Laboratory Tests and Fees

BACTERIOLOGY

TEST PERFORMED TEST   # PERFORMED FEE SPECIMEN COLLECTION
& TRANSPORT
REQUISITION CPT CODE
Aeromonas-Plesiomonas culture 2310 Daily $35.00 17, 17A 100 87046
Antibiotic susceptibility testing, urine culture isolate 2600 Daily $37.00 21 100 87184
Bacteriology primary culture 2025 Daily $74.00   100 87070
Bacteriology isolate identification (No fee for N. gonorrhoeae, N. meningitis Listeria or other pathogens of public health interest) 2085 Daily $118.00   100 87077
Campylobacter culture 2240 Daily $33.00 17, 17A 100 87046
E coli shigatoxin-producing culture 2250 Daily $36.00   100 87046
E coli shigatoxin-producing, isolate confirmation 2080 Daily $109.00     87070
Gram stain 2035 Daily $27.00   100 87205
Neisseria gonorrhoeae culture 2050 Daily $22.00 11 100 87850
Neisseria gonorrhoeae culture confirmation 2040 Daily $118.00   100 87077
Salmonella culture 2220 Daily $28.00 17, 17A 100 87045
Shigella culture 2230 Daily $40.00 17, 17A 100 87045
Streptococcus Culture 2015 Daily $31.00   100 87081
Yersinia enterocolitica culture 2270 Daily $42.00 17, 17A 100 87046
Urine culture with colony count 2065 Daily $47.00 21, 17A 100 87086
Vibrio culture 2260 Daily $37.00 17, 17A 100 87046
Shigatoxin 2290 Daily $64.00 17, 17A 100 87427
Stool culture isolate identification 2280 Daily $111.00   100 87045
PANEL TEST # FEE     CPT
Standard Stool Culture: 2200 $88.00   100  
Salmonella culture         87045
Shigella culture         87045
Campylobacter culture         87046
Shigatoxin-producing E coli culture         87046
PANEL TEST # FEE     CPT
Comprehensive Stool Culture: 2300 $214.00   100  
Salmonella culture         87045
Shigella culture         87045
Campylobacter culture         87046
Shigatoxin-producing E coli culture         87046
E coli, shigatoxin-producing         87046
Yersinia enterocolitica culture         87046
Aeromonas-Plesiomonas culture         87046
Vibrio culture         87046
Shigatoxin Enzyme-immunoassay         87427

FOOD TESTING

DESCRIPTION
Note: These tests are performed in specific circumstances and can only be submitted by authorized personnel.
TEST # FEE REQUISITION
Enteric pathogens culture Food 3010 $139.00 100 (or chain of custody)
Direct microscopic exam Food 3005 $127.00 100 (or chain of custody)

MOLECULAR AMPLIFICATION TESTING

TEST PERFORMED TEST # PERFORMED FEE SPECIMEN COLLECTION & TRANSPORT REQUISITION CPT CODE
Bordetella (pertussis) PCR 2110 Daily $128.00 6, 6A 100 87798
Chlamydia amplified assay * 2750 Daily $43.00 2 100 87491
Gonorrhea amplified assay * 2770 Daily $43.00 2 100 87591
Trichomonas amplified assay* 2850 Daily $62.00 2 100 87661
Enterovirus RT-PCR 6300 Mon-Wed-Fri $128.00 23 100 87798
Influenza virus RT-PCR 50000 Mon-Wed-Fri $128.00 9 100 87501
M.tuberculosis amplification (MTD-RIF) 3530 Daily $96.00 15, 16 100 87556
Norovirus RT-PCR 6100 Daily $128.00 17, 17A 100 87798
Poxvirus PCR Call for Information Daily $128.00 23 100 87798
Respiratory Virus Agent PCR Panel (RP):

Influenza A, H3, H1, Influenza B, Human Metapneumovirus (hMPV) Parainfluenza 1, 2, 3, 4, Respiratory Syncytial Virus Types A and B, Adenovirus, Enterovirus/Rhinovirus, Coronaviruses, B pertussis, Chlamydophila pneumoniae and Mycoplasma pneumoniae.Influenza A, H3, H1, Influenza B, Adenovirus, Corona viruses 228E, HKU1, NL63, OC43, Human Metapneumovirus (hMPV) Parainfluenza 1, 2, 3, 4,  Respiratory Syncytial Virus, Enterovirus/Rhinovirus, Bordetella pertussis, Chlamydophila pneumonia, Mycoplasma pneumonia.

