Inpatient Lab Charges
Our Commitment to Quality
Helping ensure our patients receive the highest level of care, delivered with dignity and compassion, is our goal with every patient and family member, every time. Our Board challenges us to remain in the Top 10 percent of hospitals in the country in quality scores, and they meet monthly with physicians and clinical staff to analyze the data and develop a plan to better serve our patients. It is this goal-driven mindset that has earned us recognition in key areas for our quality strides. Learn more about our quality awards and recognition.
NOTE: When reviewing the pricing for Lab or Pathology tests, if the section below a test is blank, the test is repeated again and these are additional charges (for example - Glucose four-hour tolerance test will have the test repeated one hour, two hours and then three hours after the initial blood work is collected for a total of four hours. Each test is charged separately). If your lab work is a panel, then several tests may be performed from one blood sample. You may be charged for each test separately
| Order Code Description | Billing Code | Charge | CPT Code |
|---|---|---|---|
| HEPATITIS B E ANTIGEN | 40200193 | $48.76 | 87350 |
| HEPATITIS B VIRAL DNA | 40200259 | $418.70 | 87517 |
| HCV RNA QUANT BY PCR | 40200345 | $437.78 | 87522 |
| HEPATITIS C VIRUS ANTIBODY | 40500168 | $141.00 | 86803 |
| HCV FIBROSURE | 30100427 | $152.00 | 84450 |
| 30100426 | $152.00 | 84460 | |
| 30100428 | $152.00 | 84520 | |
| 30100079 | $152.00 | 83883 | |
| 30100429 | $153.00 | 82977 | |
| HCV CONFIRMATION BY QUANT. NAAT | 40200345 | $437.78 | 87522 |
| ALLERGEN - HOUSE DUST STIER | 40200062 | $25.44 | 86003 |
| HEPATITIS DELTA ANTIBODY | 40200256 | $37.10 | 86692 |
| HELICOBACTER PYLORI ANTIBODY | 40300020 | $65.00 | 86677 |
| HEMOSIDERIN URINE | 40500098 | $72.00 | 83070 |
| HEPARIN ASSOC. AB DETECTION | 40200235 | $292.56 | 86022 |
| HEPATIC FUNCTION PANEL | 40500054 | $144.00 | 80076 |
| HEMOGLOBIN ELECTROPHORESIS PROFILE | 40200283 | $80.56 | 83021 |
| HUMAN GROWTH HORMONE HGH | 40200174 | $73.14 | 83003 |
| HISTOPLASMA GALACTONAMMAN AG UR | 30100430 | $304.20 | 87385 |
| HIV 1/2 ANTIGEN/ANTIBODY COMBO | 30200131 | $107.16 | 87389 |
| HIV DNA PCR | 40200258 | $1,009.12 | 87535 |
| HLA-B*5701 GENOTYPING | 30100310 | $662.50 | 81381 |
| HLA A,B,C, PHENOTYPE | 40200342 | $1,366.34 | 86813 |
| ALLERGEN HELMINTHOSPORIUM | 40200062 | $25.44 | 86003 |
| HEMOCHROMATOSIS MUT. DETECTION | 30100322 | $683.70 | 81256 |
| HEAVY METALS PANEL 3, URINE | 40200002 | $59.36 | 82175 |
| 40200003 | $58.80 | 83655 | |
| 40200004 | $60.42 | 83825 | |
| HEELSTICK-NEWBORN WORKUP | 40400014 | $72.00 | 86880 |
| 40400016 | $40.00 | 86900 | |
| 40400017 | $40.00 | 86901 | |
| HOMOCYSTEINE/CYSTEINE SERUM | 40500099 | $76.00 | 83090 |
| HYDROXYPROGESTERONE-17 | 40200244 | $97.52 | 83498 |
| HELICOBACTER PYLORI AG, FECAL | 40200367 | $218.36 | 87338 |
| HSV1 GLYCOPROTEIN G-SPECIFIC | 40200050 | $109.18 | 86695 |
| HERPES SIMPLEX ANTIBODY IGG | 40200329 | $64.66 | 86694 |
| HERPES SIMPLEX ANTIBODY IGM | 40200329 | $64.66 | 86694 |
| HSV 2 GLYCOPROTEIN G AB, IGG | 40200001 | $109.18 | 86696 |
| HERPES SIMPLEX VIRUS CULTURE | 40300044 | $86.00 | 87254 |
