36C25725Q0197 LineItems.xlsx

XLSX spreadsheet 462 KB Posted

Attached to
Q301--Amendment to Post Technical Q's and Extend Closing Date - NTX Reference Lab Testing Federal contract opportunity
Solicitation number
36C25725Q0197
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17

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This is a line item spreadsheet for VA solicitation 36C25725Q0197 listing 43 medical laboratory testing services required by the VA North Texas Health Care System. The services include specialized tests such as genetic mutation analysis, viral/bacterial cultures, antibody testing, and various diagnostic panels, each with specific CPT codes. The base period runs from 5/15/25 to 5/14/26, with four one-year option periods extending through 5/14/30.

The line items maintain consistent quantities across all periods, with examples including 75 Adalimumab antibody tests annually, 160 Chromogranin A serum tests, 152 Hemochromatosis mutation tests, and 240 JAK2 mutation tests. Each line item includes specific CPT codes for billing and is classified under NAICS code 621511 (Medical Laboratories) with service code Q301. The spreadsheet includes fields for unit pricing but shows no populated price values. A reserved line item is included in each period for additional laboratory tests not yet developed.

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Other files attached to Q301--Amendment to Post Technical Q's and Extend Closing Date - NTX Reference Lab Testing, newest first.
File Type Posted
S02-36C25725Q0197-Rev1.pdf PDF
36C25725Q0197-Technical Questions.pdf PDF
36C25725Q0197 0001.pdf PDF
36C25725Q0197 0001_1.docx DOCX document
QASP NTX Reference Lab.pdf PDF
S02-36C25725Q0197.pdf PDF
Wage Determination No. 2015-5227, Rev. 24.pdf PDF
36C25725Q0197_1.docx DOCX document

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Action Line Item Information

Action Type NamePrimary IDSecondary IDMod NumberTitleOrder Discount Type NameOrder Discount TypeOrder Discount
RFQ36C25725Q0197New - NTX Reference Lab Testing (Base+4)Percent0

KB Version: FY25.02A

Items

ITEM NUMBERSLINDESCRIPTIONREF CLINCOMMENTINCLUDE COMMENTS IN DOCUMENTCONTRACT PERIODPOP BEGINPOP ENDQUANTITYUNIT OF MEASUREPACKAGING MULTIPLERECEIPT TYPELINE ITEM ISUNIT PRICEITEM DISCOUNT TYPE NAMEITEM DISCOUNTDATE UPDATEDADDRESS1ADDRESS2ADDRESS3CITYSTATEZIPZIP4COUNTRYMARK FROCONTACT NAMECONTACT PHONECONTACT EMAILDDELIVERY DATEFOBSPECIAL INSTRUCTIONSINCLUDE INSTRUCTIONS/COMMENTS IN DOCUMENTINCLUDE DATA VALUES IN DOCUMENTPRINCIPAL NAICS CODEPRODUCT/SERVICE CODEUNSPSCSIC CODEMANUFACTURER PART NUMBER (MPN)NATIONAL STOCK NUMBERLOCAL STOCK NUMBERDM DOC IDDELIVERY REF. COUNTERUNIT TEXT/DESCRIPTIONDELIVERY REFERENCEITEM MASTER FILE NUMBEREXPENDABLE/NON-EXPENDABLEQUANTITY REQUESTEDUNIT OF PURCHASE CODE
0001Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397NoBase5/15/255/14/2675EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80145,8239700E75.00EA
0002Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269NoBase5/15/255/14/268EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8126900E8.00EA
0003Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520NoBase5/15/255/14/267EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8352000E7.00EA
0004Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788NoBase5/15/255/14/261EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E1.00EA
0005Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305NoBase5/15/255/14/2625EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8730500E25.00EA
0006Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207NoBase5/15/255/14/2641EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8120700E41.00EA
0007Beta-2 Transferrin CPT code 86335Beta-2 Transferrin CPT code 86335NoBase5/15/255/14/261EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8633500E1.00EA
0008BK Virus by Quantitative NAAT, Plasma CPT code 87799BK Virus by Quantitative NAAT, Plasma CPT code 87799NoBase5/15/255/14/2622EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779900E22.00EA
0009Chromogranin A serum CPT code 83616Chromogranin A serum CPT code 83616NoBase5/15/255/14/26160EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8361600E160.00EA
0010Cytomegalovirus by Qualitative PCR CPT code 87496Cytomegalovirus by Qualitative PCR CPT code 87496NoBase5/15/255/14/2610EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8749600E10.00EA
0011Autoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoBase5/15/255/14/269EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E9.00EA
0012Autoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoBase5/15/255/14/2613EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E13.00EA
0013(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449NoBase5/15/255/14/2615EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8744900E15.00EA
0014Helicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodHelicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodNoBase5/15/255/14/2612EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E12.00EA
