A2 - Price List - Reference Lab Testing Services - Revised 3-12-2021 - ELP.xlsx

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Q301--Reference Laboratory Testing Services (ELP)
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36C25721Q0374
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A4 - DoL Wage Determination 15-5447 - Rev. 11 - 12-21-2020.pdf PDF
A3 - DoL Wage Determination 15-5229 - Rev. 12 - 12-21-2020.pdf PDF
A2 - Price List - Reference Lab Testing Services - ELP.xlsx XLSX spreadsheet
A1 - Performance Work Statement - Reference Lab Testing Services - Revised 3-3-2021 (ELP).pdf PDF
Evaluation Criteria - Reference Laboratory Testing Services - ELP.pdf PDF
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Sheet1

Estimated
SUBLINETurn-AroundAnnualExtended
ITEM #Test DescriptionCPT CODE(S)Time (Days)QuantityUnit PricePrice
0001AA17-HYDROXYPROGESTERONE12
0001ABACETYLCHOLINE RECEPTOR BINDING ANTIBODY12
0001AC5' NUCLEOTIDASE12
0001ADABL KINASE DOMAIN MUTATION IN CML, CELL-BASED12
0001AEACETYLCHOLINE RECEPTOR BINDING ANTIBODY12
0001AF5-HYDROXYINDOLEACETIC ACID (5-HIAA), RANDOM URINE12
0001AGACTH, PLASMA12
0001AHADVANCED LIPID PANEL WITH INFLAMMATION, CARDIO IQ®12
0001AJACTIN (SMOOTH MUSCLE) ANTIBODY (IGG)12
0001AKALDOLASE12
0001ALALDOSTERONE/PLASMA RENIN ACTIVITY RATIO, LC/MS/MS12
0001AMALPHA-1-ANTITRYPSIN (AAT) PHENOTYPE12
0001ANALKALINE PHOSPHATASE ISOENZYMES12
0001APALPHA-1-ANTITRYPSIN, QUANTITATIVE12
0001AQALPHA-FETOPROTEIN, TUMOR MARKER12
0001ARALPHA-GLOBIN COMMON MUTATION ANALYSIS12
0001ASAMITRIPTYLINE12
0001ATANA SCR,IFA,RFL T/P/MPXAB744
0001AUANASCR,RF T/P/MPX/IDENTRA312
0001AVANCA SCREEN WITH REFLEX TO ANCA TITER60
0001AWANDROSTENEDIONE12
0001AXANTI-MULLERIAN HORMONE (AMH , Female12
0001AYANGIOTENSIN CONVERTING ENZYME60
0001AZAPOLIPOPROTEIN EVALUATION12
0001BAASPERGILLUS ANTIBODIES, IMMUNODIFFUSION, SERUM12
0001BBB-CELL CLONALITY PANEL (IGH, IGK)48
0001BCANTITHROMBIN III ACTIVITY [216]108
0001BDBETA-2-GLYCOPROTEIN I ANTIBODIES (IGG, IGA, IGM12
0001BEBLASTOMYCES ANTIBODY, IMMUNODIFFUSION, SERUM24
0001BFBCR-ABL1 GENE REARRANGEMENT, QUANTITATIVE PCR60
0001BGBK VIRUS DNA, QUANTITATIVE REAL-TIME PCR, PLASMA24
0001BHBRCAVANTAGE(R12
0001BJBLASTOMYCES ANTIBODY IMMUNODIFFUSION, SERUM24
0001BKBORDETELLA PERTUSSIS TOXIN (PT12
0001BLBordetella Pertussis/Parapertussis DNA, Qualitative, RT-PCR24
0001BMBUPRENORPHINE SCREEN, URINE24
0001BNC-PEPTIDE72
0001BPC-REACTIVE PROTEIN (CRP)456
0001BQCA 19-972
0001BRCALCIUM, 24-HOUR URINE WITHOUT CREATININE36
0001BSCA 12536
0001BTCALCIUM, IONIZED84
0001BUCALRETICULIN (CALR) MUTATION ANALYSIS36
0001BVCARBAMAZEPINE, TOTAL96