| HISTOPLASMA ANTIGEN, SERUM | 40200382 | $424.00 | 87385 |
| HERPES SIMPLEX VIRUS BY PCR | 40200037 | $413.40 | 87529 |
| HERPES SIMPLEX (HSV) DFA STAIN | 40300046 | $38.00 | 87274 |
| 40300045 | $38.00 | 87273 | |
| HUMAN T-CELL LEUKEMIA ANTIBODY | 40200328 | $182.32 | 86687 |
| HU ANTIBODY | 40200085 | $1,137.38 | 83520 |
| ALLERGEN - HYMENOPTERA PANEL | 40200062 | $27.56 | 86003 |
| 40200062 | $27.56 | 86003 | |
| 40200062 | $27.56 | 86003 | |
| 40200062 | $27.56 | 86003 | |
| 40200062 | $27.56 | 86003 | |
| HYPERSENSITIVITY PNEUMONITIS | 40200062 | $27.83 | 86003 |
| 40200062 | $26.76 | 86003 | |
| 40200062 | $26.76 | 86003 | |
| 40200062 | $26.76 | 86003 | |
| 40200126 | $26.76 | 86331 | |
| 40200126 | $26.76 | 86331 | |
| 40200126 | $26.76 | 86331 | |
| 40200126 | $26.76 | 86331 | |
| 40200126 | $26.76 | 86331 | |
| 40200126 | $26.76 | 86331 | |
| 40200126 | $26.76 | 86331 | |
| 40200188 | $26.76 | 86606 | |
| 40200188 | $26.76 | 86606 | |
| 40200188 | $26.76 | 86606 | |
| 40200188 | $26.76 | 86606 | |
| 40200188 | $26.76 | 86606 | |
| ALLERGEN - HAZELNUT (FILBERT) | 40200062 | $25.44 | 86003 |
| HERPES ZOSTER IGG TITER | 40300022 | $77.00 | 86787 |
| HERPES ZOSTER ANTIBODY STATUS | 40300022 | $48.00 | 86787 |
| IBD SGi DIAGNOSTIC | 30100153 | $87.75 | 83520 |
| 30100153 | $87.75 | 83520 | |
| 30100153 | $87.75 | 83520 | |
| 30100153 | $87.75 | 83520 | |
| 30100153 | $87.75 | 83520 | |
| 30100153 | $70.20 | 83520 | |
| 30100153 | $70.20 | 83520 | |
| 30100153 | $70.20 | 83520 | |
| 30100083 | $70.20 | 82397 | |
| 30100083 | $70.20 | 82397 | |
| 30100083 | $70.20 | 82397 | |
| 30200009 | $105.30 | 86140 | |
| 31000050 | $526.50 | 88346 | |
| 31000048 | $526.50 | 88350 | |
| 30100337 | $100.93 | 81479 | |
| 30100337 | $100.93 | 81479 | |
| 30100337 | $100.93 | 81479 | |
| 30100337 | $100.93 | 81479 | |
| CALCIUM IONIZED | 40500032 | $37.00 | 82330 |
| IMMUNE COMPLEX ASSAY | 40200220 | $799.24 | 86332 |
| SUBSTANCE ABUSE PANEL 10 | 30100411 | $371.00 | 80307 |
| CHOLINESTERASE | 40200072 | $57.77 | 82480 |
| 40200391 | $57.77 | 82482 | |
| IMMUNOFIX 24HR URINE w/INTERP | 40500037 | $381.00 | 86335 |
| INTRINSIC FACTOR BLOCKING AB | 40200314 | $80.56 | 86340 |
| IMMUNOFIX RANDOM URINE+INTERP | 40500037 | $364.00 | 86335 |
| IMMUNOGLOBULIN IGA | 40500091 | $100.00 | 82784 |
| IMMUNOGLOBULIN IGD | 40200142 | $80.56 | 82784 |
| URTICATIA-INDUCED BASOPHIL ACT | 40200153 | $182.00 | 88184 |
| 40200154 | $182.00 | 88185 | |
| 40200154 | $182.00 | 88185 | |
| INSULIN-LIKE GROWTH FACTOR | 40200296 | $86.92 | 84305 |
| IMMUNOGLOBULIN IGG | 40500091 | $100.00 | 82784 |
| IGG SUBCLASS 4 | 40200141 | $54.86 | 82787 |
| IGG SUBCLASSES | 40200141 | $54.86 | 82787 |
| 40200141 | $54.86 | 82787 | |
| 40200141 | $54.86 | 82787 | |
| 40200141 | $54.86 | 82787 | |
| IMMUNOGLOBULIN IGM | 40500091 | $100.00 | 82784 |
| IMMUNOGLOBULINS IGG,IGA,IGM | 40500091 | $100.00 | 82784 |
| 40500091 | $100.00 | 82784 | |
| 40500091 | $100.00 | 82784 | |
| IGE | 40500021 | $100.00 | 82785 |
| INSULIN ANTIBODIES, HUMAN | 40200252 | $188.68 | 86337 |
| INSULIN | 40200175 | $33.92 | 83525 |
| CALCIUM, IONIZED SERUM | 40200052 | $43.46 | 82330 |
| IRRADIATION FEE | 40400019 | $102.00 | 86945 |
| LACTATE DEHYDROGENASE ISOENZYMES | 40200158 | $50.35 | 83615 |
