D.1 Price Schedule.xlsx

XLSX spreadsheet 158 KB Posted Jan 21, 2025

Attached to: Q515--ON-SITE/OFF-SITE Pathology Services/589A7 Federal contract opportunity
Solicitation number: 36C25525Q0096_1
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 15

About this file

Written by GovTribe AI · Jan 23, 2025

This is a pricing schedule template for pathology services at the Robert J. Dole VA Medical Center in Wichita, KS. The spreadsheet includes detailed line items for various pathology CPT codes with their associated prices, quantities, and total estimated costs across a base year and four option years.

The schedule covers both laboratory testing (Line Item 0001) and board-certified pathologist services (Line Item 0002). Each contract year has an estimated value of $675,051.56 for laboratory testing, which includes cytopathology, tissue examination, immunohistochemistry, and other specialized pathology services. The pathologist services component requires approximately 70 hours per year. Major service categories include surgical pathology, cytopathology, flow cytometry, and specialized staining procedures, with the highest volume items being tissue examinations (CPT 88305) at 3,760 units annually and flow cytometry add-ons (CPT 88185) at 2,380 units annually. The template requires vendors to specify blanket discount percentages on CPT codes and hourly rates for pathologist services for each contract year.

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Other files for this federal contract opportunity

Other files attached to Q515--ON-SITE/OFF-SITE Pathology Services/589A7, newest first.
File	Type	Posted
36C25525Q0096_1.docx	DOCX document	Jan 21, 2025
D.2 Quality Assurance Surveillance Program QASP.docx	DOCX document	Jan 21, 2025
D.5 Immigration and Nationality Act.pdf	PDF	Jan 21, 2025
D.7 Wage Determination 2015-5341 rev 27 7-22-2024.docx.pdf	PDF	Jan 21, 2025
D.8 BYLAWS Robert J Dole VAMC June 2023.pdf	PDF	Jan 21, 2025
D.4 Organizational Conflict of Interest.pdf	PDF	Jan 21, 2025
D.3 Contractor Rules of Behavior.pdf	PDF	Jan 21, 2025
D.6 Past Performance References.pdf	PDF	Jan 21, 2025

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Instructions

Vendor Name

Street Address

City, State, Zip

POC

POC email

INSTRUCTIONS:

Below, fill out blanket discount on all CPT codes (use whole positive number up to two decimals for discount) and hourly rate for the base and each option year. Each year is based on current CPT pricing and a total of 70 hours per year. Workbook will provide a total for each LIN, each year, and total contract price. To see individual CPT Code pricing, click on the tab for the year you wish to see. Adjustments can only be made on this page, tabs are for reference only.

BASE YEAR: LIN 0001 BLANKET DISCOUNT %:		$675,051.56
BASE YEAR: LIN 0002 PRICE/HR (EST 70 HRS):		$0.00
	Base Total:	$675,051.56

OPTION YEAR 1: LIN 1001 BLANKET DISCOUNT %:		$675,051.56
OPTION YEAR 1: LIN 1002 PRICE/HR (EST 70 HRS):		$0.00
	OY1 Total:	$675,051.56

OPTION YEAR 2: LIN 2001 BLANKET DISCOUNT %:		$675,051.56
OPTION YEAR 2: LIN 2002 PRICE/HR (EST 70 HRS):		$0.00
	OY2 Total:	$675,051.56

OPTION YEAR 3: LIN 3001 BLANKET DISCOUNT %:		$675,051.56
OPTION YEAR3: LIN 3002 PRICE/HR (EST 70 HRS):		$0.00
	OY3 Total:	$675,051.56

OPTION YEAR 4: LIN 4001 BLANKET DISCOUNT %:		$675,051.56
OPTION YEAR 4: LIN 4002 PRICE/HR (EST 70 HRS):		$0.00
	OY4 Total:	$675,051.56

