Contract : 5753 Vendor : Quest Diagnostics Description Code

Contract : 5753
Vendor : Quest Diagnostics
Pricing for frequently ordered tests is provided below. For all other tests not listed below,
Contractor will provide a 65% discount off of their fee schedule. Contractors Fee Schedule
is provided in Exhibit C. For any tests that appear in both the Frequently Ordered Tests List
and the Fee Schedule, the pricing provided in the Frequently Ordered Tests List will
prevail.
Frequently Ordered Tests
Description
Cholesterol
Comprehensive Metabolic Panel w/eGFR
Chlamydia/GC DNA Amplified
Drug Screen 7 Panel
Drug Screen 9 Panel
Drug Screen 10 Panel
Hepatitis B Surface Antibody Quantitative
Hepatitis C Antibody
Hepatic Function Panel
HIV 1/2 EIA Antibody with Reflexes
HPV DNA (High Risk)
Herpes Simplex Type 2 lgG, HerpeSelect
Lipid Panel
Pap, ThinPrep, No RESCRN
Pap, ThinPrep, RESCRN
Triglycerides
TSH, 3rd Generation
Urine Culture
Varicella-Zoster lgG
Surgical pathology, gross and microscpic exam Level IV
profile 47
Nicotine Urine 6224
Hepatitis CaB 1590
QuantiFERON-TB
8 Panel Drug Screen
Pregnancy, Urine
PTT
Culture, Wound
Valproic Acid
Vit D, 25 Hydroxy
Gram Stain
Culture, Aerobic
Protime + INR
Prothrombin Time
EBV-VCA IGG AB
T3 Free
EBV AB IGM
Code
6165
944
17618
800
822
821
7292
1590
104
3200
110814
100051
1383
10090
1090
6440
7580
2400
123112
AC03
47
6224
1590
4399
819
4723
4023
2275
7590
17306
2025
2300
4021
111126
140465
1430
151599
Unite Price
$3.75
$6.43
$49.10
$8.24
$9.46
$10.11
$9.75
$11.33
$4.93
$8.68
$33.48
$24.44
$12.10
$20.00
$20.00
$3.75
$11.75
$8.43
$18.00
$64.43
$26.54
$25.50
$11.33
$43.35
$8.87
$8.60
$4.50
$21.00
$12.00
$58.00
$5.00
$16.00
$5.00
$5.00
$18.25
$5.62
$18.25
Time
24hr
24hr
24hr
3-5 days
3-5 days
3-5 days
24hr
24hr
24hr
24hr
24hr
24hr
24hr
5 days
5 days
24hr
24hr
24hr
6 days
24-48 hr
24hr
5 days
24hr
5 days
3-5 days
24hr
24hr
varies
24hr
9 days
24hr
varies
24hr
4 days
4 days
24hr
4 days
Contract : 5753
Vendor : Quest Diagnostics
Pricing for frequently ordered tests is provided below. For all other tests not listed below,
Contractor will provide a 65% discount off of their fee schedule. Contractors Fee Schedule
is provided in Exhibit C. For any tests that appear in both the Frequently Ordered Tests List
and the Fee Schedule, the pricing provided in the Frequently Ordered Tests List will
prevail.
Frequently Ordered Tests
Description
Code
1549
Tissue Transglutam IGA
17669
RA Diagnostic Panel
2031
Group A Strep Rapid Scn
2032
Strep Scn Group A
2034
Group A Strep No Rfx
3100
CMV AB Profile
3105
CMV IGG AB
3214
HIV- 1 WB W/RFX HIV-2
4317
Heterophile, Mono Scn
4542
Sed Rate Westergren
5233
HIV-1 AB West Blot
6315
Lithium
7275
HCG, Total, Quant
7610
Vitamin B12
3110
CMV AB IGM
12486
CMV AB IGM
3215
Western Blot HIV-1
Percentage Discount Allowed off fee schedule for tests not listed
Stat Testing Charge per specimen
Stat Courier Charge
Unite Price Time
$68.00 4 days
$102.82 3 days
$7.50
TBD
$7.50
TBD
$7.50
TBD
$45.50
24hr
$13.00
24hr
$42.39
TBD
$18.25
24hr
$4.21
24hr
$42.39
TBD
$9.83
24hr
$24.62
24hr
$49.00
24hr
$32.50
24hr
$32.50 4 days
$42.39
TBD
65%
$16.95
$7.74
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ELECTROLYTES PANEL
PROFILE 68 (SPRUE PANEL)
PROFILE 88
PROFILE 101 ANEMIA
PROFILE 103 ELECTROLYTES
AMA HEPATIC FUNCTION PNL
OBSTETRIC PANEL
HEPATITIS B SURVEILLANCE
NEEDLESTICK/EXPO PROF 145
ALLERGEN PROFILE 184
RAST FOODS COMPREHENSIVE
RAST HOUSEHOLD INHALANTS
REGIONAL PLANTS PROFILE
PROFILE 193 RAST
MYELOMA PROFILE 222
AUTOIMMUNE PROFILE 224
PROFILE 271 PRENATAL
ALLERGEN PROFILE 279
PROFILE 283 IMMUNE COMPET
C3, C4, COMPLEMENT CH50
ALLERGEN GRASSES PROFILE
ALLERGEN WEEDS PROFILE
ALLERGEN INDOOR INHALANTS
ALLERGEN TREES PROFILE
ALLERGEN MOLDS PROFILE
ALLERGEN PEDIATRIC FOOD
ALLERGEN MEATS PROFILE
ALLERGEN GRAINS PROFILE
ALLERGEN PROFILE 311
T-HELPER PANEL
IRON,TIBC AND FERRITIN
HEPATITIS PANEL, ACUTE
ALLERGEN PROF 392 (RAST)
GLUCOSE TOLERANCE 2HR
GLUCOSE TOLERANCE 1HR
GLUCOSE TOLERANCE 2 HOUR
GLUCOSE TOLERANCE 3HR
GLUCOSE FAST AND GEST
ALLERGEN PROF 427 (RAST)
GTT,GESTATIONAL,4 SPEC
GLUCOSE TOLERANCE 5 HOUR
CSF PROFILE
MYELOMA PROFILE 635
PROFILE 688
ZINC ALUMINUM SERUM
DIARRHEA PROFILE 786
PROFILE 800 7 PANEL TOX
PROFILE 819 8 PANEL TOX
PROFILE 821 10 PANEL TOX
PROFILE 822 9 PANEL TOX
PROFILE 866 7 PANEL TOX
THYROGLOBULIN PANEL
RENAL FUNCTION PANEL
COMP METAB WITH EGFR
THYROID PANEL (T3U,T4,T7)
BASIC METABOLIC
PAP 1 SLIDE (SCRN)
HUMORAL IMMUNITY STATUS
PAP INTERP BY DR
ERA/PRA IMMUNOPEROXIDASE
ERA/PRA IMMUNO NON-BREAST
CODE
42
68
88
101
103
104
125
133
145
184
187
188
189
193
222
224
271
279
283
284
300
301
302
303
304
305
306
307
311
346
359
365
392
406
410
412
418
425
427
428
441
480
635
688
784
786
800
819
821
822
866
900
916
944
975
982
1000
1048
1081
1088
1089
PRICE
$3.52
$101.85
$12.78
$24.96
$4.73
$4.05
$50.16
$53.24
$44.17
$189.00
$119.00
$56.00
$98.00
$182.00
$89.57
$154.00
$61.18
$189.00
$198.35
$65.49
$35.00
$28.00
$42.00
$35.00
$35.00
$35.00
$28.00
$35.00
$91.00
$172.83
$29.44
$98.31
$252.00
$7.60
$7.32
$15.79
$15.79
$8.96
$259.00
$15.79
$26.29
$17.85
$132.34
$9.49
$70.70
$121.07
$8.24
$8.87
$10.11
$9.46
$8.24
$66.33
$4.57
$5.27
$11.52
$4.22
$12.00
$316.40
$0.84
$89.18
$96.01
DESCRIPTION
HIV1 RNA QNT RLTM PCR CSF
INTERFERON BETA 1A
INTERFERON BETA 1B AB
BUPRENORPHINE W/O CONF,UR
ANTIMICROBIAL,RIFABUTIN
MAGNESIUM, 24 HOUR URINE
OPIATES CONF, UR
MDMA/MDA, QUANT, UR
HEPATOCELLULAR CARCINOMA
C-KIT MUTATIONS W/REFLEX
ARBOVIRUS AB PNL, CSF
INFLUENZA A H1/H3 RT PCR
RESPIRATORY PNL W/H1N1
BASE PROF W/CONF, UR
BASE PROF W/O CONF, UR
PROCALCITONIN
FUNGITELL(1-3)-B-D-GLUCAN
SRA ASSAY LMWH
SRA ASSAY FONDAPARINUX
PLATELET AB SCR INDIRECT
QUANT HIV-1 RT PCR (NIH)
GTT GESTATIONAL 4 SPEC
IGF-1 ELECTROCHEM
OPIATES EXPANDED,QUANT,UR
FRAGILE X DNA ANLYS FETUS
CAMPYLOBACTER SPECIES AG
BUPRENORPHINE SCR W/CONF
XSENSE FRAGILE X W/RFLX
BUPRENORPHINE QUANT URINE
HEMOGLOBIN A1C WITH EAG
OSTEOCALCIN, N-MID
XSENSE(R)FRAGILE X W/RFLX
LINEZOLID, HPLC
THROMBOPOIETIN (TPO)
GENOMIC ALTER PRENATAL
EML4-ALK GENE FUSION PCR
HISTAMINE, PLASMA
S PNEUMONIAE IGG AB,MAID
C DIFFICILE TOXON B
CATECHOLAMINES SUPINE
CATECHOLAMINES FRAC
CMV IGG/IGM CSF
ENCEPHALITIS AB PANEL
FENTANYL SCREEN UR W/RFLX
EBV PANEL, CSF
HIV-1 GENOTYPE TROPISM
HIV-1 VIRTUAL PHENOTYPE
PNH W/FLAER
CORTISOL FREE RESPONSE X3
CHRONIC URTICARIA PANEL
JC POLYOMA VIRUS DNA, CSF
JC POLYOMA DNA, CSF
JC POLYOMA VIRUS DNA, UR
JC POLYOMA VIRUS DNA, UR
TSH RECEPTOR ANTIBODY
PROF 1 W/CONF, UR
PROF 2 W/CONF, UR
PROF 3 W/CONF, UR
BASE PROF W/CONF, UR
LUNG CANCER MUTATION PNL
STEPWISE PART 1
CODE
16186
16201
16202
16207
16208
16213
16215
16216
16222
16237
16240
16251
16255
16259
16260
16265
16283
16284
16285
16288
16290
16292
16293
16298
16300
16302
16310
16313
16314
16320
16322
16326
16328
16336
16340
16344
16354
16374
16377
16381
16382
16385
16405
16407
16420
16430
16431
16433
16434
16440
16441
16442
16446
16447
16453
16454
16455
16456
16457
16461
16463
PRICE
$101.85
$162.40
$162.40
$60.00
$64.05
$24.17
$100.00
$100.00
$143.50
$350.00
$241.15
$104.30
$417.20
$159.39
$159.39
$85.75
$96.25
$91.00
$91.00
$80.50
$103.25
$14.98
$54.25
$100.00
$133.00
$33.95
$21.00
$105.00
$35.00
$16.45
$50.75
$327.25
$64.05
$43.75
$556.50
$192.50
$47.95
$108.15
$42.00
$52.85
$52.85
$59.15
$281.40
$12.25
$104.65
$1,690.00
$591.50
$196.88
$131.25
$128.10
$104.30
$122.15
$122.15
$104.30
$80.50
$259.00
$159.39
$192.59
$159.39
$459.90
$68.25
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
PAP,THIN LYR,RESCRN(DIAG)
PAP,THIN LYR,RESCRN(SCRN)
FACTOR VII AG.
AMINOLEVULINIC ACID,RND
POLIOVIRUS POST VACCINE
11-DEOXYCORTISOL
DRAW AND PROCESS REFERRED
DRAW AND SHIP SPECIMEN
ACETYLCHOLINE RECEPT.BIND
FLUVOXAMINE (LUVOX)
ACTH, PLASMA
CORTISOL, PRE ACTH
CORTISOL, POST ACTH
ACTH STIMULATION,PRE/POST
ALUMINUM
ANDROSTENEDIONE,LC/MS/MS
STINGING INSECT,IGE W/O T
ANTI-DNASE
GLOMERULAR BASEMENT MEMB.
G6PD QUANTITATIVE
CHROMIUM, RANDOM URINE
OXALATE
ARSENIC, QUANTITATIVE
BCR/ABL GENE REARRANGEMEN
MESTINON
PORPHYRINS,FRACTION, PL
ARSENIC,QUANTITATIVE,UR
EPIDERMAL AB W/REFLEX
VITAMIN B-12 BINDING
BETA-2-MICROGLOBULIN
ANGIOTENSIN II
BETA 2 MICROGLOBULIN
B. HERMSII IGG/IGM AB
BRUCELLA ANTIBODY
STRONGYLOIDES IGG ABS
C1 INHIBITOR, PROTEIN
KETAMINE
COMPLEMENT C2
ADRENAL AB W/RFL TITER
COMPLEMENT C5
IGG/ALBUMIN RATIO
FUNGAL SUSCEPT MIC PANEL
CA 125
ALPHA 2 ANTIPLASMIN
CA 19-9
CA 27.29
CALCITONIN
NEOPTERIN
CARNITINE
VON WILLEBRANDS FACTOR AG
B. HENSELAE IgG,IgM REFLX
CATECHOLAMINES, FRACT.
ALLERGEN WHITE ASH
CATECHOLAMINES, 24 HR UR
CHLAMYDOPHILA PSITTACI AB
ALLERGEN ITALIAN CYPRESS
BACTERIAL ANTIGEN PANEL
CATECHOLAMINES, FRACT
METHYLMALONIC/HOMOCYSTEIN
COPPER, URINE
PLASMINOGEN
CODE
1090
1091
1112
1147
1156
1205
1206
1216
1229
1231
1232
1233
1236
1237
1241
1253
1255
1256
1259
1262
1263
1267
1271
1272
1275
1276
1277
1279
1286
1289
1291
1292
1293
1295
1299
1301
1303
1307
1308
1310
1311
1312
1313
1315
1319
1320
1322
1323
1328
1332
1334
1340
1341
1343
1346
1347
1349
1350
1356
1364
1366
PRICE
$22.66
$69.50
$180.00
$25.20
$28.18
$57.75
$28.50
$65.50
$57.75
$101.00
$38.50
$21.42
$21.42
$42.84
$45.85
$58.45
$35.00
$22.75
$49.70
$23.80
$32.55
$127.00
$45.85
$151.20
$272.00
$43.75
$45.85
$17.50
$27.65
$32.55
$31.15
$31.50
$66.50
$49.00
$53.20
$33.25
$101.00
$31.50
$24.50
$33.60
$33.25
$188.30
$32.48
$35.35
$34.30
$40.60
$54.25
$45.85
$58.45
$51.45
$52.15
$52.85
$7.00
$49.35
$36.75
$7.00
$54.43
$64.75
$98.00
$26.25
$49.00
DESCRIPTION
STEPWISE PART 2
GENOMIC ALTERATIONS
PROF 4 W/CONF, UR
PROF 4 W/CONF, UR
HISTOPLASMA AB PANEL, CSF
PROF 4 W/O CONF, UR
HYPERSENSITIVITY PNEUMO
HE4,OVARIAN CANCER MONITR
INFLM BWL DIS DIFF PANEL
METHYLMALONIC ACID URINE
KRAS MUTATION ANALYSIS
PHOSPHOLIPIDS, SERUM
UGT1A1 GENOTYPING
FISH TOP2A GENE AMP
BIOTINIDASE DEFICIENCY
LEPTOSPIRA AB W/RFLX
RETICULIN IGG SCRN W/RFLX
1911A>G MUT ANALYSIS
JAK2 EXONS 12-13 MUTATION
BIOTINIDASE ACTIVITY
JAK2 V617F,QL,LEUMETA W/R
JAK2 V617F MUTATION
BK VIRUS DNA,QL,RT,PCR UR
CPK W/CKMB IF INDICATED
VITAMIN D 1,25-DIHYDROXY
THYROGLOBULIN FN ASPIRATE
PTH, INTACT, FNA
FUNGAL ID,PHENOTYPE & SEQ
FUNGAL SEQUENCING ITS REG
BK VIRUS DNA,QNT,RT,PCR U
FISH,LYMPHOID MYB del6q23
TREPONEMA PALLIDUM DNA
C. BURNETII DNA,QL,RLTM
IODINE, SERUM & PLASMA
IODINE 24-HOUR URINE
ETHYL GLUCURONIDE SULFATE
CYP2C19 GENOTYPING
HUMAN METAPNEUMOVIRUS
HEXA MUTATION ANALYSIS
PHOSPHATIDY IgG,IgA,IgM
NUCLEAR MATRIX PROTEINS
LYME DISEASE AB, TOTAL
CELIAC DISEASE PANEL 1
RETT SYN REARRANGE DELDUP
FISH, DUPLICATION 22Q11.2
PHOSPHATIDYLCHOLINE IGG
PHOSPHATICYLCHOLINE IGM
PHOSPHATIDYLCHOLINE IGA
PHOSPHATIDYLETHANOLA IgG
PHOSPHATIDYLETHANOLAM IgM
PHOSPHATIDYLETHANOLAM IgA
HSV AB IGM W/RFL TITER
PHOSPHATIDYLINOSITOL IgM
PHOSPHATIDYLINOSITOL IgA
EPSTEIN-BARR VIRUS ISH
IGG,IGA INDRCT IMMUNFLOR
ORGANIC ACID URINE QUANT
HEP B VIRUS DNA, W/RFLX
IMMUNOGLOBULIN CSF PROF
INSCAPE ER/PR/HER2 QNT
HIV-1 CORECEPTOR TROPISM
CODE
16465
16478
16483
16484
16485
16486
16490
16500
16503
16508
16510
16513
16521
16523
16526
16529
16530
16533
16536
16537
16538
16539
16553
16555
16558
16559
16560
16578
16579
16581
16593
16595
16596
16599
16602
16604
16605
16607
16612
16619
16645
16646
16652
16662
16672
16677
16678
16679
16680
16681
16682
16684
16685
16686
16688
16690
16693
16694
16705
16707
16710
PRICE
$169.75
$840.00
$242.40
$242.40
$58.45
$242.40
$161.70
$89.60
$175.00
$49.70
$203.00
$27.65
$113.75
$157.50
$262.15
$33.60
$22.75
$104.65
$175.00
$35.70
$175.00
$175.00
$107.80
$8.16
$79.45
$31.50
$52.50
$105.00
$105.00
$122.15
$207.55
$104.30
$104.30
$28.35
$35.00
$40.95
$542.50
$38.15
$441.00
$108.50
$43.75
$17.50
$124.60
$323.75
$128.80
$36.17
$36.17
$36.17
$36.17
$36.17
$36.17
$26.25
$36.17
$36.17
$57.75
$64.75
$132.65
$113.75
$42.00
$210.00
$437.50
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
CREATINE, URINE
CYSTINE QUANTITATIVE, UR
CHLAMYDIA DNA PROBE
GONORRHEA DNA PROBE (GC)
DHEA,LC/MS/MS
CHLAMYDIA DNA SCRN W/RFLX
GROUP B STREP DNA PRB CUL
LIPID PANEL
MULTIPLE SCLEROSIS PANEL
ALPHA SUBUNIT
3HR GTT/INSULIN TOLERANCE
PORPHYRINS, 24HR QUANT.
PTH INTACT/IONIZ CALCIUM
REVERSE T3
POLIO VIRUS ANTIBODY
COXSACKIE A VIRUS PANEL
HIV 1&2 ANTIBODIES
T3, FREE
MAG AUTOANTIBODY
NEURONAL NUCLEAR (RI)
YO (PURKINJE CELL) AB
NEURONAL NUCLEAR (HU)
HU AND YO AUTOANTIBODY
GIARDIA ANTIBODIES (IFA)
HEP C SUPPLEMENTAL (RIBA)
HALOPERIDOL (HALDOL)
HAEMOPHILUS INFLUENZA B
ANTI GLIADIN ANTIBODIES
HEAVY METALS, URINE
HISTAMINE, URINE
LATEX RIA PANEL
IGG SUBCLASSES
INSULIN
INSULIN, SPECIMEN 2
HANTAVIRUS (SIN NOMBRE)
A1-ANTITRYP.QNT/PHENO
GROUP B STREP DNA PRB CUL
NEURONTIN (GABAPENTIN)
INTRINSIC FACTOR BLOCKING
INSULIN, SPECIMEN 3
CALCIUM,IONIZED
LEAD, BLOOD
HSV 1 & 2, IGM
DRVVT SCREEN W/REFLEXES
THYROID STIM IMMUNO (TSI)
LYSOZYME, SERUM
T4 FREE, DIRECT DIALYSIS
PARVOVIRUS AB IGG/M,B-19
CHROMOGRANIN A
HOMOCYSTEINE CARDIOVASCUL
TRYPTASE
HERBICIDES PANEL 1
MENINGOENCEPHALOMYELITIS
CORTICOSTERONE
NTX 24HR URINE
MERCURY
IMM. COMPLEX BY C1Q BIND.