| 40200159 | $50.35 | 83625 | |
| ISLET CELL AB, IGG | 40200156 | $104.94 | 86341 |
| ISOPROPANOL (INCLUDES ACETONE) | 40200230 | $121.90 | 84600 |
| CREATINE KINASE ISOENZYME | 40200160 | $43.46 | 82550 |
| 40200161 | $43.46 | 82552 | |
| JC VIRUS BY PCR | 30100417 | $1,039.86 | 87798 |
| JAK2 (V617F) QUANTITATION | 30100313 | $1,860.30 | 81270 |
| JO 1 ANTIBODY, IGG | 40200312 | $116.60 | 86235 |
| ALLERGEN - JOHNSON GRASS | 40200062 | $25.44 | 86003 |
| POTASSIUM SERUM | 40500115 | $57.00 | 84132 |
| ALLERGEN - JUNE GRASS/KENTUCKY | 40200062 | $25.44 | 86003 |
| KEPPRA (LEVETIRACETAM) | 40200363 | $217.35 | 80177 |
| KAPPA/LAMBDA FREE LIGHT CHAINS | 30100079 | $202.99 | 83883 |
| 30100079 | $202.99 | 83883 | |
| KIDNEY STONE RISK PANEL II | 40200368 | $62.12 | 82340 |
| 40200369 | $62.12 | 82436 | |
| 40200365 | $62.12 | 82507 | |
| 40200176 | $62.12 | 82131 | |
| 40200370 | $62.12 | 83735 | |
| 40200179 | $62.12 | 83945 | |
| 40200371 | $62.12 | 84105 | |
| 40200372 | $62.12 | 84133 | |
| 40200373 | $62.12 | 84300 | |
| 40200374 | $62.12 | 84560 | |
| LACTIC ACID PLASMA | 40500106 | $111.00 | 83605 |
| LACTIC ACID SEPSIS | 40500106 | $111.00 | 83605 |
| LEGIONELLA ANTIGEN DETECTION | 40300056 | $165.00 | 87449 |
| ALLERGEN - WEED, LAMB'S QUARTER | 40200062 | $25.44 | 86003 |
| LAMOTRIGINE | 30100347 | $108.00 | 80175 |
| LEUKOCYTE ALK PHOS STAIN | 40200204 | $248.04 | 85540 |
| ALLERGEN,FOOD,LAMB,IGE | 40200062 | $25.44 | 86003 |
| LEAD, BLOOD CAPILLARY | 40200003 | $37.10 | 83655 |
| LDH SERUM | 40500044 | $35.00 | 83615 |
| LEAD INDUSTRIAL EXPOSURE | 40200003 | $50.88 | 83655 |
| 40200182 | $50.88 | 84202 | |
| DIRECT LDL | 40500023 | $95.00 | 83721 |
| LDH PLEURAL FLUID | 40500044 | $70.00 | 83615 |
| LDH PERITONEAL FLUID | 40500044 | $70.00 | 83615 |
| LDH - CSF | 40200158 | $37.10 | 83615 |
| LEAD WHOLE BLOOD | 40200003 | $37.10 | 83655 |
| LEAD, URINE | 40200003 | $33.92 | 83655 |
| GLUCOSE 1 HR PROFILE | 40500035 | $51.00 | 82947 |
| 40500093 | $18.00 | 82950 | |
| GLUCOSE 2 HR PROFILE | 40500035 | $51.00 | 82947 |
| 40500093 | $18.00 | 82950 | |
| GLUCOSE 6HR TOLERANCE | 40500013 | $51.00 | 82951 |
| 40500014 | $18.00 | 82952 | |
| 40500014 | $18.00 | 82952 | |
| 40500014 | $18.00 | 82952 | |
| 40500014 | $18.00 | 82952 | |
| 40500014 | $18.00 | 82952 | |
| CHLAMYDIA (LGV) ANTIBODY PANEL | 40200217 | $439.90 | 86631 |
| B BURGDORFERI IGG WESTERN BLOT | 40200167 | $73.14 | 86617 |
| LUTEINIZING HORMONE LH | 40500095 | $109.00 | 83002 |
| LITHIUM | 40500060 | $126.00 | 80178 |
| LIDOCAINE/XYLOCAINE | 40200033 | $125.08 | 80176 |
| LIPASE | 40500108 | $95.00 | 83690 |
| LIPID-CHOLESTEROL PROFILE | 40500053 | $68.00 | 80061 |
| LIVER-KIDNEY-MICROSOME ABS | 40200315 | $73.14 | 86376 |
| BLAST SCREEN - 8 COLOR ASSAY | 40900004 | $62.00 | 88184 |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| MYELOID LEUKEMIA 8 COLOR ASSAY | 40900004 | $62.00 | 88184 |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| LYMPHOMA (45 GATING) 8 COLOR | 40900004 | $62.00 | 88184 |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| 40900002 | $62.00 | 88185 | |
| B BURGDORFERI IGM WESTERN BLOT | 40200167 | $73.14 | 86617 |
| LipoFit by NMR | 40200093 | $186.56 | 83704 |