0001BWCARDIO IQ(R) APOE GENOTYPE12
0001BXCARDIO IQ(R) LIPOPROTEIN FRACTIONATION, ION MOBILITY12
0001BYCATECHOLAMINES, FRACTIONATED, RANDOM URINE12
0001BZCARDIOLIPIN ANTIBODIES (IGA, IGG, IGM)120
0001CACathecholamines, Fractionated, 24-Hour Urine With Creatinine12
0001CBCEA72
0001CCCELIAC DISEASE COMP PANEL W/GLIADIN AB (IGG)12
0001CDCELIAC DISEASE COMPREHENSIVE PANEL96
0001CECLOBAZAM, SERUM/PLASMA12
0001CFCERULOPLASMIN132
0001CGCHLAMYDIA/NEISSERIA GONORRHOEAE RNA, TMA, UROGENITAL12
0001CHCHLAMYDIA/NEISSERIA GONORRHOEAE RNA, TMA, RECTAL12
0001CJCHLAMYDIA/NEISSERIA GONORRHOEAE RNA, TMA, THROAT12
0001CKCOLD HEMAGGLUTININS12
0001CLCHROMOSOME ANALYSIS, HEMATOLOGIC MALIGNANCY12
0001CMCOCCIDIOIDES ANTIBODIES TO TP & F ANTIGENS, ID12
0001CNCOCCIDIOIDES ANTIBODIES (IGG, IGM), IMMUNODIFFUSION36
0001CPCOCCIDIOIDES ANTIBODY, COMPLEMENT FIXATION, SERUM12
0001CQCOCCIDIOIDES ANTIBODY ID SERUM24
0001CRCHLORIDE, RANDOM URINE WITHOUT CREATININE36
0001CSCHROMOGRANIN A24
0001CTCOLLAGEN TYPE I C-TELOPEPTIDE (CTX)36
0001CUCOMPLEMENT COMPONENT C3C & C4C36
0001CVCOPEPTIN24
0001CWCOPPER, RANDOM URINE12
0001CXCOPPER48
0001CYCORTISOL FREE, 24 HR URINE12
0001CZCRYPTOCOCCAL ANTIGEN,LATEX SCREEN W/REFLEX TO TITER24
0001DACULTURE, YEAST, W/ID AND SUSCEPT, COMPREHENSIVE12
0001DBCRYPTOCOCCUS ANTIBODY24
0001DCCREATINE KINASE ISOENZYMES (CK ISOENZYMES24
0001DDCORTISOL, TOTAL84
0001DECYCLOSPORINE A TROUGH, LCMSMS, BLOOD12
0001DFCYCLIC CITRULLINATED PEPTIDE (CCP) ANTIBODY (IGG)156
0001DGCystatin C With Glomerular Filtration Rate, Estimated (EGFR)324
0001DHCYTOMEGALOVIRUS ANTIBODIES (IGG, IGM)48
0001DJDIPHTHERIA AND TETANUS ANTITOXOIDS12
0001DKDHEA SULFATE, IMMUNOASSAY24
0001DLDIGOXIN60
0001DMDEXAMETHASONE12
0001DNDIHYDROTESTOSTERONE12
0001DPDNA (DS) ANTIBODY36
0001DQDRUG ABUSE SCREEN 5, WITHOUT CONFIRMATION, SERUM36
0001DRDRUG MONITORING PROF. 1,PLUS PROPOXYPHENE W/CONF2292
0001DSENDOMYSIAL ANTIBODY SCREEN (IGA , With Reflex to Titer12
0001DTEPIDERMAL ANTIBODIES WITH REFLEX TO TITER12
0001DUDrug Monitoring, Methylphenidate Metabolite, QN, Urine12
0001DVENTAMOEBA HISTOLYTICA ANTIBODY (IGG), ELISA12
0001DWEPSTEIN-BARR VIRUS ANTIBODY PANEL48
0001DXEpstein-Barr Virus Panel Capsid Antigen (VCA) AB (IGA)12
0001DYEpstein-Barr Virus Panel Viral Capsid Antigen (VCA) Antibody (IGG)12
0001DZDrug Toxicology Monitoring Alcohol Metab, W/ Confirm, Urine240
0001EAEpstein-Barr Virus Viral Capsid Antigen (VCA) Antibody (IGM)24
0001EBERYTHROPOIETIN84
0001ECESTRADIOL, ULTRASENSITIVE, LC/MS12
0001EDESTRADIOL84
0001EFESTROGENS, FRACTIONATED, LC/MS24
0001EGESTRONE, Antibodies (IGG, IGA)12
0001EHEVEROLIMUS, LC/MS/MS, BLOOD36
