plt+TSH+...R1 1 N GN 443.5 A N

371653 CBC+TestT+DHEA S+Prog+E2+Te...R1 1 N GN 769.25 A N

371841 CMP14+LP+Uric A+CBC/D/Plt+E...R1 1 N GN 731.5 A N

371862 GG1hr+RPR+Ab Scr+CBC/Plt+HB...R1 1 N GN 285.5 A N

375268 Alb+AST+Fe+Prot+PT+Plt R1 1 Y GN 83 A N

376426 CMP14+8AC R1 1 Y GN 35.75 A N

377036 UA/M w/rflx Culture, Routine R1 1 Y UR 26 A Y

377200 UA/M w/rflx Culture, Comp R1 1 Y UR 26 A Y

384715 von Willebrand Profile R1 1 N FA 535 A N

450020 Cystic Fibrosis Mutation 97 R1 1 N MG 800 A Y

480004 Alkaline Phosphatase (Serial) R1 1 Y AC 50 A Y

480012 AFP, Tumor Marker (Serial) R1 1 Y RI 99.25 A Y

480038 hCG, Beta Subunit, Qn (Serial)R1 1 Y RI 123 A Y

480061 CA 125, Serum (Serial) R1 1 Y RI 145.75 A Y

480095 CEA (Serial Monitor) R1 1 Y RI 109 A Y

480111 Ferritin, Serum (Serial) R1 1 Y RI 85.75 A Y

480145 PSA, Serum (Serial Monitor) R1 1 Y RI 110.5 A Y

480277 ER/PR,Immunohistochem,ParaffinR1 1 N TG 285 A Y

480293 CA 27.29 (Serial Monitor) R1 1 N RI 145.75 A Y

480300 AFP-L3% (Serial Monitor) R1 1 N RI 280.25 A Y

480533 Cystic Fibrosis Profile R1 1 N MG 306.5 A Y

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480640 PSA (Reflex To Free) (Serial) R1 1 N RI 110.5 A Y

480701 Cystic Fibrosis Mutation 97 R1 1 N MG 447.5 A N

480772 PSA Total (Reflex To Free) R1 1 N RI 87.5 A Y

480848 %fPSA Reflex R1 1 N RI 65 A N

480947 PSA Total+% Free R1 1 N RI 152.5 A Y

483248 HER-2/CEP17 FISH R1 1 N TG 731 A Y

483404 CA 15-3 (Serial Monitor) R1 1 N RI 133.75 A Y

485029 Leukemia/Lymphoma Monitor ProfR1 1 N RI 226 A Y

485086 Pancreatic CA Monitor Profile R1 1 N GN 327 A Y

485151 Testicular Cancer Monitor ProfR1 1 Y RI 194.25 A Y

485199 Prothrombin Time (PT), Serial R1 1 Y HE 53 A Y

489111 Flow Marker, First R1 1 N TG 111.75 A N

489112 Flow Markers X 3 R1 1 N TG 174 A N

489120 Flow Markers X 4 R1 1 N TG 232 A N

489128 Flow Markers X28 R1 1 N TG 1986.75 A N

489138 Flow Markers X 5 R1 1 N TG 290 A N

489146 Flow Markers X 10 R1 1 N TG 580 A N

489153 Flow Markers X 15 R1 1 N TG 870 A N

489179 Flow Markers X 20 R1 1 N TG 1522.75 A N

489200 JAK2 Mutation Analysis, Qual R1 1 N TG 400 A Y

489316 Flow Interp 16 or more R1 1 N TG 309 A N

500016 Prothrombin Fragment 1+2 MoAb R1 1 N FA 160 A Y

500070 Lupus Anticoagulant Panel R1 1 N GN 1291 A Y

500116 Vitamin D 25-Hydroxy, D2 + D3 R1 1 N XX 294 A N

500161 DHEA-Sulfate, Serum R1 1 N RI 110.25 A Y

500187 Heparin Cofactor II R1 1 N FA 185 A Y

500196 Factor VIII Antigen R1 1 N FA 200 A Y

500306 HPV, high+low-risk R1 1 N MP 201 A Y

500324 Macroprolactin R1 1 N RI 89 A Y

500463 Prt C Activity (Chromogenic) R1 1 N FA 150 A Y

500555 Anti-Thyroglobulin Antibodies R1 1 N RI 84.5 A N

500557 Prolactin, Serum (ICMA) R1 1 N RI 110.75 A N

500711 Lupus Anticoag/Cardiolipin Ab R1 1 N GN 1031 A Y

501819 Transferrin Saturation R1 1 N AC 95.75 A N

502280 FSH, Pediatric R1 1 N RI 88 A Y

502286 Luteinizing Hormone, PediatricR1 1 N RI 26 A Y

502421 Gonadotropin Releasing HormoneR1 1 N RI 241 A Y

502515 TestT+LH+DHEA S+E2+TestF+E1...R1 1 N RI 370.3 A N

503380 PTHrP (PTH-Related Peptide) R1 1 N RI 151.25 A Y

503600 T3, Free, Dialysis, LC/MS-MS R1 1 N RI 250 A Y

503610 Beta-Hydroxybutyrate R1 1 N SC 82 A Y

503850 Platelet Antibody Profile R1 1 N FA 486.75 A N

503853 Factor V Leiden Reflex to R2 R1 1 N MG 275 A Y

503880 Thyroglobulin (TG-RIA) R1 1 N SO 99 A N

504115 25-Hydroxyvitamin D LCMS D2+D3R1 1 N RI 294 A Y

505008 Helper T-Lymph-CD4 R1 1 N IM 113 A Y

505271 CD4/CD8 Ratio Profile R1 1 N IM 202.5 A Y

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507301 HPV, high-risk R1 1 N MP 187.75 A Y

507310 HPV, high-risk R1 1 N MP 187.75 A N

507385 HPV, cobas high-risk/16/18 R1 1 N MP 267.75 A Y

507405 HPV, low volume rfx R1 1 N MP 187.75 A N

507460 HPV Genotype, 16/18 R1 1 N MP 80 A N

507800 HPV Aptima R1 1 N MP 187.75 A Y

507810 HPV Genotypes 16/18,45 R1 1 N MP 80 A Y

507815 HPV, 16/18,45 R1 1 N MP 187.75 A Y

507820 HPV Genotypes 16/18,45 R1 1 N MP 80 A N

508005 cobas HPV, Rectal R1 1 N MP 267.75 A Y

510750 Thiopurine Methyltransferase R1 1 N BG 300 A Y

511154 Factor V Leiden Mutation R1 1 N MG 275 A Y

511162 Factor II, DNA Analysis R1 1 N MG 300 A Y

511172 Alpha-Thalassemia R1 1 N MG 450 A Y

511230 Cytochrome P450 2D6 GenotypingR1 1 N MG 490.25 A Y

511238 MTHFR R1 1 N MG 325 A Y

511345 Hered.Hemochromatosis, DNA R1 1 N MG 400 A Y

513002 Alk Phosphatase, Bone SpecificR1 1 N RI 101.25 A Y

513160 Alk Phosphatase, Bone SpecificR1 1 N RI 101.25 A N

550020 HPV Genotyping, PCR R1 1 N XX 408 A N

550066 HCV RNA Qn (Graph) Rfx NS3/4A R1 1 N PC 448 A Y

550070 HCV RT-PCR, Quant (Graph) R1 1 N PC 448 A Y

550071 HCV Real-Time, PCR, Quant R1 1 N XX 448 A N

550072 HCV RNA PCR Qn Rfx NS3/4A R1 1 N PC 386 A Y

550080 HCV RT-PCR, Quant (Non-Graph) R1 1 N PC 425 A Y

550087 M tuberculosis Detection, PCR R1 1 N MZ 294 A Y

550090 HCV RNA by PCR, Qn Rfx Geno R1 1 N PC 425 A Y

550100 HCV RNA by PCR, Qn Rfx Geno R1 1 N PC 448 A Y

550123 HCV FibroSure R1 1 N SC 263.75 A N

550146 HCV RNA, PCR, Ql (Quant Rflx) R1 1 N XX 347.25 A N

550250 RNA,PCR(Graph)rfx/PS Int R1 1 N PC 409 A Y

550296 HCV RT-PCR, Quant R1 1 N PC 425 A N

550312 HCV Real-Time, PCR, Quant R1 1 N PC 448 A N

550400 HCV RNA, PCR, Qualitative R1 1 N XX 347.25 A N

550420 RNA, Real Time PCR (Graph) R1 1 N PC 409 A Y

550422 RNA, PCR (Graph) rfx/Geno R1 1 N PC 409 A Y

550423 RNA, PCR (Graph) rfx/GenoPLUS R1 1 N XX 409 A N

550430 RNA, Real Time PCR (Non-Graph)R1 1 N PC 386 A Y

550432 RNA, PCR (NonGraph) rfx/Geno R1 1 N PC 386 A Y

550433 RNA,PCR (NonGra) rfx/GenoPLUS R1 1 N XX 386 A N

550450 RNA, PCR (NonGraph) rfx/PSGT R1 1 N PC 386 A Y

550466 Quant, RNA PCR R1 1 N PC 409 A N

550470 RNA, PCR (NonGraph) rfx/PS R1 1 N PC 386 A Y

550475 HCV Genotyping Non Reflex R1 1 N PC 561.25 A Y

550481 Hepatitis C Genotype R1 1 N PC 561.25 A N

550486 Hepatitis C Genotype R1 1 N PC 561.25 A N

550503 Quant, RNA PCR R1 1 N PC 386 A N

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550504 Quant, RNA PCR R1 1 N PC 386 A N

