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Genesis Hospital Price List 2021

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Genesis Hospital Price List 2021 Procedure Procedure Description Revenue CPT/HCPCS NDC Code Code (if applicable) 30200090 HC BORDETELLA IGA 302 86615 30700002 HC URINALYSIS W/ MICRO (MAN.DIP) 307 81000 30200206 HC RH PHENOTYPING COMPLETE SO 302 86906 30200091 HC BORDETELLA IGM 302 86615 30100335 HC CITRATE AGAR ELECTROPHORESIS 301 83020 30100101 HC FACTOR V LEIDEN, SO * 301 81241 30100371 HC INSULIN TOTAL 301 83525 30200909 HC INCUBATION W/INHIBITORS SO 302 86977 30100081 HC OLANZAPINE 301 80342 30000089 HC ANTIBODY ID EACH CELL SO 302 86885 44092597 HC EVAL TO USE/FIT VOICE PROSTH 444 92597 30200906 HC PLATELET AB - INDIRECT SO 302 86022 30100347 HC 17 HYDROXYPROGESTERONE*SO 301 83498 30100375 HC 17 KETO/24 HR * SO 301 83586 30100346 HC 5HIAA * SO 301 83497 30100839 HC ACE SO 301 82164 30100364 HC ACETYLCHOL MODULATING AB SO 301 83516 30100363 HC ACETYLCHOL RECEPT AB BIND SO 301 83519 30100114 HC ACTH SO 301 82024 30100152 HC AFP - AMNIO SO 301 82106 30100135 HC ALCOHOL,ETHYL,BLOOD 301 80320 30100124 HC ALDOLASE SO 301 82085 30100132 HC ALDOSTERONE SO 301 82088 30100128 HC ALDOSTERONE-UR SO 301 82088 30200001 HC ALLERGEN SO 302 86003 30100343 HC ALLERGEN-HISTAMINE 301 83088 30200002 HC ALLERGEN-LATEX 302 86003 30100140 HC ALPHA 1 ANTITRYPSIN FECES SO 301 82103 30500799 HC ALPHA 2 ANTIPLASMIN SO 305 85410 30100251 HC ALPHA TOCOPHEROL(VIT.E) SO 301 84446 30100144 HC ALPHA-FETAPROTEIN-TUMOR M 301 82105 30100156 HC ALUMINUM SO 301 82108 30100033 HC AMIKACIN SO 301 80150 30100167 HC AMINO ACID QUANT. URINE * SO 301 82139 30100165 HC AMINO ACID QUANT-BLOOD SO 301 82139 30100301 HC AMOBARBITOL SO 301 80345 30100179 HC AMYLASE, RANDOM URINE 301 82150 30100185 HC ANDROSTENEDIANE SO 301 82157 30200037 HC ANTI CHROMATIN 302 83516 30200032 HC ANTI HISTONE AB SO 302 83516 1 30200038 HC ANTI SMOOTH MUSCLE SO 302 83516 30500800 HC ANTI THROMBIN III ACTIVIT SO 305 85300 30200027 HC DSDNA AB.IGG ELISA 302 86225 30200034 HC ANTI-ENA/SM SO 302 86235 30100357 HC ANTI-MITOCHONDRIAL SO 301 83516 30100368 HC ANTINERONAL NUCLEAR SO 301 83520 30200044 HC ANTISTRIATNL MUSCLE AB SO 302 86255 30200158 HC THYROGLOBULIN AB SO 302 86800 30100136 HC ANTITRYPSIN QUANT SO 301 82103 30100189 HC APO A-1 SO 301 82172 30100191 HC APO B SO 301 82172 30100199 HC ARSENIC,BLOOD SO 301 82175 30100205 HC BETA 2 MICROGLOBULIN CSF SO 301 82232 30100286 HC BETA HCG-TUMOR MARKER 301 84702 30100703 HC BETA-2-MICROGLOBULIN SO 301 82232 30100404 HC BNP 301 83880 30200164 HC BORDETELLA PERTUSSIS CULTURE 306 87081 30200023 HC C1 ESTERAS INHIBTR FUN SO 302 86161 30200053 HC CA 15-3 SO 302 86300 30200055 HC CA 19-9 SO 302 86301 30200054 HC CA 27-29 SO 302 86300 30100219 HC CALCITONIN SO 301 82308 30100711 HC CALCIUM - IONIZED SO 301 82330 30100714 HC CARBOHYDRATE DEF. TRANSFER 301 82373 30200014 HC CARDIOLIPIN AB, IGA SO 302 86147 30100229 HC CARNITINE, FREE SO 301 82379 30100395 HC CARNITINE, TOTAL SO 301 83789 30100225 HC CARNITINE,FREE & TOTAL* SO 301 82379 30100233 HC CAROTENE SO 301 82380 30100241 HC CATECHOLAMINE,PLASMA,FRAC SO 301 82384 30100237 HC CATECHOLAMINES,URINE * SO 301 82384 30200073 HC CD-4 ABSOLUTE SO 302 86361 30100267 