MERCURY, URINE
VITAMIN B2
M.HOMINIS/UREAPLASMA CULT
METANEPHRINES,FRAC,24HR
CODE
1367
1376
1377
1378
1379
1380
1381
1383
1387
1391
1392
1393
1396
1411
1425
1428
1429
1430
1431
1432
1435
1437
1438
1439
1450
1451
1454
1456
1457
1461
1468
1472
1475
1476
1477
1480
1481
1483
1484
1485
1487
1493
1509
1513
1515
1517
1519
1524
1527
1529
1531
1534
1535
1536
1537
1538
1540
1541
1543
1545
1547
PRICE
$26.25
$45.50
$13.13
$11.10
$62.30
$37.66
$27.58
$7.21
$247.00
$47.60
$114.63
$49.00
$77.00
$60.90
$44.10
$56.00
$26.25
$55.65
$44.10
$70.00
$49.00
$87.50
$136.50
$58.10
$96.25
$39.55
$34.30
$59.50
$136.50
$57.75
$94.30
$91.35
$25.66
$25.66
$51.45
$67.90
$27.58
$31.50
$28.00
$25.66
$17.50
$22.75
$42.00
$15.75
$100.10
$31.85
$32.90
$49.00
$38.50
$56.00
$40.25
$211.00
$723.10
$35.35
$58.80
$38.50
$37.10
$38.50
$48.30
$51.80
$41.65
DESCRIPTION
HGB A1C W/RFLX GLYCOMARK
HSV TYPE 1 & 2 W/INTERP
PYRAZINAMIDE, HPLC
RUBELLA RNA,QL,RT,PCR
TAMOXIFEN P450 GENOTYPE
METHYLMALONIC ACID QNT
QNS HPV HIGH RISK
C DIF DNA/TOXIN B GENE QL
VIT D,25-HYDROXY,1,25-D
SLOS & STSD SCREEN
BRAF MUTATION ANALYSIS
YERSINIA ENTEROC IGG,IGA
HLA-A29 DNA TYPING
HLA-B51 DNA TYPING
CF MUTATION SCREEN
CALPROTECTIN, STOOL
GENOMIC ALTERATIONS CGH
HEMOGLOBIN A1C W/EAG
INFLUENZA A H1N1,RT,PCR
CELLSEARCH TUMOR, COLON
CELLSEARCH, PROSTATE
ANA SCREEN W/REFLEXES
OXALATE, RANDOM URINE
NRAS MUTATION ANALYSIS
FETOMATERNAL BLEED, FLOW
FISH, HES/LEUKEMIA 4q12
HISTAMINE RELEASE-CHRONIC
ANTIMULLERIAN HORMONE
CHROMOSOME,NEONATAL BLOOD
ANTIMIC,ETHAMBUTOL, HPLC
ALDOSTERONE/PRA-LC/MS/MS
PLASMA RENIN ACTIVITY
FISH,NHL,BCL6 3q27 REARNG
PROF 2 W/CONF, UR
PROF 2 W/O CONF, UR
PROF 3 W/CONF, UR
PROF 3 W/O CONF, UR
PROF 1 W/CONF, UR
PROF 1 W/O CONF, UR
PDGFRA MUTATION ANALYSIS
BAC ID PHENOTYPIC
INFLUENZA A/B RT-PCR W/RF
FISH,B-CELL LYMPH/LEUKEM
SELENIUM, 24 HR URINE
SELENIUM, RANDOM URINE
HIV-1 INTERGRASE GENOTYPE
FISH,IGH/FGFR3, t(4,14)
BCR-ABL1 KINASE DOMAIN
HIV-1,RNA,QUAL,CSF
GENOMIC ALTERATIONS POC
AMPHETAMINE, W/CONF, UR
BARBITURATE, W/CONF, UR
BENZODIAZEPINES W/CONF,UR
COCAINE SCRN, W/CONF, UR
MARIJUANA MET SCRN W/CON
METHADONE SCRN W/CONF, UR
OPIATES SCRN W/CONF, UR
OXYCODONE SCRN W/CONF, UR
PHENCYCLIDINE W/CONF, UR
PROPOXYPHENE W/CONF, UR
WILMS TUMOR(WT1)MUT ANLYS
CODE
16715
16720
16726
16730
16731
16732
16737
16739
16761
16764
16767
16768
16773
16775
16790
16796
16800
16802
16807
16811
16812
16814
16817
16818
16828
16837
16838
16842
16843
16844
16845
16846
16851
16852
16853
16854
16855
16856
16858
16859
16860
16861
16864
16866
16867
16868
16872
16876
16879
16884
16885
16886
16887
16888
16889
16890
16891
16892
16893
16894
16896
PRICE
$9.00
$57.75
$19.35
$104.30
$542.50
$49.70
$32.50
$104.30
$147.70
$166.25
$166.25
$59.50
$66.50
$66.50
$99.75
$61.25
$556.50
$9.00
$104.30
$203.00
$203.00
$19.25
$24.17
$138.25
$61.25
$181.30
$52.50
$54.60
$222.25
$64.05
$73.50
$31.50
$133.00
$159.39
$55.79
$192.59
$192.59
$259.00
$259.00
$199.50
$84.00
$104.30
$253.75
$48.30
$48.30
$154.00
$133.00
$162.75
$122.15
$556.50
$60.00
$60.00
$60.00
$60.00
$60.00
$60.00
$60.00
$60.00
$60.00
$60.00
$297.50
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
TISSUE TRANSGLUTAM AB IGA
SEX HORMONE BIND/GLOBULIN
MICROALB 24HR W/CREAT
IGA-FIBRONECTIN AGGREGATE
MYELIN BASIC PROTEIN, CSF
DEOXYCORTICOSTERONE
PREGNENOLONE
CANDIDA AB IgG,IgA,IgM
MYOGLOBIN
ANTI-LKM ANTIBODY
17-HYDROXYPREGNENOLONE
NEUTROPHIL,OXIDATIVE
HEPATITIS C ANTIBODY
CHROMIUM, URINE
INSULIN, SPECIMEN 4
NEUTROPHIL ANTIBODY,FC
OSMOLALITY, STOOL
Q FEVER ANTIBODY
C3d IMMUNE COMPLEX
COCCIDIOIDES CF & ID
STRAITED MUSCLE AB W/RFLX
THYROXINE BINDING GLOBUL
IGF-1 BINDING PROTEIN
ALLERGEN, RUSSIAN OLIVE
THIOTHIXENE (NAVANE)
THYROGLOBULIN
TRANSFERRIN
VARICELLA-ZOSTER IgG
VASOACTIVE INT.POLYPEPTID
VITAMIN A
VITAMIN B1 (THIAMINE)
VANILLYLMANDELIC ACID
PKU HEEL STICK COLLECTION
VITAMIN K, SERUM
VMA, 24 HOUR URINE
BORDETELLA PERTUSSIS DFA
CADMIUM, URINE
VERAPAMIL
PHENYTOIN, FREE
XYLOSE ABSORPTION, URINE
XYLOSE ABSORPTION, BLOOD
CADMIUM, BLOOD
HEPATITIS C RNA,QL,PCR
HEPATITIS C RNA PCR QUANT
CULTURE, ACANTHAMOEBA
GLUCAGON
HEPATITIS C RNA, QT, BDNA
V.ZOSTER IGM AB
IGG SYNTHESIS, CSF
HEAVY METALS PANEL,BLOOD
AMINO ACID, LC/MS, URINE
SELENIUM
IGF BINDING PROTEIN-3
TICLOPIDINE (TICLID)
3a-ANDROSTANEDIOL GLUCUR.
VITAMIN E
PORPHOBILINOGEN, QUANT
PROINSULIN
HEPATITIS B CORE AB,IGM
PORPHOBILINOGEN, QUANT
ASPERGILLUS AB,CF
CODE
1549
1555
1556
1560
1562
1564
1566
1567
1568
1572
1573
1574
1590
1593
1612
1622
1624
1625
1628
1639
1649
1657
1658
1664
1669
1672
1678
1699
1705
1708
1711
1712
1714
1715
1720
1722
1728
1729
1731
1732
1733
1734
1737
1740
1742
1748
1749
1763
1775
1782
1783
1784
1786
1791
1801
1802
1806
1809
1810
1812
1816
PRICE
$42.35
$26.25
$16.59
$103.25
$34.30
$53.90
$37.80
$39.55
$34.65
$21.00
$47.25
$60.90
$11.33
$32.55
$25.66
$54.95
$10.41
$32.55
$45.85
$47.95
$29.40
$32.20
$32.20
$39.88
$96.00
$49.53
$23.31
$29.82
$71.40
$31.15
$40.25
$50.05
$6.13
$74.90
$50.05
$26.25
$56.00
$104.00
$17.50
$27.30
$27.30
$45.85
$77.35
$147.70
$68.25
$37.10
$147.70
$26.60
$53.90
$107.10
$183.40
$38.85
$28.70
$101.00
$60.55
$26.95
$17.15
$59.85
$34.35
$17.15
$35.35
DESCRIPTION
ANAPLASMA IgG, IgM
FENTANYL, QUANT, UR
BUPRENORPHINE W/CONF, UR
CARISOPRODOL , QUANT, UR
TRICYCLIC AD, QUANT, UR
GABAPENTIN, QUANT, UR
MEPERIDINE, QUANT, UR
TRAMADOL, QUANT, UR
PREGABALIN, QUANT, UR
MDMA/MDA SCRN W/CONF, UR
HEROIN METAB, QUANT, UR
BARBITURATE CONF, UR
XYLOSE, FASTING
BENZODIAZEPINES CONF, UR
COCAINE METAB CONF, UR
MARIJUANA METAB CONF, UR
METHADONE CONF, UR
OXYCODONE CONF, UR
PHENCYCLIDINE CONF, UR
PROPOXYPHENE CONF, UR
CLOPIDOGREL CYP2C19-12345
MLH1 GENE SEQUENC,HNPCC
MSH2 GENE SEQ HNPCC
APC GENE DELETION OR DUP
APC GENE SEQUENCING
ASHKENAZI JEWISH PANEL
MUM1 IHC W/INTERPRETATION
HIV-1 QUANT W/REFLEX
VEGF MUTATION ANALYSIS
INFLUENZA H1N1 (2009)
STREP PNEUMO IgG 23 MAID
FISH,IGH/MAF,t(14,16)
CAH PANEL 6C(FULL SCREEN)
CMV DNA ULTRAQUANT
COLOVANTAGE
TRANSFERRIN CARBOHYDRATE
DENGUE VIRUS IGG AVIDITY
SULFAMETHAZOLE LEVEL HPLC
OVA1
OVA1TM (LH AND FSH)
CLONAZEPAM
FORMALDEHYDE
LUPUS ANTICOAGULANT EVAL
PHENOLPHTHALEIN-FECES
HIV PHENOSENSE GT
CANDIDA AB IMMUNODIFF
HLA TYPING CELIAC DISEASE
CHLAMYDIA GROUP AB IFA
FACTOR VIII INHIBITOR
JC POLYOMA VIRUS DNA QUAL
SALMONELLA IDENTIFICATION
CLL PROGNOSTIC COMPREHENS
CLL PROGNOSTIC LIMITED
CLL PROGNOSTIC MONITORING
KAPPA/LAMBDA LIGHT CHAINS
CHLAMYDIA TRACHOMATIS DNA
NEISSERIA GONORRHOEAE DNA
CHLAMYDIA/N GONORRHOEAE
VIT D,25-HYDROXY,LC/MS/MS
ATT QUANT AND MUTATION
CLL PROG COMPREH KAROTYPE
CODE
16897
16900
16901
16902
16903
16904
16905
16906
16908
16909
16911
16912
16913
16914
16916
16917
16918
16920
16921
16922
16924
16926
16928
16930
16934
16936
16957
16958
16959
16962
16963
16965
16978
16982
16983
16985
16987
16990
16991
16992
17052
17075
17079
17085
17100
17132
17135
17159
17168
17220
17226
17239
17240
17290
17300
17303
17304
17305
17306
17307
17312
PRICE
$23.45
$100.00
$60.00
$100.00
$100.00
$100.00
$100.00
$35.00
$100.00
$60.00
$60.00
$100.00
$27.30
$100.00
$100.00
$100.00
$100.00
$100.00
$100.00
$100.00
$138.25
$511.00
$511.00
$542.50
$630.00
$1,128.05
$57.75
$103.25
$82.25
$87.15
$193.90
$133.00
$369.60
$140.11
$0.00
$43.75
$51.80
$64.05
$227.50
$274.12
$24.68
$9.54
$31.50
$9.63
$1,787.00
$35.70
$71.75
$40.60
$77.00
$113.05
$0.00
$806.40
$469.00
$386.05
$42.18
$21.63
$21.63
$43.26
$68.25
$118.65
$534.80
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
CREATINE
ANTI-DNA SINGLE STRANDED
PTH-RELATED PROTEIN
TETRAHYDROALDOSTERONE
ANTI-THROMBIN III
PYRUVATE
MYASTHENIA GRAVIS PANEL
CULTURE, CHLAMYDIA
17-OH-CORTICOSTEROIDS 24H
17-KETOSTEROIDS W/CR,24HR
17-OH-PROGESTERINE,LCMSMS
5-HIAA, 24 HR URINE
ALLERGEN, BUMBLE BEE
C1 INHIBITOR, FUNCTIONAL
CAROTENE (BETA)
ECHOVIRUS ANTIBODY PANEL
HIV-1 DNA, PCR
HLA-B27
PARAINFLUENZA AB 1-3
JO1 ANTIBODY
LEAD, URINE
OXALIC ACID, 24 HR URINE
AMINOLEVULINIC ACID,DELTA
VITAMIN B6
TOXOPLASMA AB IGG/IGM
ESTROGEN, FRACTIONATED
PM-1 ANTIBODY
DHEA SULFATE
ESTRADIOL LC/MS/LC
CRYOGLOBULIN SCREEN W/RFL
CULTURE AND SMEAR, AFB
AFB SMEAR
CULTURE, ANAEROBIC
ANAEROBIC SENSITIVITY
IDENTIFICATION ANAEROBIC
ID ONLY, AEROBIC
SENSITIVITY ONLY
BACTERIAL TYPING
BACTERICIDAL LEVEL
GRAM STAIN
STOOL FOR WBC
INDIA INK PREP
ID & SENSITIVITY, BLOOD
FAT SCREEN, STOOL
CLINDAMYCIN DISK INDUCTIO
GROUP A STREP RAPID SCRN
MUSCLE FIBERS FECAL
GROUP A,STREP-NO REFLEX
WET MOUNT
HUMORAL IMMUNITY EVAL PNL
BLOOD CULTURE, AFB
CULTURE,FUNGAL BLOOD
CULTURE,FUNGUS,OTHER
FUNGAL SMEAR, OTHER
FUNGAL ID, MOLD
FUNGUS CULTURE W/O SMEAR
FNG SMEAR,SKN,HAIR,NAIL
FUNGAL ID, YEAST
CULTURE,NOCARDIA
CULT,FUNGUS,SKIN,HAIR,NAI
CULTURE, BLOOD ARD
CODE
1832
1834
1837
1839
1848
1854
1862
1878
1900
1902
1903
1904
1918
1919
1922
1928
1933
1937
1940
1944
1946
1951
1953
1964
1965
1968
1975
1986
1987
1996
2000
2002
2010
2011
2019
2020
2021
2022
2023
2025
2026
2027
2028
2029
2030
2031
2033
2034
2035
2070
2120
2125
2150
2152
2154
2155
2156
2157
2158
2175
2200
PRICE
$26.25
$45.59
$64.40
$78.75
$29.86
$22.40
$87.15
$33.95
$34.30
$68.60
$39.20
$26.25
$48.40
$20.30
$26.60
$55.30
$101.50
$47.25
$70.00
$19.25
$38.50
$24.15
$29.75
$61.25
$35.95
$116.90
$28.35
$52.50
$41.30
$12.25
$55.58
$9.45
$15.37
$24.12
$7.25
$7.25
$4.80
$21.60
$45.15
$5.85
$4.97
$7.84
$12.39
$34.13
$4.80
$16.07
$29.72
$16.07
$4.10
$189.70
$22.37
$12.92
$28.18
$6.30
$25.38
$11.10
$6.30
$63.00
$11.41
$27.02
$23.77
DESCRIPTION
LACTOFERRIN, QT, STOOL
FISH, MANTLE CELL LYMPH
FISH,FOLLICULAR LYMPHOMA
FISH,B-CELL MALIGNANCY
FISH, BURKITT'S/NHL/ALL
FISH,LOCUS-SPECIFIC X1
RBC FRAGILITY - INCUBATED
THALASSEMIA-HGB COMPLETE
DONOR, HEP B SURFACE AG
DONOR, HEP BC TOTAL
DONOR, HTLV 1-2 AB
DONOR, HIV 1-2 AB
HEP C DONOR
CHLAMYDIA GC DONOR PANEL
DONOR, CMV TOTAL
DONOR, RPR W/RFX SYPH IGG
HLA-DQB1 HIGH RESOLUTION
HLA-C HIGH RESOLUTION
HLA-A2 TYPING W/REFLEX
COLLAGEN TYPE I C-TELOPEP
RHEUMATOID FACTOR, CSF
PTT-LA W/REFLEX
AFP, CSF
AFP, PERITONEAL FLUID
CA125, CSF
CA 19-9, CSF
CHLAMYDIA & CHLAMYDOPHILA
CEA, CSF
CEA, PERITONEAL FLUID
CHOLINESTERASE RBC
HIV-1 GENOTYPE PLUS
HEAVY METALS, URINE
PROTEIN S ACTIVITY W/RFLX
HERPES SIMPLEX/VZV,RAPID
IRON, 24 HR URINE
HCG, TOTAL, CSF
AFP, PERICARDIAL FLUID
W NILE VIRUS RNA QUAL PCR
BORRELIA BURGDORFERI DNA
HERPES SIMPLEX, DNA (HSV)
CEA, PLEURAL FLUID
HCG TOTAL,PERITONEAL FLD
COMPLEMENT C3,PLEURAL FLD
COMPLEMENT C3,PERITONEAL
COMPLEMENT C4,PLEURAL FLD
COMPLEMENT C4,PERITONEAL
COMPLEMENT C3, SYNOVIAL
COMPLEMENT C4, SYNOVIAL
LIPASE, PANCREATIC FLUID
CEA, PERICARDIAL FLUID
PENICILLIN PROFILE 2
FENTANYL & NORFENTANYL,UR
ATYPICAL PNEUMONIA DNA
CELIAC PANEL W/O GLIADIN
C.TRACHOMATIS DNA,SDA
N.GONORRHOEAE DNA,SDA
CHLAMYDIA/N.GONORRHOEAE
MALE INFERTILITY GENETIC
SALMONELLA IGG,IGM,IGA
CYTOCHROME P450 2D6/2C19
CA 19-9, PERITONEAL FLUID
CODE
17321
17346
17347
17348
17352
17355
17364
17365
17375
17378
17379
17380
17382
17385
17388
17389
17394
17395
17398
17406
17407
17408
17409
17410
17416
17417
17419
17420
17421
17430
17480
17492
17494
17495
17515
17548
17554
17563
17570
17581
17584
17587
17593
17594
17595
17596
17597
17598
17604
17605
17606
17607
17610
17612
17615
17617
17618
17625
17631
17634
17638
PRICE
$64.75
$147.70
$147.70
$138.60
$157.50
$126.00
$9.36
$59.50
$40.16
$43.75
$49.53
$54.08
$54.16
$73.50
$76.21
$33.69
$131.25
$131.25
$68.25
$48.65
$12.25
$15.75
$26.25
$29.40
$44.80
$34.30
$36.75
$29.40
$29.40
$19.95
$157.50
$314.65
$60.55
$68.95
$21.96
$28.00
$29.40
$113.75
$93.80
$99.75
$29.40
$28.00
$34.30
$34.30
$34.30
$34.30
$34.30
$34.30
$10.41
$29.40
$28.00
$14.00
$254.80
$55.30
$24.50
$24.50
$42.00
$535.50
$32.55
$367.50
$34.30
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
BRUCELLA SCREEN
FRANCISELLA TULARENSIS SC
BACILLUS ANTHRACIS SCREEN
CULTURE, FLUID
CULTURE, GC
CULTURE, WOUND
CULTURE, SURGICAL
CULTURE, AEROBIC
HYDROCHLOROTHIAZIDE
RISPERIDONE
CULTURE,SPUTUM GRAM STAIN
CULTURE, RESPIRATORY
MRSA SCREEN
CULTURE,URINE,ROUTINE
CULTURE URINE SPECIAL
CULTURE, STOOL W/RFLX
SALMONELLA/SHIGELLA SCRN
SCABIES EXAM
CAMPYLOBACTER CULTURE
SHIGA TOXINS W/RFLX CUL
E COLI 0157 CULTURE
CULTURE, VIBRIO
CULTURE, YERSINIA
STOOL CULTURE FOR VRE
VRSA
STREP GROUP A CULTURE
STREP GROUP B CULTURE
ALLERGEN, CAULIFLOWER IGE
ALLERGEN CLOVE (F268) IGE
CULTURE, VARICELLA ZOSTER
ALLERGEN, PAPAYA IGE
CULTURE, VAGINAL
CULTURE, VAGINAL
OVA AND PARASITES
GIARDIA LAMBLIA SCREEN
CRYPTOSPORIDIUM AG STOOL
ALLERGEN GREEN PEPPER IGE
OCCULT BLOOD DIAG (1SPEC)
OCCULT BLOOD SCRN (1SPEC)
PINWORM EXAM
OCCULT BLOOD DIAG (2SPEC)
OCCULT BLOOD DIAG (3SPEC)
OCCULT BLOOD SCRN (2SPEC)
OCCULT BLOOD SCRN (3SPEC)
ANACHOICE W/RFL TITER,IFA
ANA WITH PATTERN