0015Hemochromatosis (HFE) Mutations CPT 81256Hemochromatosis (HFE) Mutations CPT 81256NoBase5/15/255/14/26152EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8125600E152.00EA
0016Human Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATHuman Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATNoBase5/15/255/14/266EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8753500E6.00EA
0017HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381NoBase5/15/255/14/2611EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E11.00EA
0018HLA-B*58:01 Genotyping, Allopurinol HypersensitivityHLA-B*58:01 Genotyping, Allopurinol HypersensitivityNoBase5/15/255/14/265EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E5.00EA
0019Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2NoBase5/15/255/14/266EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A86036,8667100E6.00EA
0020Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397NoBase5/15/255/14/26134EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80230,8239700E134.00EA
0021Calculi (Stone) Analysis CPT code 82365Calculi (Stone) Analysis CPT code 82365NoBase5/15/255/14/26125EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8236500E125.00EA
0022KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273NoBase5/15/255/14/261EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127300E1.00EA
0023Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455NoBase5/15/255/14/265EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8145500E5.00EA
0024Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256NoBase5/15/255/14/269EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636600E9.00EA
0025Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182NoBase5/15/255/14/2640EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8418200E40.00EA
0026Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256NoBase5/15/255/14/2629EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636200E29.00EA
00273-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 835163-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 83516NoBase5/15/255/14/2619EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E19.00EA
0028Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256NoBase5/15/255/14/269EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
0029Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256NoBase5/15/255/14/269EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
0030Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.NoBase5/15/255/14/2627EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E27.00EA
0031Anaerobic Organism Identification CPT codes 87076 and/or 87153; CPT codes for identification vary based on method.Anaerobic Organism Identification CPT codes 87076 and/or 87153; CPT codes for identification vary based on method.NoBase5/15/255/14/265EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E5.00EA
0032Phospholipase A2 Receptor (PLA2R) Antibody, IgG with Reflex to Titer CPT codes: 86255; if reflexed, add 86256Phospholipase A2 Receptor (PLA2R) Antibody, IgG with Reflex to Titer CPT codes: 86255; if reflexed, add 86256NoBase5/15/255/14/2672EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8625500E72.00EA
0033PML-RARA Detection by RT-PCR, Quantitative CPT: 81315PML-RARA Detection by RT-PCR, Quantitative CPT: 81315NoBase5/15/255/14/2619EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8131500E19.00EA
0034Procollagen Type I Intact N-Terminal Propeptide CPT 83519Procollagen Type I Intact N-Terminal Propeptide CPT 83519NoBase5/15/255/14/266EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351900E6.00EA
0035Thiopurine Metabolites in Red Blood Cells CPT code: 80299Thiopurine Metabolites in Red Blood Cells CPT code: 80299NoBase5/15/255/14/2633EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8029900E33.00EA
0036Ribosomal P Protein Antibody CPT 83516Ribosomal P Protein Antibody CPT 83516NoBase5/15/255/14/263EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E3.00EA
0037Aerobic Organism Identification with Reflex to Susceptibility CPT codes vary based on method.Aerobic Organism Identification with Reflex to Susceptibility CPT codes vary based on method.NoBase5/15/255/14/268EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Avaries00E8.00EA
0038Tickborne Disease Antibodies Panel CPT codes 86753; 86666 x2; 86618; if reflexed, add 86617 x2Tickborne Disease Antibodies Panel CPT codes 86753; 86666 x2; 86618; if reflexed, add 86617 x2NoBase5/15/255/14/263EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E3.00EA
0039Trypanosoma cruzi Antibody, IgG CPT 86753Trypanosoma cruzi Antibody, IgG CPT 86753NoBase5/15/255/14/262EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8675300E2.00EA
0040Vedolizumab Quantitation with Antibodies, Serum CPT code 80280, 82397Vedolizumab Quantitation with Antibodies, Serum CPT code 80280, 82397NoBase5/15/255/14/2650EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80280, 8239700E50.00EA
0041Varicella-Zoster Virus by PCR CPT 87798Varicella-Zoster Virus by PCR CPT 87798NoBase5/15/255/14/2616EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779800E16.00EA