| 30100474 | $68.00 | 80061 | |
| ALLERGEN - LOBSTER | 40200062 | $25.44 | 86003 |
| LEGIONELLA PNEUMOPHILA AB | 40200330 | $54.06 | 86713 |
| LIPOPROTEIN (a) | 40200020 | $99.64 | 83695 |
| LYMPHOCYTE SUBSET PANEL 4 | 30200137 | $214.32 | 86360 |
| 30200136 | $214.32 | 86359 | |
| LYMPHOCYTE SUBSET PANEL 5 | 40900003 | $214.32 | 86360 |
| 40900001 | $214.32 | 86359 | |
| 30200138 | $62.00 | 86355 | |
| 30200139 | $124.00 | 86357 | |
| L/S RATIO | 40200177 | $39.22 | 83661 |
| 40200293 | $39.22 | 84081 | |
| LACTOSE TOLERANCE | 40500013 | $51.00 | 82951 |
| 40500014 | $18.00 | 82952 | |
| 40500014 | $18.00 | 82952 | |
| 40500014 | $18.00 | 82952 | |
| ALLERGEN - LATEX | 40200062 | $25.44 | 86003 |
| LYME ANTIBODIES | 40200198 | $48.76 | 86618 |
| LYME BY PCR | 40200026 | $463.22 | 87476 |
| ELECTROLYTES | 40500051 | $111.00 | 80051 |
| LYSOZYME, SERUM OR BODY FLUID | 40200392 | $61.48 | 85549 |
| MALARIA ANTIBODIES, TOTAL | 40200124 | $364.64 | 86750 |
| MANGANESE, SERUM | 40200355 | $66.78 | 83785 |
| ALLERGEN - MAPLE (BOX ELDER) | 40200062 | $25.44 | 86003 |
| MYCOBACTERIUM IDENTIFICATION | 40300034 | $137.00 | 87118 |
| MYELIN BASIC PROTEIN (MBP) | 40200286 | $97.52 | 83873 |
| MYCOBACTERIUM PROBE | 40300058 | $226.00 | 87550 |
| MYCOBACTERIUM SENSITIVITY | 40300037 | $45.00 | 87190 |
| 40300037 | $45.00 | 87190 | |
| 40300037 | $45.00 | 87190 | |
| 40300037 | $45.00 | 87190 | |
| 40300037 | $45.00 | 87190 | |
| 40300037 | $45.00 | 87190 | |
| 40300037 | $45.00 | 87190 | |
| 40300037 | $45.00 | 87190 | |
| ALLERGEN - MOUNTAIN CEDAR | 40200062 | $25.44 | 86003 |
| MANUAL DIFFERENTIAL | 40500142 | $24.00 | 85007 |
| MEASLES (RUBEOLA) SEROLOGY | 40300021 | $92.00 | 86765 |
| MEASLES (RUBEOLA) IMMUNE STATUS | 40300021 | $48.00 | 86765 |
| MEASLES (RUBEOLA) IGM | 40200335 | $48.76 | 86765 |
| MECONIUM DRUG PANEL | 30100413 | $240.00 | 80307 |
| ALLERGEN - MARSH ELDER | 40200062 | $25.44 | 86003 |
| MERCURY - BLOOD | 40200004 | $50.88 | 83825 |
| METANEPHRINES, PLASMA (FREE) | 40200053 | $341.32 | 83835 |
| METANEPHRINES, URINE | 40200053 | $96.46 | 83835 |
| MEXILETINE | 30100338 | $137.80 | 80299 |
| ALLERGEN - MEADOW FESCUE | 40200062 | $25.44 | 86003 |
| MAGNESIUM SERUM | 40500109 | $67.00 | 83735 |
| MYASTHENIA GRAVIS PANEL | 30100148 | $46.81 | 83516 |
| 30100148 | $46.81 | 83516 | |
| 30100148 | $46.81 | 83516 | |
| 30100150 | $140.47 | 83519 | |
| 30200021 | $140.45 | 86255 | |
| 30200022 | $140.45 | 86256 | |
| ALLERGEN - MILK, COW | 40200062 | $25.44 | 86003 |
| METHYLMALONIC ACID | 40200288 | $86.92 | 83921 |
| MICAFUNGIN MIC | 40300036 | $471.00 | 87186 |
| MRSA PCR GeneXPert | 40300002 | $178.00 | 87641 |
| MONOTEST | 40400011 | $88.00 | 86318 |
| MYCOPLASMA PNEUMONIAE, IGG | 40200403 | $50.15 | 86738 |
| MYCOPLASMA PNEUMONIAE IGM | 40200403 | $50.15 | 86738 |
| MYELOPEROX ABS, IGG | 40200027 | $69.96 | 83876 |
| MPO REFLEX BILLING | 40200027 | $69.96 | 83876 |
| HEALTHCARE PROFESSIONAL PANEL | 30100411 | $152.64 | 80307 |
| MPO/PR-3 (ANCA) ANTIBODIES | 40200135 | $69.96 | 83516 |
| 40200027 | $69.96 | 83876 | |
| PREOP MRSA/SA SCREEN CULTURE | 30600008 | $125.00 | 87081 |
| MATERNAL QUAD SCREEN | 40200170 | $66.75 | 82677 |
| 40200313 | $66.75 | 86336 | |
| 40200216 | $66.75 | 82105 | |