6310 Daily $190.00 26 100 87633
Varicella-Zoster virus PCR 6190 Daily $128.00 23 100 87798
Gastrointestinal Pathogen PCR Panel (GP):

Rotavirus A, Norovirus G1/GII, Sapovirus, Astrovirus, Adenovirus 40/41, Diarheagenic E coli, Entertoxigenic E. coli (ETEC), Enteropathogenic E coli (EPEC), Enterotoxigenic E coli (ETEC), Escherichia coli 0157, Shigatoxin-producing E coli(stx1/stx 2) (STEC), Enteroinvasive E coli (EIEC), Salmonella, Shigella, Campylobacter, Clostridium difficile Toxin A/B, LT/ST, ,), Giardia lamblia, Cyclospora, Cryptosporidium, Entamoeba histolytica , Vibrio spp, Vibrio Cholerae, Yersinia enterocolitica.Rotavirus A, Norovirus G1/GII, Sapovirus, Salmonella, Plesiomonas, Campylobacter,Clostridium difficile Toxin A/B,  Enteropathogenic E coli, Enteroaggregative E coli, Entertoxigenic E. coli (ETEC) LT/ST, Escherichia coli 0157, Shigella/Enteroinvasive E coli, Shigatoxin-producing E coli(stx1/stx 2), Giardia lamblia, Cryptosporidium, Cyclospora cayetensis, Adenovirus 40/41,  Astrovirus, Entamoeba histolytica , Vibrio spp,Vibrio cholera,  Yersinia enterocolitica

6500 Daily $218.00     87502
*Test volume-based pricing is available
**For specimen collection and transporting refer to SLOPHLAB Collection Instructions

MYCOBATERIOLOGY and MYCOLOGY TESTING

TEST PERFORMED TEST # PERFORMED FEE SPECIMEN COLLECTION
& TRANSPORT
REQUISITION CPT CODE
M. tuberculosis amplification (MTB-RIF) 3530 Daily $96.00 15, 16 100 87556
M. tuberculosis complex probe 3571 Thurs $76.00   100 87555
M. avium complex probe 3575 Thurs $76.00   100 87560
M. kansasii probe 3581 Thurs $76.00   100 87550
M. gordonae probe 3585 Thurs $76.00   100 87550
Mycobacterial isolate identification 3555 Daily $118.00   100 87118
TB culture & identification (plus concentration*) 3545 Daily $78.00 15, 16 100 87116
TB fluorescent smear (urgent) 3526 Daily $149.00 15, 16 100 87206
TB fluorescent smear 3535 Daily $32.00 15, 16 100 87206
Quantiferon** 7700 Wed $59.00   100 86480
Mycology culture & identification 3905 Daily $114.00 7 100 87101
Mycology direct exam 3900 Daily $37.00 7 100 87220
Mycology isolate identification 3910 Daily $119.00 15, 16 100 87106
Coccidioides Probe 3915 Thurs $80.00     87149
*Concentration 9900 Daily $21.00   100 87015
 
*Specimen must be received by 2:00 pm for testing
**Test volume-based pricing available