550510 RNA, PCR (Graph) rfx/PSGT R1 1 N PC 409 A Y

550515 HCV RT-PCR, Quant R1 1 N PC 425 A N

550520 RNA, PCR (Graph) rfx/PS R1 1 N PC 409 A Y

550522 RNA, PCR (Graph) rfx/Geno EDI R1 1 N PC 409 A N

550538 Rfx to GenoSure(R) HCV NS3/4A R1 1 N SO 686 A N

550539 Rfx to GenoSure(R) HCV NS3/4A R1 1 N SO 686 A N

550555 HCV Genotype Reflex NS3/4A R1 1 N PC 561.25 A Y

550563 Rfx to GenoSure(R) HCV NS3/4A R1 1 N SO 686 A N

550630 RNA, PCR(Graph)rfx/GenoPRI R1 1 N PC 409 A Y

550713 HCV RNA NAA Qualitative R1 1 N PC 347.25 A Y

550757 informaSeq(SM) with Y AnalysisR1 1 N MG 795 A Y

550825 HCV NAA Qualitative (rfx Geno)R1 1 N PC 347.25 A Y

550840 HCV RNA NAA Qual rfx to Quant R1 1 N PC 347.25 A Y

550850 HCV RNA NAA Qualitative R1 1 N PC 347.25 A N

550880 RealTime Abbott R1 1 N PC 439.5 A Y

551242 HCV RNA Det Ql Rfx Gen R1 1 N XX 347.25 A N

551300 HCV RealTime Abbott R1 1 N PC 647.75 A Y

551319 Quant, RNA PCR R1 1 N TG 386 A N

551610 HBV Real-Time PCR, Quant R1 1 N PC 520.75 A Y

551619 HIV GenoSure(R) MG R1 1 N PC 224.25 A N

551620 HBV RT PCR, Quant (Graph) R1 1 N PC 543.5 A Y

551624 HIV GenoSure(R) MG R1 1 N PC 443.25 A N

551689 Virtual Phenotype R1 1 N XX 829.25 A N

551690 PhenoSense GT (R) R1 1 N SO 2417 A Y

551704 GenoSure PRIme(R) R1 1 N PC 665.5 A N

551707 GenoSure PRIme(R) R1 1 N PC 224.5 A N

551734 HIVDNASeq PRRT R1 1 N PC 443.25 A N

551743 HIVDNASeq PRRT Interp R1 1 N PC 224.25 A N

551781 HIV GSArchive R1 1 N PC 665.5 A N

551782 HIV GSArchive Interp R1 1 N PC 224.5 A N

551800 PhenoSense(R) R1 1 N PC 1242 A Y

551874 HIV GenoSure(R) Integrase R1 1 N PC 350 A N

551887 RNA, b-DNA, Quant, Non-Graph R1 1 N XX 416.75 A N

600973 Allergen Panel, Food-Berry R1 1 N AL 72.75 A Y

600999 Allergen Profile, Food-Legume R1 1 N AL 72.75 A Y

601013 Allergen Profile, Food-Fish R1 1 N AL 169.75 A Y

601823 Allergen Profile, Vegetable IIR1 1 N AL 218.25 A Y

601831 Allergen Profile, Vegetable I R1 1 N AL 169.75 A Y

601856 Allergen Profile, Food-Milk R1 1 N AL 145.5 A Y

601872 Allergen Profile, Food-Fruit R1 1 N AL 121.25 A Y

602284 Allergen Profile, Food-Meat R1 1 N AL 72.75 A Y

602292 Allergens(4) R1 1 N AL 97 A N

602421 Allergens (4) Foods R1 1 N AL 97 A N

602451 F013-IgE Peanut R1 1 N AL 24.25 A Y

602452 F001-IgE Egg White R1 1 N AL 24.25 A Y

602453 F002-IgE Milk R1 1 N AL 24.25 A Y

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602454 E001-IgE Cat Dander R1 1 N AL 24.25 A Y

602456 E005-IgE Dog Dander R1 1 N AL 24.25 A Y

602457 F014-IgE Soybean R1 1 N AL 24.25 A Y

602459 F004-IgE Wheat R1 1 N AL 24.25 A Y

602460 F008-IgE Corn R1 1 N AL 24.25 A Y

602462 M002-IgE Cladosporium herbarumR1 1 N AL 24.25 A Y

602463 W001-IgE Ragweed, Short R1 1 N AL 24.25 A Y

602464 G002-IgE Bermuda Grass R1 1 N AL 24.25 A Y

602465 F003-IgE Codfish R1 1 N AL 24.25 A Y

602467 D001-IgE D pteronyssinus R1 1 N AL 24.25 A Y

602468 F025-IgE Tomato R1 1 N AL 24.25 A Y

602470 F201-IgE Pecan Nut R1 1 N AL 24.25 A Y

602472 F033-IgE Orange R1 1 N AL 24.25 A Y

602473 F024-IgE Shrimp R1 1 N AL 24.25 A Y

602475 D002-IgE D farinae R1 1 N AL 24.25 A Y

602476 T008-IgE Elm, American R1 1 N AL 24.25 A Y

602478 F338-IgE Scallop R1 1 N AL 24.25 A Y

602480 T007-IgE Oak, White R1 1 N AL 24.25 A Y

602481 I206-IgE Cockroach, American R1 1 N AL 24.25 A Y

602484 W014-IgE Pigweed, Common R1 1 N AL 24.25 A Y

602485 F010-IgE Sesame Seed R1 1 N AL 24.25 A Y

602486 F203-IgE Pistachio Nut R1 1 N AL 24.25 A Y

602487 F075-IgE Egg (Yolk) R1 1 N AL 24.25 A Y

602491 T006-IgE Cedar, Mountain R1 1 N AL 24.25 A Y

602492 F093-IgE Chocolate/Cacao R1 1 N AL 24.25 A Y

602493 F023-IgE Crab R1 1 N AL 24.25 A Y

602494 T010-IgE Walnut R1 1 N AL 24.25 A Y

602495 F080-IgE Lobster R1 1 N AL 24.25 A Y

602497 F079-IgE Gluten R1 1 N AL 24.25 A Y

602498 F026-IgE Pork R1 1 N AL 24.25 A Y

602500 F083-IgE Chicken R1 1 N AL 24.25 A Y

602501 F236-IgE Whey R1 1 N AL 24.25 A Y

602503 G010-IgE Johnson Grass R1 1 N AL 24.25 A Y

602506 G006-IgE Timothy Grass R1 1 N AL 24.25 A Y

602507 F041-IgE Salmon R1 1 N AL 24.25 A Y

602509 F027-IgE Beef R1 1 N AL 24.25 A Y

602510 F040-IgE Tuna R1 1 N AL 24.25 A Y

602511 F009-IgE Rice R1 1 N AL 24.25 A Y

602512 F036-IgE Coconut R1 1 N AL 24.25 A Y

602513 F044-IgE Strawberry R1 1 N AL 24.25 A Y

602517 F012-IgE Green Pea R1 1 N AL 24.25 A Y

602518 T014-IgE Cottonwood R1 1 N AL 24.25 A Y

602519 F047-IgE Garlic R1 1 N AL 24.25 A Y

602521 F031-IgE Carrot R1 1 N AL 24.25 A Y

602523 F204-IgE Trout R1 1 N AL 24.25 A Y

602525 F015-IgE White Bean R1 1 N AL 24.25 A Y

602528 F245-IgE Egg, Whole R1 1 N AL 24.25 A Y

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602529 F207-IgE Clam R1 1 N AL 24.25 A Y

602530 F256-IgE Walnut R1 1 N AL 24.25 A Y

602531 W006-IgE Mugwort R1 1 N AL 24.25 A Y

602536 W009-IgE Plantain, English R1 1 N AL 24.25 A Y

602537 W010-IgE Lamb's Quarters R1 1 N AL 24.25 A Y

602539 F414-IgE Tilapia R1 1 N AL 24.25 A Y

602542 W018-IgE Sheep Sorrel R1 1 N AL 24.25 A Y

602546 H002-IgE House Dust Hollister R1 1 N AL 24.25 A Y

602548 M005-IgE Candida albicans R1 1 N AL 24.25 A Y

602553 F007-IgE Oat R1 1 N AL 24.25 A Y

602555 M011-IgE Rhizopus nigricans R1 1 N AL 24.25 A Y

602560 M009-IgE Fusarium proliferatumR1 1 N AL 24.25 A Y

602561 M008-IgE Setomelanomma rostratR1 1 N AL 24.25 A Y

602567 F045-IgE Yeast R1 1 N AL 24.25 A Y

602673 O001-IgE Cotton Lint R1 1 N AL 24.25 A Y

602684 E003-IgE Horse Dander R1 1 N AL 24.25 A Y

602688 E070-IgE Goose Feathers R1 1 N AL 24.25 A Y

602699 E081-IgE Sheep epithelia R1 1 N AL 24.25 A Y

602703 E085-IgE Chicken Feathers R1 1 N AL 24.25 A Y

602704 E086-IgE Duck Feathers R1 1 N AL 24.25 A Y

602708 E089-IgE Turkey Feathers R1 1 N AL 24.25 A Y

602718 F329-IgE Watermelon R1 1 N AL 24.25 A Y

602720 F042-IgE Haddock R1 1 N AL 24.25 A Y

602723 F048-IgE Onion R1 1 N AL 24.25 A Y

602724 F049-IgE Apple R1 1 N AL 24.25 A Y

602725 F050-IgE Mackerel R1 1 N AL 24.25 A Y

602726 F054-IgE Sweet Potato R1 1 N AL 24.25 A Y

602728 F415-IgE Walleye Pike R1 1 N AL 24.25 A Y

602732 F081-IgE Cheese, Cheddar Type R1 1 N AL 24.25 A Y

602734 F084-IgE Kiwi Fruit R1 1 N AL 24.25 A Y

602735 F085-IgE Celery R1 1 N AL 24.25 A Y

602736 F086-IgE Parsley R1 1 N AL 24.25 A Y

602737 F087-IgE Melon R1 1 N AL 24.25 A Y

602739 F089-IgE Mustard R1 1 N AL 24.25 A Y

602742 F092-IgE Banana R1 1 N AL 24.25 A Y

602743 F094-IgE Pear R1 1 N AL 24.25 A Y

602744 F095-IgE Peach R1 1 N AL 24.25 A Y

602756 F342-IgE Olive, Black R1 1 N AL 24.25 A Y

602757 F319-IgE Red Beet R1 1 N AL 24.25 A Y

602759 F147-IgE Flounder R1 1 N AL 24.25 A Y

602760 F263-IgE Green Bell Pepper R1 1 N AL 24.25 A Y

602765 F182-IgE Lima Bean R1 1 N AL 24.25 A Y

602770 F210-IgE Pineapple R1 1 N AL 24.25 A Y

602773 F212-IgE Mushroom R1 1 N AL 24.25 A Y

602775 F214-IgE Spinach R1 1 N AL 24.25 A Y

602776 F215-IgE Lettuce R1 1 N AL 24.25 A Y

602777 F216-IgE Cabbage R1 1 N AL 24.25 A Y

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602779 F218-IgE Paprika R1 1 N AL 24.25 A Y