Contract Total: $3,375,257.80

Sheet11

		Totals
BASE YEAR: LIN 0001 BLANKET DISCOUNT %:	______%	$_____________.__
BASE YEAR: LIN 0002 PRICE/HR (APPROX 70 HRS):	$_____.__	$_____________.__
	Base Total:	$_____________.__

OPTION YEAR 1: LIN 1001 BLANKET DISCOUNT %:	______%	$_____________.__
OPTION YEAR 1: LIN 1002 PRICE/HR (APPROX 70 HRS):	$_____.__	$_____________.__
	OY1 Total:	$_____________.__

OPTION YEAR 2: LIN 2001 BLANKET DISCOUNT %:	______%	$_____________.__
OPTION YEAR 2: LIN 2002 PRICE/HR (APPROX 70 HRS):	$_____.__	$_____________.__
	OY2 Total:	$_____________.__

OPTION YEAR 3: LIN 3001 BLANKET DISCOUNT %:	______%	$_____________.__
OPTION YEAR3: LIN 3002 PRICE/HR (APPROX 70 HRS):	$_____.__	$_____________.__
	OY3 Total:	$_____________.__

OPTION YEAR 4: LIN 4001 BLANKET DISCOUNT %:	______%	$_____________.__
OPTION YEAR 4: LIN 4002 PRICE/HR (APPROX 70 HRS):	$_____.__	$_____________.__
	OY4 Total:	$_____________.__

Contract Total: $_____________.__

RequiredInfo

Option Year

Base

1/7/20

1/6/21

CY2019

CY2018

Total Base:

447376.92

Base

1/7/20

1/6/21

Total Base:

Station

589A7

Robert J. Dole VAMC

One

1/7/21

1/6/22

Total Est OY1:

Modification

P00011

Two

1/7/22

1/6/23

Total Est OY2:

PR-IFCAP

589-24-2-4118-0004

Three

1/7/23

1/6/24

Total Est OY3:

COR:

Sherry Parsons

316-685-2221 x53816

sherry.parsons2@va.gov

Christopher Fox

316-685-2221 x52308

christopher.fox5@va.gov

Four

1/7/24

1/6/25

Total Est OY4:

Mike Carson

Contract Specialist

Michael.Carson1@va.gov

(913) 946-1119

Mike Carson

Contracting Officer

Michael.Carson1@va.gov

(913) 946-1119

589C41046

Task order

36C25524N0108

Total Base:

$447,376.92

$2,236,884.60

508026.99

$2,744,911.59

36C25520D0021 | HCS | 589A7 | South Central Pathology Lab | Option Year Base

Total Est OY1:

$447,376.92

$2,236,884.60

Total Est OY2:

$455,193.43

$2,260,334.13

$23,449.53

Total Est OY3:

$602,415.56

$2,554,778.39

$294,444.26

Total Est OY4:

$602,415.56

2261411.28

$1,077.15

Contract Total:

$2,554,778.39

$22,372.38

South Central Pathology Lab

36C25520D0021

3600 E. Harry St.

Wichita, KS 67218

January 21, 2025: Will execute option year NLT 01/07/2020

Wichita

Acquisition Type: Modification

67218

Station ID/Name: 589A7/Robert J. Dole VAMC

11SC

WI Specialty Care Svc Team

Location (City, State): Wichita, KS

25254

<--Vendor Code in VISTA

COR: Sherry Parsons

PO#: 589C41046

Contract Duration: Base plus 4

Period of Performance (PoP): January 07, 2020 - January 06, 2021

Contract Value: $2,554,778.39 ($447,376.92 for Option Year Base)