0001EJFACTOR VIII ACTIVITY, CLOTTING12
0001EKFACTOR XII ACTIVITY12
0001ELFACTOR X ACTIVITY, CLOTTING12
0001EMFACTOR V (LEIDEN) MUTATION ANALYSIS84
0001ENFACTOR VIII INHIBITOR PANEL12
0001EPFIBRINOGEN ACTIVITY, CLAUSS96
0001EQFREE KAPPA & LAMBDA, WITH K/L RATIO, SERUM24
0001ERFRUCTOSAMINE36
0001ESFTA-ABS12
0001ETFSH (FOLLICLE STIMULATING HORMONE)276
0001EUGABAPENTIN12
0001EVGLIADIN (DEAMIDATED12
0001EWGASTRIC PARIETAL CELL ANTIBODY, ELISA48
0001EXGROWTH HORMONE12
0001EYGlucose-6-Phosphate Dehydrogenase, (G-6-PD),Quantitative36
0001EZGLUTAMIC ACID DECARBOXYLASE-65 ANTIBODY12
0001FAHAPTOGLOBIN252
0001FBHEAVY METALS PANEL (VENOUS)36
0001FCHEAVY METALS PANEL, RANDOM URINE WITH CADMIUM276
0001FDHELICOBACTER PYLORI, UREA BREATH TEST144
0001FEHEMOGLOBINOPATHY EVALUATION84
0001FFHEP C Viral RNA Genotype, LIPA W/ RFX To HCV NS5A Drug Resist60
0001FGHEPATITIIS D VIRUS RNA, QUANTITATIVE, REAL-TIME PCR24
0001FHHEPATITIS A ANTIBODY, TOTAL144
0001FJHEPATITIS A ANTIBODY, TOTAL W/REFLEX IGM12
0001FKHEPATITIS A IGM ANTIBODY48
0001FLHEPATITIS B CORE ANTIBODIES (IGM, TOTAL)240
0001FMHepatitis B Surface Antigen With Reflex To Confirmation1068
0001FNHEPATITIS B VIRUS DNA, QUANTITATIVE, REAL-TIME PCR108
0001FPHEPATITIS BE ANTIBODY72
0001FQHEPATITIS BE ANTIGEN60
0001FRHepatitis C Viral RNA Genotype 1 NS5A Drug Resistance12
0001FSHEPATITIS D VIRUS (HDV12
0001FTHEPATITIS C VIRAL RNA QUANTITATIVE, REAL-TIME PCR300
0001FUHEREDITARY HEMOCHROMATOSIS DNA MUTATION ANALYSIS48
0001FVHerpes Simplex Virsus 1 and 2 (IGG), Type-Specific Antibodies, IGE (254672
0001FWHERPES SIMPLEX VIRUS 1/2 AB (IGM), IFA W/RFX TO TITER, SER84
0001FXHERPES SIMPLEX VIRUS, TYPE 1 AND 2 DNA, QUAL REAL-TIME PCR84
0001FYHETEROPHILE, MONO SCREEN12
0001FZHISTOPLASMA ANTIBODY IMMUNODIFFUSION, SERUM24
0001GAHIV 1 RNA, QUANTITATIVE REAL-TIME PCR228
0001GBHIV-1 GENOTYPE24
0001GCHIV-1 INTEGRASE GENOTYPE12
0001GDHIV-1/2 Antigen and Antibodies, 4th Generation, W/ Reflexes24
0001GEHLA TYPING FOR CELIAC DISEAS12
0001GFHLA-A,B,C INTERMEDIATE RESOLUTION TYPING12
0001GGHLA-DR/DQ INTERMEDIATE RESOLUTION TYPING12
0001GHHLA-B5701 TYPING12
0001GJHLA-B27 ANTIGEN24
0001GKHORSE SERUM (E20512
0001GLHUNTINGTON DISEASE MUTATION ANALYSI12
0001GMIGF-1, LC/MS12
0001GNHOMOCYSTEINE120
0001GPHU ANTIBODY SCREEN WITH REFLEX TO TITER AND WESTERN BLOT12
0001GQIMMUNOFIXATION (IFE), URINE84
0001GRIMMUNOFIXATION, SERUM48
0001GSIMMUNOGLOBULIN A12
0001GTIMMUNOGLOBULIN E84
0001GUIMMUNOGLOBULIN G SUBCLASSES PANEL24
0001GVIMMUNOGLOBULIN PANEL, SERUM24
0001GWINSECT VENOM PANEL IGG12
0001GXINACTIVE ASPERGILLUS ANTIBODIES, IMMUNODIFFUSION, SERUM12
0001GYINHIBIN A12