602780 F344-IgE Sage, Salvia R1 1 N AL 24.25 A Y

602781 F220-IgE Cinnamon R1 1 N AL 24.25 A Y

602782 F221-IgE Coffee R1 1 N AL 24.25 A Y

602786 F225-IgE Pumpkin R1 1 N AL 24.25 A Y

602793 F234-IgE Vanilla R1 1 N AL 24.25 A Y

602794 F235-IgE Lentil R1 1 N AL 24.25 A Y

602796 F242-IgE Bing Cherry R1 1 N AL 24.25 A Y

602798 F244-IgE Cucumber R1 1 N AL 24.25 A Y

602802 F259-IgE Grape R1 1 N AL 24.25 A Y

602803 F260-IgE Broccoli R1 1 N AL 24.25 A Y

602806 F262-IgE Eggplant R1 1 N AL 24.25 A Y

602807 F265-IgE Cumin R1 1 N AL 24.25 A Y

602816 F278-IgE Bayleaf (Laurel) R1 1 N AL 24.25 A Y

602817 F279-IgE Chili Pepper R1 1 N AL 24.25 A Y

602818 F280-IgE Black Pepper R1 1 N AL 24.25 A Y

602822 F283-IgE Oregano R1 1 N AL 24.25 A Y

602823 F284-IgE Turkey R1 1 N AL 24.25 A Y

602824 F287-IgE Kidney Bean R1 1 N AL 24.25 A Y

602829 F296-IgE Carob Bean R1 1 N AL 24.25 A Y

602835 F309-IgE Chick Pea R1 1 N AL 24.25 A Y

602838 F315-IgE Green Bean R1 1 N AL 24.25 A Y

602845 F369-IgE Catfish R1 1 N AL 24.25 A Y

602857 F381-IgE Red Snapper R1 1 N AL 24.25 A Y

602858 F384-IgE Whitefish R1 1 N AL 24.25 A Y

602860 FX02-IgE Food Mix (Seafoods) R1 1 N AL 24.25 A Y

602864 K071-IgE Castor Bean R1 1 N AL 24.25 A Y

602874 G014-IgE Oat, Cultivated R1 1 N AL 24.25 A Y

602886 I001-IgE Honeybee R1 1 N AL 24.25 A Y

602887 I002-IgE Hornet, White Face R1 1 N AL 24.25 A Y

602889 I003-IgE Yellow Jacket R1 1 N AL 24.25 A Y

602890 I004-IgE Paper Wasp R1 1 N AL 24.25 A Y

602891 I005-IgE Hornet, Yellow R1 1 N AL 24.25 A Y

602897 I205-IgE Bumblebee R1 1 N AL 24.25 A Y

602918 M024-IgE Stachybotrys atra R1 1 N AL 24.25 A Y

602927 T015-IgE Ash, White R1 1 N AL 24.25 A Y

602936 T003-IgE Common Silver Birch R1 1 N AL 24.25 A Y

602948 T011-IgE Maple Leaf Sycamore R1 1 N AL 24.25 A Y

602966 W005-IgE Wormwood R1 1 N AL 24.25 A Y

602970 W013-IgE Cocklebur R1 1 N AL 24.25 A Y

602983 F004W-IgE Wheat R1 1 N AL 24.25 A N

602989 Food Allergy Profile R1 1 N AL 291 A Y

603203 Allergens(92) Foods R1 1 N AL 2231 A N

603857 IgE Food Basic w/Component RfxR1 1 N AL 145.5 A Y

603916 IgE Peanut w/Component Reflex R1 1 N AL 24.25 A Y

603927 IgE Milk w/ Component Reflex R1 1 N AL 24.25 A Y

603940 IgE Egg White w/Component RflxR1 1 N AL 24.25 A Y

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607523 Allergens(10) R1 1 N AL 242.5 A N

648014 Allergen Profile, Food-Basic R1 1 N AL 145.5 A Y

649749 Allergen Profile, Mini-Panel R1 1 N AL 291 A Y

650390 K082-IgE Latex R1 1 N AL 24.25 A Y

660423 Allergen Profile, Basic Food R1 1 N AL 242.5 A Y

660670 Hypersensitivity Pneumonitis R1 1 N AL 433.5 A Y

665349 IgE+Latex R1 1 N AL 105.5 A N

670797 Allergens(5) R1 1 N AL 121.25 A N

671871 Hymenoptera Profile 2 R1 1 N AL 145.5 A Y

671926 Allergens(7) R1 1 N AL 169.75 A Y

672208 Allergens(9) R1 1 N AL 218.25 A N

672486 Allergen Profile, Ragweed PlusR1 1 N AL 97 A Y

672489 Allergens(9) R1 1 N AL 218.25 A N

676528 Allergens, Zone 2 R1 1 N AL 703.25 A N

676536 Allergens, Zone 3 R1 1 N AL 630.5 A N

700068 Amino Acid Profile, Qn, PlasmaR1 1 N BG 561 A Y

700070 Methadone Confirmation, Urine R1 1 N TX 119.5 A Y

700140 Amino Acid Profile, Qn, Urine R1 1 N TX 561 A Y

700195 Cystine, Quant. 24 hr Urine R1 1 N TX 187 A Y

700248 Tacrolimus (FK506), Blood R1 1 N TX 167 A Y

701869 Cannabinoid Screen, Urine R1 1 N TX 24 A Y

704411 704411 5 Drug-Unbund R1 1 N TX 50 A N

706200 Heavy Metals Profile II, BloodR1 1 N TX 440.25 A Y

706440 Clozapine (Clozaril), Serum R1 1 N TX 116.75 A Y

706465 Clomipramine, Serum R1 1 N TX 116.75 A Y

706499 Valproic Acid (Total+Free) R1 1 N TX 217 A N

706500 Carnitine, Total and Free R1 1 N TX 131.5 A Y

706501 Carnitine, Total R1 1 N TX 65.75 A N

706557 Cyclosporine, Blood R1 1 N TX 141 A Y

706705 Amiodarone (Cordarone(R)), S R1 1 N TX 141 A Y

706838 Fluoxetine (Prozac(R)), Serum R1 1 N TX 141 A Y

706887 Fluphenazine (Prolixin(R)), S R1 1 N TX 133.75 A Y

706961 Methylmalonic Acid, Serum R1 1 N TX 201.25 A Y

706994 Homocyst(e)ine, Plasma R1 1 N AC 143.25 A Y

707013 Amphetamines Confirm, Urine R1 1 N MT 119.5 A N

707031 Cocaine Metabolite Confirm R1 1 N MT 119.5 A N

707033 Opiates Confirm, Urine R1 1 N MT 119.5 A N

707052 MDMA Confirm, Urine R1 1 N MT 119.5 A N

707080 Drug Abuse, HHS/DOT - Unbund R1 1 N FT 73 A Y

707100 D/L Methamphetamine R1 1 N MT 136.5 A N

708008 PSC Specimen Collection R1 1 N TX 18.75 A N

708080 Drug Abuse, HHS/DOT-Bund R1 1 N FT 83 A Y

708120 Drug Abuse, HHS/DOT - Bund R1 1 N FT 83 A N

711034 Tacrolimus by Immunoassay R1 1 N TX 167 A Y

712562 Cannabinoid Confirmation, Ur R1 1 N TX 119.5 A N

712570 Opiates Conf (GC/MS) R1 1 N TX 119.5 A N

712588 Phencyclidine Confirmation, UrR1 1 N TX 119.5 A N

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713751 Opiates GC/MS, Urine R1 1 N TX 119.5 A N

716159 6-Acetylmorphine, Conf R1 1 N TX 137.5 A Y

716167 Ethanol, Urine R1 1 N TX 24 A N

716285 Topiramate (Topamax), Serum R1 1 N TX 135.25 A Y

716290 Homocysteine, Urine R1 1 N TX 213.75 A N

716365 Methylmalonic Acid, Urine R1 1 N TX 201.25 A Y

716563 Risperidone (Risperdal(R)), S R1 1 N TX 178.25 A Y

716720 Organic Acid Analysis, Urine R1 1 N TX 208 A Y

716795 Mycophenolic Acid and Metabo. R1 1 N TX 133.25 A Y

716803 Carbamazepine-10,11 Epoxide R1 1 N TX 98.25 A Y

716811 Gabapentin (Neurontin), Serum R1 1 N TX 133.25 A Y

716928 Oxcarbazepine (Trileptal),S R1 1 N TX 122.75 A Y

716936 Levetiracetam (Keppra), S R1 1 N TX 133.25 A Y

716944 Lamotrigine (Lamictal), Serum R1 1 N TX 133.25 A Y

717009 Lead, Blood (Pediatric) R1 1 N TX 61 A Y

717033 Lead/Protoporphyrin, PediatricR1 1 N TX 137.25 A Y

717330 Amikacin, Serum, Peak/Trough R1 1 Y TX 194 A Y

722118 MDMA R1 1 N TX 24 A Y

724542 Pb+As U+Hg U+FEP R1 1 N TX 291.75 A N

725788 725788 7 Drug-Unbund R1 1 N TX 63 A Y

726778 726778 7+Alc-Unbund R1 1 N TX 69.5 A Y

733071 Opiates GC/MS Retest R1 1 N TX 183.75 A N

733339 733339 10+Alc-Scr R1 1 N TX 100 A N

733690 733690 12+Oxycodone+Crt-Scr R1 1 N TX 188.25 A Y

733692 733692 9+Oxycodone+Crt-Scr R1 1 N TX 140 A Y

733694 733694 9+Alc+Crt-Scr R1 1 N TX 88 A N

733726 733726 13+Oxycodone+Crt-Scr R1 1 N TX 205 A Y

733848 733848 9+Alc+Crt-Scr R1 1 N TX 90.5 A N

734349 734349 3 Drug-Scr R1 1 N TX 37 A N

734351 734351 5 Drug-Scr R1 1 N TX 50 A N

734352 734352 6 Drug-Scr R1 1 N TX 56.5 A N

734353 734353 7 Drug-Scr R1 1 N TX 63 A N

737000 Methadone (GC/MS), Urine R1 1 N TX 119.5 A Y

737620 Oxycodone/Oxymorphone (GC/MS) R1 1 N TX 119.5 A N

737630 Oxycodone/Oxymorphone, Urine R1 1 N TX 58 A Y

737637 Oxycodone/Oxymorphone, Urine R1 1 N TX 58 A N

737638 Oxycodone/Oxymorphone, Urine R1 1 N TX 58 A Y

737640 Oxycodone/Oxymorphone (GC/MS) R1 1 N TX 119.5 A N

737641 Oxycodone/Oxymorphone (GC/MS) R1 1 N TX 119.5 A N

737648 Oxycodone/Oxymorphone, Urine R1 1 N TX 58 A Y

737693 Amphetamine, Urine R1 1 N TX 24 A Y

737735 Cannabinoid (GC/MS), Urine R1 1 N TX 119.5 A Y

737752 Cocaine (GC/MS), Urine R1 1 N TX 119.5 A Y

737834 Opiates Confirmation, Urine R1 1 N TX 119.5 A Y

737846 Opiates Confirmation, Urine R1 1 N TX 119.5 A Y

737892 Amphetamines (GC/MS), Urine R1 1 N TX 119.5 A N

737921 737921 12+Oxycodone+Crt-UnbundR1 1 N TX 301.75 A N

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761050 Meperidine/Normep (GC/MS), U R1 1 N TX 119.5 A Y