Notes: Exercise Option Year Base

CO Name:	Mike Carson; (913) 946-1119
CO Email:	Michael.Carson1@va.gov
CS Name:	Mike Carson; (913) 946-1119
CS Email:	Michael.Carson1@va.gov
Funding Doc ID:	589-24-2-4118-0004
Program Office Code:	11SC
Program Office Description:	WI Specialty Care Svc Team
PM Name:	Christopher Fox
PM Phone:	316-685-2221 x52308
PM Email:	christopher.fox5@va.gov
Planned Place of Perfomance:	67218
POC Name:	Mike Carson; Michael.Carson1@va.gov
POC Phone:	(913) 946-1119
Acq Team:	Healthcare Services
COR Name:	Sherry Parsons
COR Phone:	316-685-2221 x53816
COR Email:	sherry.parsons2@va.gov
Station:	589A7
IT:	None
Option Period:	Year
Number of Options:	4
Project Number:	None
Station:	589A7
NAICS:	621511
Procurement Vehicle:	5,7,9
Socioeconomic Category:	7
PSC:	Q515
Procurement Method:	1

Base + All Options: $294,444.26

2023Pricing

HCPCS Code	Modifier	Short Description	Mac Locality	Non-Facility Price	Facility Price	Non-Facility Limiting Charge	Facility Limiting Charge	GPCI Work	GPCI PE	GPCI MP	Proc Stat	Work RVU	NA Flag for Trans Non-FAC PE RVU	Transitioned Non-FAC PE RVU	NA Flag for Fully IMP Non-FAC PE RVU	Fully Implemented Non-FAC PE RVU	NA Flag for Trans facility PE RVU	Transitioned Facility PE RVU	NA Flag for Fully IMP FAC PE RVU	Fully Implemented Facility PE RVU	MP RVU	Transitioned Non-FAC Total	Transitioned Facility Total	Fully Implemented Non-Fac Total	Fully Implemented Facility Total	PCTC	Global	Pre Op	Intra Op	Post Op	Mult Surg	Bilt Surg	Asst Surg	Co Surg	Team Surg	Phys Supv	Endobase	Conv Fact	Not Used for Medicare	Diag Imaging Family Ind	Opps Non-Facility Payment Amount	Opps Facility Payment Amount	Non-Fac PE Used For Opps PMT AMT	Facility PE Used For Opps PMT AMT	Malpractice Used For Opps PMT AMT
80503		Path clin consltj sf 5-20	520200	$24.81	$20.12	$27.10	$21.98	1	0.906	0.54	A	0.43		0.36		0.36		0.2		0.2	0.02	0.81	0.65	0.81	0.65	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
80504		Path clin consltj mod 21-40	520200	$48.30	$43.03	$52.77	$47.01	1	0.906	0.54	A	0.91		0.62		0.62		0.44		0.44	0.04	1.57	1.39	1.57	1.39	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
80505		Path clin consltj high 41-60	520200	$88.12	$81.68	$96.27	$89.23	1	0.906	0.54	A	1.71		1.06		1.06		0.84		0.84	0.1	2.87	2.65	2.87	2.65	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
80506		Path clin consltj prolng svc	520200	$38.88	$38.88	$42.48	$42.48	1	0.906	0.54	A	0.8		0.42		0.42		0.42		0.42	0.04	1.26	1.26	1.26	1.26	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
83020		Hemoglobin electrophoresis	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
83020	26	Hemoglobin electrophoresis	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
84165		Protein e-phoresis serum	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
84165	26	Protein e-phoresis serum	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
84166		Protein e-phoresis/urine/csf	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
84166	26	Protein e-phoresis/urine/csf	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
84181		Western blot test	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
84181	26	Western blot test	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
84182		Protein western blot test	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
84182	26	Protein western blot test	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