ANACHOICE W/REFLEX DS-DNA
ANTI-DNA AB-DOUBLE STRAND
ANTI-NUCLEAR ANTIBODY
ANTI-SM (SMITH)
SJOGREN'S ANTIBODIES (ID)
SJOGRENS AB (SS-A)
SJOGRENS (SS-B)
SLCERODERMA ABS (SCL-70)
SLE DIAG PANEL,DRUG INDUC
MIXED CONNECT TISS DISEAS
LUPUS/RHEUMATOID ARTHRIT
EPSTEIN BARR VIRUS
PBC DIAGNOSTIC PANEL,COMP
EUGLOBULIN CLOT LYSIS TME
THYROGLOBILIN ANTIBODIES
CODE
2215
2220
2230
2250
2252
2275
2277
2300
2330
2339
2350
2375
2381
2400
2404
2500
2501
2502
2504
2506
2507
2510
2520
2550
2551
2600
2601
2635
2638
2691
2720
2800
2801
2900
2905
2930
2931
2940
2945
2950
2960
2961
2962
2963
3000
3004
3009
3010
3013
3016
3020
3021
3022
3025
3027
3028
3029
3031
3032
3043
3055
PRICE
$11.10
$11.10
$11.10
$16.07
$7.21
$16.07
$16.07
$10.22
$108.00
$32.20
$16.07
$11.43
$4.66
$11.43
$10.57
$30.54
$10.89
$6.30
$10.89
$23.85
$18.11
$29.65
$29.65
$29.61
$29.61
$4.66
$4.66
$7.00
$36.90
$45.50
$7.00
$14.32
$10.54
$18.03
$20.55
$29.40
$7.00
$4.52
$4.52
$4.52
$8.61
$12.92
$12.92
$12.92
$7.21
$16.49
$19.25
$19.25
$12.95
$19.25
$38.50
$19.25
$19.25
$19.25
$49.35
$38.50
$63.00
$111.65
$150.15
$25.20
$16.80
DESCRIPTION
HCG TOTAL, PLEURAL FLUID
GLUCOSE, PERICARDIAL FLD
CA 19-9, PLEURAL FLUID
CA 19-9, PERICARDIAL FLD
HCG TOTAL,PERICARDIAL FLD
ALBUMIN, SYNOVIAL FLUID
LDH, PERICARDIAL FLUID
17 HYDROXYPROGESTERONE
LDH, SYNOVIAL FLUID
RHEUMATOID DIAGNOSTIC PNL
H. PYLORI ANTIBODY, IGG
H PYLORI IGA ANTIBODY
LYMPHO MITOGEN/AG STIMUL
MANTLE CELL LYMPHOMA
C3A DESARG FRAGMENT
FOLLICULAR LYMPHOMA
H PYLORI AB, IGA & IGG
ADENOSINE DEAMINASE PLURL
ADENOSINE DEAMINASE PERTL
ADENOSINE DEAMINASE CSF
CLL IGVH MUTATION STATUS
ANGIODEMA PANEL
CA 125 W/HAMA TREATMENT
COMPLEMENT C3,PERICARDIAL
COMPLEMENT C4,PERICARDIAL
LUPUS ACTIVITY PANEL 2
DONOR, HIV-1/HCV NAT
AVIAN INFLUENZA H5 GENE
AVIAN INFLUENZA H5 GENE
BASIC METABOLIC W/O CAL
COMP METABOLIC W/EGFR
COMP METABOLIC W/O ALT
CREATININE CLEARANCE/EGFR
HTLV I/II, WESTERN BLOT
UGT1A1 GENE POLYMORPHISMS
CLL LYMPHOMA DIAGNOSTIC
CLL LYMPHOMA FOLLOW UP
HCL LYMPHOMA FOLLOW UP
PLASMA CELL NEOPLASIA
ACUTE LEUKEMIA FOLLOW UP
SLIDE RETURN REQUEST
ALDOSTERONE - ACTH
FIRST TRIMESTER SCREEN
FACTOR V ACTIVITY
FACTOR IX ACT & INHIBITOR
E.CHAFFEENSIS IgG,IgM
BCR/ABL REARRANGEMENT
FACTOR XI ACT & INHIBITOR
T-CELL RECEPTOR QUANT
T-CELL RECEPTOR QUAL
GROUP B STREP, PCR
FACTOR V PCR (LEIDEN)
FACTOR V HR2 ALLELE MUT
FACTOR V MUTATION
THROMBOPHILIA DNA MUTAT
FACTOR II MUTATION DNA
MTHFR DNA MUTATION
PROTEIN C & S ACTIVITY
B. BURGDORFERI AB INDEX
C TRACHOMATIS ABS IGG/A/M
CATECHOLAMINES/VMA 24 HR
CODE
17639
17641
17642
17643
17644
17646
17647
17654
17658
17669
17670
17671
17678
17679
17689
17690
17691
17696
17697
17698
17702
17706
17717
17718
17719
17725
17746
17750
17751
17759
17760
17761
17763
17780
17813
17817
17818
17819
17820
17821
17828
17832
17833
17844
17845
17851
17853
17854
17861
17862
17869
17900
17902
17904
17907
17909
17911
17942
17970
18036
18061
PRICE
$28.00
$8.75
$34.30
$34.30
$28.00
$7.70
$7.35
$39.20
$7.35
$43.75
$38.50
$38.50
$454.65
$134.75
$43.05
$147.00
$77.00
$52.50
$52.50
$52.50
$148.75
$77.35
$34.30
$34.30
$34.30
$65.80
$160.91
$113.75
$113.75
$6.03
$5.74
$5.85
$12.81
$35.00
$122.50
$0.00
$0.00
$0.00
$0.00
$0.00
$5.25
$73.50
$47.25
$100.80
$127.40
$51.10
$151.20
$127.40
$140.00
$102.90
$33.25
$91.00
$80.50
$92.75
$200.90
$68.25
$108.50
$225.40
$199.85
$36.75
$89.25
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
M.PNEUMONIAE IGG/IGM EIA
M.PNEUMONIAE AB IGM EIA
ANTI-TPO ANTIBODY
CYANIDE, BLOOD
MANGANESE RBC
CMV ANTIBODY PROFILE
CMV IGG ANTIBODY
CMV AB, IGM
TORCH ANTIBODY PANEL
TORCH AB IGM
RUBELLA ANTIBODY, IGM
HIV 1/2 AB SCREEN W/RFLXS
HIV-1 WB W/RFL HIV-2 RFL
HIV-1 AB CONF WB
METAHDONE QUANT/GCMS
BLOMIA TROPICALIS IGE
RESPIRATORY PROFILE-CHILD
RESPIRATORY PROFILE-ADULT
ENCEPHALITIS AB PROFILE
CONJUNCTIVITIS PANEL
ADENOVIRUS AB (CF)
INFLUENZA TYPE A&B AB
CHOLINESTERASE, PLASMA
HELICOBACTER PYLORI IGG
FUNGAL ANTIBODY PROFILE
ASPERGILLUS AB, SERUM
HISTOPLASMA AB PROFILE
COCCIDIOIDES ABS,IGG/IGM
COCCIDIOIDES ATBY (ID)
CRYPTOCOCCAL AG W/REFLEX
LEGIONELLA DFA
FTA-ABS
HERPES SIMPLEX VIRUS 2
HERPES SIMPLEX VIRUS 1
RESP. SYNCYTIAL VIRUS
ROTAVIRUS ANTIGEN
CLOST.DIFFICILE TOXIN
TOXOPLASMA IgG ANTIBODY
FLU ANTIGEN RAPID X2
LAMBDA LIGHT CHAIN FREE
KAPPA LIGHT CHAIN,FREE
PARASITE IDENTIFICATION
PARASITE ID,INTESTINAL
PROTHROMBIN ANTIBODY
FACTOR VIII ACTIVITY
FACTOR IX ACTIVITY
ADVANCED D-DIMER
FIBRINOGEN,ACT,CLAUSS
PROTHROMBIN TIME + INR
PTT
COAGULATION MIXING STUDY
PROTHROMBIN TIME & PTT
FTA-ABS
DIC PANEL
NICOTINE & COTININE
TREPONEMA PALLIDUM AB
N-TELOPEPTIDE SERUM
COLD AGGLUTININ
CRYOGLOBULIN, QUALITATIVE
KLEIHAUER-BETKE
ACID HEMOLYSIN
CODE
3056
3057
3060
3091
3095
3100
3105
3110
3150
3151
3160
3200
3214
3215
3258
3299
3300
3305
3310
3315
3320
3345
3351
3385
3400
3405
3413
3425
3427
3450
3460
3465
3509
3511
3515
3520
3525
3679
3714
3757
3759
3946
3950
4000
4008
4009
4012
4017
4021
4023
4030
4100
4112
4140
4190
4194
4266
4301
4305
4307
4309
PRICE
$48.30
$24.15
$14.84
$31.41
$40.60
$41.58
$6.13
$20.79
$89.50
$108.71
$40.60
$8.94
$40.43
$34.83
$39.55
$7.00
$156.45
$108.50
$115.52
$86.45
$26.25
$58.10
$16.28
$18.03
$105.00
$21.00
$55.65
$33.74
$21.70
$18.76
$39.20
$14.84
$14.00
$14.00
$28.63
$25.66
$51.50
$14.88
$15.44
$42.00
$42.00
$32.83
$32.83
$55.13
$51.45
$66.40
$19.29
$7.60
$3.22
$6.30
$9.52
$9.52
$14.84
$40.81
$14.70
$30.10
$79.45
$8.68
$6.51
$26.22
$20.65
DESCRIPTION
DOXEPIN
HBV CORE/PRECORE MUTANT
ANTIDIURETIC HORMONE
GALACTOSE 1 PHOSPHATE
RICKETTSIA ABS IGG,IGM
CALCIUM, FECES
C-PEPTIDE, 24 HOUR URINE
DRUG & ALCOHOL SCRN, BLD
NICKEL, SERUM
DRUG SCREEN I, BLOOD
HYDROCODONE
HYDROMORPHONE QUANT
PROTEIN C ACTIVITY & AG
ARYLSULFATASE A,LEUKOCYTE
ALPHA-L-IDURONIDASE
ALPHA-GALACTOSIDASE
OCCULT BLOOD, GASTRIC
ALDOST/CORT RATIO 4 SITES
CHLORIDE FECES
CASPOFUNGIN HPLC
KPC GENE REAL TIME PCR
P JIROVECII QNT PCR
P JIROVECII QL PCR
KAPPA/LAMBDA LGHT CHN,ISH
LEFLUNOMIDE METABOLITE
PREGABALIN
NEUROKININ A SUBSTANCE K
K. KINGAE DNA,QUAL
ASPERGILLUS DNA
IGE ANTIBODY
D-LACTATE, PLASMA
ACETYLCHOLINE MODULATING
ISOSPORA DETECTION FM
EVEROLIMUS BLOOD
FLUNITRAZEPAM
BK VIRUS DNA, CS
BK VIRUS DNA, CS
COLORECTAL CANCER PNL
2HR GTT 75GM PREG SCREEN
B.BURGDORFERI ABS, CSF
JAK2 V617F MUTATION QUANT
MENINGOENCEPHALITIS PNL
FLUNITRAZEPAM METAB QUANT
HIV-1 RNA QL TMA W/RFLX
MELANOMA MUTATION PNL
HEROIN METAB
OPIATES QT ENHANCED URINE
ACCUTYPE METFORMIN
CHROMOSOME ANALYSIS
CHROMOSOME ANYLS HI RES
FISH, EGFR
DRUG SCREEN COMPREHENSIVE
FISH,DUPLICATION 15q11q13
PLATELET FUNCTION
VALPROIC ACID,TL & FREE
ER/PR/MIB-1 PARAFFIN BLK
ALLERGEN NUT PANEL
FISH,BLADDER CA & WASH
NOROVIRUS RNA, RT-PCR
AMPHETAMINE VERIFICATION
MAG ANTIBODY W/REFLEX
CODE
18078
18144
18243
18333
18359
18379
18573
18581
18622
18641
18663
18664
18757
18779
18781
18784
18806
18823
18831
18832
18833
18834
18835
18854
18865
18866
18871
18872
18873
18877
18878
18879
18880
18883
18886
18889
18901
18902
18927
18941
18950
18957
18964
18967
18968
18969
18976
18979
18980
18983
19041
19044
19045
19052
19058
19070
19082
19085
19098
19127
19201
PRICE
$31.50
$181.65
$65.10
$235.90
$72.77
$226.50
$43.40
$122.00
$216.50
$115.00
$178.00
$184.00
$102.55
$363.60
$286.50
$352.40
$6.48
$162.26
$18.20
$64.05
$298.00
$349.00
$139.30
$315.00
$171.00
$59.85
$250.00
$298.00
$104.30
$17.50
$322.60
$78.75
$39.55
$149.00
$87.75
$104.30
$122.15
$581.00
$11.24
$61.95
$175.00
$858.90
$198.00
$349.00
$516.25
$79.80
$259.00
$41.03
$635.00
$781.00
$126.00
$36.72
$128.80
$45.26
$45.15
$177.45
$49.00
$157.50
$71.33
$39.81
$35.00
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
HAPTOGLOBIN
HETEROPHILE,MONO SCREEN
RHEUMATOID FACTOR, QUANT.
RUBELLA VIRUS IGG AB
STREP ANTIBODIES
RPR W/REFLEX FTA CONF
SUGAR WATER TEST
VDRL
VDRL TITER, QUANT
VDRL, CSF
RPR MONITOR W/RFL TITER
RPR DIAGNOSIS W/REFLEX
QUANTIFERON
IGG, CSF
CBC (INCLUDES DIFF/PLTS)
COMPLETE BLOOD COUNT
CBC W/O PLATELET
DIFFERENTIAL
DIFFERENTIAL REVIEW
EOSINOPHIL COUNT, TOTAL
EOSINOPHIL,NASAL SMEAR
WRIGHT STAIN-OCULAR
CBC W/DIFF W/O PLATELET
HEMATOCRIT
BLOOD PARASITE
HEMOGLOBIN (HGB)
CBC W/PLATELET
HEMOGLOBIN & HEMATOCRIT
PLATELET COUNT
PLATELET COUNT
RBC
RETICULOCYTE COUNT
CORRECTED RETIC COUNT
SICKLE CELL SCREEN
NEUTROPHILS,TOTAL
LYMPHOCYTES,TOTAL
GRANULOCYTES,TOTAL
WBC COUNT
SED RATE, WESTERGREN
RBC,HGB,HCT
AMPLICHIP CYP450 2D6 2C19
LAMOTRIGINE
ABL T3151 MUTATION,LEUMET
BILIRUBIN, URINE
CELL COUNT AND DIFF,CSF
SYNOVIAL FLUID PANEL
EOSINOPHIL, URINE
PREGNANCY, URINE
REDUCING SUBSTANCES, UR
SEMEN ANALYSIS QT,COMPL
SEMEN ANALYSIS,QL
SPECIFIC GRAVITY
SYNOVIAL FLUID PROFILE
CRYSTALS, FLUID
SPERM COUNT
ALPRAZOLAM, SERUM/PLASMA
SEMEN ANALYSIS, POST EJAC
CRYSTALS, BILE
UA COMPLETE W/RFL CULTURE
PH, URINE
UA W/REFLEX MICROSCOPIC
CODE
4311
4317
4325
4327
4329
4331
4333
4335
4337
4339
4341
4345
4399
4448
4500
4502
4503
4504
4506
4508
4509
4510
4511
4514
4515
4516
4518
4520
4524
4526
4528
4530
4531
4534
4535
4536
4537
4538
4542
4545
4565
4681
4682
4701
4705
4707
4715
4723
4725
4727
4729
4733
4734
4735
4738
4741
4744
4760
4770
4774
4775
PRICE
$22.82
$7.11
$5.92
$8.30
$9.66
$5.15
$8.40
$9.66
$10.29
$6.79
$5.30
$5.30
$22.75
$19.25
$3.35
$3.61
$3.20
$3.15
$5.36
$4.52
$6.79
$8.68
$12.67
$0.82
$6.79
$0.82
$4.12
$3.22
$0.82
$2.80
$3.15
$4.87
$4.76
$4.97
$0.00
$10.33
$10.82
$2.59
$4.41
$6.62
$344.40
$67.00
$175.00
$1.89
$8.89
$13.02
$7.49
$4.66
$3.92
$42.00
$5.95
$3.22
$23.10
$8.75
$21.00
$45.50
$5.95
$8.75
$3.50
$3.05
$4.12
DESCRIPTION
TYSABRI AB ELISA
METHYLENEDIOXAMPHETAMINE
HEPATITIS E IGG, IGM
H PYLORI IHC W/O INTERP
W NILE VIRUS, NAT DONOR
HYALURONIC ACID
SPERM AB IGA/IGG
VZV REAL-TIME PCR
HSV TYPE 1 & 2, DNA QNT
JC POLYOMA VIRUS DNA RT
INTERFERON-BETA IGG W/RFL
ANDROSTENEDIONE RESPONSE
HLA-DQA1 DNA TYPING
HLA DRB3-4-5 DNA TYPING
ALPHA-FETOPROTEIN/AFP L3
BILE ACIDS, FRAC/TL PRGNY
METANEPHRINES,FRACTIONATD
TRICHOMONAS VAGINALIS RNA
CHLAMYDIA/CHLAMYDOPH PNL2
GLYCOMARK
DONOR,CHAGAS (T.CRUZI)
DONOR, CMV TOTAL AB
FISH, MULTIPLE MYELOMA
LIVER FIBROSIS-HEPASCORE
MENORRHAGIA SCREEN
SEROTONIN
SEROTONIN, SERUM
DONOR,CHAGAS SCR W/RFL
HPV LOW/HIGH RISK DNA X2
DISACCHARIDES
HEPTIMAX HCV RNA W/RFLX
RHEUMATOID FACTOR IGA,G,M
FISH,MYELOMA 13q,14q,17p
HHV6 DNA,QNT,REALTIME,PCR
PARVO B19 DNA QNT RT PCR
TOXOPLASMA GONDII QNT RT
ADENOVIRUS DNA,QNT,RT,PCR
FISH, ALVEOLAR FKHR
FISH,SYNOVIAL SARCOMA SYT
HLA-B*5701 TYPING
AMINO ACIDS,MSUD,LC/MS
ABL T3151 MUTATION,CELL-B
VON WILLEBRAND COMP PNL
FISH,MDS MYELOID PANEL
CADMIUM, 24 HOUR URINE
COENZYME Q10
GLUCOSE,GEST 140 CUTOFF
GLUCOSE FASTING GESTATION
VWD MUTATION ANALYSIS
MYOCARDITIS/PERICARDITIS
FISH,ALL +4,+10,+17
FISH HER-2/NEU W/RFLX IHC
CD57,CD3,CD8,FC
HPV GENOTYPES 16 & 18
ANTIPHOSPHOLIPID SYN DIAG
AUTOIMMUNE DIAGNOSTIC PNL
RA DIAGNOSTIC PANEL,COMP
SJOGRENS SYNDROME DIAG
SLE COMPREHENSIVE DIAG
SLE DISEASE ACTIVITY PNL
SARCOMA MUTATION ANALYSIS
CODE
19215
19292
19337
19348
19412
19480
19492
19493
19502
19503
19509
19511
19525
19526
19529
19546
19548
19550
19589
19599
19616
19618
19619
19647
19649
19651
19652
19677
19688
19701
19702
19705
19722
19723
19724
19725
19726
19772
19773
19774
19779
19783
19790
19799
19806
19826
19833
19834
19837
19839
19856
19859
19860
19865
19872
19873
19878
19880
19881
19882
19884
PRICE
$113.75
$97.00
$61.95
$43.75
$113.75
$36.75
$40.60
$122.15
$113.75
$122.15
$61.25
$116.90
$55.13
$55.13
$47.25
$57.75
$64.75
$49.00
$36.75
$24.50
$140.00
$67.46
$181.30
$75.96
$176.40
$66.85
$66.85
$24.94
$126.00
$115.15
$147.70
$42.00
$184.54
$122.15
$122.15
$122.15
$122.15
$184.54
$184.54
$68.25
$57.75
$175.00
$270.20
$830.20
$45.85
$75.25
$5.22
$8.96
$406.00
$207.90
$181.30
$157.50
$157.50
$23.85
$171.50
$85.40
$106.05
$117.25
$232.75
$69.48
$168.00
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
UA WITH MICROSCOPIC
URINALYSIS
URINALYSIS,DIPSTICK
COPPER, LIVER
ALUMINUM WHOLE BLOOD
SELENIUM
DIAZEPAM
MEXILETINE SERUM/PLASMA
TRAZODONE
ANTICARDIOLIPIN AB
ALLERGY REGION XVII+ IgE
GLU TOL GESTATIONAL 4 SPC
COUMADIN
GASTRIN
HEPATITIS Be PANEL
RETIC CNT & HGB COMPONENT
ANTICARDIOLIPIN IGG/IGM
HISTOPLASMA AB, CSF
IGG SUBCLASS 4
MACROAMYLASE, SERUM
METHAQUALONE, SERUM
ACETONE, SEMI-QUANTITATIV
ACETONE, QUAL, URINE
ALBUMIN
ALK PHOS ISOENZYMES
ALKALINE PHOSPHATASE
AMMONIA
AMYLASE
AMYLASE, URINE
AMYLASE, RANDOM URINE
BLOOD GASES- ARTERIAL
BICARBONATE
BILIRUBIN, DIRECT
BILIRUBIN,INFANT
BILIRUBIN, TOTAL INFANT
BILIRUBIN TOTAL & DIRECT
BILIRUBIN, TOTAL
UREA NITROGEN PERITONEAL
UREA NITROGEN (BUN)
BUN,POST DIALYSIS
BUN/CREAT RATIO W/EGFR
BUN AND CREATININE
CALCIUM
CA RANDOM URINE W/CREAT
CALCIUM, PEDIATRIC URINE
ALLERGEN FISH ALLERY PROF
ALLERGEN SHELLFISH PROF.