761141 Fentanyl, Urine R1 1 N TX 60 A N

761153 Buprenorphine, Urine R1 1 N TX 58 A N

763400 Buprenorphine, Urine R1 1 N TX 58 A Y

763401 Buprenorphine LC/MS/MS R1 1 N XX 119.5 A N

763824 763824 12+Oxycodone+Crt-UnbundR1 1 N TX 198 A Y

763897 Oxycodone/Oxymorphone Confirm R1 1 N TX 119.5 A Y

763910 Benzodiazepines Confirm, UrineR1 1 N TX 119.5 A Y

764024 Carisoprodol/Meprobamate, Ur R1 1 N TX 143.75 A N

764060 Benzodiazepines Confirm, UrineR1 1 N TX 119.5 A N

764130 Buprenorphine, Urine R1 1 N TX 60 A N

764227 764227 9+Oxyco+Crt-Unbund R1 1 N TX 255 A N

764365 Tramadol R1 1 N TX 60 A Y

764400 Buprenorphine Confirm, Urine R1 1 N TX 119.5 A Y

764875 Drug Profile 764875 R1 1 N TX 208.5 A Y

764883 764883 11+Oxyco+Alc+Crt-Bund R1 1 N TX 196 A N

764888 764888 10+Oxyco+Alc+Crt-Bund R1 1 N TX 190 A Y

764928 764928 11+Oxycodone+Crt-Bund R1 1 N TX 313.5 A N

765000 765000 11+Oxyco+Alc+Crt-Bund R1 1 N TX 196.5 A N

765204 765204 15+Oxyco-Bund+Bup-Scr R1 1 N TX 308 A N

765507 765507 9+MDMA+Oxyco+Crt-Bund R1 1 N TX 158.5 A N

766550 Drug Profile, Blood (5 Drugs) R1 1 N TX 227.5 A N

767640 Opiates (GC/MS), Blood R1 1 N TX 314.5 A N

768431 768431 10+Oxycodone+Crt-Bund R1 1 N TX 185.5 A N

770565 Cocaine(Metab.)Screen, Urine R1 1 N TX 43.5 A N

770628 770628 7 Drug-Scr R1 1 N TX 63 A N

770701 Drug Scrn, Treatment Center R1 1 N TX 80 A Y

772012 DRUG PROFILE 772012 R1 1 N TX 82.5 A N

772111 772111 9+Alc+Crt-Scr R1 1 N TX 88 A N

772236 772236 8+Alc-Scr R1 1 N TX 81.5 A N

780400 Oral Fluid Drug Analysis R1 1 N TX 60 A N

788243 788243 10+Alc-Bund R1 1 N TX 106.75 A N

788423 788423 7 Drug-Bund R1 1 N TX 66 A N

788583 788583 10+Crt-Bund R1 1 N TX 109 A N

788877 CreatU+pH U+Specific Gravity R1 1 N TX 8 A N

788878 788878 9+MDMA-Bund R1 1 N TX 92.5 A N

788890 Adulteration (Dilution), UrineR1 1 N TX 8 A Y

788923 Specific Gravity R1 1 N TX 8 A N

788927 Creatinine, Urine R1 1 N TX 17 A N

788941 788941 7+MDMA-Bund R1 1 N TX 71.5 A N

789034 789034 7+Crt-Bund R1 1 N TX 71.5 A N

789888 789888 6+MDMA+Crt-Bund R1 1 N TX 79 A N

790034 790034 9+MDMA+Crt-Bund R1 1 N TX 98.5 A N

790350 Mephedrone, MDPV, Methylone R1 1 N TX 131.25 A Y

790390 Drugs of Abuse Screen,11 SerumR1 1 N TX 207.5 A Y

790394 Gabapentin, Urine R1 1 N TX 177.5 A Y

790430 Drugs of Abuse Screen, 10 WB R1 1 N TX 290.96 A Y

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790560 Heroin, Serum/Plasma/WB R1 1 N TX 267.74 A Y

790600 Compliance Drug Analysis, Ur R1 1 N TX 354 A Y

790621 Opiates, Unconjugated Exp. WB R1 1 N TX 314.5 A Y

790738 Synthetic Cannabinoids, Conf R1 1 N SO 131.25 A N

790742 Synthetic Cannabinoids, Urine R1 1 N TX 58 A Y

790856 Paliperidone, Serum R1 1 N TX 100.8 A Y

790890 PCB Serum w/rfx to Confir R1 1 N TX 100.6 A Y

791194 Comprehensive Drug Analysis,UrR1 1 N TX 434.6 A N

791566 Cannabinoid Analysis, WB R1 1 N TX 82.25 A Y

791570 Blood Drugs of Abuse 6, WB R1 1 N TX 227.5 A Y

791588 Amphetamine Analysis, WB R1 1 N TX 82.25 A Y

791590 Blood Drugs of Abuse 8, WB R1 1 N TX 289.5 A Y

791632 Drugs of Abuse Scr ONLY, 10,WBR1 1 N TX 271.3 A Y

791706 Bld Drugs of Abuse, 7, WB R1 1 N TX 302.5 A Y

791710 Benzodiazepine Confirm, QT, WBR1 1 N TX 314.5 A Y

791718 THC (Tetrahydrocannabinol), WBR1 1 N TX 314.5 A Y

791742 791742 10+Oxycodone+Alc-Bund R1 1 N TX 171.5 A N

794370 Drug Profile, Ur, 9 Drugs R1 1 N TX 86 A Y

794388 794388 7 Drug-Bund R1 1 N TX 73 A Y

794902 Specific Gravity R1 1 Y TX 6 A N

798067 Ethyl Glucuronide, Urine R1 1 N TX 121 A N

798419 Benzodiazepines GC/MS Retest R1 1 N TX 183.75 A N

799007 799007 7 Drug-Bund R1 1 N TX 73 A N

799452 799452 5 Drug-Bund R1 1 N TX 60 A N

803301 Hydrocodone + Metabolites, U R1 1 N TX 157.5 A Y

804500 VAP Cholesterol Profile R1 1 N SO 204.5 A N

805891 Coriander/Cilantro IgE R1 1 N SO 48.5 A N

805904 Venom European Hornet IgE R1 1 N SO 48.5 A N

805922 Sardine, Pilchard IgE R1 1 N XX 48.5 A N

805979 Tilapia IgE R1 1 N XX 48.5 A N

806021 Tarragon IgE R1 1 N SO 62.5 A N

806054 Marjoram IgE R1 1 N SO 62.5 A N

806130 Venom Paper Wasp IgE R1 1 N XX 48.5 A N

806443 Ketone Bodies Panel, S/P R1 1 N SO 320.5 A N

806698 Hair Standard R1 1 N SO 70 A N

808374 Naproxen (Aleve,Naprosyn,Ana.)R1 1 N TX 134 A Y

808377 Mercaptopurine (6-MP,Purin.) R1 1 N TX 172.5 A Y

808404 Quetiapine (Seroquel) R1 1 N TX 113.25 A Y

808462 Ibuprofen, Serum/Plasma R1 1 N TX 76.25 A Y

808933 Solvent Inhalants Panel, WB R1 1 N TX 241.5 A Y

808966 Paraneoplastic Profile II R1 1 N SO 556 A N

809623 Pregabalin, Urine R1 1 N TX 127 A Y

809671 Aripiprazole R1 1 N TX 189.5 A Y

811338 Azathioprine (Imuran) R1 1 N TX 180 A Y

811394 Mineral Profile (7), RBC's R1 1 N SO 319.25 A N

811513 Olanzapine (Zyprexa) R1 1 N TX 143.25 A Y

811903 Clonazepam, Ur as Metabolite R1 1 N TX 168 A Y

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812238 Harmony with XY Analysis R1 1 N SO 1104.75 A N

814483 Bartonella + Bact. Aerobic R1 1 N SO 153 A N

816212 Hair Drug Screen 9 Panel R1 1 N SO 408.25 A N

816767 Pneumococcal IM (14 Serotype) R1 1 N SO 269.25 A N

816853 Sugar Cane IgE* R1 1 N SO 37 A N

823203 Histoplasma Antigen, Urine R1 1 N SO 115.25 A N

823239 Porphyrins, Total Plasma R1 1 N SO 171.25 A N

823263 Francisella tularensis Abs R1 1 N SO 139.5 A N

823331 Hepatitis E IgM R1 1 N SO 173.25 A N

823334 Hepatitis E IgG R1 1 N SO 173.25 A N

826359 Jalapeno Pepper, IgE R1 1 N SO 48.5 A N

826700 Black Bean IgE R1 1 N SO 48.5 A N

827632 PBG Deaminase, Erythrocytes R1 1 N SO 245 A N

828391 Dengue Fever Ab R1 1 N SO 176 A N

828395 Dengue Fever Virus Ab, IgM R1 1 N SO 93.75 A N

828470 Dengue Fever Virus Ab, IgG R1 1 N SO 87 A N

828735 Trypanosoma Cruzi Ab, IgM R1 1 N SO 85.5 A N

828737 Trypanosoma Cruzi Ab IgG R1 1 N SO 85.5 A N

828755 Strongyloides Ab IgG, ELISA R1 1 N SO 92.25 A N

829044 Huntington Disease Mutation R1 1 N SO 679.5 A N

831000 Rheumatoid Factor (RF), IgA R1 1 N SO 46.5 A N

842104 Tiagabine (Gabitril) R1 1 N TX 80.49 A Y

847525 Ziprasidone (Geodon,Zeldox) R1 1 N SO 153 A N

850601 Blood-SMR,Periph,Int/Phy 1st R1 1 N HI 84.5 A N

875194 Leucine Aminopeptidase, Serum R1 1 N SO 126 A N

881411 Physician Read Pap R1 1 N CY 53.75 A N

883001 88300 Surgical Pathology R1 1 N HI 40 A N

883041 88304 Surgical Path-1st Site R1 1 N HI 102.75 A N

883042 88304 Surgical Path-2nd Site R1 1 N HI 102.75 A N

883051 88305 Surg Path-1st Site R1 1 N HI 148 A N

883052 88305 Surg Path-2nd Site R1 1 N HI 148 A N

883053 88305 Surg Path-3rd Site R1 1 N HI 148 A N

883054 88305 Surg Path-4th Site R1 1 N HI 148 A N

883055 88305 Surg Path-5th Site R1 1 N HI 148 A N

883056 88305 Surg Path-6th Site R1 1 N HI 148 A N

883057 88305 Surg Path-7th Site R1 1 N HI 148 A N

883058 88305 Surg Path-8th Site R1 1 N HI 148 A N

883071 88307 Surgical Pathology R1 1 N HI 260.5 A N

883072 88307 Surgical Pathology R1 1 N HI 260.5 A N

883073 88307 Surgical Pathology R1 1 N HI 260.5 A N

883121 Spec-Stain,GRP I-Micro 1st R1 1 N HI 128.75 A N

883122 Spec-Stain,GRP I-Micro 2nd R1 1 N HI 128.75 A N

883123 Spec-Stain,GRP I-Micro 3rd R1 1 N HI 128.75 A N

883124 Spec-Stain,GRP I-Micro 4th R1 1 N HI 128.75 A N

883125 Spec-Stain,GRP I-Micro 5th R1 1 N HI 128.75 A N

883131 Spec-Stain,GRP II-All-Oth 1st R1 1 N HI 102.25 A N

883132 Spec-Stain,GRP II-All-Oth 2nd R1 1 N HI 102.25 A N

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883211 Consul+Rep/Ref Slides 1st SiteR1 1 N HI 170.25 A N