PARASITOLOGY TESTING

TEST PERFORMED TEST   # PERFORMED FEE SPECIMEN COLLECTION
& TRANSPORT
REQUISITION CPT CODE
Ova and Parasites 4025 Daily $73.00 18 100 87177
Parasite identification- Trichrome stain 4010 Daily $49.00 18 100 87209
Wet prep vaginal 4055 Daily $50.00 22 100 87210
Cryptosporidium-Giardia DFA (with concentration*) 4030 Daily $57.00 18 100 87272, 87269, 87015
Parasite special direct exam 4000 Daily $69.00 18 100 87207
Parasite wet mount, feces 4050 Daily $53.00 17, 17A 100 87177
Helminth-Arthropod identification 4020 Daily $41.00     87169
Tick Identification
Anyone may request this test
4015 Daily $29.00     87168
Cyclospora direct exam 4045 Daily $81.00   100 87206, 87015
Microsporidia special direct exam 4060 Daily $69.00 18 100 87206, 87015
Isospora special direct exam 4065 Daily $69.00 18 100 87206, 87015
Parasite blood smear exam 4040 Daily $43.00 5 100 86750
Pinworm prep 4005 Daily $37.00 12 100 87172
 
Standard Parasitology Panel 4025 Daily $196.00 18 100  
Ova & Parasites concentration & exam           87177
Trichrome stain & exam           87209
 
Comprehensive Parasitology Panel: 4300 Daily $213.00 18 100  
Ova & Parasites concentration & exam           87177
Trichrome stain & exam           87209
Cryptosporidium DFA           87272
Giardia DFA           87269
 
*Concentration     $21.00     87015

SEROLOGY TESTING

TEST PERFORMED TEST   # PERFORMED FEE REQUISITION CPT CODE
RPR, serum 5035 Tues & Thurs $25.00 100 86592
RPR, serum, titer 5040 Tues & Thurs $45.00 100 86593
Treponema pallidum particle agglutination test (TP-PA, syphilis conf.) 5065 Tues & Thurs $58.00 100 86780
HIV 1,2  antibody, EIA, serum * 5500 Tues & Thurs $31.00 100 87389
HIV 1 antibody, EIA, oral fluid * 5600 Tues & Thurs $28.00 100 86701
HIV antibody differentiation test 5700 day after screen $78.00 100 86689
HIV antibody, Western blot, oral fluid (HIV antibody confirmation test) 5030 day after screen $225.00 100 86689
Varicella-Zoster (VZV) antibody 5100 Mon & Thurs $48.00 100 86787
VDRL, CSF 5060 Tues & Thurs $33.00 100 86593
 
*Test volume-based pricing available
 

SEXUALLY-TRANSMITTED DISEASE (STD) TESTING

TEST PERFORMED TEST   # PERFORMED FEE SPECIMEN COLLECTION
& TRANSPORT
REQUISITION CPT CODE
N. gonorrhoeae culture 2050 Daily $22.00 11 100 87081
VDRL, CSF 5060 Daily $33.00   100 86593
RPR, serum 5035 Daily $25.00   100 86592
RPR, serum, titer 5040 Daily $45.00   100 86593
Treponema pallidum particle agglutination (TP-PA, syphilis confirmation.) 5065 Day after screen $58.00   100 86780
Herpes Virus culture 6010 2-5 da $73.00 30 100 87252
Herpes virus fluorescent antibody confirmation/typing 6015 Daily $67.00 30 100 87273
HIV 1 antibody, EIA, serum * 5500 Tues-Thurs $31.00     86701
HIV 1 antibody, EIA, oral fluid* 5600 Tues-Thurs $28.00   100 86701
HIV antibody differentiation test 5700 day after screen $78.00   100 87389
HIV antibody, Western blot, oral fluid (HIV antibody confirmation test) 5030 day after screen $225.00   100 86689
Chlamydia amplified assay * 2750 Daily $43.00 2 100 87491
Gonorrhea amplified assay * 2770 Daily $43.00 2 100 87591
Trichomonas amplification 2850 Daily $62.00 2 100 87661
*Test volume-based pricing available