85060		Blood smear interpretation	520200	$21.53	$21.53	$23.52	$23.52	1	0.906	0.54	A	0.45		0.22		0.22		0.22		0.22	0.03	0.7	0.7	0.7	0.7	8	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
85097		Bone marrow interpretation	520200	$63.34	$43.41	$69.20	$47.43	1	0.906	0.54	A	0.94		1.1		1.1		0.42		0.42	0.04	2.08	1.4	2.08	1.4	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
85390		Fibrinolysins screen i&r	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
85390	26	Fibrinolysins screen i&r	520200	$33.11	$33.11	$36.17	$36.17	1	0.906	0.54	A	0.75		0.29		0.29		0.29		0.29	0.02	1.06	1.06	1.06	1.06	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
85396		Clotting assay whole blood	520200	$17.59	$17.59	$19.22	$19.22	1	0.906	0.54	A	0.37		0.18		0.18		0.18		0.18	0.02	0.57	0.57	0.57	0.57	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
85576		Blood platelet aggregation	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
85576	26	Blood platelet aggregation	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86077		Phys blood bank serv xmatch	520200	$48.69	$44.29	$53.19	$48.39	1	0.906	0.54	A	0.94		0.6		0.6		0.45		0.45	0.04	1.58	1.43	1.58	1.43	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86078		Phys blood bank serv reactj	520200	$48.69	$44.59	$53.19	$48.71	1	0.906	0.54	A	0.94		0.6		0.6		0.46		0.46	0.04	1.58	1.44	1.58	1.44	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86079		Phys blood bank serv authrj	520200	$48.39	$44.29	$52.87	$48.39	1	0.906	0.54	A	0.94		0.59		0.59		0.45		0.45	0.04	1.57	1.43	1.57	1.43	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86153	26	Cell enumeration phys interp	520200	$30.58	$30.58	$33.41	$33.41	1	0.906	0.54	A	0.69		0.27		0.27		0.27		0.27	0.02	0.98	0.98	0.98	0.98	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86255		Fluorescent antibody screen	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
86255	26	Fluorescent antibody screen	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86256		Fluorescent antibody titer	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
86256	26	Fluorescent antibody titer	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86320		Serum immunoelectrophoresis	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
86320	26	Serum immunoelectrophoresis	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86325		Other immunoelectrophoresis	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
86325	26	Other immunoelectrophoresis	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86334		Immunofix e-phoresis serum	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
86334	26	Immunofix e-phoresis serum	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86335		Immunfix e-phorsis/urine/csf	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
86335	26	Immunfix e-phorsis/urine/csf	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86486		Skin test unlisted antign ea	520200	$5.45	$5.45	$5.95	$5.95	1	0.906	0.54	A	0		0.18		0.18		0.18		0.18	0.01	0.19	0.19	0.19	0.19	3	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86510		Histoplasmosis skin test	520200	$6.62	$6.62	$7.23	$7.23	1	0.906	0.54	A	0		0.22		0.22		0.22		0.22	0.01	0.23	0.23	0.23	0.23	3	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
86580		Tb intradermal test	520200	$8.67	$8.67	$9.48	$9.48	1	0.906	0.54	A	0		0.29		0.29		0.29		0.29	0.01	0.3	0.3	0.3	0.3	3	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
87164		Dark field exam spec collj	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