| 40200306 | $66.75 | 84702 | |
| ALLERGEN - MUCOR RACEMOSUS | 40200062 | $25.44 | 86003 |
| MRSA SCREEN | 40300029 | $129.00 | 87081 |
| M TUBERCULOSIS PCR - CSF | 40200386 | $858.60 | 87556 |
| M TUBERCULOSIS BY PCR SPUTUM | 30600073 | $100.00 | 87556 |
| 30100417 | $82.00 | 87798 | |
| MTHFR MUTATION PANEL | 30100312 | $330.72 | 81291 |
| METHOTREXATE SERUM | 30100338 | $125.08 | 80299 |
| MUMPS SEROLOGY | 40200332 | $44.52 | 86735 |
| MUSK ANTIBODY | 40200073 | $1,964.18 | 83519 |
| MYOGLOBIN | 40500015 | $100.00 | 83874 |
| MYOSITIS ASSESS R PLUS JO-1 | 40200312 | $254.40 | 86235 |
| 40200135 | $254.40 | 83516 | |
| 40200083 | $254.40 | 8351691 | |
| 40200083 | $254.40 | 8351691 | |
| 40200083 | $254.40 | 8351691 | |
| 40200083 | $254.40 | 8351691 | |
| 40200083 | $254.40 | 8351691 | |
| 40200083 | $253.34 | 8351691 | |
| SODIUM SERUM | 40500122 | $57.00 | 84295 |
| NT-ProBNP | 40500020 | $100.00 | 83880 |
| NEWBORN METABOLIC SCREENING | 40800002 | $138.00 | S3620 |
| NICOTINE AND METABOLITES SERUM | 30100409 | $280.90 | 80323 |
| NICOTINE AND METABOLITES, URINE | 30100409 | $162.24 | 80323 |
| DRUG PROFILE - NIDA5 | 30100411 | $185.50 | 80307 |
| NMR LIPOPROTEIN | 40200093 | $186.56 | 83704 |
| NOSE CULTURE GS | 40300026 | $125.00 | 87070 |
| 40300038 | $66.00 | 87205 | |
| NORTRIPTYLINE | 30100415 | $69.96 | 80335 |
| NOSE CULTURE | 40300026 | $125.00 | 87070 |
| NEURON SPECIFIC ENOLASE | 40200110 | $137.80 | 86316 |
| NUCLEOTIDASE, 5' SERUM | 40200224 | $137.80 | 83915 |
| ALLERGEN - NUT PANEL IGE | 40200062 | $27.56 | 86003 |
| 40200062 | $27.56 | 86003 | |
| 40200062 | $27.56 | 86003 | |
| 40200062 | $27.56 | 86003 | |
| 40200062 | $27.56 | 86003 | |
| ACTIVATED CLOTTING TIME - OR | 40500031 | $74.00 | 85347 |
| ALLERGEN - OAK TREE | 40200062 | $25.44 | 86003 |
| ALLERGEN - OAK, VIRGINIA LIVE | 40200062 | $25.44 | 86003 |
| ALLERGEN - OAT | 40200062 | $25.44 | 86003 |
| ORGANIC ACIDS, URINE | 40200248 | $530.00 | 83918 |
| OCCULT BLOOD - GASTRIC | 40300004 | $29.00 | 82271 |
| OCCULT BLOOD - STOOL | 40300001 | $29.00 | 82272 |
| OCCULT BLOOD - STOOL X 3 | 40300003 | $78.00 | 82270 |
| OR - CA ION | 40500032 | $37.00 | 82330 |
| GLUCOSE - OR | 40500035 | $32.00 | 82947 |
| HEMOGLOBIN - OR | 40500033 | $43.00 | 85018 |
| ABG + OTHERS - OR | 40500009 | $137.00 | 82805 |
| 40500031 | $74.00 | 85347 | |
| 40500032 | $37.00 | 82330 | |
| 40500033 | $43.00 | 85018 | |
| 40500122 | $32.00 | 84295 | |
| 40500035 | $32.00 | 82947 | |
| 40500115 | $32.00 | 84132 | |
| OR POTASSIUM* | 40500115 | $32.00 | 84132 |
| OLIGOCLONAL BANDING | 40200287 | $70.81 | 83916 |
| 40200142 | $70.81 | 82784 | |
| 40200142 | $70.81 | 82784 | |
| 40200268 | $70.81 | 82040 | |
| 40200269 | $70.81 | 82042 | |
| OR - NA | 40500122 | $32.00 | 84295 |
| NA & K - OR | 40500122 | $32.00 | 84295 |
| 40500115 | $32.00 | 84132 | |
| ALLERGEN, FOOD, ONION | 40200062 | $25.44 | 86003 |
| OR - ABG | 40500009 | $137.00 | 82805 |
| ALLERGEN - ORANGE | 40200062 | $23.32 | 86003 |
| K, NA, GLUC, & CA ++ - OR | 40500032 | $37.00 | 82330 |
| 40500122 | $32.00 | 84295 | |
| 40500115 | $32.00 | 84132 | |
| 40500035 | $32.00 | 82947 | |
| OSMOLALITY, FECAL | 40200375 | $106.00 | 84999 |
| OSMOLALITY SERUM | 40500110 | $72.00 | 83930 |