ALLERGEN SEAFOOD PANEL
ADULT RESPIRATORY PANEL
UPPER RESPIRATORY,CHILD
ALLERGEN FOOD PANEL
URD PANEL #2, ADULT
ALLERGEN ARIXONA PANEL
ELECTROLYTES, URINE
CHLORIDE
CHLORIDE, RANDOM URINE
ELECTROLYTES, URINE
CHOLESTEROL
CARBON DIOXIDE (CO2)
CPK
CREATININE CLEAR W/EGFR
CODE
4780
4781
4785
4859
4862
4875
4926
4934
4960
5026
5031
5085
5103
5121
5166
5172
5281
5297
5428
5499
5912
6005
6006
6015
6020
6025
6030
6040
6050
6052
6055
6070
6075
6080
6081
6086
6090
6102
6103
6104
6105
6106
6110
6118
6119
6122
6123
6124
6125
6126
6127
6128
6129
6134
6145
6156
6157
6165
6175
6180
6186
PRICE
$6.18
$3.50
$3.50
$49.00
$48.30
$48.30
$34.30
$90.00
$30.80
$65.10
$182.00
$15.79
$21.96
$25.55
$40.46
$33.25
$43.40
$31.50
$19.60
$47.60
$39.81
$3.50
$3.50
$3.08
$26.95
$3.08
$21.25
$6.02
$5.04
$14.95
$32.90
$4.97
$3.08
$4.20
$3.75
$4.24
$3.08
$7.74
$3.08
$3.75
$4.20
$4.20
$3.08
$13.79
$13.79
$21.00
$28.00
$28.00
$154.00
$105.00
$56.00
$119.00
$189.00
$15.26
$3.08
$13.97
$23.00
$3.08
$3.08
$11.90
$13.44
DESCRIPTION
HIV-1 RNA, QT BY BDNA
RNP ANTIBODY
HTLV I/II DNA, PCR
CORTISOL SALIVA LC/MS/MS
RNA POLYMERASE III AB
LSD QUANTITATION
HODGKINS LYMPHOMA PNL IHC
ASPERGILLUS IGG,A,M,EIA
C-KIT MUTATION, LEUMETA
COCCIDIOIDES AB TP & F ID
INFLUENZA TYPE A IGG/IGM
LIPOPROTEIN FRCTN PNL 2
DES-GAMMA-CARBOXY-PT
HISTOPLASMA ANTIGEN,URINE
TROFILE TROPISM ASSAY
HUMAN IMMUNODEFICIENCY
CULTURE ID EA ORGANISM
URINE CULT PRESUMPTIVE ID
SENSITIVITY MICRO
CULTURE,FUNGAL YEAST ID
CULTURE,FUNGAL MOLD ID
SENSITIVITY DISK (KB)
ID, SEROGROUPING
BETA LACTAMASE
HLA-B 1502 TYPING
FISH,CHROMOSOME CLARISURE
PROLACTIN,DILUTUON STUDY
FISH, ALL, EXTENDED PANEL
FISH,ALL,PRE-B PANEL
FISH,MALT LYMPHOMA 18q21
FISH,MALT LYMPHOMA AP12
FISH,MALT LMP rea 18q21
TOX SCRN-MARIJUAN&VOLATIL
CLONAZEPAM 7-AMINO CLONZ
FENTANYL/NORFENTANYL
BREAST CANCER PANEL
INFLUENZA TYPE B AB, IGM
INFLUENZA TYPE A, IGM
HIV-1 RNA,QNT,RL TM,PCR
EBV VCA IGG AB,IFA
EPSTEIN BARR AB ACIF
HSV-2 INHIBITION STUDY
LCM, IFA
CHIKUNGUNYA ABS W/REFLEX
S PNEUMONIAE IGG AB X14
PRIMIDONE
S.PNEUMONIAE IGG (7) MAID
PNEUMOCOCCAL IgG VACCINE
BARBITURATES CFM, MECON
ALLERGEN WILD RICE
B.PERTUSSIS AB IGG, MAID
B. PERTUSSIS IgG-IgA MAID
MITOCHONDRIAL AB W/RFLX
CMV IGG AVIDITY,ELISA
AMINO ACID, LC/MS, CSF
ALLERGEN, LIMA BEAN
CAPILLARY VENIPUNCTURE
AMNIOTIC FLUID BILIRUBIN
HEMOSIDERIN,QL
TROPHERYMA WHIPPLEI DNA
M TUBERCULOSIS PCR
CODE
19886
19887
19896
19897
19899
19917
19936
19941
19960
19963
19973
19979
19982
19994
19995
19996
40003
40004
40006
40007
40008
40015
40017
40019
40045
40047
40049
40050
40052
40053
40056
40057
40059
40064
40065
40080
40081
40082
40085
40465
40485
40597
40625
40680
40682
40751
40752
40765
40864
42210
42250
42255
42481
42600
42630
43510
43555
45614
46441
46500
47277
PRICE
$119.35
$19.25
$109.90
$24.50
$26.25
$49.53
$560.00
$133.00
$350.00
$24.15
$25.20
$63.00
$96.25
$46.90
$2,825.00
$2,825.00
$0.88
$1.33
$1.33
$12.64
$12.64
$1.30
$1.33
$0.67
$131.25
$115.50
$45.50
$1,002.40
$487.90
$208.60
$208.60
$208.60
$32.52
$58.45
$14.00
$218.75
$12.60
$12.60
$103.25
$11.64
$24.50
$88.90
$53.55
$60.55
$116.90
$13.74
$87.50
$76.30
$39.81
$39.88
$44.10
$70.00
$21.00
$43.05
$183.40
$48.40
$6.13
$15.75
$16.94
$63.00
$104.30
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
CREATININE, 24 HR URINE
CREATININE, RANDOM URINE
CREATININE W/EGFR
HEPARIN INDUCED PLT AB
CREATININE,AMNIOTIC FLUID
CSF CHEMISTRIES
CREATININE W/O eGFR
GLUCOSE FASTING
GLUCOSE 2 HOUR
GGTP
GLUCOSE,90 MINUTE
GLUCOSE, FASTING
GLUCOSE,RANDOM
GLUCOSE,1 HOUR
GLUCOSE, 2 HOUR P.P.
GLUCOSE, CSF
GLUCOSE TOLERANCE 2 HR
GLUCOSE 2.5 HOUR
GLUCOSE,FASTING MATERNAL
GLUCOSE,GEST SCREEN (50G)
GLUCOSE,2 HOUR MATERNAL
GLUCOSE,3 HOUR MATERNAL
HDL CHOLESTEROL
IRON
IRON AND IRON BINDING CAP
LACTIC ACID (LACTATE)
ALBUMIN/GLOBULIN RATIO
LD (LACTIC DEHYDROGENASE)
DIRECT LDL
LIPASE
LITHIUM
MAGNESIUM
OSMOLALITY, URINE
OSMOLALITY, SERUM
PH
PH, STOOL
PHOSPHORUS
PHOSPHATE, RANDOM URINE
PHOSPHATE, PEDIATRIC UR
POTASSIUM
POTASSIUM, RANDOM URINE
PROTEIN/CREAT RATIO, URIN
PROTEIN, TOTAL
PROTEIN, TL, RANDOM URINE
PROTEIN, TOTAL, CSF
PROTEIN, SYNOVIAL FLUID
ALBUMIN, PERICARDIAL FLD
ALBUMIN, PERITONEAL FLUID
ALBUMIN, PLEURAL
AST (SGOT)
AMYLASE, PLEURAL FLUID
CREATININE,PERITONEAL FLD
GLUCOSE, PERITONEAL FLUID
GLUCOSE, PLEURAL FLUID
ALT (SGPT)
PROTEIN,TL,PERICARDIAL FL
PROTEIN,TL,PERITONEAL FLD
PROTEIN TL,PLEURAL FLUID
AMYLASE, PERITONEAL FLUID
SODIUM
SODIUM AND POTASSIUM
CODE
6190
6191
6200
6201
6205
6210
6220
6221
6229
6240
6244
6245
6247
6248
6249
6250
6251
6253
6258
6259
6260
6261
6275
6285
6290
6291
6295
6300
6307
6310
6315
6335
6340
6345
6350
6355
6363
6366
6367
6380
6386
6390
6400
6406
6410
6411
6412
6413
6414
6415
6416
6417
6418
6419
6420
6421
6422
6423
6424
6425
6426
PRICE
$10.15
$10.15
$3.08
$43.40
$24.15
$8.96
$3.75
$3.75
$3.75
$3.08
$3.75
$3.75
$3.08
$3.75
$3.75
$3.75
$8.75
$3.75
$3.75
$5.22
$5.22
$5.22
$3.92
$3.86
$7.72
$17.85
$7.49
$3.08
$5.11
$14.60
$8.79
$8.40
$11.03
$1.89
$10.43
$4.87
$3.08
$13.79
$13.79
$3.08
$13.97
$13.97
$3.08
$13.97
$5.22
$3.92
$8.09
$8.09
$8.09
$3.08
$11.10
$24.15
$9.21
$9.21
$3.08
$11.03
$11.03
$11.03
$11.10
$3.08
$4.20
DESCRIPTION
M TUBERCULOSIS PCR
ENTEROVIRUS RNA EVAL
URINALYSIS
BABESIA MICROTI DNA PCR
HIV-2 PROVIRAL DNA, QUAL
HIV MONITOR ATAZANAVIR
TETANUS ANTITOXOID AB
AMPHOTERICIN B HPLC
ANTIFUNGAL SERUM LEVEL
KETOCONAZOLE LEVEL, BA
LEGIONELLA/DETECTION DFA
SALMONELLA SEROTYPING
SYNERGY STUDIES,ANTIMICRO
AMOXICILLIN LEVEL, BA
CEPHAZOLIN LEVEL, BA
CEFUROXIME LEVEL, BA
CEPHALEXIN LEVEL, BA
HEPATITIS Be ANTIBODY
KANAMYCIN LEVEL, BA
HEPATITIS Be ANTIGEN
METRONIDAZOLE LEVEL
VORICONAZOLE, ANTIFUNGAL
MINOCYCLINE LEVEL, BA
NAFCILLIN LEVEL, BA
OXACILLIN LEVEL, BA
PENICILLIN LEVEL, BA
ISONIAZID, HPLC
PIPERACILLIN LEVEL, BA
GANCICLOVIR LEVEL
ANTIRETROVIRAL AMPRENAVIR
INDINAVIR, ANTIRETROVIRAL
NELFINAVIR,ANTIRETROVIRAL
SAQUINAVIR
ANTIRETROVIRAL NEVIRAPINE
KALETRA, ANTIRETROVIRAL
TETRACYCLINE LEVEL, BA
TICARCILLIN LEVEL, BA
DELAVIRDINE,ANTIRETROVIRL
N MENINGITIDIS SEROTYPING
H INFLUENZAE SEROTYPING
TRIMETHOPRIM/SULFAMETHOX
AZTREONAM LEVEL, BA
NEOMYCIN LEVEL, BA
MEASLES ANTIBODY (IgG)
M.PNEUMONIAE AB IGG EIA
ANTIVIRAL,ACYCLOVIR
ANTIVIRAL,FOSCARNET
ANTIVIRAL,GANCICLOVIR
CONFIRMED DRUG PROF #52
HIV-1 ANTIBODY & RPR
IMMIGRATION PANEL
ALLERGEN, TUNA, IGG
LEVOFLOXACIN LEVEL
ALLERGEN, PINTO BEAN IGE
CONF. DRUG PROFILE#57 X10
MANGANESE-SERUM/PLASMA
HSV ANTIGEN DETECTION
PROTEIN S ACTIVITY
TESTOSTERONE, FREE
TISSUE PLASMINOGEN ACTIV
PLASMINOGEN
CODE
47298
47300
47755
47800
49000
50477
50922
51426
51523
51685
51705
51735
51740
51760
51795
51835
51840
51896
51910
51912
51920
51929
51930
51940
51955
51960
51963
51965
51967
51971
51972
51973
51974
51976
51987
51990
51995
51999
52025
52030
52060
52105
52140
52449
52555
53180
53185
53190
53807
54002
54003
55220
56175
56310
56377
56838
58552
58891
58958
59717
59915
PRICE
$104.30
$128.63
$3.50
$120.75
$113.05
$35.00
$37.80
$69.30
$69.30
$45.15
$67.55
$47.25
$88.90
$45.15
$45.15
$45.15
$45.15
$19.25
$45.15
$19.25
$43.40
$66.50
$45.15
$45.15
$45.15
$45.15
$62.30
$45.15
$69.30
$69.30
$69.30
$69.30
$69.30
$69.30
$69.30
$45.15
$45.15
$69.30
$45.15
$42.00
$45.15
$45.15
$45.15
$21.91
$24.15
$115.50
$115.50
$115.50
$10.22
$12.78
$17.43
$43.50
$43.40
$39.88
$32.52
$28.00
$29.75
$52.89
$48.30
$52.50
$42.00
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ANION GAP PANEL
GLUCOSE, AMNIOTIC
SODIUM, RANDOM URINE
CHOLESTEROL,PERITONEAL FL
CHOLESTEROL, PLEURAL FLD
TRIGLYCERIDES, PERITONEAL
PROTEIN,TOTAL & A/G RATIO
TRIGLYCERIDES,PLEURAL FLD
LIPASE JP DRAINAGE
LDH, PERITONEAL FLUID
LDH, PLEURAL FLUID
TRIGLYCERIDES
LIPASE PERITONEAL FLUID
LIPASE,PLEURAL FLUID
UREA CLEARANCE
UREA NITROGEN, URINE
URIC ACID
URIC ACID, RANDOM URINE
URIC ACID, PEDIATRIC UR
TRIGLYCERIDES W/VLDL CALC
LIPO FRAC,ION MOBIL W/RFL
ALPHA-1-ANTITRYPSIN
COMPLEMENT C3
MICROALBUMIN RNDM W/CREAT
COMPLEMENT C4
STONE ANALYSIS NON-KIDNEY
C4a LEVEL
COMPLEMENT, TOTAL (CH 50)
CPK W/CPK-MB IF INDICATED
PROTEIN ELECT-CSF
PROTEIN ELECTRO. URINE
PROTEIN ELECTROPHORESIS
ALBUMIN, CSF
GLYCOHEMOGLOBIN (HGB A1C)
LDH, CSF
HEMOGLOBIN A2
HEMOGLOBIN F
HEMOGLOBINOPATHY EVAL
IMMUNOFIXATION W/IGG,A,M
IMMUNOFIXATION, SERUM
IMMUNOFIXATION, URINE
IMMUNOFIXATION, URINE
IGA
IGG
IGM
IMMUNOGLOBULINS, QUANT.
CPK ISOENZYMES
METHEMOGLOB./SULFHEMOGLOB
OLIGOCLONAL BANDS
HEMOGLOBIN, PLASMA
PREALBUMIN
PROTEIN ELECTRO. SERUM
VISCOSITY, SERUM
CERULOPLASMIN
APOLIPOPROTEIN A1,B
APOLIPOPROTEIN A-1
APOLIPOPROTEIN B
ANGIOTENSIN ENZ
FETAL FIBRONECTIN
AFP,TUMOR MARKER
QUAD SCREEN
CODE
6427
6429
6431
6432
6433
6434
6435
6436
6437
6438
6439
6440
6441
6442
6445
6450
6455
6464
6466
6470
6472
6505
6515
6517
6520
6525
6536
6540
6556
6561
6570
6571
6603
6605
6606
6617
6618
6619
6625
6630
6635
6636
6640
6645
6650
6655
6657
6675
6690
6703
6720
6725
6755
6770
6775
6776
6777
6896
7004
7007
7008
PRICE
$5.11
$9.21
$15.37
$7.74
$7.74
$7.74
$4.20
$7.74
$14.60
$7.74
$7.74
$3.08
$14.60
$14.60
$11.31
$3.92
$3.08
$13.79
$13.79
$30.03
$63.00
$18.55
$12.43
$22.51
$18.55
$25.20
$100.60
$34.51
$12.01
$41.30
$23.73
$30.07
$19.25
$9.27
$3.92
$22.05
$22.05
$22.05
$59.05
$54.25
$52.05
$58.38
$9.87
$12.95
$12.95
$35.77
$34.65
$155.20
$32.55
$21.70
$22.72
$19.85
$15.40
$19.08
$9.03
$4.52
$4.52
$73.50
$107.45
$21.56
$169.75
DESCRIPTION
PROTEIN C ACTIVITY
BLASTOMYCES AB CF, (CSF)
ALLERGEN, BANANA
ALLERGEN, BREWERS YEAST
HERPES SIMPLEX1-2 IGG CSF
NMO EVALUATION W/REFLEX
ALLERGEN, GOAT EPITHELIUM
ALLERGEN,GUINEA PIG EPITH
ERYTHROPOIETIN
GROWTH HORMONE, HUMAN
HGH 2 SPECIMENS
HGH 3 SPECIMENS
HGH 4 SPECIMENS
HGH 5 SPECIMENS
HGH 6 SPECIMENS
HGH 7 SPECIMEN
HGH 8 SPECIMEN
HGH 9 SPECIMEN
HGH 10 SPECIMEN
CHLORIDE,24HR UR NO CREAT
ALLERGEN LEMON
PIGEON DROPPINGS IgE
RABBIT EPITHELIUM
ALLERGEN MAPLE SUGAR
CLOSTRIDIUM TOX B SCREEN
POTASSIUM 24HR NO CREAT
PROTEIN,TL 24HR W/O CREAT
SODIUM 24HR NO CREATININE
LEGIONELLA URINARY AG
CELL COUNT, FLUID
MUMPS VIRUS ANTIBODY, IGG
TEICHOIC ACID AB SCREEN
TRYPSINOGEN
CULT,VIRUS,BODY FL,TISSUE
URIC ACID SYNOVIAL FLUID
CALCIUM, 24 HOUR URINE
CHLORIDE, 24-HOUR URINE
PH, FLUID
PHOSPHATE, 24 HR URINE
POTASSIUM, 24-HOUR URINE
PROTEIN, TL,24-HOUR URINE
SODIUM, 24-HOUR URINE
URIC ACID, 24 HR URINE
CLOMIPRAMINE
HONEY BEE VENOM IgG
ALLERGEN PAPER WASP IgG
YELLOW HORNET VENOM IgG
TSH ULTRASENSITIVE
ALPHA-1 ANTITRYPSIN PHENO
CYCLOBENAZPRINE
ALLERGEN, GREEN BEAN
ALLERGEN, GERBIL
PENICILLOYL G, IGE
FELBAMATE
PROTEINASE-3 AB
MYELOPEROXIDASE AB
TACROLIMUS & SIROLIMUS
TACROLIMUS,HS,LC/MS/MS
FACTOR VIII ACTIVITY
VON WILLEBRAND TYPE 2N
BLASTOMYCES AB PNL CF&ID
CODE
60061
60180
60350
60517
60555
60796
61275
61341
61403
61445
61502
61503
61504
61505
61506
61507
61508
61509
61510
61551
61598
62174
62232
62710
63628
63851
64051
64301
64477
64706
64766
65383
65552
65847
66105
66115
66155
66350
66365
66385
66405
66430
66460
66605
67272
67314
67397
67580
67702
67975
68312
68403
68510
68999
69682
69690
70006
70007
70050
70068
70070
PRICE
$40.71
$35.70
$7.74
$39.88
$103.00
$540.60
$7.00
$7.00
$46.73
$34.13
$65.03
$97.55
$130.06
$162.58
$195.09
$227.61
$260.12
$292.64
$325.15
$3.82
$7.00
$7.00
$7.00
$35.40
$45.50
$3.82
$3.82
$3.82
$33.60
$5.60
$3.59
$22.75
$34.65
$63.00
$3.75
$7.46
$7.46
$10.43
$7.46
$7.63
$7.46
$7.63
$7.46
$38.15
$12.95
$12.95
$12.95
$19.08
$45.50
$94.00
$7.74
$7.00
$14.00
$26.25
$35.00
$35.00
$99.40
$54.25
$51.45
$77.00
$44.10
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ALDOSTERONE URINE
ALLERGEN ALMOND
AMIKACIN RANDOM
AMIKACIN, PEAK LEVEL
AMIKACIN, TROUGH LEVEL
ALLERGEN WORMWOOD
ALLERGEN CURULARIA LUNATA
ALLERGEN BIRCH
ALLERGEN PHOMA BETAE
ALLERGEN AUREO. PULLULANS
ALLERGEN, COW DANDER
ALLERGEN TURKEY FEATHERS
ALLERGEN CHICKEN FEATHERS
ALLERGEN DUCK FEATHERS
PROTEIN S ANTIGENIC/FUNCT
HEPATITIS B CORE AB,TOTAL
ALLERGEN HELMINTH HALODES
HEPATITIS A IGM ANTIBODY
ALLERGEN BARLEY
ALLERGEN BERMUDA GRASS
ALLERGEN BAYBERRY
ALLERGEN COCKLEBUR
ALLERGEN MARSHELDER
ALLERGEN WILLOW
ALLERGEN WINGSCALE
ALLERGEN BLUEGRASS
ALLERGEN BROME GRASS
CARBAMAZEPINE (TEGRETOL)
CEA ABBOTT
ALLERGEN COMMON RAGWEED
ALLERGEN ENGLISH PLANTAIN
ALLERGEN SHEEP SORREL
ALLERGEN BOX MAPLE ELDER
ALLERGEN CHICKEN MEAT
ALLERGEN ALDER
ALLERGEN WALNUT TREE
ALLERGEN WHITE PINE
ALLERGEN EUCALYPTUS
ALLERGEN KOCHIA
ALLERGEN ACACIA
HOUSE DUST GREER
ALLERGEN CODFISH
ALLERGEN SALMON
ALLERGEN MUSTARD
ALLERGEN BEEF
ALLERGEN PEA
ALLERGEN GARLIC
ALLERGEN APPLE
ALLERGEN YEAST
ALLERGEN ONION
CORTISOL, A.M.