87164	26	Dark field exam spec collj	520200	$17.42	$17.42	$19.03	$19.03	1	0.906	0.54	A	0.37		0.18		0.18		0.18		0.18	0.01	0.56	0.56	0.56	0.56	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
87207		Smear special stain	520200	$0.00	$0.00	$0.00	$0.00	1	0.906	0.54	X	0		0		0		0		0	0	0	0	0	0	9	XXX	0	0	0	9	9	9	9	9	9		32.3465		99	NA	NA	0	0	0
87207	26	Smear special stain	520200	$16.54	$16.54	$18.07	$18.07	1	0.906	0.54	A	0.37		0.15		0.15		0.15		0.15	0.01	0.53	0.53	0.53	0.53	6	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88104		Cytopath fl nongyn smears	520200	$71.68	$71.68	$78.31	$78.31	1	0.906	0.54	A	0.56		1.81		1.81		1.81		1.81	0.03	2.4	2.4	2.4	2.4	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88104	TC	Cytopath fl nongyn smears	520200	$46.36	$46.36	$50.65	$50.65	1	0.906	0.54	A	0		1.57		1.57		1.57		1.57	0.02	1.59	1.59	1.59	1.59	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88104	26	Cytopath fl nongyn smears	520200	$25.32	$25.32	$27.66	$27.66	1	0.906	0.54	A	0.56		0.24		0.24		0.24		0.24	0.01	0.81	0.81	0.81	0.81	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88106		Cytopath fl nongyn filter	520200	$63.19	$63.19	$69.04	$69.04	1	0.906	0.54	A	0.37		1.73		1.73		1.73		1.73	0.03	2.13	2.13	2.13	2.13	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88106	TC	Cytopath fl nongyn filter	520200	$46.07	$46.07	$50.33	$50.33	1	0.906	0.54	A	0		1.56		1.56		1.56		1.56	0.02	1.58	1.58	1.58	1.58	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88106	26	Cytopath fl nongyn filter	520200	$17.12	$17.12	$18.71	$18.71	1	0.906	0.54	A	0.37		0.17		0.17		0.17		0.17	0.01	0.55	0.55	0.55	0.55	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88108		Cytopath concentrate tech	520200	$62.64	$62.64	$68.44	$68.44	1	0.906	0.54	A	0.44		1.64		1.64		1.64		1.64	0.02	2.1	2.1	2.1	2.1	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88108	TC	Cytopath concentrate tech	520200	$42.38	$42.38	$46.29	$46.29	1	0.906	0.54	A	0		1.44		1.44		1.44		1.44	0.01	1.45	1.45	1.45	1.45	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88108	26	Cytopath concentrate tech	520200	$20.27	$20.27	$22.14	$22.14	1	0.906	0.54	A	0.44		0.2		0.2		0.2		0.2	0.01	0.65	0.65	0.65	0.65	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88112		Cytopath cell enhance tech	520200	$60.96	$60.96	$66.60	$66.60	1	0.906	0.54	A	0.56		1.45		1.45		1.45		1.45	0.02	2.03	2.03	2.03	2.03	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88112	TC	Cytopath cell enhance tech	520200	$35.93	$35.93	$39.25	$39.25	1	0.906	0.54	A	0		1.22		1.22		1.22		1.22	0.01	1.23	1.23	1.23	1.23	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88112	26	Cytopath cell enhance tech	520200	$25.03	$25.03	$27.34	$27.34	1	0.906	0.54	A	0.56		0.23		0.23		0.23		0.23	0.01	0.8	0.8	0.8	0.8	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88120		Cytp urne 3-5 probes ea spec	520200	$494.52	$494.52	$540.26	$540.26	1	0.906	0.54	A	1.2		15.52		15.52		15.52		15.52	0.05	16.77	16.77	16.77	16.77	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88120	TC	Cytp urne 3-5 probes ea spec	520200	$441.58	$441.58	$482.42	$482.42	1	0.906	0.54	A	0		15.05		15.05		15.05		15.05	0.03	15.08	15.08	15.08	15.08	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88120	26	Cytp urne 3-5 probes ea spec	520200	$52.94	$52.94	$57.84	$57.84	1	0.906	0.54	A	1.2		0.47		0.47		0.47		0.47	0.02	1.69	1.69	1.69	1.69	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88121		Cytp urine 3-5 probes cmptr	520200	$358.93	$358.93	$392.13	$392.13	1	0.906	0.54	A	1		11.12		11.12		