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