Pathology Charge Schedule
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.
| Test Name | Technical Code | Charge | CPT CODE |
|---|---|---|---|
| Special Stain Group I | 41100002 | $44.46 | 88312 |
| Special Stain Group II | 41100003 | $44.36 | 88313 |
| Morphometric Analysis | 31000038 | $370.50 | 88360 |
| Cyto Eval. FNA | 40600008 | $245.10 | 88173 |
| B-CELL IgH | 30100343 | $877.50 | 81261 |
| B-CELL IgK | 30100344 | $877.50 | 81264 |
| Immunohistochemistry | 41100017 | $200.00 | 88342 |
| Immunohistochemistry Add. | 31000042 | $98.04 | 88341 |
| BRAF 81210 | 30100340 | $594.75 | 81210 |
| BRAF CODON 600 | 31000033 | $594.75 | 88381 |
| BRAF IHC | 41100017 | $292.50 | 88342 |
| Cyto fluids/washing/brushing | 40600006 | $92.34 | 88104 |
| Surg Path Lev I Gross only | 41100018 | $74.10 | 88300 |
| Surg Path Lev II Gross & micro | 41100019 | $152.76 | 88302 |
| Surg Path Lev III Gross & micro | 41100020 | $200.64 | 88304 |
| Surg Path Lev IV Gross & micro | 41100021 | $252.34 | 88305 |
| Surg Path Lev V Gross & micro | 41100022 | $298.68 | 88307 |
| Surg Path Lev VI Gross & micro | 41100023 | $347.70 | 88309 |
| Chlamydia PCR - ThinPrep | 40600001 | $55.00 | 87491 |
| Cyto CSF Slide prep | 40600004 | $108.30 | 88112 |
| Cytology Exam Touch Prep 1 | 31100019 | $174.42 | 88333 |
| Cytology Exam Touch Prep 2 | 31100020 | $174.42 | 88334 |
| Decalcification | 41100024 | $27.36 | 88311 |
| Flow Cytometry DNA Analysis | 40600007 | $499.32 | 88182 |
| DNA Ploidy by Image Analysis | 41100025 | $577.98 | 88358 |
| EBV By FISH Paraffin | 31000028 | $858.00 | 88365 |
| EGFR | 30100339 | $965.25 | 81235 |
| EGFR Microdissection | 31000033 | $965.25 | 88381 |
| EGFR Immunohistochemistry | 41100017 | $423.06 | 88342 |
| EGFR Immunohistochemistry Add. | 31000042 | $98.04 | 88341 |
| Molecular Path. Proc. EML4/ALK | 30100324 | $1,365.00 | 81401 |
| Cyto Evaluation of FNA | 40600009 | $174.42 | 88172 |
| Cyto Evaluation of FNA add | 31100018 | $28.00 | 88177 |
| Cytology Extended Study | 40600010 | $51.30 | 88162 |
| FISH | 41100001 | $778.05 | 88365 |
| FISH HER2 | 31000043 | $702.00 | 88367 |
| FISH HER2 PANEL | 31000044 | $526.50 | 88368 |
| GC PCR - Thin Prep | 40600002 | $55.00 | 87591 |
| Gene Rearrangement | 41100026 | $2,667.80 | 88348 |
| Cytology Conventional Smear screen | 40600011 | $40.00 | 88150 |
| Cytology Thin Prep screen | 40600012 | $92.34 | 88142 |
| Cytology ThinPrep Imaged screen | 40600015 | $93.00 | 88175 |
| Gyn Cytology w/ Maturation Index | 40600013 | $82.08 | 88155 |
| Herpes simplex virus I by PCR | 31100022 | $117.00 | 87529 |
| Herpes simplex virus II by PCR | 31100022 | $117.00 | 87529 |
| HPV FISH | 31000028 | $1,092.00 | 88365 |
| HPV 16/18 Genotyping | 30600054 | $140.00 | 87625 |
| HPV/DNA Typing High Risk | 30600080 | $164.00 | 87624 |
| HPV/DNA Typing Low Risk | 40600014 | $47.00 | 87623 |
| KRAS | 30100341 | $494.00 | 81275 |
| Molecular Path HRAS | 30100342 | $494.00 | 81403 |
| KRAS Microdissection | 31000033 | $494.00 | 88381 |
| Muscle Biopsy Lev I | 41100018 | $1,038.83 | 88300 |
| Muscle Biopsy Lev IV | 41100021 | $1,038.82 | 88305 |
| Muscle Biopsy Immunochemistry | 41100003 | $1,038.82 | 88313 |
| Muscle Biopsy Histo Stain | 41100027 | $1,038.82 | 88319 |
| OR Consult | 41100028 | $58.14 | 88329 |
| OR Consult w Frozen Section | 41100029 | $98.04 | 88331 |
| OR Consult w Additional Frozen Sect | 41100030 | $86.00 | 88332 |
| Cytology Non-Gyn Smear & Interp | 40600003 | $92.34 | 88108 |
| Renal Biopsy Lev IV | 41100021 | $1,854.78 | 88305 |
| Renal Biopsy Antibody Stain | 41100031 | $1,854.78 | 88346 |
| Renal Biopsy Election Microscope | 41100026 | $1,854.78 | 88348 |
| Stone Analysis | 41100032 | $102.00 | 82355 |
| T-Cell Clonality | 30100325 | $1,170.00 | 81342 |
| ThinPrep Cytology | 40600004 | $81.00 | 88112 |
| Trichomonas vaginalis on ThinPrep | 31100021 | $109.00 | 87661 |
| Vaginitis Panel BVAB | 30600081 | $90.00 | 87801 |
| Vaginitis Panel Candida glabrata | 30600082 | $43.75 | 87481 |
| Vaginitis Panel Candida Group | 30600082 | $43.75 | 87481 |
| Vaginitis Panel Candida krusei | 30600082 | $43.75 | 87481 |
| Vaginitis Panel Trichomonas Vaginalis | 30600076 | $43.75 | 84661 |
