| Basic metabolic panel (blood test)
CPT 80048
BASIC METABOLIC PANEL 80048 |
$67.20 |
$84.00 |
20% |
| Basic metabolic panel (blood test) inpatient
CPT 80048
BASIC METABOLIC PANEL 80048 |
$67.20 |
$84.00 |
20% |
| Cholesterol and triglycerides (lipid panel) blood test
CPT 80061
LIPID PANEL 80061 |
$75.20 |
$94.00 |
20% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient
CPT 80061
LIPID PANEL 80061 |
$75.20 |
$94.00 |
20% |
| Complete blood count (CBC) with differential
CPT 85025
KEYSTONE CBC W DIFF 85025 |
$32.00 |
$40.00 |
20% |
| Complete blood count (CBC) with differential
CPT 85025
COMPLETE CBC W/AUTO DIFF WBC 85025 |
$42.40 |
$53.00 |
20% |
| Complete blood count (CBC) with differential inpatient
CPT 85025
KEYSTONE CBC W DIFF 85025 |
$32.00 |
$40.00 |
20% |
| Complete blood count (CBC) with differential inpatient
CPT 85025
COMPLETE CBC W/AUTO DIFF WBC 85025 |
$42.40 |
$53.00 |
20% |
| Complete blood count (CBC), no differential
CPT 85027
BLOOD COUNT COMPLETE AUTOMATED 85027 |
$32.00 |
$40.00 |
20% |
| Complete blood count (CBC), no differential inpatient
CPT 85027
BLOOD COUNT COMPLETE AUTOMATED 85027 |
$32.00 |
$40.00 |
20% |
| Comprehensive metabolic panel (blood test)
CPT 80053
COMPREHENSIVE METABOLIC PANEL 80053 |
$79.20 |
$99.00 |
20% |
| Comprehensive metabolic panel (blood test) inpatient
CPT 80053
COMPREHENSIVE METABOLIC PANEL 80053 |
$79.20 |
$99.00 |
20% |
| Kidney function blood test panel
CPT 80069
RENAL FUNCTION PANEL 80069 |
$77.60 |
$97.00 |
20% |
| Kidney function blood test panel inpatient
CPT 80069
RENAL FUNCTION PANEL 80069 |
$77.60 |
$97.00 |
20% |
| Liver function blood test panel
CPT 80076
HEPATIC FUNCTION PANEL 80076 |
$64.00 |
$80.00 |
20% |
| Liver function blood test panel inpatient
CPT 80076
HEPATIC FUNCTION PANEL 80076 |
$64.00 |
$80.00 |
20% |
| Obstetric blood test panel
CPT 80055
OBSTETRIC PANEL 80055 |
$204.80 |
$256.00 |
20% |
| Obstetric blood test panel inpatient
CPT 80055
OBSTETRIC PANEL 80055 |
$204.80 |
$256.00 |
20% |
| PSA (prostate-specific antigen) blood test, free
CPT 84154
PSA FREE 84154 |
$89.60 |
$112.00 |
20% |
| PSA (prostate-specific antigen) blood test, free inpatient
CPT 84154
PSA FREE 84154 |
$89.60 |
$112.00 |
20% |
| PSA (prostate-specific antigen) blood test, total
CPT 84153
CDMR ASSAY OF PSA TOTAL 84153 |
$89.60 |
$112.00 |
20% |
| PSA (prostate-specific antigen) blood test, total inpatient
CPT 84153
CDMR ASSAY OF PSA TOTAL 84153 |
$89.60 |
$112.00 |
20% |
| Partial thromboplastin time (PTT) clotting test
CPT 85730
THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 |
$41.60 |
$52.00 |
20% |
| Partial thromboplastin time (PTT) clotting test inpatient
CPT 85730
THROMBOPLASTIN TIME PARTIAL PLASMA WHOLE BLOOD (PTT) 85730 |
$41.60 |
$52.00 |
20% |
| Prothrombin time (PT/INR) clotting test
CPT 85610
PROTIME 85610 |
$32.80 |
$41.00 |
20% |
| Prothrombin time (PT/INR) clotting test
CPT 85610
PT INR FINGERSTICK-QW 85610 |
$32.80 |
$41.00 |
20% |
| Prothrombin time (PT/INR) clotting test
CPT 85610
PROTIME - PROTIME CLINIC 85610 |
$33.60 |
$42.00 |
20% |
| Prothrombin time (PT/INR) clotting test inpatient
CPT 85610
PT INR FINGERSTICK-QW 85610 |
$32.80 |
$41.00 |
20% |
| Prothrombin time (PT/INR) clotting test inpatient
CPT 85610
PROTIME 85610 |
$32.80 |
$41.00 |
20% |
| Prothrombin time (PT/INR) clotting test inpatient
CPT 85610
PROTIME - PROTIME CLINIC 85610 |
$33.60 |
$42.00 |
20% |
| Thyroid-stimulating hormone (TSH) blood test
CPT 84443
THYROID STIMULATING HORMONE (TSH) 84443 |
$81.60 |
$102.00 |
20% |
| Thyroid-stimulating hormone (TSH) blood test inpatient
CPT 84443
THYROID STIMULATING HORMONE (TSH) 84443 |
$81.60 |
$102.00 |
20% |
| Urinalysis with microscope exam, automated
CPT 81001
URINALYSIS AUTO W/SCOPE 81001 |
$31.20 |
$39.00 |
20% |
| Urinalysis with microscope exam, automated inpatient
CPT 81001
URINALYSIS AUTO W/SCOPE 81001 |
$31.20 |
$39.00 |
20% |
| Urinalysis with microscope exam, manual
CPT 81000
UA NON-AUTOMATED W MICROS81000 |
$35.20 |
$44.00 |
20% |
| Urinalysis with microscope exam, manual inpatient
CPT 81000
UA NON-AUTOMATED W MICROS81000 |
$35.20 |
$44.00 |
20% |
| Urinalysis without microscope exam, automated
CPT 81003
URINALYSIS-DIPSTICK ONLY 81003 |
$24.80 |
$31.00 |
20% |
| Urinalysis without microscope exam, automated
CPT 81003
URINE AUTO NO MICRO SGL ANALYT |
$24.80 |
$31.00 |
20% |
| Urinalysis without microscope exam, automated inpatient
CPT 81003
URINALYSIS-DIPSTICK ONLY 81003 |
$24.80 |
$31.00 |
20% |
| Urinalysis without microscope exam, automated inpatient
CPT 81003
URINE AUTO NO MICRO SGL ANALYT |
$24.80 |
$31.00 |
20% |
| Urinalysis without microscope exam, manual
CPT 81002
CLINITEST DIPSTICK TABLET81002 |
$16.00 |
$20.00 |
20% |
| Urinalysis without microscope exam, manual
CPT 81002
OB UA DIPSTK NONAU W/O MICRO 81002 |
$17.60 |
$22.00 |
20% |
| Urinalysis without microscope exam, manual inpatient
CPT 81002
CLINITEST DIPSTICK TABLET81002 |
$16.00 |
$20.00 |
20% |
| Urinalysis without microscope exam, manual inpatient
CPT 81002
OB UA DIPSTK NONAU W/O MICRO 81002 |
$17.60 |
$22.00 |
20% |