0001GZINHIBIN B12
0001HAINSULIN72
0001HBINSULIN AUTOANTIBODY12
0001HCJAK2 V617F MUTATION ANALYSIS96
0001HDKappa/Lambda Light Chains, Total, W/Calculation 24HR Urine12
0001HEINTRINSIC FACTOR BLOCKING ANTIBODY, W/FLAER(HIGH SENSI48
0001HFLACOSAMIDE12
0001HGLACTATE DEHYDROGENASE (LD) ISOENZYME PANEL36
0001HHLACTIC ACID, PLASMA12
0001HJLEAD (VENOUS)12
0001HKLAMOTRIGINE96
0001HLLEUKEMIA/LYMPHOMA EVALUATION180
0001HMLEVETIRACETAM24
0001HNLIPOPROTEIN (A12
0001HPLIPOPROTEIN ELECTROPHORESI12
0001HQLH276
0001HRLITHIUM120
0001HSLIVER FIBROSIS, FIBROTEST-ACTITEST PANEL132
0001HTLIVER KIDNEY MICROSOMAL (LKM-1) ANTIBODY (IGG)24
0001HULupus Anticoagulant and Cardiolipin AB Panel With Reflexes60
0001HVLYME DISEASE ANTIBODY WITH REFLEX TO BLOT (IGG,IGM)36
0001HWLYSOZYME (MURAMIDASE)12
0001HXLYMPHOCYTE SUBSET PANEL 4144
0001HYMEASLES ANTIBODY (IGG)408
0001HZMetanephrines, Fractionated, LC/MS/MS, Random Urine24
0001JAMethylenetetrahydrofolate Reductase, DNA Mutation Analysis24
0001JBMETHYLMALONIC ACID72
0001JCMITOCHONDRIA M2 ANTIBODY (IGG), EIA168
0001JDMYCOPLASMA HOMINIS/UREAPLASMA CULTURE24
0001JEMYASTHENIA GRAVIS PANEL 2 W/REFLEX TO MUSK AB24
0001JFMUMPS VIRUS ANTIBODY (IGG)408
0001JGMYOGLOBIN, SERUM24
0001JHOMEGA-3 AND -6 FATTY ACIDS12
0001JJNICOTINE AND COTININE, SERUM/PLASMA60
0001JKNORTRIPTYLINE24
0001JLNICOTINE AND COTININE, URINE48
0001JMOSMOLALITY, SERUM36
0001JNOSMOLALITY, URINE48
0001JPOXCARBAZEPINE METABOLITE36
0001JQPAROXYSMAL NOCTURNAL HEMOGLOBINURIA(PNH)12
0001JRPHARMACOGENOMICS PANEL12
0001JSPHENYTOIN, FREE12
0001JTPHENYTOIN36
0001JUPHOSPHATIDIC ACID ANTIBODY (IGA)84
0001JVPHOSPHATIDIC ACID ANTIBODY (IGG)84
0001JWPHOSPHATIDIC ACID ANTIBODY (IGM84
0001JXPhosphatidic Acid Antibody (IGM), Repeat #xpansion Test [371] (9290384
0001JYPHOSPHATIDYLCHOLINE ANTIBODIES (IGG, IGA, IGM)84
0001JZPHOSPHATIDYLETHANOLAMINE ANTIBODIES (IGG, IGA, IGM)84
0001KAPHOSPHATIDYLGLYCEROL ANTIBODIES (IGG, IGA, IGM)96
0001KBPHOSPHATIDYLINOSITOL ANTIBODIES (IGG, IGA, IGM)84
0001KCPHOSPHATIDYLSERINE ANTIBODIES (IGG, IGA, IGM)84
0001KDPOTASSIUM, 24-HOUR URINE WITHOUT CREATININE12
0001KEPLATELET ANTIBODY SCREEN (INDIRECT)36
0001KFPRIMIDONE12
0001KGPOTASSIUM, RANDOM URINE WITHOUT CREATININE36
0001KLPROGESTERONE12
0001KMPROLACTIN120
0001KNPROTEIN C ANTIGEN12
0001KPPROTEIN C & PROTEIN S, FUNCTIONAL132
0001KQPROTEIN C ACTIVITY72
0001KRPROTEIN ELECTRO,W/TOTAL PROTEIN, REFLEX,IFE,SERUM168
0001KSPROTEIN ELECTROPHORESIS, 24-HOUR URINE (UPEP)48
0001KTPROTEIN S ANTIGEN, TOTAL12
0001KUPROTEIN ELECTROPHORESIS, RANDOM URINE (UPEP)72
0001KVPROTEIN S ACTIVITY60
0001KWPROTEIN, TOTAL 24HR URINE36