ALLERGEN EGG YOLK
ALLERGEN CELERY
CORTISOL
ALLERGEN, TEA
CORTISOL, P.M.
DEXAMETHASONE SUPPRESSION
ACTH STIMULATION, 3 SPEC
CORTISOL FR LC/MS/MS 24HR
ALLERGEN COTTONWOOD
ALLERGEN COW'S MILK
CODE
7010
7020
7025
7027
7029
7030
7031
7032
7033
7034
7035
7036
7037
7038
7039
7040
7041
7045
7060
7065
7066
7068
7069
7070
7071
7075
7085
7100
7110
7111
7112
7113
7114
7115
7116
7117
7118
7119
7122
7123
7124
7125
7126
7127
7128
7129
7131
7132
7133
7134
7135
7136
7137
7138
7139
7140
7141
7144
7145
7150
7160
PRICE
$36.75
$7.00
$26.67
$26.67
$26.67
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$122.85
$17.75
$7.00
$34.35
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$39.88
$7.00
$7.00
$18.27
$29.40
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$21.42
$7.00
$7.00
$21.42
$7.00
$21.42
$64.26
$64.26
$48.65
$7.00
$7.00
DESCRIPTION
BENZODIAZEPINES
OLANZAPINE
MEPERIDINE & NORMEPRIDINE
LIPID PNL W/NON-HDL CHOL
CYCLOSERINE LEVEL, HPLC
BIOTINIDASE
SALMONELLA & BRUCELLA
FEBRILE ANTIBODIES PNL
FEBRILE/FRANCISELLA PANEL
DONOR, IVF MALE PANEL
DONOR, TISSUE DONOR PANEL
STEM CELLS DONOR PANEL
DONOR,IVF FEMALE PANEL
ANCA W/MPO/PR3 W/REFLEX
ANCA SCREEN
MUMPS VIRUS RNA,QL,RT,PCR
PML/RARA t(15:17) QUANT
17-KS FRCT PEDS URINE
ENTERVIRUS/PARECHOVIRUS
MSH2,IHC W/INTERP
21-HYDROXYLASE AB
ALLERGEN, ASPARAGUS IGE
ALLERGEN, BAY LEAF IGE
C-PEPTIDE
TACROLIMUS (FK506)
PSA (FREE AND TOTAL)
C-PEPTIDE RESPONSE,2 SPEC
C-PEPTIDE RESPONSE,3 SPEC
C-PEPTIDE RESPONSE,4 SPEC
C-PEPTIDE RESPONSE,5 SPEC
C-PEPTIDE RESPONSE,6 SPEC
C-PEPTIDE RESPONSE,7 SPEC
C-PEPTIDE RESPONSE,8 SPEC
C-PEPTIDE RESPONSE,9 SPEC
WHITE FACED HORNET VENOM
PSA W/REFLEX TO FREE
ALLERGEN, PAPRIKA IGE
CHLORIDE RANDOM NO CREAT
POTASSIUM RANDOM NO CREAT
SODIUM,RANDOM NO CREAT
ALLERGEN TANGERINE IGE
YELLOW JACKET IgG
ALLERGEN,RABBIT EPITHEL.
CHLAMYDIA PNEU CULTURE
MUMPS VIRUS DIRECT DETECT
THYROGLOBULIN TUMOR SERUM
PHOSPHATIDYLCHOLINE ABS
THALLIUM,24 HR URINE
PROTEIN C & S PANEL
PLATELET ANTIBODY PROFILE
ALLERGEN SULFAMETHOXAZOL
CC PAYMENT HOLDING
ANA IF RA DIAG PNL W/RFLX
ANA IFA W/RFX LUPUS/SLE
ANA IFA W/RFL TIT/PAT/SCL
ANA IFA W/RFX CON TISSUE
ANA SCREEN (IFA) SJOGRENS
ACCUTYPE IL28B
HSV 2 IGG TYPE SPECIFIC
ASIALO GM-1 ANTIBODY IGM
XYLOSE, BLOOD 1HR POST
CODE
70071
70073
70074
70083
70114
70132
70140
70141
70142
70143
70145
70146
70147
70159
70171
70172
70182
70184
70189
70197
70265
70995
71258
71298
71330
71744
72302
72303
72304
72305
72306
72307
72308
72309
74179
74551
75630
76155
76385
76430
77313
77685
80710
81030
81180
83069
83170
84723
85480
86264
87610
90002
90071
90072
90073
90074
90077
90251
100051
103598
104521
PRICE
$36.40
$99.75
$7.35
$21.26
$62.30
$35.70
$75.95
$105.70
$140.70
$634.99
$462.00
$570.24
$526.75
$105.00
$35.00
$104.30
$117.60
$68.60
$126.00
$57.75
$178.00
$36.90
$48.40
$55.97
$54.25
$40.36
$111.93
$167.90
$223.86
$279.83
$335.79
$391.76
$447.72
$503.69
$12.95
$27.20
$7.00
$3.82
$3.82
$3.82
$48.40
$12.95
$48.40
$23.98
$47.25
$151.68
$108.50
$39.55
$93.59
$140.35
$48.40
$0.00
$63.00
$17.50
$17.50
$17.50
$70.00
$113.75
$18.79
$36.40
$28.67
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ALLERGEN CRAB
ALLERGEN CASHEW
CRP, QUANTITATIVE
ALLERGEN DANDELION
ALLERGEN CLAM
ALLERGEN WALNUT FOOD
ALLERGEN, SCALLOP
DIGOXIN (LANOXIN)
ALLERGEN EGG WHITE
ALLERGEN ELM TREE
ESTRADIOL
ALLERGEN FALSE RAGWEED
FERRITIN
FOLATE
FSH
GENTAMICIN, RANDOM
GENTAMICIN, PEAK LEVEL
GENTAMICIN, TROUGH LEVEL
ALLERGEN GOLDENROD
ALLERGEN GOOSE FEATHERS
HEP B SURFACE ANTIGEN
HEPATITIS B SURFACE AG
HCG, TOTAL, QUANTITATIVE
UPPER RESPIRATORY, ADULT
UPPER RESPIRATORY,CHILD
ALLERGEN MINOR FOOD PROF
ALLERGEN PERENNIAL PANEL
HEPATITIS A TOTAL
HEPATITIS BS AB QUAL
HEPATITIS B SURFACE AB QT
CYCLOSPORINE WHOLE MOLE.
ALLERGEN HORSE DANDER
ALLERGEN HOUSE DUST
IGE
ALLERGEN JOHNSON GRASS
LIDOCAINE
LH (LUTEINIZING HORMONE)
LH W/FSH AND RATIO
ALLERGEN, M. RACEMOSUS
ALLERGEN MESQUITE
RESPIRATORY ALLERGY PROF
MULBERRY TREE, ALLERGEN
PRIMIDONE/PHENOBARBITAL
ALLERGEN OAK
SUBSTANCE ABUSE PNL 6-50+
ALLERGEN OATS
OLIVE TREE, ALLERGEN
ALLERGEN ORANGE
ALLERGEN ORCHARD GRASS
ALLERGEN PEANUT
ALLERGEN PECAN
ALLERGEN PENICILLIUM
CHILDHOOD ALLERGY PANEL
ALLERGEN PERENNIAL RYE
ALLERGEN D. PTERONYSSINUS
ALLERGEN COCKROACH
ALLERGEN CANDIDA ALBICANS
ALLERGEN MTN JUNIPER
PHENOBARBITAL
PHENYTOIN
ALLERGEN PORK
CODE
7165
7167
7170
7180
7181
7182
7183
7185
7195
7200
7205
7220
7225
7230
7235
7239
7242
7244
7255
7260
7269
7270
7275
7280
7281
7282
7283
7285
7290
7292
7300
7310
7315
7320
7330
7335
7340
7342
7345
7350
7351
7355
7360
7365
7374
7375
7380
7385
7390
7395
7400
7405
7406
7410
7411
7412
7413
7414
7415
7420
7430
PRICE
$7.00
$7.00
$16.80
$7.00
$7.00
$7.00
$7.00
$11.62
$7.00
$7.00
$38.26
$7.00
$9.27
$19.95
$24.99
$26.67
$26.67
$26.67
$7.00
$7.00
$17.75
$18.28
$19.57
$161.00
$84.00
$70.00
$35.00
$7.00
$17.75
$41.67
$44.52
$7.00
$7.00
$21.00
$7.00
$18.38
$23.04
$46.62
$7.00
$7.00
$168.00
$7.00
$49.14
$7.00
$8.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$105.00
$7.00
$7.00
$7.00
$7.00
$7.00
$17.47
$12.39
$7.00
DESCRIPTION
SOY MILK FORMULA PROTIEN
LYME DNA PCR CSF OR SF
BETA2-GLYCOPROTEIN G,A,M
ORGANIC ACID, QUALITATIVE
MYASTHENIA GRAVIS PANEL 2
B. BURGDORFERI, DNA
LACTOFERRIN, STOOL
EBV DNA QUANT
LORAZEPAM
ALLOPURINOL & METABOLITE
INTRACELLULAR MARKERS
PORPHYRINS, TOTAL
PARAINFLUENZA ANTIGEN DFA
OVARIAN ANTIBODY SCREEN
ELASTASE-1, FECAL
HLA-DR4
HIV-1 VIRTUAL PHENOTYPE
ALLERGEN LIME IGE
CYTOCHROME GENOTYPE
PHEOCHROMOCYTOMA EVAL
HEPATITIS B GENOTYPE
HEPTIMAX (TM)
CYSTATIN C
GAD/ICA 512/INSULIN AB
CMV DNA QNT REAL TIME PCR
RESPIRATORY ALLERGY, II
RESPIRATORY ALLERGY,RG XI
RESPIRATORY ALLERGY,XII
RESPIRATORY ALLERGY,XIII
CHILDHOOD ALLERGY + IGE
ALLERGEN FOOD PROFILE
HPV HIGH RISK CAPTURE DNA
CYSTINE, QUANTITATIVE
RITUXAN SENSITIVITY
WEST NILE VIRUS, RT-PCR
CARBITAL QUANTITATION
GLIPIZIDE
ELECTROLYTES, STOOL
W. NILE VIRUS, RT-PCR,CSF
FACTOR IX AG.
ANTI-SULFATIDE ANTIBODIES
GLIADIN ANTIBODY (IGG)
MAGNESIUM, PEDIATRIC
OXALIC ACID, PEDIATRIC
LCHAD MUTATION ANALYSIS
THROMBOPHILIA MUTATION
COBALT QUANTITATION
PEROXISOMAL PANEL, SERUM
COLCHICINE
THROMBOPHILIA, INHERITED
PROTEIN S PANEL
THROMBOTIC MARKER PANEL
ARSENIC HAIR
ACHR BLOCKING AUTOAB
GANGLIOSIDE GM-1 IGG/IGM
C1Q COMPLEMENT COMPONENT
ALLERGEN,FERRET EPITHEL.
ALPHA GLOBIN COMMON MUT
ALLERGEN, CAYENNE PEPPER
CORTICOTROPIN RELEASING H
7-DEHYDROCHOLESTEROL
CODE
105125
108472
110002
110087
110104
110109
110156
110186
110202
110213
110248
110290
110322
110328
110446
110454
110469
110483
110490
110520
110529
110565
110570
110584
110600
110644
110653
110654
110655
110659
110714
110814
110947
110981
110992
111019
111079
111124
111190
111205
111210
111212
111220
111222
111244
111261
111290
111319
111320
111327
111343
111345
111409
111412
111510
111615
111724
111751
111880
112136
112306
PRICE
$23.80
$93.80
$81.90
$46.90
$194.25
$93.80
$43.75
$89.25
$32.20
$125.00
$54.60
$27.30
$35.00
$25.90
$78.40
$52.50
$154.00
$7.00
$120.75
$98.00
$138.60
$147.70
$37.80
$157.50
$119.70
$182.00
$189.00
$175.00
$189.00
$105.00
$84.00
$33.48
$45.50
$52.50
$113.75
$163.00
$130.00
$55.30
$113.75
$175.00
$420.00
$29.75
$24.17
$24.17
$113.40
$200.90
$91.00
$282.70
$425.00
$369.95
$221.55
$137.55
$167.80
$57.75
$52.50
$34.06
$7.00
$161.00
$39.88
$75.25
$236.00
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ALLERGEN POTATO
PREGNANCY, QUALITATIVE
PREG,QUAL,W/REFLX,QUANT
PROGESTERONE
PROLACTIN
PSA, TOTAL (SCREENING)
PSA, TOTAL, DIAGNOSTIC
ALLERGEN RICE
ALLERGEN RUSSIAN THISTLE
ALLERGEN RYE
ALLERGEN,MUGWORT
ALLERGEN SOYBEAN
ALLERGEN SYCAMORE
INSULIN RESPONSE,2 SPECIM
T3, TOTAL
INSULIN RESPONSE,3 SPECIM
INSULIN RESPONSE,4 SPECIM
INSULIN RESPONSE,5 SPECIM
INSULIN TOLERANCE 5 HOUR
T3 UPTAKE
INSULIN RESPONSE,7 SPECIM
INSULIN RESPONSE,8 SPECIM
INSULIN RESPONSE,9 SPCMEN
T4 (THYROXINE),TOTAL
FREE T4
HOMOCYSTEINE(NUTRITIONAL)
ALLERGEN GIANT RAGWEED
TESTOSTERONE
THEOPHYLLINE
ALLERGEN TIMOTHY GRASS
TOBRAMYCIN, RANDOM
TOBRAMYCIN, PEAK LEVEL
TOBRAMYCIN, TROUGH LEVEL
ALLERGEN TOMATO
ALLERGEN LAMB MEAT
ALLERGEN DOG DANDER
ALLERGEN LOBSTER
ALLERGEN BLUE MUSSEL
TSH,ULTRASENSITIVE
TSH ULTRASENSITIVE INFANT
TSH W/REFLEX TO FREE T4
ALLERGEN TUNA
VALPROIC ACID (DEPAKENE)
VANCOMYCIN, RANDOM
VANCOMYCIN, PEAK
VANCOMYCIN, TROUGH
PTH, INTACT W/CALCIUM
PTH INTACT W/O CALCIUM
VITAMIN B12
VITAMIN B12/FOLATE
WESTERN RAGWEED
ALLERGEN WHEAT
ALDOSTERONE, LC/MS/MS
QUINIDINE
ALLERGEN SHRIMP
ALLERGEN MEADOW FESCUE
ALLERGEN CULTIVATED RYE
ALLERGEN DERMATO. FARINAE
ALLERGEN LAMB'S QUARTERS
ALLERGEN, RED TOP GRASS
ALLERGEN, CLADOSPORIUM
CODE
7435
7440
7441
7445
7450
7455
7458
7470
7475
7480
7485
7505
7510
7511
7515
7516
7517
7518
7519
7520
7521
7522
7523
7525
7528
7529
7535
7545
7550
7555
7559
7562
7564
7575
7576
7577
7578
7579
7580
7583
7584
7585
7590
7594
7597
7599
7600
7602
7610
7611
7615
7620
7630
7710
7720
7725
7730
7735
7740
7741
7750
PRICE
$7.00
$5.73
$5.56
$26.29
$18.03
$28.02
$27.20
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$51.31
$31.50
$76.97
$102.62
$128.28
$153.93
$8.03
$179.59
$205.24
$230.90
$11.31
$14.68
$56.00
$7.00
$37.52
$13.06
$7.00
$26.71
$26.71
$26.71
$7.00
$7.00
$7.00
$7.00
$7.00
$4.64
$19.08
$19.08
$7.00
$18.27
$18.76
$18.76
$18.76
$59.50
$55.76
$21.96
$56.70
$7.00
$7.00
$62.30
$20.79
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
DESCRIPTION
GLYCOSAMINOGLYCANS, URINE
HEPATITIS D VIRUS AB PNL
IODINE PANEL
ANGIOEDEMA PROFILE 1
VAP CHOLESTEROL
DEXTROMETHORPHAN
RICKETTSIA (RMSF) ABS
ALLERGEN, SWORDFISH IgE
CITRIC ACID, 24 HOUR UR
URR PANEL
MDMA & METABOLITE
FUNGAL ANTIBODY PANEL CSF
RUBEOLA IGM
PHENOL,UR
FREE KAPPA & LAMBDA
HIV-1/HIV-2 AB WB/IB
5 FLUOROCYTOSINE
SELENIUM
SILVER QUANTITATION
VASCULAR ENDOLTHELIAL GF
VWF PROTEASE ACTIV W/RFX
SEROTONIN RELEASE ASSAY
A-1 ANTITRYPSIN, FECES
PRADER-WILLI/ANGELMAN SYN
BETA GLOBIN COMPLETE
CMV GENOTYPE
ALLERGEN, PINENUT IGE
ADIPONECTIN
LEGIONELLA DNA,QL,RT,PCR
RETT SYNDROME MUTATION
THYROID CASCADING REFLEX
POLYCHLORINATED BIPHENYLS
CYSTIC FIBROSIS D1152H
IMMUNE CELL FUNCTION
TA90 IMMUNE COMPLEX
DPD GENE MUTATION ANALYSI
RHEUMATOID FACTOR IGA
ZAP-70
CELLSEARCH, BREAST
WEST NILE VIRUS AB, IGM
WEST NILE VIRUS IGM, CSF
BULLOUS PEMPHIGOID AG
MANNOSE BINDING LECTIN
RSV RNA, QUALITATIVE PCR
AVIAN FLU VIRUS RNA PCR
RESPIRATORY VIRUS PANEL
FAMILIAL MEDITERRANEAN
FIRST TRI SCREEN hCG
PHENYLKETONURIA MUTATION
CRP HIGH SENSITIVITY
CHROMAGRANIN A
H PYLORI IGG AND IGM AB
IODINE, RANDOM URINE
PHOSPHATIDYLINOSITOL IgG
PIK3CA MUTATION ANALYSIS
CYP1B1 MUTATION ANALYSIS
CRP, CSF
CA 27.29, CSF
AFP, PLEURAL FLUID
THIOSULFATE, URINE
ISLET CELL AB W/RFL TITER
CODE
112358
112401
112503
112535
112800
112915
113022
113055
113095
113310
113321
113400
113610
113620
113883
114100
114135
114180
114200
114512
114532
114627
114628
114662
114974
114980
115010
115060
115062
115088
115102
115103
115335
115435
115524
115538
115682
116000
116011
116012
116013
116034
116039
116047
116090
116094
116141
116145
116152
116182
116379
116442
116601
116684
116897
117205
117401
117419
117555
117892
118202
PRICE
$100.00
$106.75
$31.50
$107.80
$173.00
$104.00
$35.00
$7.00
$70.70
$7.14
$21.70
$178.50
$33.25
$94.00
$112.46
$70.00
$173.40
$79.00
$87.00
$78.75
$77.00
$91.00
$39.90
$138.25
$244.30
$138.60
$7.74
$62.48
$104.30
$388.50
$26.60
$36.40
$61.60
$96.25
$47.95
$122.50
$14.00
$80.50
$203.00
$19.60
$19.60
$19.25
$35.00
$105.00
$113.75
$458.50
$175.00
$68.25
$875.00
$21.00
$44.45
$77.00
$35.00
$36.17
$138.25
$199.50
$22.75
$34.30
$29.40
$171.00
$29.40
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ALLERGEN ALTERNARIA TENIU
ALLERGEN MAIZE/CORN F8
ALLERGEN CHOCOLATE
ADULT ALLERGY PANEL
ADULT FOOD PANEL
CHILD FOOD PANEL
FOLATE, RBC
FOLATE,RBC (NO SERUM)
ALLERGEN CAT EPITHELIUM
ALLERGEN ASPERGILLUS
ALLERGEN PIGWEED
ALLERGEN SCALE, LENSCALE
FTI
CHOLINESTERASE W/DIB
AMPHETAMINES UR SCREEN
BARBITURATES UR SCREEN
BENZODIAZAPINES UR SCREEN
COCAINE METAB UR SCREEN
METHADONE URINE SCREEN
OPIATES URINE SCREEN
PCP URINE SCREEN
CANNABINOIDS UR SCREEN
ETHANOL URINE SCREEN
PROPOXYPHENE UR SCREEN
OXYCODONE URINE SCREEN
PRO 800 URINE DRUG SCREEN
PRO 819 URINE DRUG SCREEN
PRO 821 URINE DRUG SCREEN
CREATININE, URINE
AMPHETAMINE UR SCRN W/CON
BARBITURATES UR SCR W/CON
BENZODIAZEPINES UR W/CON
COCAINE METAB UR W/CON
METHADONE UR SCRN W/CONF
OPIATES UR SCREEN W/CONF
PCP UR SCRN W/CONFIRM
THC UR SCRN W/CONFIRM
PROPOXYPHENE UR W/CONFIRM
OXYCODONE UR SCRN W/CON
HEMOGLOBIN A1C W/MPG
PROFILE 8192 UR/BLD ALC
ANTITHROMBIN III W/REFLEX
ACETAMINOPHEN,QT-TYLENOL
DISOPYRAMIDE, QUANTITATIV
ETHOSUXIMIDE, QUANTITATIV
PROCAINAMIDE WITH NAPA
MEPHENYTOIN,QT-MESANTION
ACYLCLOVIR, HPLC
TEMAZEPAM
LOXAPINE
COTININE SCREEN,URINE
SULFONAMIDE
EBV NUCLEAR AG (EBNA)
BUPROPRION
ALCOHOL/VOLATILES
CARBOXYHEMOGLOBIN
HIPPURIC ACID, URINE
GIARDIA ANTIGEN EIA STOOL
PENTOBARBITAL,QT-NEMBUTAL
SALICYLATE, QT (ASPIRIN)
AMPHETAMINES UR CONFIRM
CODE
7755
7760
7765
7780
7781
7782
7805
7807
7825
7830
7845
7846
7925
7961
8001
8002
8003
8004
8005
8006
8008
8009
8011
8012
8013
8017
8018
8019
8021
8041
8042
8043
8044
8045
8046
8048
8049
8052
8053
8181
8192
8267
8300
8320
8330
8350
8380
8398
8436
8540
8542
8561
8564
8592
8600
8606
8614
8625
8650
8666
8705
PRICE
$7.00
$7.00
$7.00
$84.00
$42.00
$38.68
$46.94
$26.99
$7.00
$7.00
$7.00
$7.00
$19.34
$25.55
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$73.85
$79.52
$90.65
$2.50
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$2.34
$9.00
$20.37
$54.78
$23.49
$43.75
$32.90
$22.58
$89.00
$62.30
$137.00
$206.00
$78.00
$29.40
$26.95
$122.00
$10.68
$17.40
$89.00
$21.09
$29.44
$9.00
$35.00
DESCRIPTION
RETINOL BINDING PROTEIN
ANGIOTENSIN CONV. ENZYME
ANACHOICE CASCADING RFLX
CELIAC DISEASE COMP PNL
C-KIT MUTATION,CELL-BASED
LYMPHOCYTE MITOGEN SCREEN
GLUCOSE, URINE
TREPONEMA PALLIDUM PNL
LACTIC ACID, BODY FLUID