883421 Immunohistochem, 1st Antibody R1 1 N XX 187.75 A N

883422 Immunohistochem, 2nd Antibody R1 1 N XX 187.75 A N

883423 Immunohistochem, 3rd Antibody R1 1 N XX 187.75 A N

883431 1st addtl IHC Ab per slide R1 1 N XX 100 A N

883432 2nd addtl IHC Ab per slide R1 1 N XX 100 A N

883433 3rd addtl IHC Ab per slide R1 1 N XX 100 A N

884000 NMR LipoProfile w/IR Markers R1 1 N SC 99 A N

884247 NMR LipoProfile R1 1 N SC 99 A Y

884280 Lipoprotein Analysis, by NMR R1 1 N SC 80.28 A N

884318 Lipoprotein Analysis by NMR R1 1 N SC 80.28 A Y

910339 Litholink CMP14+P R1 1 Y AC 29.75 A N

977709 CBC/Diff Ambiguous Default R1 1 Y GN 25.75 A N

995407 Hourly Phlebotomy Coverage FeeR1 1 N VN 24 A N

C90139 CVS Chrom Analysis 88235 R1 1 N CG 250 A N

C90140 Chromosome Blood Routine 88230R1 1 N CG 250 A N

C90142 Chrom Analy 5 Cell 1 Karyo R1 1 N CG 250 A N

C90145 Count 15-20 cells, 2 KaryotypeR1 1 N CG 424 A N

C90149 Chromosome Amniotic Fluid R1 1 N CG 250 A N

M90001 MIC Organism #1 R1 1 N MI 75 A N

M90002 MIC Organism #2 R1 1 N MI 75 A N

M90003 MIC Organism #3 R1 1 N MI 75 A N

P20061 IHC 1st AB Stain x1 PROF R1 1 N HI 118.25 A N

P20062 IHC 1st AB Stain x2 PROF R1 1 N HI 236.5 A N

P20063 IHC 1st AB Stain x3 PROF R1 1 N HI 354.75 A N

P20064 IHC 1st AB Stain x4 PROF R1 1 N HI 473 A N

P20065 IHC 1st AB Stain x5 PROF R1 1 N HI 591.25 A N

P20066 IHC 1st AB Stain x6 PROF R1 1 N HI 709.5 A N

P20067 IHC 1st AB Stain x7 PROF R1 1 N HI 827.75 A N

P20068 IHC 1st AB Stain x8 PROF R1 1 N HI 946 A N

P20069 IHC 1st AB Stain x9 PROF R1 1 N HI 1064.25 A N

P20070 IHC 1st AB Stain x10 PROF R1 1 N HI 1182.5 A N

P20071 IHC 1st AB Stain x11 PROF R1 1 N HI 1300.75 A N

P20072 IHC 1st AB Stain x12 PROF R1 1 N HI 1419 A N

P20073 IHC 1st AB Stain x13 PROF R1 1 N HI 1537.25 A N

P20074 IHC 1st AB Stain x14 PROF R1 1 N HI 1655.5 A N

P20075 IHC 1st AB Stain x15 PROF R1 1 N HI 1773.75 A N

P20076 IHC 1st AB Stain x16 PROF R1 1 N HI 1892 A N

P20077 IHC 1st AB Stain x17 PROF R1 1 N HI 2010.25 A N

P20078 IHC 1st AB Stain x18 PROF R1 1 N HI 2128.5 A N

P20079 IHC 1st AB Stain x19 PROF R1 1 N HI 2246.75 A N

P20080 IHC 1st AB Stain x20 PROF R1 1 N HI 2365 A N

P20081 IHC 1st AB Stain x21 PROF R1 1 N HI 2483.25 A N

P20082 IHC 1st AB Stain x22 PROF R1 1 N HI 2601.5 A N

P20083 IHC 1st AB Stain x23 PROF R1 1 N HI 2719.75 A N

P20084 IHC 1st AB Stain x24 PROF R1 1 N HI 2838 A N

P20085 IHC 1st AB Stain x25 PROF R1 1 N HI 2956.25 A N

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P20086 IHC 1st AB Stain x26 PROF R1 1 N HI 3074.5 A N

P20087 IHC 1st AB Stain x27 PROF R1 1 N HI 3192.75 A N

P20088 IHC 1st AB Stain x28 PROF R1 1 N HI 3311 A N

P20089 IHC 1st AB Stain x29 PROF R1 1 N HI 3429.25 A N

P20090 IHC 1st AB Stain x30 PROF R1 1 N HI 3547.5 A N

P20291 IHC X1 RUO Prof R1 1 N UB 118.25 A N

P20292 IHC X2 RUO Prof R1 1 N UB 236.5 A N

P20293 IHC X3 RUO Prof R1 1 N UB 354.75 A N

P20294 IHC X4 RUO Prof R1 1 N UB 473 A N

P20295 IHC X5 RUO Prof R1 1 N UB 591.25 A N

P20296 IHC X6 RUO Prof R1 1 N UB 709.5 A N

P20297 IHC X7 RUO Prof R1 1 N UB 827.75 A N

P20298 IHC X8 RUO Prof R1 1 N UB 946 A N

P20299 IHC X9 RUO Prof R1 1 N UB 1064.25 A N

P20310 IHC X10 RUO Prof R1 1 N UB 1182.5 A N

P20321 Add'l IHC Per Slide X1 Prof R1 1 N UB 65 A N

P20401 IHC ea Addl x1 RUO PROF R1 1 N HI 118.25 A N

P20402 IHC ea Addl x2 RUO PROF R1 1 N HI 236.5 A N

P20403 IHC ea Addl x3 RUO PROF R1 1 N HI 354.75 A N

P20404 IHC ea Addl x4 RUO PROF R1 1 N HI 473 A N

P20405 IHC ea Addl x5 RUO PROF R1 1 N HI 591.25 A N

P20406 IHC ea Addl x6 RUO PROF R1 1 N HI 709.5 A N

P20407 IHC ea Addl x7 RUO PROF R1 1 N HI 827.75 A N

P20408 IHC ea Addl x8 RUO PROF R1 1 N HI 946 A N

P20409 IHC ea Addl x9 RUO PROF R1 1 N HI 1064.25 A N

P20410 IHC ea Addl x10 RUO PROF R1 1 N HI 1182.5 A N

P20530 IHC ea addl AB Stain x1 PROF R1 1 N HI 118.25 A N

P20531 IHC ea addl AB Stain x2 PROF R1 1 N HI 236.5 A N

P20532 IHC ea addl AB Stain x3 PROF R1 1 N HI 354.75 A N

P20533 IHC ea addl AB Stain x4 PROF R1 1 N HI 473 A N

P20534 IHC ea addl AB Stain x5 PROF R1 1 N HI 591.25 A N

P20535 IHC ea addl AB Stain x6 PROF R1 1 N HI 709.5 A N

P20536 IHC ea addl AB Stain x7 PROF R1 1 N HI 827.75 A N

P20537 IHC ea addl AB Stain x8 PROF R1 1 N HI 946 A N

P20538 IHC ea addl AB Stain x9 PROF R1 1 N HI 1064.25 A N

P20539 IHC ea addl AB Stain x10 PROF R1 1 N HI 1182.5 A N

P20540 IHC ea addl AB Stain x11 PROF R1 1 N HI 1300.75 A N

P20541 IHC ea addl AB Stain x12 PROF R1 1 N HI 1419 A N

P20542 IHC ea addl AB Stain x13 PROF R1 1 N HI 1537.25 A N

P20543 IHC ea addl AB Stain x14 PROF R1 1 N HI 1655.5 A N

P20544 IHC ea addl AB Stain x15 PROF R1 1 N HI 1773.75 A N

P20545 IHC ea addl AB Stain x16 PROF R1 1 N HI 1892 A N

P20546 IHC ea addl AB Stain x17 PROF R1 1 N HI 2010.25 A N

P20547 IHC ea addl AB Stain x18 PROF R1 1 N HI 2128.5 A N

P20548 IHC ea addl AB Stain x19 PROF R1 1 N HI 2246.75 A N

P20549 IHC ea addl AB Stain x20 PROF R1 1 N HI 2365 A N

P20550 IHC ea addl AB Stain x21 PROF R1 1 N HI 2483.25 A N

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P20551 IHC ea addl AB Stain x22 PROF R1 1 N HI 2601.5 A N