11.12		11.12	0.04	12.16	12.16	12.16	12.16	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88121	TC	Cytp urine 3-5 probes cmptr	520200	$314.80	$314.80	$343.92	$343.92	1	0.906	0.54	A	0		10.73		10.73		10.73		10.73	0.02	10.75	10.75	10.75	10.75	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88121	26	Cytp urine 3-5 probes cmptr	520200	$44.13	$44.13	$48.21	$48.21	1	0.906	0.54	A	1		0.39		0.39		0.39		0.39	0.02	1.41	1.41	1.41	1.41	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88125		Forensic cytopathology	520200	$26.05	$26.05	$28.46	$28.46	1	0.906	0.54	A	0.26		0.59		0.59		0.59		0.59	0.02	0.87	0.87	0.87	0.87	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88125	TC	Forensic cytopathology	520200	$13.66	$13.66	$14.92	$14.92	1	0.906	0.54	A	0		0.46		0.46		0.46		0.46	0.01	0.47	0.47	0.47	0.47	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88125	26	Forensic cytopathology	520200	$12.39	$12.39	$13.54	$13.54	1	0.906	0.54	A	0.26		0.13		0.13		0.13		0.13	0.01	0.4	0.4	0.4	0.4	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88141		Cytopath c/v interpret	520200	$22.65	$22.65	$24.75	$24.75	1	0.906	0.54	A	0.26		0.48		0.48		0.48		0.48	0.01	0.75	0.75	0.75	0.75	2	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88160		Cytopath smear other source	520200	$74.43	$74.43	$81.31	$81.31	1	0.906	0.54	A	0.5		1.97		1.97		1.97		1.97	0.03	2.5	2.5	2.5	2.5	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88160	TC	Cytopath smear other source	520200	$51.05	$51.05	$55.77	$55.77	1	0.906	0.54	A	0		1.73		1.73		1.73		1.73	0.02	1.75	1.75	1.75	1.75	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88160	26	Cytopath smear other source	520200	$23.38	$23.38	$25.54	$25.54	1	0.906	0.54	A	0.5		0.24		0.24		0.24		0.24	0.01	0.75	0.75	0.75	0.75	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88161		Cytopath smear other source	520200	$75.02	$75.02	$81.96	$81.96	1	0.906	0.54	A	0.5		1.99		1.99		1.99		1.99	0.03	2.52	2.52	2.52	2.52	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88161	TC	Cytopath smear other source	520200	$51.93	$51.93	$56.73	$56.73	1	0.906	0.54	A	0		1.76		1.76		1.76		1.76	0.02	1.78	1.78	1.78	1.78	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88161	26	Cytopath smear other source	520200	$23.09	$23.09	$25.22	$25.22	1	0.906	0.54	A	0.5		0.23		0.23		0.23		0.23	0.01	0.74	0.74	0.74	0.74	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88162		Cytopath smear other source	520200	$117.89	$117.89	$128.79	$128.79	1	0.906	0.54	A	0.76		3.16		3.16		3.16		3.16	0.04	3.96	3.96	3.96	3.96	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88162	TC	Cytopath smear other source	520200	$82.29	$82.29	$89.90	$89.90	1	0.906	0.54	A	0		2.79		2.79		2.79		2.79	0.03	2.82	2.82	2.82	2.82	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88162	26	Cytopath smear other source	520200	$35.60	$35.60	$38.89	$38.89	1	0.906	0.54	A	0.76		0.37		0.37		0.37		0.37	0.01	1.14	1.14	1.14	1.14	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88172		Cytp dx eval fna 1st ea site	520200	$51.39	$51.39	$56.14	$56.14	1	0.906	0.54	A	0.69		0.98		0.98		0.98		0.98	0.02	1.69	1.69	1.69	1.69	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88172	TC	Cytp dx eval fna 1st ea site	520200	$19.22	$19.22	$21.00	$21.00	1	0.906	0.54	A	0		0.65		0.65		0.65		0.65	0.01	0.66	0.66	0.66	0.66	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88172	26	Cytp dx eval fna 1st ea site	520200	$32.16	$32.16	$35.14	$35.14	1	0.906	0.54	A	0.69		0.33		0.33		0.33		