Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS … · 2015. 10. 27. · Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List

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.

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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



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


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





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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



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



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






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



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

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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

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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

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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

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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

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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

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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

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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

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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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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

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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

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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

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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

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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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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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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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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

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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

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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


489179 Flow Markers X 20 88184, 88185 (x19), 88189 N N N $1,522.75 $1,522.75 $332.56 $332.56




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

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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

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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

Documents

Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS … · 2015. 10. 27. · Net Fee Schedule LabCorp Net Fee Schedule VADMHMRSAS Contract RFP720C-04093-07D 0493 - 15/17 Price List