P20552 IHC ea addl AB Stain x23 PROF R1 1 N HI 2719.75 A N

P20553 IHC ea addl AB Stain x24 PROF R1 1 N HI 2838 A N

P20554 IHC ea addl AB Stain x25 PROF R1 1 N HI 2956.25 A N

P20555 IHC ea addl AB Stain x26 PROF R1 1 N HI 3074.5 A N

P20556 IHC ea addl AB Stain x27 PROF R1 1 N HI 3192.75 A N

P20557 IHC ea addl AB Stain x28 PROF R1 1 N HI 3311 A N

P20558 IHC ea addl AB Stain x29 PROF R1 1 N HI 3429.25 A N

P20559 IHC ea addl AB Stain x30 PROF R1 1 N HI 3547.5 A N

P30001 IHC Multiplex x1 Prof R1 1 N HI 248.25 A N

P30002 IHC Multiplex x2 Prof R1 1 N HI 496.5 A N

P30003 IHC Multiplex x3 Prof R1 1 N HI 744.75 A N

P30004 IHC Multiplex x4 Prof R1 1 N HI 993 A N

P30005 IHC Multiplex x5 Prof R1 1 N HI 1241.25 A N

P30006 IHC Multiplex x6 Prof R1 1 N HI 1489.5 A N

P30007 IHC Multiplex x7 PROF R1 1 N HI 1737.75 A N

P30008 IHC Multiplex x8 Prof R1 1 N HI 1986 A N

P30009 IHC Multiplex x9 Prof R1 1 N HI 2234.25 A N

P30010 IHC Multiplex x10 Prof R1 1 N HI 2482.5 A N

P30111 IHC Multiplex x11 Prof R1 1 N HI 2730.75 A N

P30112 IHC Multiplex x12 Prof R1 1 N HI 2979 A N

P83001 Level I,Gross Only 1st (Prof) R1 1 N HI 8.75 A N

P83041 Level III Surg Path 1st (Prof)R1 1 N HI 22 A N

P83042 Level III Surg Path 2nd (Prof)R1 1 N HI 22 A N

P83051 88305 Prof Comp-1st Site R1 1 N HI 62 A N

P83052 88305 Prof Comp-2nd Site R1 1 N HI 62 A N

P83053 88305 Prof Comp-3rd Site R1 1 N HI 62 A N

P83054 88305 Prof Comp-4th Site R1 1 N HI 62 A N

P83055 88305 Prof Comp-5th Site R1 1 N HI 62 A N

P83056 88305 Prof Comp-6th Site R1 1 N HI 62 A N

P83057 88305 Prof Comp-7th Site R1 1 N HI 62 A N

P83058 88305 Prof Comp-8th Site R1 1 N HI 62 A N

P83071 Level V Surg Path 1st (Prof) R1 1 N HI 128.25 A N

P83072 Level V Surg Path 2nd (Prof) R1 1 N HI 128.25 A N

P83121 Spec Stn,Grp I Micro 1st(Prof)R1 1 N HI 50.25 A N

P83421 88342-Prof Comp 1st Antibody R1 1 N XX 101 A N

P83422 88342-Prof Comp 2nd Antibody R1 1 N XX 101 A N

P83423 88342-Prof Comp 3rd Antibody R1 1 N XX 101 A N

P83431 PC 1st addtl IHC Ab per slide R1 1 N XX 65 A N

P83432 PC 2nd addtl IHC Ab per slide R1 1 N XX 65 A N

P83433 PC 3rd addtl IHC Ab per slide R1 1 N XX 65 A N

P83501 Prof Only Prostate Biopsy x1 R1 1 N HI 62.16 A N

P83502 Prof Only Prostate Biopsies x2R1 1 N HI 124.32 A N

P83503 Prof Only Prostate Biopsies x3R1 1 N HI 186.48 A N

P83504 Prof Only Prostate Biopsies x4R1 1 N HI 248.64 A N

P83505 Prof Only Prostate Biopsies x5R1 1 N HI 310.8 A N

P83506 Prof Only Prostate Biopsies x6R1 1 N HI 372.96 A N

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P83507 Prof Only Prostate Biopsies x7R1 1 N HI 435.12 A N

P83508 Prof Only Prostate Biopsies x8R1 1 N HI 497.28 A N

P83509 Prof Only Prostate Biopsies x9R1 1 N HI 559.44 A N

P83510 ProfOnly Prostate Biopsies x10R1 1 N HI 621.6 A N

P83511 ProfOnly Prostate Biopsies x11R1 1 N HI 683.76 A N

P83512 ProfOnly Prostate Biopsies x12R1 1 N HI 745.92 A N

P83513 ProfOnly Prostate Biopsies x13R1 1 N HI 808.08 A N

P83514 ProfOnly Prostate Biopsies x14R1 1 N HI 870.24 A N

P83515 ProfOnly Prostate Biopsies x15R1 1 N HI 932.4 A N

P83516 ProfOnly Prostate Biopsies x16R1 1 N HI 994.56 A N

P83517 ProfOnly Prostate Biopsies x17R1 1 N HI 1056.72 A N

P83518 ProfOnly Prostate Biopsies x18R1 1 N HI 1118.88 A N

P83519 ProfOnly Prostate Biopsies x19R1 1 N HI 1181.04 A N

P83520 ProfOnly Prostate Biopsies x20R1 1 N HI 1243.2 A N

P83521 ProfOnly Prostate Biopsies x21R1 1 N HI 1305.36 A N

P83522 ProfOnly Prostate Biopsies x22R1 1 N HI 1367.52 A N

P83523 ProfOnly Prostate Biopsies x23R1 1 N HI 1429.68 A N

P83524 ProfOnly Prostate Biopsies x24R1 1 N HI 1491.84 A N

P83525 ProfOnly Prostate Biopsies x25R1 1 N HI 1554 A N

P83526 ProfOnly Prostate Biopsies x26R1 1 N HI 1616.16 A N

P83527 ProfOnly Prostate Biopsies x27R1 1 N HI 1678.32 A N

P83528 ProfOnly Prostate Biopsies x28R1 1 N HI 1740.48 A N

P83529 ProfOnly Prostate Biopsies x29R1 1 N HI 1802.64 A N

P83530 ProfOnly Prostate Biopsies x30R1 1 N HI 1864.8 A N

P83531 ProfOnly Prostate Biopsies x31R1 1 N HI 1926.96 A N

P83532 ProfOnly Prostate Biopsies x32R1 1 N HI 1989.12 A N

P83533 ProfOnly Prostate Biopsies x33R1 1 N HI 2051.28 A N

P83534 ProfOnly Prostate Biopsies x34R1 1 N HI 2113.44 A N

P83535 ProfOnly Prostate Biopsies x35R1 1 N HI 2175.6 A N

P83536 ProfOnly Prostate Biopsies x36R1 1 N HI 2237.76 A N

P83537 ProfOnly Prostate Biopsies x37R1 1 N HI 2299.92 A N

P83538 ProfOnly Prostate Biopsies x38R1 1 N HI 2362.08 A N

P83539 ProfOnly Prostate Biopsies x39R1 1 N HI 2424.24 A N

P83540 ProfOnly Prostate Biopsies x40R1 1 N HI 2486.4 A N

R83501 Prostate Biopsy x1 R1 1 N HI 148 A N

R83502 Prostate Biopsies x2 R1 1 N HI 296 A N

R83503 Prostate Biopsies x3 R1 1 N HI 444 A N

R83504 Prostate Biopsies x4 R1 1 N HI 592 A N

R83505 Prostate Biopsies x5 R1 1 N HI 740 A N

R83506 Prostate Biopsies x6 R1 1 N HI 888 A N

R83507 Prostate Biopsies x7 R1 1 N HI 1036 A N

R83508 Prostate Biopsies x8 R1 1 N HI 1184 A N

R83509 Prostate Biopsies x9 R1 1 N HI 1332 A N

R83510 Prostate Biopsies x10 R1 1 N HI 1480 A N

R83511 Prostate Biopsies x11 R1 1 N HI 1628 A N

R83512 Prostate Biopsies x12 R1 1 N HI 1776 A N

R83513 Prostate Biopsies x13 R1 1 N HI 1924 A N

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R83514 Prostate Biopsies x14 R1 1 N HI 2072 A N

R83515 Prostate Biopsies x15 R1 1 N HI 2220 A N

R83516 Prostate Biopsies x16 R1 1 N HI 2368 A N

R83517 Prostate Biopsies x17 R1 1 N HI 2516 A N

R83518 Prostate Biopsies x18 R1 1 N HI 2664 A N

R83519 Prostate Biopsies x19 R1 1 N HI 2812 A N

R83520 Prostate Biopsies x20 R1 1 N HI 2960 A N

R83521 Prostate Biopsies x21 R1 1 N HI 3108 A N

R83522 Prostate Biopsies x22 R1 1 N HI 3256 A N

R83523 Prostate Biopsies x23 R1 1 N HI 3404 A N

R83524 Prostate Biopsies x24 R1 1 N HI 3552 A N

R83525 Prostate Biopsies x25 R1 1 N HI 3700 A N

R83526 Prostate Biopsies x26 R1 1 N HI 3848 A N

R83527 Prostate Biopsies x27 R1 1 N HI 3996 A N

R83528 Prostate Biopsies x28 R1 1 N HI 4144 A N

R83529 Prostate Biopsies x29 R1 1 N HI 4292 A N

R83530 Prostate Biopsies x30 R1 1 N HI 4440 A N

R83531 Prostate Biopsies x31 R1 1 N HI 4588 A N

R83532 Prostate Biopsies x32 R1 1 N HI 4736 A N

R83533 Prostate Biopsies x33 R1 1 N HI 4884 A N

R83534 Prostate Biopsies x34 R1 1 N HI 5032 A N

R83535 Prostate Biopsies x35 R1 1 N HI 5180 A N

R83536 Prostate Biopsies x36 R1 1 N HI 5328 A N

R83537 Prostate Biopsies x37 R1 1 N HI 5476 A N

R83538 Prostate Biopsies x38 R1 1 N HI 5624 A N

R83539 Prostate Biopsies x39 R1 1 N HI 5772 A N

R83540 Prostate Biopsies x40 R1 1 N HI 5920 A N

S00001 Sensitivity Organism #1 R1 1 N MI 70 A N

S00002 Sensitivity Organism #2 R1 1 N MI 70 A N

S00003 Sensitivity Organism #3 R1 1 N MI 70 A N

S00004 Sensitivity Organism #4 R1 1 N MI 70 A N

T20061 IHC 1st AB Stain x1 TECH R1 1 N HI 100.75 A N

T20062 IHC 1st AB Stain x2 TECH R1 1 N HI 201.5 A N

T20063 IHC 1st AB Stain x3 TECH R1 1 N HI 302.25 A N

T20064 IHC 1st AB Stain x4 TECH R1 1 N HI 403 A N

T20065 IHC 1st AB Stain x5 TECH R1 1 N HI 503.75 A N

T20066 IHC 1st AB Stain x6 TECH R1 1 N HI 604.5 A N

T20067 IHC 1st AB Stain x7 TECH R1 1 N HI 705.25 A N

T20068 IHC 1st AB Stain x8 TECH R1 1 N HI 806 A N

T20069 IHC 1st AB Stain x9 TECH R1 1 N HI 906.75 A N

T20070 IHC 1st AB Stain x10 TECH R1 1 N HI 1007.5 A N

T20071 IHC 1st AB Stain x11 TECH R1 1 N HI 1108.25 A N

T20072 IHC 1st AB Stain x12 TECH R1 1 N HI 1209 A N

T20073 IHC 1st AB Stain x13 TECH R1 1 N HI 1309.75 A N

T20074 IHC 1st AB Stain x14 TECH R1 1 N HI 1410.5 A N

T20075 IHC 1st AB Stain x15 TECH R1 1 N HI 1511.25 A N

T20076 IHC 1st AB Stain x16 TECH R1 1 N HI 1612 A N

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T20077 IHC 1st AB Stain x17 TECH R1 1 N HI 1712.75 A N