0.33	0.01	1.03	1.03	1.03	1.03	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88173		Cytopath eval fna report	520200	$154.15	$154.15	$168.41	$168.41	1	0.906	0.54	A	1.39		3.69		3.69		3.69		3.69	0.06	5.14	5.14	5.14	5.14	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88173	TC	Cytopath eval fna report	520200	$90.96	$90.96	$99.37	$99.37	1	0.906	0.54	A	0		3.08		3.08		3.08		3.08	0.04	3.12	3.12	3.12	3.12	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88173	26	Cytopath eval fna report	520200	$63.19	$63.19	$69.03	$69.03	1	0.906	0.54	A	1.39		0.61		0.61		0.61		0.61	0.02	2.02	2.02	2.02	2.02	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88177		Cytp fna eval ea addl	520200	$27.24	$27.24	$29.76	$29.76	1	0.906	0.54	A	0.42		0.46		0.46		0.46		0.46	0.01	0.89	0.89	0.89	0.89	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88177	TC	Cytp fna eval ea addl	520200	$7.62	$7.62	$8.32	$8.32	1	0.906	0.54	A	0		0.26		0.26		0.26		0.26	0	0.26	0.26	0.26	0.26	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88177	26	Cytp fna eval ea addl	520200	$19.62	$19.62	$21.44	$21.44	1	0.906	0.54	A	0.42		0.2		0.2		0.2		0.2	0.01	0.63	0.63	0.63	0.63	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88182		Cell marker study	520200	$142.71	$142.71	$155.91	$155.91	1	0.906	0.54	A	0.77		3.99		3.99		3.99		3.99	0.05	4.81	4.81	4.81	4.81	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88182	TC	Cell marker study	520200	$108.25	$108.25	$118.26	$118.26	1	0.906	0.54	A	0		3.67		3.67		3.67		3.67	0.04	3.71	3.71	3.71	3.71	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88182	26	Cell marker study	520200	$34.46	$34.46	$37.65	$37.65	1	0.906	0.54	A	0.77		0.32		0.32		0.32		0.32	0.01	1.1	1.1	1.1	1.1	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88184		Flowcytometry/ tc 1 marker	520200	$68.22	$68.22	$74.53	$74.53	1	0.906	0.54	A	0		2.31		2.31		2.31		2.31	0.03	2.34	2.34	2.34	2.34	3	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88185		Flowcytometry/tc add-on	520200	$19.93	$19.93	$21.77	$21.77	1	0.906	0.54	A	0		0.68		0.68		0.68		0.68	0	0.68	0.68	0.68	0.68	3	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88187		Flowcytometry/read 2-8	520200	$32.96	$32.96	$36.01	$36.01	1	0.906	0.54	A	0.74		0.29		0.29		0.29		0.29	0.03	1.06	1.06	1.06	1.06	2	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88188		Flowcytometry/read 9-15	520200	$55.81	$55.81	$60.97	$60.97	1	0.906	0.54	A	1.2		0.55		0.55		0.55		0.55	0.05	1.8	1.8	1.8	1.8	2	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88189		Flowcytometry/read 16 & >	520200	$76.14	$76.14	$83.18	$83.18	1	0.906	0.54	A	1.7		0.68		0.68		0.68		0.68	0.07	2.45	2.45	2.45	2.45	2	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88291		Cyto/molecular report	520200	$31.24	$31.24	$34.13	$34.13	1	0.906	0.54	A	0.52		0.48		0.48		0.48		0.48	0.02	1.02	1.02	1.02	1.02	2	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88300		Surgical path gross	520200	$14.66	$14.66	$16.02	$16.02	1	0.906	0.54	A	0.08		0.4		0.4		0.4		0.4	0.02	0.5	0.5	0.5	0.5	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88300	TC	Surgical path gross	520200	$10.72	$10.72	$11.72	$11.72	1	0.906	0.54	A	0		0.36		0.36		0.36		0.36	0.01	0.37	0.37	0.37	0.37	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88300	26	Surgical path gross	520200	$3.93	$3.93	$4.30	$4.30	1	0.906	0.54	A	0.08		0.04		0.04		0.04		0.04	0.01	0.13	0.13	0.13	0.13	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88302		Tissue exam by pathologist	520200	