HC CELIAC DISEASE IGA 301 82784 30100348 HC CENTROMERE ANTIBODY IGG SO 301 83516 30100245 HC CERULOPLASMIN SO 301 82390 30200179 HC CHLAMYDIA DETECTION/DFA SO 306 87270 30100305 HC CHLORAZEPOXIDE (LIBRIUM) SO 301 80346 30100257 HC CHLORIDE/URINE 301 82436 30100260 HC CITRATE - URINE * SO 301 82507 30100084 HC CLOMIPRAMINE SO 301 80335 30100037 HC CLONAZEPAM SO 301 80346 30100293 HC CLORAZEPATE SO 301 80346 30100717 HC CLOZAPINE SO 301 80159 30200191 HC CMV BY PCR SO 306 87496 30200178 HC CMV CULTURE SO 306 87254 2 30200104 HC CMV IGG IFA SO 302 86644 30100264 HC COCAINE QUANT. URINE 301 80353 30200016 HC COLD AGGLUTININS 302 86157 30200019 HC COMPLEMENT COMPONENT 2 302 86160 30100276 HC COPPER - BLOOD SO 301 82525 30100200 HC COPPER - URINE * SO 301 82525 30100725 HC CORTISOL/URINE SO 301 82530 30100837 HC COTININE (NICOTINE) URINE SO 301 80323 30100726 HC C-PEPTIDE SO 301 84681 30600064 HC CRYPTOSPORIDUM ANTIGEN 306 87328 30200201 HC CSF HERPES BY PCR SO 306 87529 30200026 HC CYCLIC CITRULINATED PEPT. IGG 302 86200 30100045 HC CYCLOSPORIN LEVEL SO 301 80158 30100099 HC CYSTIC FIBROSIS,MUTATION PANE 301 81220 30100727 HC DHEA SO 301 82626 30100262 HC DHEA SULFATE SO 301 82627 30200106 HC DIPTHERIA AB SO 302 86648 30100048 HC DOXEPIN (SINEQUAN) SO 301 80335 30100728 HC D-XYLOSE TOL SO 301 84620 30200047 HC ENDOMYSIAL IGA TITER REF 302 86256 30100911 HC ERYTHRO POIETIN SO 301 82668 30100292 HC ESTRIOL SO 301 82677 30100284 HC ESTROGEN, SR. FRACT SO 301 82671 30100296 HC ESTRONE (E1) SO 301 82679 30100049 HC ETHOSUXIMIDE(ZARONTIN) SO 301 80168 30100300 HC ETHYLENE GLYCOL SO 301 82693 30500806 HC FACTOR II SO 305 85210 30100244 HC FACTOR IX SO 305 85250 30500807 HC FACTOR V SO 305 85220 30500808 HC FACTOR VII SO 305 85230 30100228 HC FACTOR VIII SO 305 85240 30100248 HC FACTOR X SO 305 85260 30100252 HC FACTOR XI SO 305 85270 30100256 HC FACTOR XII SO 305 85280 30500809 HC FACTOR XIII/UREA SOL SO 305 85291 30100304 HC FAT/QUANT SO 301 82710 30100297 HC FELBABATE (FELBATOL) SO 301 80339 30100731 HC FLECAINIDE SO 301 80299 30100086 HC FLUXETINE (PROZAC) SO 301 80332 30100733 HC FOLATE, RED CELL SO 301 82747 30100291 HC FREE T3 301 84481 30100737 HC G-6-PD-SO* 301 82955 30100285 HC GABAPENTIN LEVEL SO 301 80171 30100910 HC GALATOSE 1 PHOSURIDYL SO 301 82775 30100738 HC GASTRIN SO 301 82941 3 30200215 HC GC & CHLAMYDIA,THIN PREP 306 87801 30100359 HC GLIADIN IGA SO 301 83516 30100360 HC GLIADIN IGG SO 301 83516 30200039 HC GLOMERULARBASEMENTMEMBRAB SO 302 86255 30100739 HC GLUCAGON SO 301 82943 30100742 HC GLUCOSE URINE SO* 301 82945 30100355 HC GLUTAMIC ACID DECARBOXYLASE 301 83516 30200185 HC HELICOBACTER PYLOR ANTGN STOO 306 87338 30100100 HC H CHEMOCH MUTATION DETECT HERD S 301 81256 30100340 HC HEMOGLOBULIN A2 & F 301 83036 30100342 HC HEMOSIDERIN ST - UR SO 301 83070 30200130 HC HEP B CORE AB,IGG,IGM SO 302 86704 30200193 HC HEP B DNA ULTRA QUANT PCR 306 87517 30200197 HC HEP C VIRUS RNA QUANT GENO 306 87522 30200004 HC HEPARIN ASSOCIATED ANTIBODY 302 86022 30200134 HC HEPATITIS A AB TOTAL 302 86708 30200132 HC HEPATITIS B SURF AB (WAS: A 302 86706 30200133 HC HEPATITIS BE AB (WAS: AB TO 302 86707 30200187 HC HEPATITIS BE AG SO 306 87350 30200223 HC HEPATITIS C GENOTYPE REFLEX 306 87902 30200199 HC HEPATITIS C RNA QUANT