| TEG ANALYSIS | 40500031 | $27.00 | 85347 |
| 40500151 | $47.00 | 85384 | |
| 40500153 | $104.00 | 85576 | |
| 40500148 | $29.00 | 85175 | |
| OVA & PARASITE EXAM | 40200388 | $126.14 | 87177 |
| 40200389 | $126.14 | 87209 | |
| OXALATE, URINE | 40200179 | $92.22 | 83945 |
| ALLERGEN - OYSTER | 40200062 | $23.32 | 86003 |
| PAI 4G5G MUTATION | 30100323 | $723.98 | 81400 |
| PLATELET ANTIBODIES, INDIRECT | 40200235 | $364.64 | 86022 |
| PLATELET ASSOC. ABS, DIRECT | 40200263 | $110.24 | 86023 |
| 40200264 | $110.24 | 86023 | |
| PREALBUMIN - SERUM | 40500117 | $77.00 | 84134 |
| PANCREATIC ELASTASE, FECAL BY ELISA | 40200023 | $520.65 | 83520 |
| PARANEOPLASTIC REFLEXIVE PANEL | 40200191 | $341.25 | 86255 |
| 40200083 | $341.25 | 83516 | |
| PARVOVIRUS B19 ANTIBODIES | 40200196 | $87.98 | 86747 |
| 40200196 | $87.98 | 86747 | |
| PORPHOBILINOGEN QUANT. URINE | 40200227 | $135.68 | 84110 |
| PARIETAL CELL AB | 40200191 | $109.18 | 86255 |
| ALLERGEN - PECAN NUT | 40200062 | $25.44 | 86003 |
| CHOLINESTERASE | 40200072 | $46.64 | 82480 |
| PROTEIN ELECTROPHOR 24HR URINE | 40500038 | $137.00 | 84166 |
| ALLERGEN, FOOD PEA | 40200062 | $25.44 | 86003 |
| ALLERGEN, FOOD, PEAR | 40200062 | $25.44 | 86003 |
| ALLERGEN, FOOD, PEACH | 40200062 | $25.44 | 86003 |
| ALLERGEN - PECAN TREE | 40200062 | $25.44 | 86003 |
| PROTEIN ELECTROPHOR-SERUM | 40500039 | $141.00 | 84165 |
| PROTEIN ELECTROPH RANDOM URINE | 40500038 | $137.00 | 84166 |
| HEMOGLOBIN PLASMA (FREE HGB) | 40200180 | $74.20 | 83051 |
| ALLERGEN - PEDIATRIC FOOD GRP | 40200062 | $25.44 | 86003 |
| 40200062 | $25.44 | 86003 | |
| 40200062 | $25.44 | 86003 | |
| 40200062 | $25.44 | 86003 | |
| 40200062 | $25.44 | 86003 | |
| PROTHROMBIN GENE MUTATION | 30100311 | $269.24 | 81240 |
| BLOOD PH | 40500092 | $50.00 | 82800 |
| pH, AMNIOTIC FLUID | 40300008 | $24.00 | 83986 |
| pH - BODY FLUID | 40500045 | $57.00 | 83986 |
| PHENOBARBITAL | 40500061 | $166.00 | 80184 |
| PHENYTOIN (DILANTIN) | 40500062 | $166.00 | 80185 |
| PHLEBOTOMY, THERAPEUTIC | 40400022 | $174.00 | 99195 |
| PHOSPHOROUS | 40500113 | $28.00 | 84100 |
| ALLERGEN - PIGWEED | 40200062 | $25.44 | 86003 |
| ALLERGEN - PINEAPPLE | 40200062 | $25.44 | 86003 |
| ALLERGEN, FOOD, PINE NUT | 40200062 | $25.44 | 86003 |
| INTRAOPERATIVE INTACT PTH | 40500003 | $104.00 | 83970 |
| ALLERGEN, PORK | 40200062 | $23.32 | 86003 |
| POTASSIUM PLASMA | 40500115 | $57.00 | 84132 |
| PLATELET COUNT | 40500147 | $39.00 | 85049 |
| PLATELET COUNT | 40500147 | $39.00 | 85049 |
| PM-1 ANTIBODY | 40200312 | $298.92 | 86235 |
| PLATELET MAPPING ASSAY | 40500031 | $27.00 | 85347 |
| 40500151 | $47.00 | 85384 | |
| 40500153 | $150.00 | 85576 | |
| 40500153 | $150.00 | 8557691 | |
| 40500153 | $150.00 | 8557691 | |
| STREP PNEUMONIA URINARY ANTIGEN | 30100399 | $66.00 | 87899 |
| PNH, RBC | 40200153 | $287.26 | 88184 |
| 40200154 | $287.26 | 88185 | |
| 40200154 | $287.26 | 88185 | |
| PNH, WBC | 40200153 | $379.48 | 88184 |
| 40200154 | $379.48 | 88185 | |
| 40200154 | $379.48 | 88185 | |
| ALLERGEN - PENICILLIUM NOTATUM | 40200062 | $25.44 | 86003 |
| PNEUMOCOCCAL ABS, IGG | 40200054 | $18.82 | 86317 |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| 40200055 | $18.82 | 86317 | |
| ALLERGEN - PEANUT | 40200062 | $25.44 | 86003 |
