| TEST NAME |
PT FEE |
|
TEST NAME |
PT FEE |
|
| 17-HYDROXYPROGESTERONE LC/MS/MS |
$60.00 |
|
GLUCOSE |
$15.00 |
|
| 25 OH VITAMIN D |
$55.00 |
|
GLUCOSE TOLERANCE, GESTATIONAL, 4 SPEC |
$31.00 |
|
| ABO BLOOD TYPE |
$10.00 |
|
GLUCOSE, FASTING |
$15.00 |
|
| ABO GROUP & RH TYPE |
$25.00 |
|
GLUCOSE, FASTING AND POSTPRANDIAL 1 HOUR |
$30.00 |
|
| ACTH, plasma |
$65.00 |
|
GLUCOSE, GESTATIONAL SCREEN |
$11.00 |
|
| ALBUMIN |
$15.00 |
|
Glucose, Post Prandial |
$15.00 |
|
| ALKALINE PHOSPHATASE |
$15.00 |
|
Glycomark |
$35.00 |
|
| ALT |
$15.00 |
|
GROUP B STREP CULTURE |
$35.00 |
|
| AMYLASE |
$15.00 |
|
HCG, SERUM QUAL |
$13.75 |
|
| AMIODORONE |
$40.50 |
|
HCG, SERUM QUANT |
$15.00 |
|
| ANA TITER AND PATTERN (REFLEX ADD ON) |
$32.00 |
|
HDL-CHOLESTEROL |
$12.00 |
|
| Antinuclear Antibodies W/Refl Titer & Pattern |
$20.00 |
|
HEMATOCRIT |
$6.00 |
|
| APTT |
$15.00 |
|
HEMOGLOBIN |
$6.00 |
|
| ASO |
$15.00 |
|
HEMOGLOBIN A1C |
$20.00 |
|
| AST |
$15.00 |
|
HEMOGLOBIN/HEMATOCRIT |
$12.00 |
|
| BASIC METABOLIC PANEL |
$20.58 |
|
HEMOGLOBINOPATHY EVALUATION |
$35.00 |
|
| BILIRUBIN DIRECT |
$15.00 |
|
HEMOGRAM |
$15.05 |
|
| BILIRUBIN TOTAL |
$15.00 |
|
HEMOGRAM AND PLATELET |
$17.00 |
|
| BLOOD DRAW |
$5.00 |
|
HEP B SURFACE AB, QUAL |
$23.00 |
|
| BNP |
$50.00 |
|
Hep. A Ab |
$25.00 |
|
| BUN |
$15.00 |
|
Hep. B Core Ab |
$25.00 |
|
| BUN/CREATININE RATIO |
$15.00 |
|
Hep. B Surface Antigen w/ Conf. |
$15.00 |
|
| BVV |
$140.00 |
|
Hep. C Ab. |
$25.00 |
|
| C DIFF |
$25.00 |
|
HEPATIC FUNCTION |
$19.71 |
|
| C REACTIVE PROTEIN |
$12.00 |
|
Hepatitis B Surf. Ab., Quant |
$25.00 |
|
| CA 125 |
$55.00 |
|
HEPATITIS B SURFACE ANTIGEN |
$21.00 |
|
| CALCIUM |
$15.00 |
|
HEPATITIS PANEL ACUTE |
$65.00 |
|
| Calcium, ionized |
$15.00 |
|
HERPE SELECT, HSV 1 & 2 |
$72.00 |
|
| CARBAMAZEPINE, TOTAL |
$30.00 |
|
HERPES CULTURE |
$45.00 |
|
| CBC(HEMOGRAM/PLATELET/DIFF) |
$19.00 |
|
HERPES CULTURE WITH REFLX TYPING |
$45.00 |
|
| CCP |
$45.00 |
|
HETEROPHILE, MONO SCREEN |
$12.00 |
|
| CEA |
$30.00 |
|
HIV SCREEN WITH REFLEXES |
$25.00 |
|
| Celiac Disease Panel |
$70.00 |
|
Homosysteine, Cardio |
$30.00 |
|
| CHEMISTRY 12 PANEL |
$24.00 |
|
HPV |
$51.30 |
|
| CHLORIDE |
$15.00 |
|
Hpylori Breath Test |
$108.00 |
|
| CHOLESTEROL, TOTAL |
$6.40 |
|
HSV IGM W/RFLX TITER |
$72.00 |
|
| CMV IGG |
$35.00 |
|
HSV2 IGG HERPESELECT |
$36.00 |
|
| CMV IGM |
$32.00 |
|
ICAP, CHILDHOOD ALLERGY PANEL |
$165.00 |
|
| CO2 |
$15.00 |
|
ICAP, FOOD ALLERGY PANEL |
$130.00 |
|
| COMPREHENSIVE METABOLIC PANEL |
$25.71 |
|
ICAP, RESPIRATORY PANEL |
$370.00 |
|
| Cortisol, AM |
$21.00 |
|
IGF-I |
$30.00 |
|
| Cortisol, PM |
$21.00 |
|
INSULIN |
$18.75 |
|
| Cortisol, Random |
$21.00 |
|
INSURE FECAL IMMUNOCHEMISTRY |
$46.00 |
|
| CREATINE KINASE |
$14.00 |
|
Intrinsic Factor Blocking Ab. |
$35.00 |
|
| CREATININE |
$15.00 |
|
Iron,Total, Ibc + % Saturation |
$28.00 |
|
| CREATININE CLEARANCE |
$23.00 |
|
LDH |
$18.00 |
|
| CRP,CARDIO |
$40.00 |
|
LH |
$32.00 |
|
| CT, AMPLIFIED |