BILIRUBIN, TOTAL, FLUID
NATURAL KILLER CELL ASSAY
ASIALO GM1 ANTIBODIES
MAG ANTIBODY DUAL ELISA
GM1 ANTIBODIES, IGG,A,M
PARANEOPLASTIC SYNDROME
CHLORAMPHENICOL
TRYPSIN
CITRIC ACID-RANDOM URINE
CORTISOL FREE SERUM/PLAS
ALPRAZOLAM
HOMOVANILLIC ACID,RANDOM
DOPAMINE, PLASMA
VITAMIN B1, BLOOD
EPINEPHRINE PLASMA
ESTROGEN, TOTAL
FECAL FAT, QUALITATIVE
RAPAMYCIN
NONESTERIFIED FATTY ACIDS
MYOGLOBIN,URINE,QUANT
FRUCTOSAMINE
LGV DIFFERENTIATION PANEL
HEP B VIRUS PRECORE TAG
VARICELLA ZOSTER IGG/IGM
ALLERGEN, COTTON SEED
ALLERGEN, FLOUNDER
IGM, CSF
INHIBIN A
KI67,ER,PR,HER2-BREAST
KI67/ER/PR/HER2 W/O RFX
ER,PR,HER2-NEU,BREAST
ALLERGEN RASPBERRY IgE
CIC
NOREPINEPHRINE
PANCREATIC POLYPEPTIDE
IGF BINDING PROTEIN-2
MAGNESIUM, RANDOM URINE
HEPATITIS D RNA, QUAL
POTASSIUM, RBC
HEPATITIS G VIRUS RNA
SODIUM, FECES
MITOCHONDRIA M2 AB (IGG)
TRANSCORTIN
CARBAMAZEPINE,FREE
TRYPTOPHAN, LC/MS
TESTOSTERONE,BIOAVAILABLE
ASIALO GM-1 ANTIBODY IGG
ALLERGEN YOGURT
AT III ACTIVITY (AT3)
HGB S QUANT INCLUDES A1&F
FIBRIN DEGRADATION PROD
HEPARIN, UNFRACTIONATED
CODE
118366
118572
119946
119955
119961
120392
120476
120493
120504
120510
120595
121001
121004
121050
121051
121062
121105
121207
121469
121592
121807
122160
122191
122301
122541
122707
122721
122749
122917
122947
123005
123025
123112
123862
123893
124711
124786
125401
125402
125405
126281
126472
126666
127219
127233
127447
127500
128241
128500
129520
130321
130338
130642
130718
130741
130898
131510
131765
131852
132524
132748
PRICE
$26.95
$24.15
$19.25
$55.30
$350.00
$141.40
$53.80
$40.60
$49.00
$47.00
$137.20
$76.65
$94.15
$74.20
$101.50
$71.00
$44.84
$74.24
$43.75
$22.66
$36.75
$52.50
$40.25
$50.75
$44.10
$30.98
$45.15
$27.65
$17.05
$20.30
$84.00
$161.00
$53.20
$7.00
$7.00
$19.25
$59.50
$180.64
$180.64
$163.77
$7.00
$128.45
$50.75
$83.06
$28.70
$24.17
$113.05
$23.10
$113.05
$18.90
$21.00
$26.95
$21.09
$52.50
$96.25
$40.25
$39.88
$57.51
$28.00
$26.95
$47.25
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
BARBITURATES UR CONFIRM
BENZODIAZEPINES UR CON
CAFFEINE
COCAINE METAB UR CONFIRM
PROTEIN C ACTIVITY W/RFLX
METHADONE UR CONFIRMATION
OPIATES URINE CONFIRM
PCP URINE CONFIRMATION
PROPOXYPHENE UR CONFIRM
THC URINE CONFIRMATION
FLUPHENAZINE
IRON, LIVER
PROTEIN S ACTIVITY W/RFLX
ETHANOL UR SCRN W/CONFIRM
ALCOHOL,ETHYL,BLOOD
ETHANOL UR CONFIRMATION
ISOPROPANOL,BLOOD
ACETONE,BLOOD
MIXING CORRECTION STUDY
ETHYLENE GLYCOL, SERUM
L/S RATIO WITH PG
FETAL LUNG MATURITY (FLM)
MECONIUM DRUG SCREEN
RENAL FUNCTION W/O eGFR
EPSTEIN BARR VIRUS AB PNL
GHB ACID SCREEN, URINE
METABOLIC PNL W/O eGFR
ABO BLOOD GROUP/ Rh TYPE
PRENATAL ABO GROUP/RH TYP
ABO GROUP/RH CORD BLOOD
DIRECT ANTIGLOBULIN TEST
DIRECT ANTIGLOBULIN,CORD
DIRECT ANTIGLOBULIN IGG
COOMBS, INDIRECT
FETAL SCREEN
RH PHENOTYPE
ANTIBODY SCREEN
ANTIBODY IDENTIFICATION
ANTIBODY TITER
ALLERGY PANEL 12,ANIMAL
ANTIGEN ID
TOXICOLOGY SCRN,BLD & UR
METABOLIC PNL W/O eGRF
ELUATE
TORCH PANEL (IgG & IgM)
PAP,INTRP,NO RESCRN(SCRN)
CAH PANEL 11,NEONATAN
ORGANIC ACIDS QUAL URINE
ACETOACETATE
HCV RNA, QUANT, TMA
MALARIA ANTIBODY SCREEN
PAP,T LYR,NO RESCRN(DIAG)
PAP,T LYR,NO RESCRN(SCRN)
PROPYLENE GLYCOL
TAT COMPLEX
PHOSPHATIDYLSERINE AB IGA
ALBUTEROL QUANTITATION
HBV DNA, QUAL RT PCR
CITALOPRAM
MYASTHENIA GRAVIS PNL 3
S. CEREVISIAE IGG
CODE
8710
8717
8720
8740
8754
8760
8775
8780
8790
8799
8815
8828
8838
8901
8903
8906
8907
8908
8922
8955
8960
8965
8996
9161
9197
9342
9441
9500
9502
9504
9520
9521
9523
9525
9535
9540
9550
9553
9555
9581
9650
9810
9821
9986
10008
10015
10046
10049
10060
10073
10089
10090
10091
10122
10162
10163
10165
10179
10184
10211
10294
PRICE
$35.00
$35.00
$22.54
$35.00
$52.19
$35.00
$35.00
$35.00
$35.00
$35.00
$99.00
$50.40
$60.55
$2.34
$12.53
$35.00
$24.85
$22.75
$18.90
$17.40
$62.55
$19.15
$58.31
$5.64
$80.85
$207.00
$5.88
$13.65
$13.65
$13.65
$5.60
$5.60
$11.00
$6.51
$13.83
$30.17
$6.51
$10.43
$15.93
$35.00
$7.81
$69.23
$5.46
$9.94
$189.00
$13.00
$166.60
$46.90
$148.00
$147.70
$230.00
$22.66
$69.50
$121.00
$38.85
$24.85
$223.00
$77.00
$144.00
$229.95
$35.00
DESCRIPTION
COPPER, FREE
VARICELLA ZOSTER DNA
CHROMATIN ANTIBODIES IgG
MAG ANTIBODY
INHIBIN B
TOXOPLASMA GONDII,DNA,QL
TUMOR NECROSIS FACTOR
ANGIOTENSIN CONV. ENZYME
CHLAMYDOPHILA PNEUM ABS
A. NIGER, ALLERGEN IGE
QUETIAPINE, QUANTITATION
UPPER RESPIRATORY (ADULT)
CHILDHOOD ALLERGY PROF
PSYCHOTHERAPEUTIC SCREEN
WEST NILE VIRUS IGG IGM
WEST NILE VIRUS CSF IGG/M
GANGLIOSIDE GD1B IGM
GANGLIOSIDE GD1B IGG AB
MYELIN ASSOC GLYCOPROTEIN
INSULIN, FREE (BIOACTIVE)
DOPAMINE, RANDOM URINE
B-NATRIURETIC PEPTIDE
HYDROXYPOLINE, LC/MS
FLUORIDE
METHOTREXATE
ALLERGEN,CASEIN(COW MILK)
ALLERGEN PUMPKIN SEED IGG
COCCIDIOIDES AB, CSF
GAD-65 AUTOANTIBODY
PTH ANTIBODY
FUNGUS CULTURE W/REFLEX
BRUCELLA AB AGGLUTINATION
ENTAMOEBA HISTOLYTICA AB
PLATELET ANTIBODY DIRECT
ARBOVIRUS IgM AB PANEL
STREPTOCOCCUS GRP B AG
S PNEUMONIAE AG DETECTION
NEISSERIA GONORRHOEAE AB
BRUCELLA ABORTUS AB PANEL
CAL. ENCEPHALITIS AB, IGG
TRYPANOSOMA CRUZI PANEL
TRYPANOSOMA CRUZI IGG
TRYPANOSOMA CRUZI IGM
COCCIDIOIDES ANTIBODY CF
COXSACKIE B (1-6) AB, CF
CYSTICERCUS ANTIBODY
DENGUE FEVER ABS,IGG/IGM
E. EQUINE ENCEPHALITIS
E EQUINE ENCEPHALITIS IGG
EBV-VCA IGG ANTIBODY
FILARIA IGG4 ANTIBODY
ALLERGEN, RABBIT MEAT
HERPESVIRUS 7 IgG AB
HERPES VIRUS 7 IGG, IGM
HERPESVIRUS IGG, AB IFA
HERPES SIMPLEX AB PNL
LEISHMANIASIS ANTIBODY
DEXAMETHASONE, QUANT
HEAVY METALS,UR RANDOM
LCM, IGG
LYMPH CHORIOMEN IGM
CODE
133311
134052
134088
134134
134445
134451
134485
134692
134722
134938
135299
135552
135562
136249
136596
136597
136614
136622
136648
136700
137331
137386
137558
137802
137937
138100
138310
139170
139261
139287
139515
140020
140105
140129
140145
140160
140170
140200
140205
140220
140245
140250
140255
140280
140335
140350
140400
140417
140420
140465
140495
140510
140542
140543
140544
140551
140610
140624
140627
140630
140635
PRICE
$89.00
$78.40
$31.15
$40.25
$55.30
$103.60
$52.50
$24.15
$38.50
$7.00
$46.55
$175.00
$126.00
$28.00
$39.20
$39.20
$26.25
$35.00
$37.80
$33.25
$43.75
$45.15
$50.40
$13.41
$29.33
$12.95
$62.50
$26.25
$52.50
$58.45
$20.30
$31.85
$38.15
$59.85
$121.80
$38.50
$37.10
$39.90
$45.50
$38.15
$79.45
$44.10
$44.10
$33.46
$56.00
$46.55
$54.25
$59.85
$34.30
$27.30
$61.95
$48.40
$59.85
$114.80
$61.25
$75.95
$45.15
$32.55
$133.00
$30.10
$32.55
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
S. CEREVISIAE IGA
CAH PANEL 6B COMPREHENSIV
AMPHETAMINES D/L RATIO UR
PREKALLIKREIN ACTIVITY
ARSENIC URINE, RANDOM
AMINO ACIDS, LC/MS
ANTIMONY, BLOOD
PHOSPHATIDYLINOSITOL AB
ALLERGEN BLUEBERRY IGE
B-TRYPTASE
BACTRIM PROFILE
ASPIRIN RESISTANCE
MAGNESIUM, RBC
AMBIEN SERUM/PLASMA
BERYLLIUM, QUANTITATION
BETA-2 TRANSFERRIN
SOTALOL
BETA-HYDROXYBUTYRIC ACID
BICARBONATE, URINE
RESPIRATORY ALLERGY PROF
MYCOPHENOLIC ACID
FACTOR X ACTIVITY
PLATELET GLYCOPROTEIN AB
DIPHTHERIA ANTITOXOID AB
HUMAN PLT AG 1 GENOTYPE
TICK ID/RFLX LYME DIS DNA
BRODIFACOUM, QUANT
BROMIDE
CARDIOLIPIN AB SCREEN
LIPOPROTEIN a (LPa)
PAP,T LYR,INTRP,RSCN-DIAG
PAP,TLYR,W/INTRP W/RESCRN
PAP,T LYR,INTRP,NO RESCRN
HLA-B CLASS I DNA TYPING
HLA-A CLASS I DNA TYPING
HLA-DRB1 CLASS II DNA TYP
HLA-DQB1 CLASS II DNA TYP
ER/PR/HER2 W/RFL HER2
PSA, POST PROSTATECTOMY
MYLOTARG SENSITIVITY CD33
CAMPATH 1H (CD52)
MAG & GM1 ANTIBODY PANEL
SURFACE LIGHT CHAINS
FSH PEDIATRIC
ETHYLENE GLYCOL MONOBUTYL
CIRCULATING IMM COMP DET
HUMORAL IMMUNE EVALUATION
THROMBIN TIME
THROMBOSIS PANEL
BK/JC VIRUS DNA, QUAL PCR
TISSUE TRANSGLUTAMINASE
ENDOMYSIAL ABS IGG & IGA
PROTEIN S ANTIGEN FREE
VW TYPE 2N SEQUENCE ANALY
HEXOSAMINIDASE A & TOTAL
FUNGUS CULTURE PROGRESSIV
ANGIOTENSIN II TYPE 1
LDH ISOENZYMES
GASTRIC ANALYSIS, SINGLE
CRYOFIBRINOGEN
ANTI-CCP ANTIBODY
CODE
10295
10299
10329
10334
10357
10401
10410
10480
10482
10497
10498
10518
10551
10590
10638
10640
10641
10642
10645
10657
10662
10663
10678
10682
10707
10710
10717
10720
10793
10800
10911
10920
10921
10950
10951
10952
10953
10970
10976
10977
10980
11004
11015
11024
11038
11040
11043
11045
11051
11068
11070
11073
11087
11090
11091
11105
11118
11122
11143
11150
11173
PRICE
$35.00
$423.50
$239.00
$40.25
$45.85
$183.40
$79.00
$108.50
$7.00
$100.00
$135.00
$43.75
$42.53
$145.00
$82.00
$122.68
$117.00
$92.00
$82.00
$168.00
$42.53
$53.20
$57.75
$44.10
$89.25
$52.15
$171.00
$89.00
$19.25
$36.75
$23.50
$93.30
$23.50
$41.30
$41.30
$55.13
$55.13
$213.50
$30.10
$52.50
$52.50
$159.60
$80.50
$31.50
$125.00
$188.30
$142.80
$26.25
$196.35
$128.80
$42.35
$84.70
$63.70
$675.00
$240.60
$22.82
$65.10
$36.75
$10.92
$23.80
$31.50
DESCRIPTION
B BURGDORFERI IGG, WB
BORRELIA BURGDORFERI IGG
B. BURGDORFERI AB PANEL
SUBSTANCE P
M. PNEUMONIAE AB
S PNEUMO IGG SEROTYPES 12
BURKHOLDERIA PSEUDOMALLEI
B. PSEUDOMALLEI IGG/IGM
RICKETTSIA ANTIBODY PANEL
ST. LOUIS ENCEPHALITIS AB
ST LOUIS ENCEPHALITIS IGG
SCHISTOSOMA IGG ANTIBODY
TOXOCARA ANTIBODY
FRANCISELLA TULARENSIS AB
W. EQUINE ENCEPHALITIS
W EQUINE ENCEPHALITIS IGG
WEIL-FELIX
P53 ONCOPROTEIN
DNA CELL CYCLE ANALYSIS
ESTRADIOL, FREE
HUMAN ANTI-MOUSE ANTIBODY
CORTISONE 24 HR URINE
dsDNA AB, IFA
ANTI-SMOOTH ANTIBODY
HEPATITIS E ANTIBODY, IGM
HDL CHOLESTEROL SUBCLASS
CAMPYLOBACTER JEJUNI AB
ALLERGEN, SUGAR CANE
GANGLIOSIDE GQ1b ANTIBODY
17 KETOSTEROIDS FRAC-UR
PARVOVIRUS,DNA,PCR
CARDIOLIPIN ABS (IGG,A,M)
ALLERGEN REGIONAL PNL F
NATURAL KILLER CELLS
ALLERGY-REGIONAL J PANEL
ALLERGY-PERENNIAL PROFILE
ALLERGY-ANIMAL PANEL
ALLERGEN, CILANTRO IGE
FREE T3 AND FREE T4
PHOSPHATIDYLSERINE IGG/M
PYRUVATE, CSF
CAH PANEL 7
M PNEUMONIAE PCR
PROTEIN S, TOTAL ANTIGEN
BK VIRUS DNA, QUANT PCR
BK VIRUS DNA, PCR
PROGESTERONE, LC/MS/MS
METAPNEUMOVIRUS RNA RTPCR
M. TUBERCULOSIS COMPLEX
M. TUBERCULOSIS COMPLEX
HIV MONITR - TENOFOVIR
E HISTOLYTICA ANTIGEN
COMPLEMENT FACTOR B-C3PA
HISTOPLASMA CAPSULATUM ID
IMIPENEM LEVEL
PNEUMOCYSTIS JIROVECI DFA
MIC SUSCEPTIBILITY AFB
CULTURE, B. PERTUSSIS
5-FLUCYTOSINE LEVEL
EBV IGM VIRAL CAPSID AG
LYME DISEASE PANEL W/BAND
CODE
140645
140655
140677
140699
140730
140762
140775
140777
140840
140895
140900
140915
140945
140995
141045
141046
141050
141061
141566
141772
141882
141889
142069
142085
142125
142374
142388
142410
142547
142929
143010
143072
143729
143786
143844
144032
144073
144110
144438
145392
145784
146201
146300
146771
147900
148900
148908
149200
149724
149732
150040
150105
150145
150161
150255
151015
151187
151555
151590
151599
151732
PRICE
$42.00
$33.60
$58.45
$106.05
$32.90
$104.30
$37.45
$68.01
$73.50
$65.45
$38.15
$47.60
$50.05
$42.70
$70.70
$39.90
$37.80
$53.90
$63.00
$60.55
$73.50
$70.00
$20.30
$24.15
$35.00
$25.90
$51.45
$13.96
$37.45
$72.03
$49.70
$186.00
$70.00
$26.95
$70.00
$56.00
$28.00
$48.40
$113.05
$54.25
$40.65
$141.40
$113.05
$62.30
$130.90
$116.55
$25.90
$130.90
$65.80
$65.80
$45.50
$38.15
$31.71
$52.50
$45.15
$29.40
$45.15
$32.20
$44.10
$26.95
$37.24
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
18-HYDROXYCORTISOL FREE U
PRO BNP,N-TERMINAL
PROSTAGLANDIN D2
FRUCTOSE, SEMEN
RICKETTSIAL DISEASE PANEL
KAPPA/LAMBDA LIGHT CHAIN
ONTAK SENSITIVITY (CD25)
SENSORIMOTOR NEUROPATHY
HEPATITIS B DNA,QNT PCR
CLONAZEPAM, URINE
LUPUS ERYTHEMATOSUS PNL
HIV-2 AB,IMMUNOBLOT
PLACENTAL LACTOGEN, HUMAN
GLIADIN ANTIBODY IGA
FECAL GLOBIN
FECAL GLOBIN (MEDICARE)
CYTOCHROME P450 2C9 GENOT
INVASIVE TROPHOBLAST AG
LAMBERT-EATON SYNDROME AB
TROPONIN
CALCIUM,24HR NO CREATININ
OXALIC ACID, 24 HR URINE
MAGNESIUM, 24 HR URINE
SARS CORONAVIRUS,RNA,QL
C4 BINDING PROTEIN
HOMOVANILLIC ACID
HEPATITIS C VIRAL RNA
P O ANTIBODIES
C. TRACHOMATIS RNA TMA
N. GONORRHOEAE RNA, TMA
B PERTUSSIS/PARAPERT DNA
HIV-1 gp4 ENVELOPE G-TYPE
PLASMINOGEN ACTIVATOR INH
LH PEDIATRICS
OROTIC ACID, URINE
ALLERGEN, CATFISH IgE
SACCHAROMYCES CEREVISIAE
DDT W/DDD & DDE QUANT
HERPESVIRUS 6 ABS,IGG/IGM
HSV VIRUS 1/2 IGG,TYP SPC
STAT FEE
TRAVEL ALLOWANCE
5-HIAA, 24 HOUR URINE
ANGIODEMA EVALUATION
ALLERGEN SUNFLOWER SEED
ACID PHOS,PROSTATIC (RIA)
COMPLEMENT C2 PROTEIN
NICKEL, URINE
PROTEIN C ANTIGENIC
PROTEIN S ANTIGENIC
BONE SPECIFIC ALK PHOS
ANTI-HISTONE ANTIBODY
STACHYBOTRYS ATRA PANEL
MACROGLOBULIN (ALPHA-2)
MOLD PROFILE IGG
STAPH AUREUS SCREEN-MRSA
ANTI-RETICULIN ANTIBODY
DEPYRIDAMOLE
STACHYBOTRYS IGE
ALLERGEN C. GLOBOSUM
HYPERSEN PNEUMONITIS
CODE
11178
11188
11201
11224
11233
11234
11237
11264
11265
11270
11272
11279
11283
11288
11290
11293
11294
11303
11306
11309
11313
11318
11322
11324
11335
11346
11348
11350
11361
11362
11365
11367
11368
11391
11426
11432
11445
11470
11492
11499
11519
11521
11523
11529
11565
11576
11605
11618
11649
11659
11687
11702
11712
11732
11750
11752
11764
11777
11782
11783
11784
PRICE
$80.15
$45.15
$300.00
$54.64
$113.40
$84.00
$52.50
$1,995.00
$113.75
$85.00
$104.65
$35.00
$52.71
$29.75
$21.00
$21.00
$70.06
$55.30
$284.90
$36.40
$14.02
$14.02
$14.02
$91.00
$31.50
$36.75
$147.70
$132.00
$21.00
$21.00
$119.00
$154.00
$69.30
$28.70
$53.62
$36.90
$84.00
$114.00
$34.30
$55.87
$7.81
$14.60
$26.25
$93.45
$48.40
$20.49
$155.60
$29.75
$52.85
$129.50
$40.81
$30.10
$167.30
$34.76
$217.50
$5.83
$45.50
$95.00
$48.40
$48.40
$59.15
DESCRIPTION
AMPICILLIN LEVEL
HELICOBACTER PYLORI IGM
CEFTAZIDIME LEVEL
CEFTRIAXONE
CLINDAMYCIN LEVEL,BA
DICLOXACILLIN
DOXYCYCLINE
ERYTHROMYCIN LEVEL
STREPTOMYCIN LEVEL HPLC
RIFAMPIN LEVEL
HEPATITIS D AB TOTAL
LEPTOSPIRA CULT & STAIN
S PNEUMONIAE SEROTYPING
TOXIC SHOCK ANTIBODY PNL
ACANTHAMOEBA STAIN
CIPROFLOXACIN
AZITHROMYCIN LEVEL
INFLUENZA TYPE A ANTIBODY
INFLUENZA TYPE B ANTIBODY
INSULIN AUTOANTIBODY
CRYPTOSPORIDIUM ANTIGEN
PARVOVIRUS B19 IgM AB
PHOSPHATIDYLSERINE AB PNL
ESTRONE SULFATE
ALLERGEN ANCHOVY IGE
ANTI-TSH ANTIBODY
VARICELLA ZOSTER AB, IGG
ALLERGY-FOOD PROFILE
ALLERGEN HONEY BEE VENOM
ALLERGY-MINOR FOOD + IGE
NEURONAL NUCLEAR AB (HU)
CAH PANEL 4
ALLERGEN SWEET POTATO
COBALT, 24 HR URINE
CAH PANEL 3
BACTERIAL MENINGITIS PNL
INSECT VENOM ALLERGEN PNL
CAH PANEL 1
RET PROTO ONCOGENE MUTAT.