| POC OACT ELITE | 40800008 | $74.00 | 85347 |
| GLUCOSE POINT OF CARE | 41000003 | $20.00 | 36416 |
| 40800006 | $51.00 | 82947 | |
| POC URINE HCG | 40800007 | $48.00 | 84703 |
| POC ACT RESPONSE | 40800008 | $74.00 | 85347 |
| POC URINALYSIS | 40800004 | $14.00 | 81003 |
| PORPHYRINS, URINE | 40200228 | $120.84 | 84120 |
| ALLERGEN - POTATO, WHITE | 40200062 | $25.44 | 86003 |
| PRO-PREDICTR 6MP METABOLITES | 40200221 | $502.44 | 82491 |
| 40200350 | $502.44 | 82491 | |
| POC PT WITH INR | 40800005 | $17.00 | 85610 |
| ALLERGEN A. PULLULANS | 40200062 | $25.44 | 86003 |
| SERINE PROTEASE 3, IGG | 40200135 | $69.96 | 83516 |
| PR3 REFLEX BILLING | 40200135 | $69.96 | 83516 |
| PROCALCITONIN | 30100419 | $113.00 | 84145 |
| OBSTETRIC PANEL *** REMEM | 41000008 | $128.00 | 80055 |
| ALLERGEN - PERENNIAL RYE GRASS | 40200062 | $25.44 | 86003 |
| PRIMIDONE AND METABOLITE | 40200057 | $25.44 | 80184 |
| 40200058 | $25.44 | 80188 | |
| PROCAINAMIDE (PRONESTYL) | 40200034 | $89.04 | 80192 |
| PROGESTERONE | 40500118 | $104.00 | 84144 |
| PROLACTIN | 40500119 | $121.00 | 84146 |
| PROTEIN PLEURAL FLUID | 40500047 | $65.00 | 84157 |
| PRE APHERESIS PLATELET | 40500047 | $65.00 | 84157 |
| PROTEIN PERITONEAL FLUID | 40500047 | $65.00 | 84157 |
| PROSTATE SPECIFIC ANTIGEN | 40500120 | $152.00 | 84153 |
| PSA FRACTIONATED(INC TOT & FREE) | 40200295 | $58.30 | 84154 |
| 40200294 | $58.30 | 84153 | |
| PROSTATE SPECIFIC ANTIGEN | 40500173 | $152.00 | G0103 |
| ALLERGEN - PISTACHIO | 40200062 | $25.44 | 86003 |
| PROTEIN C ANTIGEN | 40200239 | $73.14 | 85302 |
| PROTEIN C ACTIVITY | 40200200 | $116.60 | 85303 |
| PTH RELATED PEPTIDE (PTHrP) | 40200073 | $778.04 | 83519 |
| PTH, INTACT | 40500003 | $70.00 | 83970 |
| PT PROTHROMBIN TIME WITH INR | 40500154 | $64.00 | 85610 |
| PROTEIN S ANTIGEN | 40200236 | $73.14 | 85305 |
| PROTEIN S ACTIVITY | 40200201 | $188.68 | 85306 |
| PTT PARTIAL THROMBOPLASTIN | 40500158 | $78.00 | 85730 |
| PTT 1:1 MIX | 40500159 | $85.00 | 85732 |
| PT 1:1 MIX | 40500155 | $64.00 | 85611 |
| ALLERGEN - PRIVET TREE | 40200062 | $25.44 | 86003 |
| HIV-1 RNA QNT | 40200346 | $413.40 | 87536 |
| QUANTIFERON TB GOLD IN TUBE | 40200380 | $265.00 | 86480 |
| QUINIDINE SERUM | 40200064 | $265.00 | 80194 |
| BLOOD GAS ARTERIAL - RECOVERY ROOM | 40500009 | $137.00 | 82805 |
| ALLERGEN RAGWEED COMMON/SHORT | 40200062 | $25.44 | 86003 |
| REFLEX AMPHETAMINES CONFIRMATION BILL ON | 30100401 | $358.28 | 80324 |
| AMPHETAMINE CONF MECONIUM | 30100401 | $292.50 | 80324 |
| 30100481 | $292.50 | 80359 | |
| RA RHEUMATOID ARTHRITIS | 40500163 | $30.78 | 86431 |
| BARBITURATES CONF MECONIUM | 30100404 | $581.10 | 80345 |
| AMPHETAMINE, S/P, QUANT | 30100401 | $358.28 | 80324 |
| REFLEX BARBITURATES CONFIRMATION BILL ON | 30100404 | $218.36 | 80345 |
| REFLEX BARBITURATES CONFIRMATION BILL | 30100404 | $218.36 | 80345 |
| REFLEX BENZODIAZEPINE CONFIRMATION BILL | 30100403 | $181.26 | 80346 |
| BZE, COCAINE, S/P, QUANT | 30100405 | $252.00 | 80353 |
| BENZODIAZEPINE CONF MECONIUM | 30100403 | $565.50 | 80346 |
| BENZODIAZEPINES CONFIRMATION | 30100403 | $565.50 | 80346 |
| REFLEX BENZODIAZEPINES CONFIRMATION BILL | 30100403 | $181.26 | 80346 |
| BLOOD GAS & OTHERS - RECOVERY | 40500032 | $37.00 | 82330 |