BY PCR 306 87522 30000002 HC HEPATITIS DELTA VIRUS AB 300 86692 30200126 HC HERPE TYPE 2 GLYC G SPE AB IG 302 86696 30200908 HC HERPES I & II IGG * SO 302 86694 30200124 HC HERPES I & II IGM * SO 302 86694 30200125 HC HERPES TYPE 1 GLYC SPEC AB IG 302 86695 30500903 HC HEXAGONAL PHOSPHOLIPID NEUTRA 305 85598 30100338 HC HGB ELECTROPHORESIS SO 301 83021 30100332 HC HGH SO 301 83003 30200188 HC HISTOPLASMA AG. URINE 306 87385 30200123 HC HIV - WESTERN BLOT SO 302 86689 30600901 HC HIV 1 GENOTYPE 306 87901 30200203 HC HIV VIRUS BY BRANCHED DNA SO 306 87536 30200161 HC HLA - ANTIBODY TEST SO 302 86807 30200163 HC HLA - DR TYPING SO 302 86813 30200162 HC HLA-B27 SO 302 86812 30100746 HC IGE SO 301 82785 30100249 HC IGF BINDING PROTEIN -3 301 82397 30200137 HC INFLUENZA A IGM 302 86710 30200177 HC INFLUENZA CULTURE 306 87254 30200065 HC INSULIN AB SO 302 86337 30100370 HC INSULIN RANDOM SO 301 83525 30100751 HC INSULIN-LIKE GRWTH FACT 1 IGF 301 84305 30200066 HC INTRINSIC FACTOR BLOCKING AB. 302 86340 30100102 HC JAK2(V617F)MUTATION BY PCR 301 81270 4 30200030 HC JO-1 ANTIBODY IGG 302 86235 30100082 HC KEPPRA LEVEL 301 80177 30100078 HC LAMOTRIGINE 301 80175 30100379 HC LDH ISOENZYMES SO 301 83625 30200141 HC LEGIONELLA AB TYPE 1 IGG 302 86713 30200140 HC LEGIONELLA AB TYPE 1 IGM 302 86713 30200165 HC LEGIONELLA CULTURE SO 306 87081 30200189 HC LEGIONELLA URINE AG SO 306 87449 30200142 HC LEPTOSPIRA AB SO 302 86720 30100384 HC LIPOPROTEIN (A) 301 83695 30100385 HC LIPOPROTEIN-ASSOC PHOS A2 301 83698 30200092 HC LYME AB IGM WESTERN BLOT 302 86617 30200096 HC LYME AB,SERUM SO 302 86618 30200095 HC LYMEAB,IGG,WESTERNBLOT SO 302 86617 30500812 HC LYSOZYME, SERUM/BF SO 305 85549 30100392 HC MAGNESIUM/URINE * 301 83735 30100399 HC METANEPHRINES TOTAL * SO 301 83835 30100398 HC METANEPHRINES,PLASMA 301 83835 30100083 HC METHOTREXATE SO 301 80299 30100104 HC METHYLENE. REDUCTASE MUTAT SO 301 81291 30200074 HC MICROSOMAL AB-THYROID SO 302 86376 30200075 HC MICROSOMALAB,LIVER-KIDNEY SO 302 86376 30200144 HC MUMPS AB,IGM SO 302 86735 30200143 HC MUMPS VIRUS AB.IGM 302 86735 31000012 HC MUSCLE FIBERS - FECAL SO 300 89160 30200146 HC MYCOPLASMA IGG SO 302 86738 30200145 HC MYCOPLASMA IGM SO 302 86738 30100402 HC MYOGLOBIN - UR SO 301 83874 30100403 HC MYOGLOBIN-BL SO 301 83874 30200042 HC NEUTROPHIL CYTOPLASMIC AB SO 302 86255 30100074 HC NORPACE SO 301 80299 30100056 HC NORTIPTYLINE SO 301 80335 30100272 HC N-TELOPEPTIDE,CRSS-LNKED URIN 301 82523 30100137 HC OPIATES QUANITATION SERUM 301 83925 30100139 HC OPIATES QUANTITATION-URINE 301 80361 30100121 HC ORGANIC ACIDS - URINE SO 301 83918 30100147 HC OXALATE * SO 301 83945 30100042 HC OXAZEPAM SO 301 80346 30100075 HC OXCARBAZEPINE 301 80183 30100155 HC PAP SO 301 84066 30200043 HC PARIETAL CELL AB SO 302 83516 30200147 HC PARVOVIRUS IGG SO (PART 302 86747 30200148 HC PARVOVIRUS IGM SO ( 302 86747 30100289 HC PENTABARBITOL SO 301 80345 30100161 HC PG SCREEN SO 301 84081 5 30100753 HC PHENOPTHALEIN (STOOL) SO 301 84999 30100836 HC PHENYLALANINE 301 82131 30100163 HC PHENYLALANINE-LAB 301 82131 30100126 HC PHOSPHORUS - UR * 301 84105 30100341 HC PLASMA HEMOGLOBIN SO 301 83051 30500813 HC PLASMINOGEN SO 305 85420 30100130 HC PORPHOBILINOGEN
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