$51.30 |
|
LIPASE |
$10.00 |
|
| CT/GC, AMPLIFIED |
$102.55 |
|
LIPID PANEL |
$27.45 |
|
| CULTURE, AEROBIC AND ANA |
$35.00 |
|
MATERNAL SERUM 4 |
$91.90 |
|
| CYCLIC C PEPTIDE |
$28.00 |
|
MICROALBUMIN |
$13.00 |
|
| DHEAS |
$50.00 |
|
MICROALBUMIN, RANDOM URINE WITH CREATINIE |
$18.00 |
|
| Dihydrotestosterone |
$50.00 |
|
OB PANEL |
$75.00 |
|
| DILANTIN |
$45.00 |
|
ORGANISM ID |
$10.50 |
|
| DIRECT LDL |
$23.00 |
|
Ova & Parasites |
$75.00 |
|
| DRUG SCREEN |
$210.00 |
|
Pathology Review |
$25.85 |
|
| DRUG SCREEN PANEL 10 |
$210.00 |
|
PHOSPHORUS |
$15.00 |
|
| ELECTROLYTE PANEL |
$17.15 |
|
PLATELET COUNT |
$8.00 |
|
| Epstein-Barr Panel |
$75.00 |
|
POTASSIUM |
$15.00 |
|
| ESTRADIOL |
$55.00 |
|
PRESUMPTIVE ID |
$10.50 |
|
| ESTROGEN TOTAL |
$50.00 |
|
PROGESTERONE |
$35.00 |
|
| FERRITIN |
$25.00 |
|
PROLACTIN |
$38.00 |
|
| FETAL FIBRONECTIN |
$120.00 |
|
PSA |
$28.75 |
|
| FSH |
$30.00 |
|
PT WITH INR |
$8.00 |
|
| Gastrin |
$27.50 |
|
PTH intact |
$65.00 |
|
| GC, AMPLIFIED |
$51.30 |
|
PTH, intact & Calcium |
$75.00 |
|
| GENITAL CULTURE |
$20.00 |
|
QUANTIFERON |
$110.00 |
|
| GGT, gamma glutamyl trans. |
$15.00 |
|
RA PANEL |
$43.50 |
|
| GLOBULIN TOTAL |
$15.00 |
|
RBC ANTIBODY SCREEN |
$20.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| RENAL PANEL |
$22.29 |
|
|
|
|
| RH TYPE |
$10.00 |
|
|
|
|
| RHEUMATOID FACTOR |
$15.00 |
|
|
|
|
| RPR(DX) W/RFLX TITER & FTA |
$9.50 |
|
|
|
|
| RPR(MONITORING)W/RFLX TITER |
$9.50 |
|
|
|
|
| RUBELLA VIRUS IGG AB |
$21.05 |
|
|
|
|
| SED RATE |
$8.00 |
|
|
|
|
| Serum Total Protein Electro. |
$25.00 |
|
|
|
|
| SODIUM |
$15.00 |
|
|
|
|
| Stool, (Salm./Shig/Campy) |
$30.00 |
|
|
|
|
| Strep, Group A culture |
$25.00 |
|
|
|
|
| SUSCEPTIBILITY |
$10.50 |
|
|
|
|
| T3 FREE |
$45.00 |
|
|
|
|
| T3 TOTAL |
$28.00 |
|
|
|
|
| T3 UPTAKE |
$15.00 |
|
|
|
|
| T4 FREE |
$20.00 |
|
|
|
|
| T4 TOTAL |
$15.00 |
|
|
|
|
| TESTOSTERONE, FREE AND TOTAL LC/MS/MS |
$110.00 |
|
|
|
|
| TESTOSTERONE, TOTAL |
$60.00 |
|
|
|
|
| THIN PREP, IMAGED |
$37.50 |
|
|
|
|
| THIN PREP, IMAGED WITH HPV |
$88.80 |
|
|
|
|
| THIN PREP, IMAGED, REFLX TO HPV |
$37.50 |
|
|
|
|
| THIN PREP, NON-IMAGED |
$30.00 |
|
|
|
|
| THIN PREP, NON-IMAGED WITH HPV |
$80.85 |
|
|
|
|
| THIN PREP, NON-IMAGED, REFLX TO HPV |
$30.00 |
|
|
|
|
| Thyroglobulin Ab |
$32.00 |
|
|
|
|
| TORCH PANEL ACUTE |
$155.00 |
|
|
|
|
| TOTAL PROTEIN |
$15.00 |
|
|
|
|
| TPO Ab |
$30.00 |
|
|
|
|
| TRIGLYCERIDES |
$9.05 |
|
|
|
|
| TSH |
$26.75 |
|
|
|
|
| TSH W/RFLX TO FT4 |
$26.75 |
|
|
|
|
| UA, COMPLETE |
$8.00 |
|
|
|
|
| URIC ACID |
$10.00 |
|
|
|
|
| URINALYSIS (REFLEX) |
$6.80 |
|
|
|
|
| URINALYSIS, CULTURE IF INDICATED |
$8.00 |
|
|
|
|
| URINALYSIS, MACRO |
$6.80 |
|
|
|
|
| URINALYSIS, MICRO |
$7.80 |
|
|
|
|
| URINE CULTURE |
$25.00 |
|
|
|
|
| VALPROIC ACID |
$30.00 |
|
|
|
|
| VAP CHOLESTEROL TEST |
$80.00 |
|
|
|
|
| VARICELLA |
$28.25 |
|
|
|
|
| VIT B PANEL |
$60.00 |
|
|
|
|
| VITAMIN B12 |
$44.00 |
|
|
|
|
| WBC |
$6.00 |
|
|
|
|