0042Viral Culture, Non-Respiratory 87252; if definitive identification required, add 87253Viral Culture, Non-Respiratory 87252; if definitive identification required, add 87253NoBase5/15/255/14/2611EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8725200E11.00EA
0043JAK2 (V617F) Mutation by ddPCR, Qualitative With Reflex to CALR (Calreticulin) Exon 9 Mutation Analysis by PCR and MPL Mutation Detection CPT codes 81270; if reflexed add 81219 and 81338JAK2 (V617F) Mutation by ddPCR, Qualitative With Reflex to CALR (Calreticulin) Exon 9 Mutation Analysis by PCR and MPL Mutation Detection CPT codes 81270; if reflexed add 81219 and 81338NoBase5/15/255/14/26240EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127000E240.00EA
0044Reserved for additional laboratory tests not yet developed or listed in contract or part of the price schedule NAICS 621511 Service code Q301Reserved for additional laboratory tests not yet developed or listed in contract or part of the price schedule NAICS 621511 Service code Q301NoBase5/15/255/14/261EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/AVaries00E1.00EA
1001Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397NoOption 15/15/265/14/2775EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80145,8239700E75.00EA
1002Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269NoOption 15/15/265/14/278EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8126900E8.00EA
1003Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520NoOption 15/15/265/14/277EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8352000E7.00EA
1004Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788NoOption 15/15/265/14/271EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E1.00EA
1005Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305NoOption 15/15/265/14/2725EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8730500E25.00EA
1006Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207NoOption 15/15/265/14/2741EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8120700E41.00EA
1007Beta-2 Transferrin CPT code 86335Beta-2 Transferrin CPT code 86335NoOption 15/15/265/14/271EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8633500E1.00EA
1008BK Virus by Quantitative NAAT, Plasma CPT code 87799BK Virus by Quantitative NAAT, Plasma CPT code 87799NoOption 15/15/265/14/2722EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779900E22.00EA
1009Chromogranin A serum CPT code 83616Chromogranin A serum CPT code 83616NoOption 15/15/265/14/27160EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8361600E160.00EA
1010Cytomegalovirus by Qualitative PCR CPT code 87496Cytomegalovirus by Qualitative PCR CPT code 87496NoOption 15/15/265/14/2710EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8749600E10.00EA
1011Autoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoOption 15/15/265/14/279EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E9.00EA
1012Autoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoOption 15/15/265/14/2713EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E13.00EA
1013(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449NoOption 15/15/265/14/2715EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8744900E15.00EA
1014Helicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodHelicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodNoOption 15/15/265/14/2712EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E12.00EA
1015Hemochromatosis (HFE) Mutations CPT 81256Hemochromatosis (HFE) Mutations CPT 81256NoOption 15/15/265/14/27152EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8125600E152.00EA
1016Human Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATHuman Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATNoOption 15/15/265/14/276EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8753500E6.00EA
1017HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381NoOption 15/15/265/14/2711EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E11.00EA
1018HLA-B*58:01 Genotyping, Allopurinol HypersensitivityHLA-B*58:01 Genotyping, Allopurinol HypersensitivityNoOption 15/15/265/14/275EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E5.00EA
1019Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2NoOption 15/15/265/14/276EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A86036,8667100E6.00EA
1020Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397NoOption 15/15/265/14/27134EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80230,8239700E134.00EA
1021Calculi (Stone) Analysis CPT code 82365Calculi (Stone) Analysis CPT code 82365NoOption 15/15/265/14/27125EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8236500E125.00EA
1022KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273NoOption 15/15/265/14/271EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127300E1.00EA
1023Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455NoOption 15/15/265/14/275EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8145500E5.00EA