0001KXPROTEIN, TOTAL AND PROTEIN ELECTROPHORESIS (74772
0001KYPROTEIN, TOTAL URINE RANDOM12
0001KZPROTHROMBIN (FACTOR II) 20210G>A MUTATION ANALYSIS96
0001LAPTH, INTACT WITHOUT CALCIUM456
0001LBPSA POST PROSTATECTOMY12
0001LCPTH-RELATED PROTEIN (PTH-RP)24
0001LDRABIES RFFIT SEROLOGY END POINT TITER (9181012
0001LEREFLEX ENDOMYSIAL ANTIBODY SCREEN (IGA12
0001LFQuantitative Thyroglobulin W/O Thyroglobulin Antibodies36
0001LGREFLEX TISSUE TRANSGLUTAMINASE ANTIBODY36
0001LHRISTOCETIN COFACTOR12
0001LJRISPERIDONE AND METABOLITE12
0001LKRHEUMATOID FACTOR516
0001LLSARS-COV-2 SEROLOGY (COVID-1912
0001LMRUBELLA IMMUNE STATUS420
0001LNSALMONELLA ANTIBODIES12
0001LPSCA1 (ATXN112
0001LQSEROTONIN, SERUM36
0001LRSIROLIMUS, LC/MS/MS12
0001LSSEX HORMONE BINDING GLOBULIN (SHBG)48
0001LTSJOGREN'S ANTIBODIES (SS-A,SS-B)36
0001LUSODIUM WITHOUT CREATININE, 24-HOUR URINE12
0001LVSM/RNP ANTIBODY12
0001LWSODIUM, RANDOM URINE WITHOUT CREATININE84
0001LXSTREPTOCOCCUS GROUP A, DNA PROBE (1456512
0001LYSTREPTOCOCCUS PNEUMONIAE IGG AB (23 SEROTYPES12
0001LZSOLUBLE TRANSFERRIN RECEPTOR12
0001MASTRATIFY JCV (TM) AB (W/INDEX) W/RFLX TO INHIBITION ASSAY12
0001MBSURESWAB (R), CANDIDIASIS, PCR12
0001MCSURESWAB(R), VAGINOSIS/VAGINITIS PLUS120
0001MDT-CELL RECEPTOR (TCR) BETA GENE REARRANGEMENT, PCR84
0001MET-CELL RECEPTOR (TCR) GAMMA GENE REARRANGEMENT, PCR60
0001MFT3 UPTAKE12
0001MGT3, TOTAL72
0001MHT4 (THYROXINE), TOTAL60
0001MJTACROLIMUS, HIGHLY SENSITIVE, LC/MS/MS444
0001MKTBG (THYROXINE BINDING GLOBULIN)24
0001MLTESTOSTERONE, FREE252
0001MMTHEOPHYLLINE12
0001MNTESTOSTERONE, TOTAL, MALES (ADULT), IMMUNOASSAY1176
0001MPTESTOSTERONE, FREE (DIALYSIS252
0001MQTHYROID PEROXIDASE ANTIBODIES84
0001MRTISSUE TRANSGLUTAMINASE ANTIBODY (IGG)12
0001MSTISSUE TRANSGLUTAMINASE ANTIBODY (IGG, IGA)12
0001MTTRICHINELLA IGG ANTIBODY36
0001MUTOPIRAMATE72
0001MVTOXOPLASMA ANTIBODIES (IGG,IGM12
0001MWTOXOPLASMA GONDII ANTIBODY (IGA12
0001MXTSI (THYROID STIMULATING IMMUNOGLOBULIN)24
0001MYTTR DNA SEQUENCING TEST12
0001MZVALPROIC ACID384
0001NAVITAMIN A (RETINOL)36
0001NBVARICELLA-ZOSTER VIRUS ANTIBODY (IGG)408
0001NCVITAMIN B1 (THIAMINE), PLASMA/SERUM, LC/MS/MS276
0001NDVITAMIN B2 (RIBOFLAVIN), PLASMA48
0001NEVITAMIN B3252
0001NFVITAMIN B6, PLASMA60
0001NGVITAMIN C12
0001NHVITAMIN D, 1,25-DIHYDROXY3756
0001NJVITAMIN E (TOCOPHEROL)72
0001NKVITAMIN K12
0001NLZINC48
0001NMQuantiFERON-TB Gold100
Estimated Annual Total:$ - 0
Estimated Monthly:$ - 0

&"-,Bold"&14PRICE LIST

&"Times New Roman,Bold Italic"Attachment 2 36C25721Q0374 &"Times New Roman,Bold Italic"Price List, Revised 3/12/2021 Page &P of &N

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