| 40500009 | $137.00 | 82805 | |
| 40500115 | $32.00 | 84132 | |
| 40500122 | $32.00 | 84295 | |
| 40500035 | $32.00 | 82947 | |
| METHADONE, S/P, QUANT | 30100400 | $301.04 | 80358 |
| 11-NOR-9 CARBOXY-THC, S/P, QUANT | 30100406 | $284.08 | 80349 |
| REFLEX METHADONE CONFIRMATION BILL | 30100400 | $301.04 | 80358 |
| REFLEX OPIATE CONFIRMATION BILL | 30100407 | $500.32 | 80361 |
| PHENCYCLIDINE, PCP, S/P, QUANT | 40200106 | $293.62 | 83992 |
| REFLEX PROPOXYPHENE CONFIRMATION BILL | 30100408 | $405.98 | 80367 |
| REFLEX BUP & METABOLITES CONFIRMATION BI | 30200131 | $259.39 | 80348 |
| BACTERIAL/WOUND CULTURE | 40300026 | $125.00 | 87070 |
| BACTERIAL CULTURE IN BOTTLES | 40300026 | $137.00 | 87070 |
| BACTERIAL/WOUND CULTURE GS | 40300026 | $125.00 | 87070 |
| 40300038 | $66.00 | 87205 | |
| COCAINE CONFIRM MECONIUM | 30100405 | $442.65 | 80353 |
| CV2.1 ANTIBODY TITER, IGG | 40200092 | $1,072.50 | 86256 |
| NA, K, GLUCOSE - RECOVERY | 40500115 | $32.00 | 84132 |
| 40500122 | $32.00 | 84295 | |
| 40500035 | $32.00 | 82947 | |
| RENIN ACTIVITY | 40200212 | $97.52 | 84244 |
| RBC FOLATE PACKAGE | 40200280 | $74.00 | 82747 |
| RENAL FUNCTION PANEL | 40500004 | $153.00 | 80069 |
| RETICULOCYTES HEMOGLOBIN | 40200387 | $61.48 | 85046 |
| RHOGAM WORKUP | 40400017 | $40.00 | 86901 |
| 40400016 | $40.00 | 86900 | |
| 40400012 | $54.00 | 86850 | |
| ALLERGEN - RICE | 40200062 | $25.44 | 86003 |
| MARIJUANA CONFIRM MECONIUM | 30100406 | $446.55 | 80349 |
| REFLEX AMPHETAMINES MECONIUM | 30100401 | $292.50 | 80324 |
| 30100481 | $292.50 | 80359 | |
| REFLEX BARBITURATES MECONIUM | 30100404 | $581.00 | 80345 |
| REFLEX BUPRENORPHINE MECONIUM | 30100425 | $370.50 | 80348 |
| REFLEX COCAINE CONF BILL ONLY | 30100405 | $442.65 | 80353 |
| METHADONE CONF MECONIUM | 30100400 | $446.55 | 80358 |
| REFLEX MARIJUANA CONF BILL ONLY | 30100406 | $446.55 | 80349 |
| REFLEX METHADONE MECONIUM | 30100400 | $446.55 | 80358 |
| REFLEX OPIATES CONF BILL ONLY | 30100407 | $223.27 | 80361 |
| 30100476 | $223.28 | 80365 | |
| REFLEX PHENCYCLIDINE MECONIUM | 40200106 | $565.50 | 83992 |
| ROCKY MT. SPOTTED FEVER IGG | 40200231 | $73.14 | 86757 |
| NEURONAL NUC AB IGG,IMMUNOBLOT | 40200083 | $452.40 | 83516 |
| ALLERGEN - RHIZOPUS NIGRICANS | 40200062 | $25.44 | 86003 |
| REFLEX NEURONAL NUCLEAR AB | 40200092 | $452.40 | 86256 |
| OPIATES CONFIRM MECONIUM | 30100407 | $223.18 | 80361 |
| 30100476 | $223.17 | 80365 | |
| REFLEX OPIATES CONFIRMATION BILL ONLY | 30100407 | $500.32 | 80361 |
| PHENCYCLIDINE CONF MECONIUM | 30100213 | $565.50 | 83992 |
| RPR | 40300016 | $39.00 | 86592 |
| RPR TITER | 40300017 | $45.00 | 86593 |
| RAPID PTH, INTACT | 40500003 | $70.00 | 83970 |
| PURKINJE CELL AB TITER IGG | 40200092 | $452.40 | 86256 |
| RESPIRATORY CULTURE | 40300026 | $125.00 | 87070 |
| RESPIRATORY CULTURE GS | 40300026 | $125.00 | 87070 |
| 40300038 | $66.00 | 87205 | |
| REDUCING SUBSTANCES STOOL | 40500124 | $37.00 | 84376 |
| RSV ANTIGEN DETECTION | 40300054 | $109.00 | 87420 |
| RETICULIN AB, IGA W/REFLEX | 40200191 | $73.14 | 86255 |
| RETICULIN IGA REFLEX BILL ONLY | 40200092 | $193.98 | 86256 |
| RETICULOCYTE COUNT | 40500145 | $72.00 | 85045 |
| ROTAVIRUS ANTIGEN DETECTION | 40300055 | $88.00 | 87425 |