1024Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256NoOption 15/15/265/14/279EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636600E9.00EA
1025Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182NoOption 15/15/265/14/2740EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8418200E40.00EA
1026Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256NoOption 15/15/265/14/2729EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636200E29.00EA
10273-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 835163-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 83516NoOption 15/15/265/14/2719EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E19.00EA
1028Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256NoOption 15/15/265/14/279EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
1029Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256NoOption 15/15/265/14/279EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
1030Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.NoOption 15/15/265/14/2727EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E27.00EA
1031Anaerobic Organism Identification CPT codes 87076 and/or 87153; CPT codes for identification vary based on method.Anaerobic Organism Identification CPT codes 87076 and/or 87153; CPT codes for identification vary based on method.NoOption 15/15/265/14/275EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E5.00EA
1032Phospholipase A2 Receptor (PLA2R) Antibody, IgG with Reflex to Titer CPT codes: 86255; if reflexed, add 86256Phospholipase A2 Receptor (PLA2R) Antibody, IgG with Reflex to Titer CPT codes: 86255; if reflexed, add 86256NoOption 15/15/265/14/2772EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8625500E72.00EA
1033PML-RARA Detection by RT-PCR, Quantitative CPT: 81315PML-RARA Detection by RT-PCR, Quantitative CPT: 81315NoOption 15/15/265/14/2719EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8131500E19.00EA
1034Procollagen Type I Intact N-Terminal Propeptide CPT 83519Procollagen Type I Intact N-Terminal Propeptide CPT 83519NoOption 15/15/265/14/276EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351900E6.00EA
1035Thiopurine Metabolites in Red Blood Cells CPT code: 80299Thiopurine Metabolites in Red Blood Cells CPT code: 80299NoOption 15/15/265/14/2733EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8029900E33.00EA
1036Ribosomal P Protein Antibody CPT 83516Ribosomal P Protein Antibody CPT 83516NoOption 15/15/265/14/273EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E3.00EA
1037Aerobic Organism Identification with Reflex to Susceptibility CPT codes vary based on method.Aerobic Organism Identification with Reflex to Susceptibility CPT codes vary based on method.NoOption 15/15/265/14/278EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Avaries00E8.00EA
1038Tickborne Disease Antibodies Panel CPT codes 86753; 86666 x2; 86618; if reflexed, add 86617 x2Tickborne Disease Antibodies Panel CPT codes 86753; 86666 x2; 86618; if reflexed, add 86617 x2NoOption 15/15/265/14/273EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E3.00EA
1039Trypanosoma cruzi Antibody, IgG CPT 86753Trypanosoma cruzi Antibody, IgG CPT 86753NoOption 15/15/265/14/272EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8675300E2.00EA
1040Vedolizumab Quantitation with Antibodies, Serum CPT code 80280, 82397Vedolizumab Quantitation with Antibodies, Serum CPT code 80280, 82397NoOption 15/15/265/14/2750EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80280, 8239700E50.00EA
1041Varicella-Zoster Virus by PCR CPT 87798Varicella-Zoster Virus by PCR CPT 87798NoOption 15/15/265/14/2716EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779800E16.00EA
1042Viral Culture, Non-Respiratory 87252; if definitive identification required, add 87253Viral Culture, Non-Respiratory 87252; if definitive identification required, add 87253NoOption 15/15/265/14/2711EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8725200E11.00EA
1043JAK2 (V617F) Mutation by ddPCR, Qualitative With Reflex to CALR (Calreticulin) Exon 9 Mutation Analysis by PCR and MPL Mutation Detection CPT codes 81270; if reflexed add 81219 and 81338JAK2 (V617F) Mutation by ddPCR, Qualitative With Reflex to CALR (Calreticulin) Exon 9 Mutation Analysis by PCR and MPL Mutation Detection CPT codes 81270; if reflexed add 81219 and 81338NoOption 15/15/265/14/27240EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127000E240.00EA
1044Reserved for additional laboratory tests not yet developed or listed in contract or part of the price schedule NAICS 621511 Service code Q301Reserved for additional laboratory tests not yet developed or listed in contract or part of the price schedule NAICS 621511 Service code Q301NoOption 15/15/265/14/271EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/AVaries00E1.00EA
2001Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397NoOption 25/15/275/14/2875EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80145,8239700E75.00EA
2002Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269NoOption 25/15/275/14/288EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8126900E8.00EA