AFB PCR,CULT,SMR SPUTUM
BISMUTH, RANDOM URINE
COBALT, BLOOD
MANGANESE, WHOLE BLOOD
MANGANESE, URINE
MERCURY,RANDOM
NICKEL
COCCI IMMITIS ID,DNA
ZINC, RBC
ALLERGEN, BELL PEPPER IgE
OSMOTIC GAP FECES 24 HR.
OSMOTIC GAP FECES RANDOM
ADENOVIRUS AG DETECTION
ADENOVIRUS ANTIGEN DFA
VZV ANTIGEN DETECTION
KAPPA-LAMBDA LIGHT CHAIN
ALLERGEN ALFALFA
PLASMINOGEN ACTIVATOR INH
VWF MULTIMERIC ANALYSIS
RISTOCETIN COFACTOR
ASPERGILLUS AB CF, (CSF)
COXSACKIE A ABS, CSF
CODE
151765
151771
151815
151830
151865
151885
151890
151895
151962
151964
152001
152015
152020
152050
152075
152120
152135
152290
152308
152324
152500
152746
152952
153551
153810
153843
154031
154189
154319
154494
154700
154809
154810
154882
154890
155053
155327
155368
155426
155434
155988
156259
156812
156846
156895
157059
157500
157612
157710
157715
157718
158255
158289
158818
159162
159710
159766
160137
160145
160150
160330
PRICE
$45.15
$110.00
$45.15
$45.15
$45.15
$45.15
$45.15
$45.15
$69.30
$69.30
$32.55
$72.10
$61.95
$113.40
$45.15
$45.15
$45.15
$29.05
$29.05
$52.50
$25.90
$24.50
$79.10
$62.30
$48.40
$41.30
$26.60
$35.00
$7.00
$91.00
$87.50
$227.15
$36.90
$41.30
$0.00
$68.95
$35.00
$231.00
$153.30
$128.80
$16.80
$43.40
$31.50
$28.00
$38.50
$29.75
$62.48
$29.05
$36.90
$34.39
$34.39
$31.15
$31.15
$19.25
$21.70
$36.90
$38.50
$74.90
$50.05
$38.85
$59.50
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
ALLERGEN HORSE HAIR
CULTURE,HSV,RAPID
LEUCINE AMINOPEPTIDASE
LIPASE,URINE
LIPID ASSOC SIALIC ACID
ALLERGEN ERYTHROMYCIN IGE
CHLORPROMAZINE
BABESIA/LYME AB PANEL,IFA
LIPOPROTEIN ELECTROPHORES
5-HIAA, RANDOM URINE
VMA, 24 HOUR URINE
GOLD
COMPLEMENT C6
C7,SERUM
COMPLEMENT C8
COMPLEMENT C9
ESCITALOPRAM QUANTITATION
ESTRIOL, SERUM
TDT(TERMINAL TRANSFERASE)
GLYBURIDE
SOL. TRANSFERRIN RECEPTOR
HUMORAL IMMUNITY 12 SERO
ENTEROVIRUS PANEL II
FORMIC ACID
FOSPHENYTOIN, QUANT
FUROSEMIDE, URINE
GLUTETHIMIDE
PHENYLALANINE
BACTERIAL ANTIGEN
DRUG ABUSE SCREEN, RIA
E GRANULOSUS AB, IGG
METHYLPHENIDATE (RITALIN)
ER/PR/HER2 NEU NONBREAST
CLOSTRIDIUM DIFFICILE CUL
INFLUENZA A&B DETECTION
TRICHINELLA ANTIBODY
IRON, URINE RANDOM
ITRACONAZOLE,QUANTITATION
HIV-2 AB,EIA W/RFL WB
BLASTOMYCES AB,CF
ALLERGEN APRICOT
BILE ACIDS FRACTIONAT/TL
CMV CULTURE
ALLERGEN GINGER
RESPIRATORY SYNCYTIAL AB
DIGITOXIN
MERCAPTOPURINE
IBUPROFEN
MERCURY
PROFILE 12711 OBSTETRIC
METFORMIN
COLORADO TICK FEVER
SILVER, BLOOD
BILE ACIDS TOTAL
NEUROTENSIN
METHOCARBAMOL
THIOCYANATE
VITAMIN B5 PANTOTHENIC AC
HCV RNA, QUAL W/REFLEX
IGD
ZINC PROTOPORPHYRIN
CODE
11804
11841
11842
11872
11875
11877
11882
11900
11929
11930
11934
11944
11950
11952
11954
11956
11965
11972
12059
12060
12073
12078
12080
12134
12136
12140
12160
12162
12245
12287
12321
12338
12407
12411
12423
12427
12430
12460
12477
12511
12563
12593
12627
12644
12646
12650
12660
12668
12670
12711
12740
12799
12818
12833
12882
12900
12949
13028
13040
13055
13073
PRICE
$39.88
$24.15
$22.40
$14.00
$27.65
$48.40
$101.00
$101.50
$23.80
$36.40
$39.90
$38.61
$35.70
$33.95
$33.95
$33.95
$144.00
$35.70
$43.12
$107.00
$66.50
$332.85
$185.15
$90.00
$121.00
$108.00
$104.00
$30.80
$161.35
$31.28
$61.25
$43.02
$0.00
$36.40
$58.10
$44.10
$187.20
$312.00
$26.25
$32.20
$7.00
$57.75
$64.75
$7.00
$36.05
$23.45
$155.00
$10.50
$61.00
$50.16
$133.00
$58.10
$116.20
$56.50
$200.00
$89.00
$20.13
$175.00
$77.35
$41.30
$26.25
DESCRIPTION
CRYPTOCOCCUS AG DETECTION
CYSTICERCUS ANTIBODY, CSF
ALLERGEN, AVOCADO
E EQUINE ENCEPHALITIS IGM
ECHOVIRUS ANTIBODY PANEL
ALLERGEN, BLACK PEPPER
ALLERGEN, B. CINEREA IGE
ALLERGEN BROCCOLI IGE
HERPESVIRUS 6 IGM AB
INFLUENZA A&B, CSF
CASEIN, ALLERGEN
B BURGDORFERI IGG CSF
ALLERGEN,AMERICAN CHEESE
MEASLES IGG ANTIBODY, CSF
MUMPS IGG ANTIBODY
MUMPS IGM ANTIBODY
M. PNEUMONIAE AB, CF(CSF)
ALLERGEN COFFEE
ST LOUIS ENCEPHALITIS IGM
BARTONELLA IGG ANTIBODY
BARTONELLA IGM ANTIBODY
ANTINEURONAL NUCLEAR AB
VARICELLA ZOSTER VIRUS AB
VARICELLA ZOSTER AB CSF
W EQUINE ENCEPHALITIS
W EQUINE ENCEPHALITIS IGM
ALLERGEN, FIRE ANT
ALLERGEN GLUTEN
ALLERGEN GRAPEFRUIT
ALLERGEN, HAMPSTER
HAZELNUT, ALLERGEN
ALLERGEN HAZELNUT TREE
ALLERGEN KIWI FRUIT IGE
ALLERGEN, LETTUCE IgE
ALLERGEN, MALTI IgE
ALLERGEN, MANGO FRUIT
ALLERGEN MELONS
ALLERGEN MOUSE EPITHELIUM
ALLERGEN, PAPER WASP
ALLERGEN PEACH
ALLERGEN PEAR
ALLERGEN, PECAN NUT IgE
ALLERGEN PINEAPPLE
QUEEN PALM, ALLERGEN
ALLERGEN RAT EPITHELIUM
NTX RANDOM URINE
VALPROIC ACID, FREE
S. BOTRYOSUM, ALLERGEN
STRAWBERRY, ALLERGEN
ALLERGEN, TROUT
ALLERGEN, TURKEY MEAT IgE
WHITE FACE HORNET
ALLERGEN, YELLOW HORNET
AUSTRALIAN PARROT DROP
FTA, IFA, CSF
C DIFFICILE A&B
ADULT ALLERGY PROFILE #2
CYTOMEGALOVIRUS DNA PCR
ALDOLASE
ALLERGEN, CHERRY IgE
ALLERGEN CUCUMBER IGE
CODE
160345
160350
160355
160425
160435
160459
160491
160525
160535
160585
160624
160655
160673
160690
160710
160715
160730
160830
160905
160925
160926
161006
161015
161025
161046
161047
161176
161259
161317
161358
161366
161374
161549
161614
161663
161671
161721
161796
161986
162059
162075
162083
162182
162224
162240
162287
162442
162521
162570
162687
162711
162802
162885
163040
163486
163636
165552
166334
166985
167199
167249
PRICE
$31.85
$50.05
$7.74
$37.80
$58.80
$7.35
$7.00
$7.00
$43.05
$47.25
$7.00
$37.10
$7.35
$35.35
$37.45
$37.45
$36.40
$7.00
$39.20
$58.80
$58.80
$65.45
$41.65
$68.60
$43.40
$43.40
$7.74
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.74
$7.00
$7.00
$7.00
$58.80
$33.46
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.74
$30.10
$39.20
$140.00
$101.50
$14.70
$7.74
$7.00
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
MIRTAZAPINE QUANTITATION
HTLV 1/2 AB, EIA
NEFAZODONE
CULTURE, LEGIONELLA
CULTURE, M. PNEUMONIAE
RUBELLA AB'S IGG/IGM
PAROXETINE
PHENOSENSE HIV COMP
TESTOSTERONE, FREE
INTERFERON ALPHA
PARALDEHYDE & METABOLITE
HISTOPLASMA ANTIBODY,CF
APC RESISTANCE
CARDIOLIPIN SCRN W/RFX
ANTICARDIOLIPIN AB IGA
IGF-II
FUNGAL PNL W/CRYPTOCOCCUS
BLASTOMYCES AB ID SERUM
HISTOPLASMA AB IMMUNODIFF
ALLERGEN, SPRUCE IGE
PERCHLOROETHYLENE
FREE T3 TRACER DIALYSIS
UBT COLLECTION FEE
ALPHA-1-ACID GLYCOPROTEIN
ARBOVIRUS IGG AB PROFILE
NEURON SPECIFIC ENOLASE
COLLECTION/TRANSPORT FEE
VENIPUNCTURE
VONWILLEBRAND DISEASE PNL
RESPIRATORY VIRAL W/REFLX
PHENOBARBITAL FREE&BOUND
MUMPS/RUBELLA/RUBEOLA IGM
MUMPS AB IGM
HSV 1 IGG TYPE SPECIFIC
B HENSELAE ABS IGG/IGM
CATECHOLAMINES, URINE
ENDOMYSIAL AB IGA W/RFL
BETA2-GLYCOPROTEIN I IGG
BETA2 GLYCOPROTEIN I IGM
HPV, DNA (HUMAN PAPILL)
CHROMIUM
PLATINUM
RUBEOLA AB IGG IGM
INTERLEUKIN 6
HEPATITIS E ANTIBODY IGG
HSV 1/2 IGG,HSV IGM W/RFL
LACTIC ACID, CSF
CULTURE,HSV,W/RFL TYPING
ANTI-MYOCARDIAL AB W RFX
CHLORIDE, CSF
ZINC, URINE
FLECAINIDE
ANCA VASCULITIDES
PEG PREC IGG IMMUNE COMPL
ESTRONE, SERUM
MANGANESE, URINE
PORPHYRINS FRACTIONATED
ESTROGEN FRACTIONATION
ZINC, PLASMA
IMIPRAMINE
SILICON QUANTITATION
CODE
13075
13113
13145
13151
13164
13176
13187
13200
13259
13290
13310
13340
13365
13371
13374
13383
13400
13410
13415
13426
13430
13434
13444
13498
13522
13535
13553
13555
13558
13563
13582
13590
13595
13636
13637
13639
13677
13678
13749
13760
13782
13783
13820
13828
13838
13843
13844
13881
13892
14004
14026
14035
14044
14081
14100
14106
14117
14122
14154
14158
14190
PRICE
$104.00
$73.50
$87.00
$41.65
$30.10
$59.50
$96.00
$1,220.00
$36.40
$60.55
$99.00
$33.95
$19.22
$19.25
$21.70
$35.26
$135.45
$28.35
$21.70
$7.00
$100.00
$70.00
$9.21
$23.10
$124.25
$31.97
$35.00
$3.47
$227.85
$22.75
$138.00
$102.55
$28.70
$37.08
$41.30
$49.35
$30.10
$27.30
$27.30
$66.50
$34.65
$139.00
$66.50
$78.75
$26.95
$86.45
$18.48
$23.45
$22.75
$6.74
$24.85
$19.25
$87.50
$17.15
$39.90
$28.00
$34.65
$81.20
$24.85
$37.80
$95.00
DESCRIPTION
POTASSIUM, FECES
HELICOBACTER PYLORI IGA
ALLERGEN JUNIPER WESTERN
ALLERGEN CINNAMON
ALLERGEN, GRAPE IgE
ALLERGEN, HALIBUT
ALLERGEN MUSHROOM
ALLERGEN SPINACH
ALLERGEN, SQUID IGE
CA 15-3
CLOZAPINE
B BURGDORFERI IgG,IgM ABS
RHEUMATOID FACTOR, FLUID
ALLERGEN BASIL
ALLERGEN, RED KIDNEY BEAN
ALLERGEN CABBAGE
ALLERGEN CHESTNUT IGE
ALLERGEN DILL
ALLERGEN, GOAT MILK IgE
ALLERGEN LENTIL
HEREDITARY HEMOCHROMATOSI
ALTERNARIA TENUIS IGG
ALLERGEN ALT TENUIS IGA
ASPERGILLUS FUMIGATUS IG
ASPERGILLUS PRECIPITANT
ALLERGEN A FUMIGATIS IGA
CLADOSPORIUM HERBARUM IGG
H HALOIDES IGG
ALLERGEN OREGANO IGE
OYSTER, ALLERGEN
MUCOR RACEMOSUS IGG
PENICILLIUM NOTATUM IGG
ALLERGEN P NOTATUM IGA
ALLERGEN, CHICK PEA IGE
CHILI PEPPER, ALLERGEN
ALLERGEN PISTACHIO
PRIVET TREE, ALLERGEN
CEPH ACREMONIUM IGG
ALLERGEN ASPERG NIGER IGG
ALLERGEN ASP NIGER IGA
ALLERGEN WHEY
RETICULIN IGA
STACHYBOTRYS IgG
ASPERGILLUS VERSICOLOR
ASPERGILLUS AMSTELODAMI
HELMINTH SATIVUM
SUCCYNYLCHOLINE IGG
SUCCINYLCHOLINE IGA
GALACTOSE-1-PHOSPHATE
AMYLASE, PANCREATIC
MEN2 (2A,2B,FMTC) MUT SCR
ALLERGEN,RABBIT HAIR
CHLAMYDIA TRACHOMATIS DFA
C DIFF TOXIN AB,NEUTRALIZ
NOROVIRUS, EIA (STOOL)
ACYLGLYCINES QUANT,URINE
SULFATE,URINE
ALLERGEN,RAT PROTEINS
CYCLOSPORA DETECTION
TRICHOMONAS CULTURE
ALLERGEN,RAT UR PROTEINS
CODE
167926
168002
168310
168379
168411
168429
168486
168569
168585
168759
168965
170340
170352
171183
171290
171696
172199
172801
173403
174583
175021
175120
175130
175220
175225
175230
175420
175520
175523
175580
175620
175720
175730
175739
175911
176133
176323
176820
177320
177330
177743
178002
178220
178620
178720
179510
179920
179930
180337
180376
180573
180610
181035
181055
181106
181249
181815
181910
182000
182001
182010
PRICE
$18.20
$38.50
$39.88
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$34.30
$26.25
$82.25
$28.70
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$7.00
$137.55
$43.50
$86.97
$37.04
$64.17
$86.97
$43.50
$43.50
$7.00
$7.00
$43.50
$43.50
$70.00
$7.00
$7.00
$7.00
$7.00
$43.50
$43.50
$86.97
$7.00
$22.75
$64.00
$43.50
$64.17
$63.40
$43.50
$70.00
$416.40
$126.70
$701.20
$39.88
$26.25
$64.75
$42.00
$396.70
$134.90
$48.40
$46.20
$42.70
$48.40
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
HEAVY METALS COMPREHENSIV
STRONTIUM
17 HYDROXYPROGESTERONE
SULFONAMIDES, UNDIFFERENT
COPPER
HYPOGLYCEMIC PANEL, QUAL
CELIAC DISEASE AB PNL
CHROMIUM, BLOOD
LEAD, RANDOM URINE
INTERLEUKIN-1 BETA
TYROSINE
GLUCOSE, SYNOVIAL FLUID
ASORBIC ACID (VITAMIN C)
ZINC RANDOM URINE
IGA, CSF
ALUMINUM, 24 HR UR
LIMULUS AMEBOCYTE LYSATE
THROMBIN CLOTTING TIME
FACTOR XIII, FUNCTIONAL
TIAGABINE QUANTITATION
TIN, TOTAL
TITANIUM
BONE MARROW ENFRAG STUDY
KAPPA/LAMBDA LIGHT CHAINS
TOPIRAMATE (TOPAMAX)
LP-PLA2
ACYLCARNITINE, PLASMA
CULTURE, MYCOBACTERIUM
ALUMINUM, RANDOM URINE
STREPTOCOCCUS GROUP A DNA
BD AFFIRM VPIII MICROBIAL
CHROMOSOME ANALYSIS
5' NUCLEOTIDASE
CARDIOLIPIN ANTIBODY, IGG
CARDIOLIPIN ANTIBODY, IGM
Y CHROMOSOME MICRODELETIO
FISH ALL/NHL MYC-BA 8q24
ANAPLASMA/EHRLICHIA PNL
TRAZODONE SERUM/PLASMA
L. PNEUMOPHILIA IGG
C-PEPTIDE STIMULATION X4
URANIUM, URINE 24 HOUR
CAH COMMON MUTATIONS
VENLAFAXINE & METABOLITE
ALLERGEN ASPEN TREE
VITAMIN B3
THALLIUM, BLOOD
PSA, POST PROSTATECTOMY
LIPID PANEL W/REFLEX DLDL
ZIPRASIDONE
RESP CULTURE W/REFLEX
HEPARIN IND THROMBOPENIA
COPPER URINE, RANDOM
ZONISAMIDE
ANTIPHOSPHOLIPID AB PANEL
FLUCONAZOLE
CADMIUM EXPOSURE PANEL
ASPERGILLUS ANTIGEN
METANEPHRINES,FRAC,RANDOM
BASIC METABOLIC W/EGFR
COMP. METABOLIC W/EGFR
CODE
14200
14212
14215
14245
14250
14261
14263
14278
14297
14309
14368
14410
14425
14437
14447
14451
14453
14459
14461
14479
14485
14486
14487
14492
14518
14530
14531
14554
14561
