Molecular Amplification

TEST PERFORMED TEST # PERFORMED FEE

SPECIMEN

COLLECTION

&

TRANSPORT

REQUISITION CPT CODE

Corona-SARS-CoV-2 Amplification

Corona-SARS-CoV-2 PCR-STAT

Corona-SARS-Cov-2 PCR

6860

 

6852

 

6850

Daily

 

Daily

 

Daily

$58***

 

$95***

 

$141***

6A

 

6A

 

6A

100

 

100

 

100

87635

 

87635

 

87635

Bordetella (pertussis) PCR 2110 Daily $141 6 100 87798
Chlamydia amplified assay * 2750 Daily $30 2 100 87491
Gonorrhea amplified assay * 2770 Daily $30 2 100 87591
Trichomonas amplified assay* 2850 Daily $57 2 100 87661
Mycoplasma genitalium amplification 2870 Daily $66 2 100 87798
Enterovirus RT-PCR 6300 Mon-Wed-Fri $141 23 100 87798
Herpes Simplex Virus NAAT 6840 Daily $81 35 100 87798
Influenza virus RT-PCR 50000 Mon-Wed-Fri $141 6, 6A 100 87501
Influenza virus RT-PCR with reflex to Resp PCR Panel 50010 Daily $141 (+$227 if RP performed) 6, 6A 100 87798
Measles Virus PCR (Rubeola) 6180 Daily $141 28, 28A 100 87798
M.tuberculosis amplification (MTD-RIF) 3530 Daily $138 15, 16 100 87556
Mumps Virus PCR 6170 Daily $141 20 100 87798
Norovirus RT-PCR 6100 Daily $141 17, 17A 100 87798
Pneumonia PCR Panel

Bacteria reported with numeric values of 104 105, 106, or 107 Acinetobacter calcoaceticus-baumannii complex, Klebsiella oxytoca, Serratia marcescens Enterobacter cloacae complex, Klebsiella pneumoniae group, Staphylococcus aureus Escherichia coli, Moraxella catarrhalis , Streptococcus agalactiae, Haemophilus influenzae Proteus spp., Streptococcus pneumoniae, Klebsiella aerogenes Pseudomonas aeruginosa, Streptococcus pyogenes, Atypical Bacteria Chlamydiophila pneumoniae, Legionella pneumophila' Mycoplasma pneumoniae, Viruses: Adenovirus,Coronavirus,Human Metapneumovirus (hMPV),Human Rhinovirus/Enterovirus.Respiratory Syncytial Virus (RSV),Influenza Virus A, Influenza B,Parainfluenza virus Antimicrobial Resistance Genes; CTX-M , NDM, mecA/C and MREJ, IMP, OXA-48-like, KPC and VIM

6620 Daily $279 15, 16 100 87631,87541,87581,8748, 87798 x (13), 87150 x (7)
Poxvirus PCR Call for Information Daily $141 13 100 87798
Respiratory 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. Adenovirus, Corona viruses 228E, HKU1, NL63, OC43, Human Metapneumovirus (hMPV) Parainfluenza 1, 2, 3, 4,  Respiratory Syncytial Virus, Enterovirus/Rhinovirus, Bordetella pertussis, Bordetella para pertussis, Chlamydophila pneumonia, Mycoplasma pneumonia,Corona Virus SARS-CoV2

6310 Daily $227 6, 6A 100 87633
Varicella-Zoster Virus NAAT 6900 Daily $141 35 100 87798
Gastrointestinal 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.

6500 Daily $254 17, 17A 100 0097U
*Test volume-based pricing is available
**For specimen collection and transporting refer to SLOPHLAB Collection Instructions
***No charge at this time - Fees will be operative August 7, 2020 (Corona-sars-Cov-2)