2003Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520NoOption 25/15/275/14/287EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8352000E7.00EA
2004Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788NoOption 25/15/275/14/281EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E1.00EA
2005Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305NoOption 25/15/275/14/2825EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8730500E25.00EA
2006Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207NoOption 25/15/275/14/2841EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8120700E41.00EA
2007Beta-2 Transferrin CPT code 86335Beta-2 Transferrin CPT code 86335NoOption 25/15/275/14/281EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8633500E1.00EA
2008BK Virus by Quantitative NAAT, Plasma CPT code 87799BK Virus by Quantitative NAAT, Plasma CPT code 87799NoOption 25/15/275/14/2822EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779900E22.00EA
2009Chromogranin A serum CPT code 83616Chromogranin A serum CPT code 83616NoOption 25/15/275/14/28160EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8361600E160.00EA
2010Cytomegalovirus by Qualitative PCR CPT code 87496Cytomegalovirus by Qualitative PCR CPT code 87496NoOption 25/15/275/14/2810EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8749600E10.00EA
2011Autoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoOption 25/15/275/14/289EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E9.00EA
2012Autoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoOption 25/15/275/14/2813EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E13.00EA
2013(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449NoOption 25/15/275/14/2815EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8744900E15.00EA
2014Helicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodHelicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodNoOption 25/15/275/14/2812EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E12.00EA
2015Hemochromatosis (HFE) Mutations CPT 81256Hemochromatosis (HFE) Mutations CPT 81256NoOption 25/15/275/14/28152EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8125600E152.00EA
2016Human Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATHuman Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATNoOption 25/15/275/14/286EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8753500E6.00EA
2017HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381NoOption 25/15/275/14/2811EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E11.00EA
2018HLA-B*58:01 Genotyping, Allopurinol HypersensitivityHLA-B*58:01 Genotyping, Allopurinol HypersensitivityNoOption 25/15/275/14/285EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E5.00EA
2019Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2NoOption 25/15/275/14/286EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A86036,8667100E6.00EA
2020Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397NoOption 25/15/275/14/28134EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80230,8239700E134.00EA
2021Calculi (Stone) Analysis CPT code 82365Calculi (Stone) Analysis CPT code 82365NoOption 25/15/275/14/28125EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8236500E125.00EA
2022KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273NoOption 25/15/275/14/281EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127300E1.00EA
2023Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455NoOption 25/15/275/14/285EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8145500E5.00EA
2024Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256NoOption 25/15/275/14/289EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636600E9.00EA
2025Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182NoOption 25/15/275/14/2840EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8418200E40.00EA
2026Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256NoOption 25/15/275/14/2829EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636200E29.00EA
20273-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 835163-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 83516NoOption 25/15/275/14/2819EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E19.00EA
2028Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256NoOption 25/15/275/14/289EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
2029Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256NoOption 25/15/275/14/289EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
2030Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.NoOption 25/15/275/14/2827EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E27.00EA
2031Anaerobic Organism Identification CPT codes 87076 and/or 87153; CPT codes for identification vary based on method.Anaerobic Organism Identification CPT codes 87076 and/or 87153; CPT codes for identification vary based on method.NoOption 25/15/275/14/285EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E5.00EA
