| Test Name |
Test Code |
WSLH Price |
CPT Codes |
2008 Medicare
Reimbursement |
| Arbovirus IgM CEIA Ab Diagnostic Panel |
2435 |
$200.00 |
|
|
| Eastern Equine Encephalitis IgM |
2437M |
$50.00 |
86652 |
8.12 |
| St Louis Encephalitis IgM |
2439M |
$50.00 |
86653 |
8.12 |
| LaCrosse Encephalitis IgM |
2440M |
$50.00 |
86651 |
8.12 |
| West Nile Virus IgM Ab |
2442M |
$50.00 |
86790 |
8.12 |
| Cat Scratch Disease Serology |
622 |
$90.00 |
86611
86611 |
|
| Bartonella quintana |
|
$45.00 |
86611 |
8.12 |
| Bartonella henselae |
|
$45.00 |
86611 |
8.12 |
| Chlamydia-Gonorrhoea Combination Amplified Molecular Assay |
111 |
$97.00 |
87591
87491 |
|
|
Neisseria gonorrhoeae AMA |
112D |
$48.50 |
87591 |
49.04 |
| Chlamydia trachomiatis AMA |
118D |
$48.50 |
87491 |
49.04 |
| Cryptosporidium/Giardia Antigen Detection (DFA) |
670F |
$50.00 |
87272
87269 |
|
|
Cryptosporidium DFA |
|
$25.00 |
87272 |
16.76 |
| Giardia DFA |
|
$25.00 |
87269 |
16.76 |
| Hantavirus IgM and IgG |
2822 |
$300.00 |
86790
86790 |
|
| Hantavirus IgG |
2822G |
$120.00 |
86790 |
20.95 |
| Hantavirus IgM |
2822M |
$180.00 |
86790 |
20.95 |
| Hepatitis B Immune Status Panel |
38 |
$40.00 |
86704
86706 |
|
| Hepatitis B Core Ab |
38C |
$20.00 |
86704 |
16.84 |
| Hepatitis B Surface Ab |
38BQ |
$20.00 |
86706 |
15.01 |
| Hepatitis B Serodiagnosis Panel |
37 |
$51.00 |
87340
86704
86706 |
|
| Hepatitis B Surface Ag |
37G |
$17.00 |
87340 |
14.43 |
| Hepatitis B Core Ab |
37C |
$17.00 |
86704 |
16.84 |
| Hepatitis B Surface Ab |
37BQ |
$17.00 |
86706 |
15.01 |
| HTLV I/II |
2754 |
$70.00 |
Please call for details. |
|
| HTLV I |
|
$35.00 |
86687 |
11.72 |
| HTLV II |
|
$35.00 |
86688 |
19.57 |
| Lyme Disease Western Blot IgM and IgG |
792 |
$130.00 |
86617
86617 |
|
| Lyme Disease Western Blot IgM |
792M |
$65.00 |
86617 |
21.64 |
| Lyme Disease Western Blot IgG |
792G |
$65.00 |
86617 |
21.64 |
| Measles IgM and IgG Ab |
2814 |
$120.00 |
86765
86765 |
|
| Measles IgM |
2814M |
$100.00 |
86765 |
18.00 |
| Measles IgG |
2814G |
$20.00 |
86765 |
18.00 |
| Mycobacteria (AFB) Smear and Culture |
650 |
$46.00 |
87116
87206
87015 |
|
| Mycobacteriology Smear |
653 |
$10.00 |
87206 |
7.50 |
| Mycobacteriology Culture Direct |
659 |
$28.00 $8.00 |
87116
87015 |
15.10
5.22 |
| Parvovirus B19 IgM and IgG Ab |
2821 |
$120.00 |
86747
86747 |
|
| Parvovirus B19 IgG |
2821IGG |
$60.00 |
86747 |
21.00 |
| Parvovirus B19 IgM |
2821IGM |
$60.00 |
86747 |
21.00 |
| Q Fever Ab |
2532 |
$90.00 |
86638
86638 |
|
| Q Fever Phase 1 |
|
$45.00 |
86638 |
8.12 |
| Q Fever Phase 2 |
|
$45.00 |
86638 |
8.12 |
| Rickettsia Ab |
2542 |
$100.00 |
86757
86757 |
|
| Rickettsia Ab Rocky Mountain |
|
$50.00 |
86757 |
27.05 |
| Rickettsia Ab Typhus |
|
$50.00 |
86757 |
27.05 |
| Rubella IgM and IgG Ab |
2825 |
$70.00 |
86762
86762 |
|
| Rubella IgM |
2825M |
$35.00 |
86762 |
20.11 |
| Rubella IgG |
2825G |
$35.00 |
86762 |
20.11 |
| Varicella zoster IgM and IgG Ab |
2827 |
$100.00 |
86787
86787 |
|
| Varicella zoster IgM |
2827M |
$80.00 |
86787 |
8.12 |
| Varicella zoster IgG |
2827G |
$20.00 |
86787 |
8.12 |