T20078 IHC 1st AB Stain x18 TECH R1 1 N HI 1813.5 A N

T20079 IHC 1st AB Stain x19 TECH R1 1 N HI 1914.25 A N

T20080 IHC 1st AB Stain x20 TECH R1 1 N HI 2015 A N

T20081 IHC 1st AB Stain x21 TECH R1 1 N HI 2115.75 A N

T20082 IHC 1st AB Stain x22 TECH R1 1 N HI 2216.5 A N

T20083 IHC 1st AB Stain x23 TECH R1 1 N HI 2317.25 A N

T20084 IHC 1st AB Stain x24 TECH R1 1 N HI 2418 A N

T20085 IHC 1st AB Stain x25 TECH R1 1 N HI 2518.75 A N

T20086 IHC 1st AB Stain x26 TECH R1 1 N HI 2619.5 A N

T20087 IHC 1st AB Stain x27 TECH R1 1 N HI 2720.25 A N

T20088 IHC 1st AB Stain x28 TECH R1 1 N HI 2821 A N

T20089 IHC 1st AB Stain x29 TECH R1 1 N HI 2921.75 A N

T20090 IHC 1st AB Stain x30 TECH R1 1 N HI 3022.5 A N

T20291 IHC X1 RUO Tech R1 1 N UB 100.75 A N

T20292 IHC X2 RUO Tech R1 1 N UB 201.5 A N

T20293 IHC X3 RUO Tech R1 1 N UB 302.25 A N

T20294 IHC X4 RUO Tech R1 1 N UB 403 A N

T20295 IHC X5 RUO Tech R1 1 N UB 503.75 A N

T20296 IHC X6 RUO Tech R1 1 N UB 604.5 A N

T20297 IHC X7 RUO Tech R1 1 N UB 705.25 A N

T20298 IHC X8 RUO Tech R1 1 N UB 806 A N

T20299 IHC X9 RUO Tech R1 1 N UB 906.75 A N

T20310 IHC X10 RUO Tech R1 1 N UB 1007.5 A N

T20321 Add'l IHC Per Slide X1 Tech R1 1 N UB 35 A N

T20401 IHC ea Addl x1 RUO TECH R1 1 N HI 100.75 A N

T20402 IHC ea Addl x2 RUO TECH R1 1 N HI 201.5 A N

T20403 IHC ea Addl x3 RUO TECH R1 1 N HI 302.25 A N

T20404 IHC ea Addl x4 RUO TECH R1 1 N HI 403 A N

T20405 IHC ea Addl x5 RUO TECH R1 1 N HI 503.75 A N

T20406 IHC ea Addl x6 RUO TECH R1 1 N HI 604.5 A N

T20407 IHC ea Addl x7 RUO TECH R1 1 N HI 705.25 A N

T20408 IHC ea Addl x8 RUO TECH R1 1 N HI 806 A N

T20409 IHC ea Addl x9 RUO TECH R1 1 N HI 906.75 A N

T20410 IHC ea Addl x10 RUO TECH R1 1 N HI 1007.5 A N

T20530 IHC ea addl AB Stain x1 TECH R1 1 N HI 100.75 A N

T20531 IHC ea addl AB Stain x2 TECH R1 1 N HI 201.5 A N

T20532 IHC ea addl AB Stain x3 TECH R1 1 N HI 302.25 A N

T20533 IHC ea addl AB Stain x4 TECH R1 1 N HI 403 A N

T20534 IHC ea addl AB Stain x5 TECH R1 1 N HI 503.75 A N

T20535 IHC ea addl AB Stain x6 TECH R1 1 N HI 604.5 A N

T20536 IHC ea addl AB Stain x7 TECH R1 1 N HI 705.25 A N

T20537 IHC ea addl AB Stain x8 TECH R1 1 N HI 806 A N

T20538 IHC ea addl AB Stain x9 TECH R1 1 N HI 906.75 A N

T20539 IHC ea addl AB Stain x10 TECH R1 1 N HI 1007.5 A N

T20540 IHC ea addl AB Stain x11 TECH R1 1 N HI 1108.25 A N

T20541 IHC ea addl AB Stain x12 TECH R1 1 N HI 1209 A N

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T20542 IHC ea addl AB Stain x13 TECH R1 1 N HI 1309.75 A N

T20543 IHC ea addl AB Stain x14 TECH R1 1 N HI 1410.5 A N

T20544 IHC ea addl AB Stain x15 TECH R1 1 N HI 1511.25 A N

T20545 IHC ea addl AB Stain x16 TECH R1 1 N HI 1612 A N

T20546 IHC ea addl AB Stain x17 TECH R1 1 N HI 1712.75 A N

T20547 IHC ea addl AB Stain x18 TECH R1 1 N HI 1813.5 A N

T20548 IHC ea addl AB Stain x19 TECH R1 1 N HI 1914.25 A N

T20549 IHC ea addl AB Stain x20 TECH R1 1 N HI 2015 A N

T20550 IHC ea addl AB Stain x21 TECH R1 1 N HI 2115.75 A N

T20551 IHC ea addl AB Stain x22 TECH R1 1 N HI 2216.5 A N

T20552 IHC ea addl AB Stain x23 TECH R1 1 N HI 2317.25 A N

T20553 IHC ea addl AB Stain x24 TECH R1 1 N HI 2418 A N

T20554 IHC ea addl AB Stain x25 TECH R1 1 N HI 2518.75 A N

T20555 IHC ea addl AB Stain x26 TECH R1 1 N HI 2619.5 A N

T20556 IHC ea addl AB Stain x27 TECH R1 1 N HI 2720.25 A N

T20557 IHC ea addl AB Stain x28 TECH R1 1 N HI 2821 A N

T20558 IHC ea addl AB Stain x29 TECH R1 1 N HI 2921.75 A N

T20559 IHC ea addl AB Stain x30 TECG R1 1 N HI 3022.5 A N

T30001 IHC Multiplex x1 Tech R1 1 N HI 170.75 A N

T30002 IHC Multiplex x2 Tech R1 1 N HI 341.5 A N

T30003 IHC Multiplex x3 Tech R1 1 N HI 512.25 A N

T30004 IHC Multiplex x4 Tech R1 1 N HI 683 A N

T30005 IHC Multiplex x5 Tech R1 1 N HI 853.75 A N

T30006 IHC Multiplex x6 Tech R1 1 N HI 1024.5 A N

T30007 IHC Multiplex x7 Tech R1 1 N HI 1195.25 A N

T30008 IHC Multiplex x8 Tech R1 1 N HI 1366 A N

T30009 IHC Multiplex x9 Tech R1 1 N HI 1536.75 A N

T30010 IHC Multiplex x10 Tech R1 1 N HI 1707.5 A N

T30111 IHC Multiplex x11 Tech R1 1 N HI 1878.25 A N

T30112 IHC Multiplex x12 Tech R1 1 N HI 2049 A N

T83001 88300 Tech Comp-1st Site R1 1 N HI 31.25 A N

T83041 88304 Tech Comp-1st Site R1 1 N HI 80.75 A N

T83042 88304 Tech Comp-2nd Site R1 1 N HI 80.75 A N

T83051 88305 Tech Comp-1st Site R1 1 N HI 86 A N

T83052 88305 Tech Comp-2nd Site R1 1 N HI 86 A N

T83053 88305 Tech Comp-3rd Site R1 1 N HI 86 A N

T83054 88305 Tech Comp-4th Site R1 1 N HI 86 A N

T83056 88305 Tech Comp-6th Site R1 1 N HI 86 A N

T83057 88305 Tech Comp-7th Site R1 1 N HI 86 A N

T83058 88305 Tech Comp-8th Site R1 1 N HI 86 A N

T83071 88307 Tech Comp-1st Site R1 1 N HI 132.25 A N

T83072 88307 Tech Comp-2nd Site R1 1 N HI 132.25 A N

T83121 88312 Tech Comp-1st Stain R1 1 N HI 78.5 A N

T83421 88342 Tech Comp-1st Antibody R1 1 N XX 86.75 A N

T83422 88342 Tech Comp-2nd Antibody R1 1 N XX 86.75 A N

T83423 88342 Tech Comp-3rd Antibody R1 1 N XX 86.75 A N

T83431 TC 1st addtl IHC Ab per slide R1 1 N XX 35 A N

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T83432 TC 2nd addtl IHC Ab per slide R1 1 N XX 35 A N