2032Phospholipase A2 Receptor (PLA2R) Antibody, IgG with Reflex to Titer CPT codes: 86255; if reflexed, add 86256Phospholipase A2 Receptor (PLA2R) Antibody, IgG with Reflex to Titer CPT codes: 86255; if reflexed, add 86256NoOption 25/15/275/14/2872EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8625500E72.00EA
2033PML-RARA Detection by RT-PCR, Quantitative CPT: 81315PML-RARA Detection by RT-PCR, Quantitative CPT: 81315NoOption 25/15/275/14/2819EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8131500E19.00EA
2034Procollagen Type I Intact N-Terminal Propeptide CPT 83519Procollagen Type I Intact N-Terminal Propeptide CPT 83519NoOption 25/15/275/14/286EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351900E6.00EA
2035Thiopurine Metabolites in Red Blood Cells CPT code: 80299Thiopurine Metabolites in Red Blood Cells CPT code: 80299NoOption 25/15/275/14/2833EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8029900E33.00EA
2036Ribosomal P Protein Antibody CPT 83516Ribosomal P Protein Antibody CPT 83516NoOption 25/15/275/14/283EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E3.00EA
2037Aerobic Organism Identification with Reflex to Susceptibility CPT codes vary based on method.Aerobic Organism Identification with Reflex to Susceptibility CPT codes vary based on method.NoOption 25/15/275/14/288EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Avaries00E8.00EA
2038Tickborne Disease Antibodies Panel CPT codes 86753; 86666 x2; 86618; if reflexed, add 86617 x2Tickborne Disease Antibodies Panel CPT codes 86753; 86666 x2; 86618; if reflexed, add 86617 x2NoOption 25/15/275/14/283EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E3.00EA
2039Trypanosoma cruzi Antibody, IgG CPT 86753Trypanosoma cruzi Antibody, IgG CPT 86753NoOption 25/15/275/14/282EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8675300E2.00EA
2040Vedolizumab Quantitation with Antibodies, Serum CPT code 80280, 82397Vedolizumab Quantitation with Antibodies, Serum CPT code 80280, 82397NoOption 25/15/275/14/2850EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80280, 8239700E50.00EA
2041Varicella-Zoster Virus by PCR CPT 87798Varicella-Zoster Virus by PCR CPT 87798NoOption 25/15/275/14/2816EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779800E16.00EA
2042Viral Culture, Non-Respiratory 87252; if definitive identification required, add 87253Viral Culture, Non-Respiratory 87252; if definitive identification required, add 87253NoOption 25/15/275/14/2811EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8725200E11.00EA
2043JAK2 (V617F) Mutation by ddPCR, Qualitative With Reflex to CALR (Calreticulin) Exon 9 Mutation Analysis by PCR and MPL Mutation Detection CPT codes 81270; if reflexed add 81219 and 81338JAK2 (V617F) Mutation by ddPCR, Qualitative With Reflex to CALR (Calreticulin) Exon 9 Mutation Analysis by PCR and MPL Mutation Detection CPT codes 81270; if reflexed add 81219 and 81338NoOption 25/15/275/14/28240EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127000E240.00EA
2044Reserved for additional laboratory tests not yet developed or listed in contract or part of the price schedule NAICS 621511 Service code Q301Reserved for additional laboratory tests not yet developed or listed in contract or part of the price schedule NAICS 621511 Service code Q301NoOption 25/15/275/14/281EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/AVaries00E1.00EA
3001Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397Adalimumab and Antibodies to Adalimumab Quantitation CPT codes 80145 82397NoOption 35/15/285/14/2975EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80145,8239700E75.00EA
3002Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269Alpha Globin (HBA1 and HBA2) Deletion/Duplication CPT code 81269NoOption 35/15/285/14/298EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8126900E8.00EA
3003Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520Alpha Subunit, Free, Pituitary Glycoprotein Hormones (PGH) CPT code: 83520NoOption 35/15/285/14/297EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8352000E7.00EA
3004Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788Arbovirus Antibodies, IgG and IgM, CSF CPT codes:86651 x2; 86652 x2; 86653 x2; 86654 x2; 86789; 86788NoOption 35/15/285/14/291EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E1.00EA
3005Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305Aspergillus Galactomannan Antigen by EIA, Bronchoscopy CPT code 87305NoOption 35/15/285/14/2925EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8730500E25.00EA
3006Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207Quantitative Detection of BCR-ABL1, Minor Form (p190) CPT code 81207NoOption 35/15/285/14/2941EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8120700E41.00EA
3007Beta-2 Transferrin CPT code 86335Beta-2 Transferrin CPT code 86335NoOption 35/15/285/14/291EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8633500E1.00EA
3008BK Virus by Quantitative NAAT, Plasma CPT code 87799BK Virus by Quantitative NAAT, Plasma CPT code 87799NoOption 35/15/285/14/2922EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8779900E22.00EA