SPECIAL SERVICES

DESCRIPTION FEE REQUISITION
Urgent Charge—Per Episode (testing done outside regularly scheduled hours) $146.00 NA
Miscellaneous Testing Per Hour $134.00 NA
Non-Diagnostic General Health Assessment, Single Event Program $85.00 NGHA Application
Non-Diagnostic General Health Assessment, Multiple Event Program $125.00 NGHA Application
TEST PERFORMED TEST #   PERFORMED FEE REQUISITION CPT CODE
Blood Lead 9150   Daily $32.00 100 83655

VIROLOGY TESTING

TEST PERFORMED TEST   # PERFORMED FEE SPECIMEN COLLECTION & TRANSPORT REQUISITION CPT CODE
Herpes Virus culture 6010 Daily $73.00 30 100 87252
Herpes virus fluorescent antibody confirmation/typing 6015 Daily $67.00   100 87253
Norovirus RT-PCR 6100 Daily $128.00   100 87798
Influenza virus RT-PCR 6030 Mon-Wed-Fri $128.00 9 100 87798
Respiratory Virus Agent PCR Panel (RP):

Influenza A, H3, H1, Influenza B, Adenovirus, Corona viruses 228E, HKU1, NL63, OC43, Human Metapneumovirus (hMPV) Parainfluenza 1, 2, 3, 4,  Respiratory Syncytial Virus, Enterovirus/Rhinovirus, Bordetella pertussis, Chlamydophila pneumoniae, Mycoplasma pneumonia.

6310 Daily $190.00 26 100

87501

87502

87503 X 2

87798 X 8
Varicella-Zoster virus PCR 6190 Daily $128.00 23 100 87798
VZV antibody 5100 Mon $48.00     86787
Gastrointestinal Pathogen PCR Panel (GP):

Rotavirus A, Norovirus G1/GII, Sapovirus, Salmonella, Plesiomonas, Campylobacter,Clostridium difficile Toxin A/B,  Enteropathogenic E coli, Enteroaggregative E coli, Entertoxigenic E. coli (ETEC) LT/ST, Escherichia coli 0157, Shigella/Enteroinvasive E coli, Shigatoxin-producing E coli(stx1/stx 2), Giardia lamblia, Cryptosporidium, Cyclospora cayetensis, Adenovirus 40/41Astrovirus, Entamoeba histolytica , Vibrio spp,Vibrio cholera,  Yersinia enterocolitica

6500 Daily $218.00 17, 17A 100 82507
Rabies DFA
Anyone may request this test
6000 Daily $116.00   300 N/A

WATER and SHELLFISH TESTING

TEST PERFORMED TEST # PERFORMED FEE REQUISTION METHOD
Enterococci, MPNEnterococci, MPN 8010 Daily, 1 da $26.00 200 SM 9230
Fecal coliforms, water 8020 Daily 3-4 da $55.00 200 DM 9221E
Fecal coliforms, water, A1 method 8910 Daily 1 da $55.00 200 DM 9221E
Heterotrophic Plate Count 8045 Daily 2 da $48.00 200 DM9215B
Pseudomonas Count 8050 Daily 1 da $34.00 200 chromogenic
Total coliforms-E coli MPN (Quantitray) 8025 Daily 1 da $28.00 200 SM 9223
Total coliforms-E coli, Presence/Absence* 8040 Daily 1 da $24.00 200 SM 9223
Salinity 8069 Daily 1 da $7.00 200 refractometry
Total and fecal coliforms MPN 8400 Daily 3-4 day $55.00 200 SM 9221E
Fecal coliforms, shellfish meat 8070 scheduled, 3-4 da $149.00 200 FDA
Domoic acid, shellfish meat 9005 scheduled, 2 da $167.00 200 EIA
 
*Drinking water samples accepted Mon thru Fri; Call 805-781-5508 to schedule testing for other water testing
*Test volume -based pricing is available

Reference

Courier-Services
Explanation-of-Fees
Insurance-Carriers-Currently-Billed
Requisition 100
Requisition 200
Requisition 300 - Animal
Laboratory Web Portal
NGHA-Application
Laboratory Hot Topics