T83433 TC 3rd addtl IHC Ab per slide R1 1 N XX 35 A N

T83501 Tech Only Prostate Biopsy x1 R1 1 N HI 85.84 A N

T83502 Tech Only Prostate Biopsies x2R1 1 N HI 171.68 A N

T83503 Tech Only Prostate Biopsies x3R1 1 N HI 257.52 A N

T83504 Tech Only Prostate Biopsies x4R1 1 N HI 343.36 A N

T83505 Tech Only Prostate Biopsies x5R1 1 N HI 429.2 A N

T83506 Tech Only Prostate Biopsies x6R1 1 N HI 515.04 A N

T83507 Tech Only Prostate Biopsies x7R1 1 N HI 600.88 A N

T83508 Tech Only Prostate Biopsies x8R1 1 N HI 686.72 A N

T83509 Tech Only Prostate Biopsies x9R1 1 N HI 772.56 A N

T83510 TechOnly Prostate Biopsies x10R1 1 N HI 858.4 A N

T83511 TechOnly Prostate Biopsies x11R1 1 N HI 944.24 A N

T83512 TechOnly Prostate Biopsies x12R1 1 N HI 1030.08 A N

T83513 TechOnly Prostate Biopsies x13R1 1 N HI 1115.92 A N

T83514 TechOnly Prostate Biopsies x14R1 1 N HI 1201.76 A N

T83515 TechOnly Prostate Biopsies x15R1 1 N HI 1287.6 A N

T83516 TechOnly Prostate Biopsies x16R1 1 N HI 1373.44 A N

T83517 TechOnly Prostate Biopsies x17R1 1 N HI 1459.28 A N

T83518 TechOnly Prostate Biopsies x18R1 1 N HI 1545.12 A N

T83519 TechOnly Prostate Biopsies x19R1 1 N HI 1630.96 A N

T83520 TechOnly Prostate Biopsies x20R1 1 N HI 1716.8 A N

T83521 TechOnly Prostate Biopsies x21R1 1 N HI 1802.64 A N

T83522 TechOnly Prostate Biopsies x22R1 1 N HI 1888.48 A N

T83523 TechOnly Prostate Biopsies x23R1 1 N HI 1974.32 A N

T83524 TechOnly Prostate Biopsies x24R1 1 N HI 2060.16 A N

T83525 TechOnly Prostate Biopsies x25R1 1 N HI 2146 A N

T83526 TechOnly Prostate Biopsies x26R1 1 N HI 2231.84 A N

T83527 TechOnly Prostate Biopsies x27R1 1 N HI 2317.68 A N

T83528 TechOnly Prostate Biopsies x28R1 1 N HI 2403.52 A N

T83529 TechOnly Prostate Biopsies x29R1 1 N HI 2489.36 A N

T83530 TechOnly Prostate Biopsies x30R1 1 N HI 2575.2 A N

T83531 TechOnly Prostate Biopsies x31R1 1 N HI 2661.04 A N

T83532 TechOnly Prostate Biopsies x32R1 1 N HI 2746.88 A N

T83533 TechOnly Prostate Biopsies x33R1 1 N HI 2832.72 A N

T83534 TechOnly Prostate Biopsies x34R1 1 N HI 2918.56 A N

T83535 TechOnly Prostate Biopsies x35R1 1 N HI 3004.4 A N

T83536 TechOnly Prostate Biopsies x36R1 1 N HI 3090.24 A N

T83537 TechOnly Prostate Biopsies x37R1 1 N HI 3176.08 A N

T83538 TechOnly Prostate Biopsies x38R1 1 N HI 3261.92 A N

T83539 TechOnly Prostate Biopsies x39R1 1 N HI 3347.76 A N

T83540 TechOnly Prostate Biopsies x40R1 1 N HI 3433.6 A N

W20061 IHC 1st AB Stain x1 GLBL R1 1 N HI 219 A N

W20062 IHC 1st AB Stain x2 GLBL R1 1 N HI 438 A N

W20063 IHC 1st AB Stain x3 GLBL R1 1 N HI 657 A N

W20064 IHC 1st AB Stain x4 GLBL R1 1 N HI 876 A N

W20065 IHC 1st AB Stain x5 GLBL R1 1 N HI 1095 A N

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W20066 IHC 1st AB Stain x6 GLBL R1 1 N HI 1314 A N

W20067 IHC 1st AB Stain x7 GLBL R1 1 N HI 1533 A N

W20068 IHC 1st AB Stain x8 GLBL R1 1 N HI 1752 A N

W20069 IHC 1st AB Stain x9 GLBL R1 1 N HI 1971 A N

W20070 IHC 1st AB Stain x10 GLBL R1 1 N HI 2190 A N

W20071 IHC 1st AB Stain x11 GLBL R1 1 N HI 2409 A N

W20072 IHC 1st AB Stain x12 GLBL R1 1 N HI 2628 A N

W20073 IHC 1st AB Stain x13 GLBL R1 1 N HI 2847 A N

W20074 IHC 1st AB Stain x14 GLBL R1 1 N HI 3066 A N

W20075 IHC 1st AB Stain x15 GLBL R1 1 N HI 3285 A N

W20076 IHC 1st AB Stain x16 GLBL R1 1 N HI 3504 A N

W20077 IHC 1st AB Stain x17 GLBL R1 1 N HI 3723 A N

W20078 IHC 1st AB Stain x18 GLBL R1 1 N UB 3942 A N

W20079 IHC 1st AB Stain x19 GLBL R1 1 N HI 4161 A N

W20080 IHC 1st AB Stain x20 GLBL R1 1 N HI 4380 A N

W20081 IHC 1st AB Stain x21 GLBL R1 1 N HI 4599 A N

W20082 IHC 1st AB Stain x22 GLBL R1 1 N HI 4818 A N

W20083 IHC 1st AB Stain x23 GLBL R1 1 N HI 5037 A N

W20084 IHC 1st AB Stain x24 GLBL R1 1 N HI 5256 A N

W20085 IHC 1st AB Stain x25 GLBL R1 1 N HI 5475 A N

W20086 IHC 1st AB Stain x26 GLBL R1 1 N HI 5694 A N

W20087 IHC 1st AB Stain x27 GLBL R1 1 N HI 5913 A N

W20088 IHC 1st AB Stain x28 GLBL R1 1 N HI 6132 A N

W20089 IHC 1st AB Stain x29 GLBL R1 1 N HI 6351 A N

W20090 IHC 1st AB Stain x30 GLBL R1 1 N HI 6570 A N

W20291 IHC X1 RUO Global R1 1 N UB 219 A N

W20292 IHC X2 RUO Global R1 1 N UB 438 A N

W20293 IHC X3 RUO Global R1 1 N UB 657 A N

W20294 IHC X4 RUO Global R1 1 N UB 876 A N

W20295 IHC X5 RUO Global R1 1 N UB 1095 A N

W20296 IHC X6 RUO Global R1 1 N UB 1314 A N

W20297 IHC X7 RUO Global R1 1 N UB 1533 A N

W20298 IHC X8 RUO Global R1 1 N UB 1752 A N

W20299 IHC X9 RUO Global R1 1 N UB 1971 A N

W20310 IHC X10 RUO Global R1 1 N UB 2190 A N

W20321 Add'l IHC Per Slide X1 Glbl R1 1 N UB 100 A N

W20401 IHC ea Addl x1 RUO GLBL R1 1 N HI 219 A N

W20402 IHC ea Addl x2 RUO GLBL R1 1 N HI 438 A N

W20403 IHC ea Addl x3 RUO GLBL R1 1 N HI 657 A N

W20404 IHC ea Addl x4 RUO GLBL R1 1 N HI 876 A N

W20405 IHC ea Addl x5 RUO GLBL R1 1 N HI 1095 A N

W20406 IHC ea Addl x6 RUO GLBL R1 1 N HI 1314 A N

W20407 IHC ea Addl x7 RUO GLBL R1 1 N HI 1533 A N

W20408 IHC ea Addl x8 RUO GLBL R1 1 N HI 1752 A N

W20409 IHC ea Addl x9 RUO GLBL R1 1 N HI 1971 A N

W20410 IHC ea Addl x10 RUO GLBL R1 1 N HI 2190 A N

W20530 IHC ea addl AB Stain x1 GLBL R1 1 N HI 219 A N

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W20531 IHC ea addl AB Stain x2 GLBL R1 1 N HI 438 A N

W20532 IHC ea addl AB Stain x3 GLBL R1 1 N HI 657 A N

W20533 IHC ea addl AB Stain x4 GLBL R1 1 N HI 876 A N

W20534 IHC ea addl AB Stain x5 GLBL R1 1 N HI 1095 A N

W20535 IHC ea addl AB Stain x6 GLBL R1 1 N HI 1314 A N

W20536 IHC ea addl AB Stain x7 GLBL R1 1 N HI 1533 A N

W20537 IHC ea addl AB Stain x8 GLBL R1 1 N HI 1752 A N

W20538 IHC ea addl AB Stain x9 GLBL R1 1 N HI 1971 A N

W20539 IHC ea addl AB Stain x10 GLBL R1 1 N HI 2190 A N

W20540 IHC ea addl AB Stain x11 GLBL R1 1 N HI 2409 A N

W20541 IHC ea addl AB Stain x12 GLBL R1 1 N HI 2628 A N

W20542 IHC ea addl AB Stain x13 GLBL R1 1 N HI 2847 A N

W20543 IHC ea addl AB Stain x14 GLBL R1 1 N HI 3066 A N

W20544 IHC ea addl AB Stain x15 GLBL R1 1 N HI 3285 A N

W20545 IHC ea addl AB Stain x16 GLBL R1 1 N HI 3504 A N

W20546 IHC ea addl AB Stain x17 GLBL R1 1 N HI 3723 A N

W20547 IHC ea addl AB Stain x18 GLBL R1 1 N HI 3942 A N

W20548 IHC ea addl AB Stain x19 GLBL R1 1 N HI 4161 A N

W20549 IHC ea addl AB Stain x20 GLBL R1 1 N HI 4380 A N

W20550 IHC ea addl AB Stain x21 GLBL R1 1 N HI 4599 A N

W20551 IHC ea addl AB Stain x22 GLBL R1 1 N HI 4818 A N

W20552 IHC ea addl AB Stain x23 GLBL R1 1 N HI 5037 A N

W20553 IHC ea addl AB Stain x24 GLBL R1 1 N HI 5256 A N

W20554 IHC ea addl AB Stain x25 GLBL R1 1 N HI 5475 A N

W20555 IHC ea addl AB Stain x26 GLBL R1 1 N HI 5694 A N

W20556 IHC ea addl AB Stain x27 GLBL R1 1 N HI 5913 A N

W20557 IHC ea addl AB Stain x28 GLBL R1 1 N HI 6132 A N

W20558 IHC ea addl AB Stain x29 GLBL R1 1 N HI 6351 A N

W20559 IHC ea addl AB Stain x30 GLBL R1 1 N HI 6570 A N

W30001 IHC Multiplex X1 Gbl R1 1 N HI 419 A N

W30002 IHC Multiplex X2 Gbl R1 1 N HI 838 A N

W30003 IHC Multiplex X3 Gbl R1 1 N HI 1257 A N

W30004 IHC Multiplex X4 Gbl R1 1 N HI 1676 A N

W30005 IHC Multiplex X5 Gbl R1 1 N HI 2095 A N

W30006 IHC Multiplex X6 Gbl R1 1 N HI 2514 A N

W30007 IHC Multiplex X7 Gbl R1 1 N HI 2933 A N

W30008 IHC Multiplex X8 Gbl R1 1 N HI 3352 A N

W30009 IHC Multiplex X9 Gbl R1 1 N HI 3771 A N

W30010 IHC Multiplex X10 Gbl R1 1 N HI 4190 A N

W30111 IHC Multiplex X11 Gbl R1 1 N HI 4609 A N

W30112 IHC Multiplex X12 Gbl R1 1 N HI 5028 A N

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