3009Chromogranin A serum CPT code 83616Chromogranin A serum CPT code 83616NoOption 35/15/285/14/29160EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8361600E160.00EA
3010Cytomegalovirus by Qualitative PCR CPT code 87496Cytomegalovirus by Qualitative PCR CPT code 87496NoOption 35/15/285/14/2910EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8749600E10.00EA
3011Autoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, Serum CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoOption 35/15/285/14/299EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E9.00EA
3012Autoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerAutoimmune Encephalopathy/Dementia Panel, CSF CPT codes:86341; 84182 x2; 86255 x10; if reflexed add 84182 x4; 86256 per titerNoOption 35/15/285/14/2913EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E13.00EA
3013(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449(1,3)-Beta-D-Glucan (Fungitell) CPT code: 87449NoOption 35/15/285/14/2915EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8744900E15.00EA
3014Helicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodHelicobacter pylori culture CPT codes 87070; 87176; Identification and susceptibility CPT codes may vary based on methodNoOption 35/15/285/14/2912EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E12.00EA
3015Hemochromatosis (HFE) Mutations CPT 81256Hemochromatosis (HFE) Mutations CPT 81256NoOption 35/15/285/14/29152EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8125600E152.00EA
3016Human Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATHuman Immunodeficiency Virus 1 (HIV-1) by Qualitative NAATNoOption 35/15/285/14/296EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8753500E6.00EA
3017HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381HLA-B*57:01 for Abacavir Sensitivity CPT code: 81381NoOption 35/15/285/14/2911EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E11.00EA
3018HLA-B*58:01 Genotyping, Allopurinol HypersensitivityHLA-B*58:01 Genotyping, Allopurinol HypersensitivityNoOption 35/15/285/14/295EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8138100E5.00EA
3019Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2Inflammatory Bowel Disease Differentiation Panel CPT codes: 86036; 86671 x2NoOption 35/15/285/14/296EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A86036,8667100E6.00EA
3020Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397Infliximab and Antibodies to Infliximab Quantitation CPT codes 80230,82397NoOption 35/15/285/14/29134EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A80230,8239700E134.00EA
3021Calculi (Stone) Analysis CPT code 82365Calculi (Stone) Analysis CPT code 82365NoOption 35/15/285/14/29125EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8236500E125.00EA
3022KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273KIT (D816V) Mutation by ddPCR, Quantitative CPT 81273NoOption 35/15/285/14/291EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8127300E1.00EA
3023Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455Myeloid Malignancies Mutation and Copy Number Variation Panel by Next Generation Sequencing CPT code 81455NoOption 35/15/285/14/295EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8145500E5.00EA
3024Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256Muscle-Specific Kinase (MuSK) Antibody, IgG by CBA-IFA with Reflex to Titer, Serum CPT codes:86366 if reflexed, add 86256NoOption 35/15/285/14/299EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636600E9.00EA
3025Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182Myasthenia Gravis/Lambert-Eaton Myasthenic Syndrome Evaluation, serum CPT code 84182NoOption 35/15/285/14/2940EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8418200E40.00EA
3026Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256Myelin Oligodendrocyte Glycoprotein (MOG) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86362; if reflexed, add 86256NoOption 35/15/285/14/2929EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8636200E29.00EA
30273-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 835163-Hydroxy-3-Methylglutaryl Coenzyme A Reductase (HMGCR) Antibody, IgG CPT code 83516NoOption 35/15/285/14/2919EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8351600E19.00EA
3028Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, Serum CPT codes: 86052; if reflexed, add 86256NoOption 35/15/285/14/299EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
3029Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256Aquaporin-4 (AQP4) Antibody, IgG by CBA-IFA With Reflex to Titer, CSF CPT code 86052; if reflexed, add 86256NoOption 35/15/285/14/299EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/A8605200E9.00EA
3030Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.Aerobic Organism Identification CPT codes 87077 and/or 87153; CPT codes for identification vary based on method.NoOption 35/15/285/14/2927EA0QuantityPricedPercent0NONENoNo621511Q301N/AN/Amulti00E27.00EA

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