14565
14577
14599
14624
14662
14663
14679
14706
14720
14732
14739
14747
14751
14755
14769
14778
14780
14790
14808
14852
14860
14867
14874
14877
14884
14890
14904
14915
14950
14961
15044
15045
PRICE
$199.85
$61.00
$78.40
$107.00
$26.25
$110.00
$147.35
$34.65
$48.30
$78.75
$41.02
$8.75
$39.55
$35.00
$19.25
$32.55
$42.53
$26.25
$60.27
$20.85
$109.00
$116.00
$126.00
$44.42
$33.25
$62.48
$60.20
$63.00
$45.85
$26.25
$88.20
$466.00
$19.02
$21.70
$21.70
$113.89
$133.00
$74.55
$81.00
$32.24
$133.00
$137.00
$166.25
$233.00
$39.88
$172.00
$39.55
$30.10
$8.72
$120.00
$63.00
$134.75
$36.40
$34.65
$219.10
$69.30
$104.65
$40.95
$51.84
$5.46
$5.88
DESCRIPTION
FATTY ACID ESSENTIAL
PARROT DROPPINGS IGG
EOSINOPHIL CATIONIC PROT
N-METHYLHISTAMINE URINE
HEREDITARY PANCREATITIS B
GANGLIOSIDE ANTIBODY PNL
CAH PANEL 9
H PYLORI IGG,IGM,IGA AB'S
MYCOBAC PCR RESPIRATORY
MYCOBAC PCR NON-RESP
CRYPTOCOCCUS ANTIBODY
MUMPS ANTIBODY PANEL
IGA SUBCLASSES
TRICYCLIC ANTIDEPRESSANT
ISLET CELL AG 512 AUTOABS
DHEA URINE
ALLERGEN FLAXSEED IGE
YELLOW JACKET VENOM ALRGN
WHITE FACED HORNET ALRGN
YELLOW HORNET VENOM ALRGN
FIRE ANTS VENOM ALLERGEN
LIPIDS, TOTAL STOOL
RPR QUANTITATIVE TITER
ALLERGEN, BLACK ANT (IGE)
LSD,URINE
HEPATITIS D ANTIGEN
T4 ANTIBODY
INTERLEUKIN 2 RECEPTOR
CRYPTOCOCCUS AG W/REFLEX
HPV LOW/HIGH RISK W/RFLX
PROTEIN C & S AG FACT VII
FACTOR VIII ANTIGEN
FACTOR X INHIBITOR
PLATELET NEUTRALIZATION
MILK PRECIPITIN PANEL
BIRD FANCIER'S PANEL
ABPA
STACHYBOTRYS CHARTARUM
BUILDING RELATED ALLERGY
ALLERGEN SO COASTAL CALIF
ALLERGEN ARID SOUTHWEST
HYMENOPTERA ALLERGY PANEL
T-LYMPH/CD4/CBC
CIPROFLOXACIN, PROGENE
PROGENE, IBUPROFEN
ACETAMINOPHEN, PROGENE
PROGENE, LVS-ASPIRIN
PROGENE, DICLOFENAC
PROGENE, AMOXICILLIN
SHOX DNA GENE MUTATION
LATEX, H.BRAZILIENSIS
FUSARIUM MONILIFORME IGG
LISTERIA ANTIBODY
FISH,CHROM 20q DELETION
FISH, AML1/ETO, t(8:21)
FISH,UROVYSION BLADDER
FANCONI ANEMIA DNA MUTAT
NIEMANN-PICK DNA MUTATION
BLOOM SYNDROME DNA MUTAT
CELL CULT,ADDT'L PRENATAL
CF DNA ANALYSIS - FETUS
CODE
182426
182620
182891
183011
183019
183089
183139
183253
183329
183378
184210
185845
186181
186249
186736
186934
187910
190220
190420
190520
190620
191700
192656
193310
194247
195265
195802
196545
198186
198641
300032
300208
300725
300805
401668
401707
401710
401713
402409
402541
402548
402619
457059
501352
501360
501361
501365
501369
501381
504005
1161580
1175120
1510022
10055N
10106N
10107N
10221N
10222N
10224N
10225N
10226N
PRICE
$444.60
$43.50
$42.00
$207.30
$487.00
$221.20
$230.30
$115.50
$128.80
$128.80
$24.85
$54.25
$38.50
$28.00
$52.50
$73.50
$48.40
$70.50
$70.50
$70.50
$70.70
$44.80
$8.75
$48.40
$40.43
$30.80
$41.30
$70.00
$30.45
$47.71
$314.00
$180.00
$275.00
$145.00
$122.93
$200.77
$108.40
$87.68
$154.70
$227.30
$177.05
$166.04
$162.72
$190.00
$104.25
$190.00
$190.00
$190.00
$190.00
$425.00
$7.00
$43.50
$47.95
$128.80
$138.60
$157.50
$85.75
$78.75
$82.25
$30.80
$110.25
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
RENAL FUNCTION PNL W/EGFR
CFTR INTRON 8 POLY T
FLUOXETINE
PORPHYRINS, FRACTIONATED
GASTRIC PARIETAL CELL AB
PSA, TOTAL
KAPPA/LAMBDA LIGHT CHAINS
HJ SOUTHWESTERN PNL + IGE
LEVETIRACETAM
HJ SOUTHWESTERN PROFILE
ALLERGY NUT MIX
ALLERGEN YELLOW JACKET
PARVOVIRUS B19, IGG
HEPARIN-INDUCED PLT AB
ALPHA-1 ANTITRYPSIN MUT
TAY SACHS ENZY. CARRIER
BISMUTH
SPIRONOLACTONE&METABOLITE
RHEUMATOID FACTOR
PERNICIOUS ANEMIA DIAGNOS
EPSTEIN BARR AG AB IGG
HLA-C CLASS I DNA TYPING
IGVH MUTATION ANALYSIS
HLA CLASS I A,B,C DNA TYP
HLA DR,DQ CLASS II DNA TY
TESTOSTERONE,FREE/TOTAL
BETA-2 MICROGLOBULIN, CSF
SURESWAB VAGINOS-VAGINIT
URORISK DIAG. PROFILE
INFLUENZA TYPE B IGG,IGM
HYDROCODONE & METABOLITE
VON WILLEBRAND COMP PNL 2
LYME DISEASE DNA, CSF
HLA-B27, DNA TYPING
STONERISK DIAGNOSTIC
MICROSPORIDIA SMEAR
RSV ANTIGEN DETECTION
HLA A,B CLASS I DNA TYP
LYME DISEASE DNA, B
BABESIA MICROTI IgG IgM
BRAZIL NUT
ALLERGEN BUCKWHEAT
ALLERGEN COCONUT
ALLERGEN SESAME SEED
LYME DISEASE DNA, UR
HERPES VIRUS 8 DNA PCR
C4 BINDING PROTEIN, PLSMA
LIVER CYTOSOL ANTIBODIES
HPV DNA, HIGH RISK
ALLERGEN CARROT
ANGIOEDEMA PANEL,ACQUIRED
LUNG HEMORRHAGE NEPHRITIS
CELIAC DISEASE PANEL
CELIAC DISEASE COMP,INFNT
TESTOSTERONE, LC/MS/MS
HERPES VIRUS 6 DNA QUAL
CHLAMYDIA PNEUMONIAE, PCR
B-CELL GENE REARRANGEMENT
PCNA ANTIBODY
VMA,METANEPHRINE,CATECHOL
CYSTINURIA PROFILE,QN 24H
CODE
15046
15053
15066
15078
15114
15119
15122
15134
15142
15144
15183
15193
15261
15334
15340
15350
15374
15383
15384
15413
15447
15463
15480
15484
15485
15487
15500
15509
15515
15518
15532
15540
15564
15584
15671
15676
15697
15757
15777
15819
15836
15837
15838
15841
15868
15873
15914
15922
15949
15961
15963
15971
15980
15981
15983
16001
16003
16005
16010
16013
16016
PRICE
$5.64
$99.75
$28.00
$31.85
$18.20
$27.20
$84.00
$112.00
$22.84
$91.00
$30.94
$7.00
$24.50
$43.40
$96.25
$342.90
$26.25
$127.00
$15.75
$100.45
$31.50
$131.25
$148.75
$123.90
$110.25
$62.30
$37.80
$780.00
$112.00
$25.20
$42.18
$315.70
$104.30
$66.50
$147.00
$23.45
$24.50
$82.60
$104.30
$25.20
$7.00
$7.00
$7.74
$7.00
$104.30
$104.30
$31.50
$55.30
$61.25
$7.00
$90.06
$137.20
$85.05
$85.05
$54.25
$70.70
$63.00
$105.00
$29.75
$144.55
$275.40
DESCRIPTION
HUNTINGTON DISEASE MUTAT
MATRNL CELL CONTAMINATION
CYSTIC FIBROSIS DNA MUTAT
FISH,SUBTELOMERIC REGION
BCR ABL PCR W/REFLEX GENE
FISH, AML, CBFB/MTH 11
CHROMOSOME FOLLOW-UP BLD
ASHKENAZI JEWISH PANEL
C. FIBROSIS RARE MUTATION
CYSTIC FIBROSIS 2 EXON
CYSTIC FIBROSIS RARE MUT
ALLERGEN GLUTEN, IGG
FISH, SKY MARKER CHROM
MCAD MUTATION ANALYSIS
MUCOLIPIDOSIS TYPE IV MUT
FISH, CLL/ALL, BCR/ABL
CHROMOSOMES,AMNIOTIC FLD
CHROMOSOMES & AFP W/RFL
CHROM, CHORIONIC VILLUS
CHROMOSOME, TISSUE
CHROM ANALYSIS HI RESOLUT
CHROM ANALYSIS, BLOOD
CHROMOSOME, MOSAICISM
CHROM ANALYSIS, BREAKAGE
CHROM,HEMATOL MALIGNANCY
CHROMOSOME, CLL/LPD
FISH, PRENATAL SCR ANEUV
FISH, PRADER-WILLI
FISH, ANGELMAN
FISH, WILLIAMS
FISH,DIGEORGE VELOCARDIO
FISH, SMITH-MAGENIS
FISH, MILLER-DIEKER
FISH, WOLF-HIRSCHHORN
FISH, CRI DU CHAT
FISH, KALLMANN
FISH AML M3 PML/RARA TRAN
FISH ALL TEL/AML1 TRANSLO
FISH X/Y POST BONE MARROW
FISH,HER-2/NEU,PARAFFIN
FISH, N-MYC NEUROBLASTOMA
FISH,PRODUCTS OF CONCEPT
MSH2 MUT 1 EXON HNPCC
MSH6 MUTATION HNPCC
MSH6 MUTATION 1 EXON
MLH1 MUTATION ONE EXON
MLH1 & MSH2 MUTAT HNPCC
MICROSATELLITE HNPCC
BCL-1/JH t(11,14) GENE
CBFB MYH11 INV (16) PCR
PML/RARA t(15,17) QUANT
AML1/ETO t(8,21) QT PCR
BCL2/JH t(14,18) GENE
LYME DISEASE DNA, TICK
STONERISK DIAG. PROFILE
STONERISK CITRATE
STONERISK CYSTINE
ARIPIPRAZOLE
TCR GENE REARRANGEMENT
FAMILIAL DYSAUTONOMIA DNA
FACTOR VII R353Q MUTATION
CODE
10247X
10262N
10458N
10468N
10510N
10635X
10708X
10910X
10913X
10915X
10917X
11084X
11122X
11176X
11192X
12070X
14590X
14591X
14592X
14593X
14595X
14596X
14597X
14598X
14600X
14601X
14604X
14605X
14608X
14609X
14610X
14611X
14612X
14613X
14614X
14615X
14617X
14618X
14619X
14620X
14621X
14820X
14981X
14982X
14983X
14984X
14986X
14989X
14991X
14992X
14994X
14995X
15007X
15510X
15567X
15568X
15569X
15922X
15930X
16040X
16180X
PRICE
$122.50
$105.00
$99.75
$385.00
$151.20
$133.00
$222.25
$789.25
$89.95
$170.80
$862.75
$17.71
$525.00
$97.65
$103.25
$136.50
$253.40
$144.96
$298.20
$348.60
$273.35
$222.25
$248.50
$246.75
$271.60
$271.60
$148.75
$126.00
$126.00
$126.00
$126.00
$126.00
$126.00
$126.00
$126.00
$126.00
$126.00
$126.00
$236.25
$157.50
$126.00
$238.00
$140.00
$630.00
$140.00
$140.00
$1,022.00
$175.00
$134.75
$117.60
$117.60
$117.60
$147.00
$113.05
$95.20
$37.10
$35.00
$76.07
$102.90
$85.75
$104.65
Contract : 5753
Vendor : Quest Diagnostics
Quest Fee Schedule
DESCRIPTION
FACTOR XI MUTATION ANALYS
VW FACTOR ACTIVITY
ABL KINASE MUTATION
ABL KINASE MUTATION
DESMOGLEIN ANTIBODIES
B BURGDORFERI AB PANEL
AMYLASE ISOENZYMES
ANTIMONY
ADENOVIRUS DNA QUAL PCR
FACTOR VIII ACTIVITY
MLH1 & MSH2 MUTATIONS
RTH MUTATION ANALYSIS
BENZTROPINE, QUANTITATION
ACHONDROPLASIA MUTATION
MAPLE SYRUP DISEASE
GLYCOGEN STORAGE DISEASE
MULTIPLE MYELOMA,FISH
CYSTIC FIBROSIS CFTR GENE
INFLUENZA TYPE A&B RNA
PARAINFLUENZA VIR RNA X3
CENTROMERE B ANTIBODY
HIV DETECTION PANEL
EGFR MUTATION ANALYSIS
TOXOPLASMA ABS, IGG/IGM
DNA (DS) AB HIGH AVIDITY
FONDAPARINUX SODIUM
FISH,EWING/PNET/ESWR1
FISH, ALCL,ALK,2p23
FISH, OLIGODENDROGLIOMA
ALPHA-GLOBIN GENE SEQ
B-CELL REAARANGEMENT QUAN
B-CELL REARRANGEMENT QUAL
MACROPROLACTIN
ALPHA-GLOBIN DETECTION
RAS MUTATION LEUMETA
ras MUTATION CELL BASED
ALLERGEN ARIZONA PNL&IGE
BULLOUS PEMPHIGOID BP230
PANCREATIC EXOCRINE CELL
PROTEASOME ACTIVITY
ALPHA-1 ANTITRYPSIN PHENO
MACULAR DEGENERATION MUT
NPM(EXON12)MUTATION,ANALY
NPM(EXON12)MUTATION,LEUME
CYTOCHROME P450 & VKROC1
FIBROBLAST GROWTH FACTOR
JAK2 MUTATION (LEUMETA)
BETA-2 ADRENERGIC
FACTOR XIII V34L MUTATION
BETA-FIBRINOGEN 455G>A
MPL W515/7MPL S505 MUT
HIV-1 RNA,QUALITATIVE TMA
CODE
16023
16028
16029
16031
16033
16034
16036
16037
16046
16049
16051
16053
16055
16061
16067
16069
16077
16080
16086
16087
16088
16090
16091
16092
16093
16103
16112
16114
16115
16116
16118
16119
16122
16124
16127
16128
16129
16136
16143
16144
16145
16155
16158
16159
16160
16171
16175
16176
16178
16182
16184
16185
PRICE
$120.75
$42.00
$140.00
$140.00
$29.75
$78.75
$31.15
$79.00
$105.00
$51.45
$182.00
$271.25
$94.00
$95.55
$123.55
$112.00
$166.25
$140.00
$104.30
$149.10
$19.25
$115.85
$199.50
$63.35
$20.30
$53.20
$120.75
$120.75
$168.00
$213.50
$77.00
$70.35
$49.00
$201.25
$192.50
$192.50
$210.00
$24.50
$35.70
$22.75
$74.20
$175.00
$108.50
$108.50
$175.00
$43.75
$175.00
$104.65
$104.65
$104.65
$199.50
$122.15
DESCRIPTION
BUPRENORPHINE, QUANT, UR
SPECIMEN VALIDITY TEST,UR
BOVINE THROMBIN INHIBITOR
RESPIRATORY VIRUS PNL IV
ZINC RANDOM URINE W/CREAT
NG,RNA,TMA,RECTAL
CT,RNA,TMA,RECTAL
CT/NG,RNA,TMA,RECTAL
P53 MUT ANALYSIS LEUMETA
PM ALCOHOL METAB CONF UR
AMPHETAMINE CONF, UR
MORPHINE-TOTAL, UR
TPMT ACTIVITY
OXYCODONE/METAB
GAUCHER DISEASE DNA MUT
AFP AMNIOTIC FLD W/REFLEX
CANAVAN DISEASE MUT ANALY
CHROMIUM, BLOOD
C TRACHOMATIS TMA THROAT
NG GONORRHOEAE,TMA,THROAT
CT/NG, RNA, TMA, THROAT
HEPATITIS B CORE AB
MLL (11q23) GENE REARRANG
FISH, NEONATAL
SICKLE CELL DNA, FETUS
B-CELL GENE REARRANGEMENT
ACETYLCHOLINESTERASE
MICRODELETION SYNDROME
SNHD EXPOSURE PANEL
TISSUE EXAM 302
TISSUE EXAM 304
TISSUE EXAM 305
TISSUE EXAM 307
CHEMISTRIES (10)
CHEMISTRIES (11)
CHEMISTRIES (12)
CHEMISTRIES (13)
CHEMISTRIES (14)
CHEMISTRIES (15)
CHEMISTRIES (16)
CHEMISTRIES (17)
CHEMISTRIES (18)
CHEMISTRIES (19)
CHEMISTRIES (2)
CHEMISTRIES (20)
CHEMISTRIES (21)
CHEMISTRIES (3)
CHEMISTRIES (4)
CHEMISTRIES (5)
CHEMISTRIES (6)
CHEMISTRIES (7)
CHEMISTRIES (8)
CHEMISTRIES (9)
CODE
16213X
16278X
16373X
16473X
16502X
16504X
16505X
16506X
16515X
16910X
16913X
17712X
18831X
18885X
43539N
4713N
54577N
6085X
70048X
70049X
70051X
7040E
84269N
84350N
84541N
84731N
84897N
88039N
9000E
AC01
AC02
AC03
AC04
CHEM10
CHEM11
CHEM12
CHEM13
CHEM14
CHEM15
CHEM16
CHEM17
CHEM18
CHEM19
CHEM2
CHEM20
CHEM21
CHEM3
CHEM4
CHEM5
CHEM6
CHEM7
CHEM8
CHEM9
PRICE
$100.00
$64.00
$23.63
$643.65
$45.15
$21.00
$21.00
$42.00
$402.50
$60.00
$100.00
$163.00
$128.10
$34.21
$129.50
$30.10
$157.50
$16.45
$21.00
$21.00
$42.00
$21.70
$126.00
$140.00
$157.50
$70.35
$41.65
$166.25
$82.50
$37.00
$40.00
$45.00
$138.20
$4.57
$4.75
$4.92
$5.10
$5.27
$5.46
$5.63
$5.86
$6.10
$6.32
$3.17
$6.56
$6.79
$3.35
$3.52
$3.70
$3.87
$4.05
$4.22
$4.40