$29.46	$29.46	$32.19	$32.19	1	0.906	0.54	A	0.13		0.85		0.85		0.85		0.85	0.02	1	1	1	1	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88302	TC	Tissue exam by pathologist	520200	$23.33	$23.33	$25.48	$25.48	1	0.906	0.54	A	0		0.79		0.79		0.79		0.79	0.01	0.8	0.8	0.8	0.8	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88302	26	Tissue exam by pathologist	520200	$6.14	$6.14	$6.71	$6.71	1	0.906	0.54	A	0.13		0.06		0.06		0.06		0.06	0.01	0.2	0.2	0.2	0.2	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88304		Tissue exam by pathologist	520200	$37.94	$37.94	$41.45	$41.45	1	0.906	0.54	A	0.22		1.04		1.04		1.04		1.04	0.02	1.28	1.28	1.28	1.28	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88304	TC	Tissue exam by pathologist	520200	$27.72	$27.72	$30.29	$30.29	1	0.906	0.54	A	0		0.94		0.94		0.94		0.94	0.01	0.95	0.95	0.95	0.95	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88304	26	Tissue exam by pathologist	520200	$10.22	$10.22	$11.17	$11.17	1	0.906	0.54	A	0.22		0.1		0.1		0.1		0.1	0.01	0.33	0.33	0.33	0.33	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88305		Tissue exam by pathologist	520200	$65.05	$65.05	$71.07	$71.07	1	0.906	0.54	A	0.75		1.38		1.38		1.38		1.38	0.02	2.15	2.15	2.15	2.15	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88305	TC	Tissue exam by pathologist	520200	$31.24	$31.24	$34.13	$34.13	1	0.906	0.54	A	0		1.06		1.06		1.06		1.06	0.01	1.07	1.07	1.07	1.07	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88305	26	Tissue exam by pathologist	520200	$33.81	$33.81	$36.94	$36.94	1	0.906	0.54	A	0.75		0.32		0.32		0.32		0.32	0.01	1.08	1.08	1.08	1.08	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88307		Tissue exam by pathologist	520200	$256.04	$256.04	$279.72	$279.72	1	0.906	0.54	A	1.59		6.94		6.94		6.94		6.94	0.07	8.6	8.6	8.6	8.6	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88307	TC	Tissue exam by pathologist	520200	$182.10	$182.10	$198.95	$198.95	1	0.906	0.54	A	0		6.19		6.19		6.19		6.19	0.04	6.23	6.23	6.23	6.23	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88307	26	Tissue exam by pathologist	520200	$73.93	$73.93	$80.77	$80.77	1	0.906	0.54	A	1.59		0.75		0.75		0.75		0.75	0.03	2.37	2.37	2.37	2.37	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88309		Tissue exam by pathologist	520200	$383.85	$383.85	$419.36	$419.36	1	0.906	0.54	A	2.8		9.96		9.96		9.96		9.96	0.08	12.84	12.84	12.84	12.84	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88309	TC	Tissue exam by pathologist	520200	$253.32	$253.32	$276.75	$276.75	1	0.906	0.54	A	0		8.62		8.62		8.62		8.62	0.04	8.66	8.66	8.66	8.66	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88309	26	Tissue exam by pathologist	520200	$130.54	$130.54	$142.61	$142.61	1	0.906	0.54	A	2.8		1.34		1.34		1.34		1.34	0.04	4.18	4.18	4.18	4.18	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88311		Decalcify tissue	520200	$18.37	$18.37	$20.07	$20.07	1	0.906	0.54	A	0.24		0.35		0.35		0.35		0.35	0.02	0.61	0.61	0.61	0.61	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88311	TC	Decalcify tissue	520200	$7.21	$7.21	$7.87	$7.87	1	0.906	0.54	A	0		0.24		0.24		0.24		0.24	0.01	0.25	0.25	0.25	0.25	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88311	26	Decalcify tissue	520200	$11.16	$11.16	$12.19	$12.19	1	0.906	0.54	A	0.24		0.11		0.11		0.11		0.11	0.01	0.36	0.36	0.36	0.36	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88312		Special stains group 1	520200	$99.46	$99.46	$108.66	$108.66	1	0.906	0.54	A	0.54		2.78		2.78		2.78		2.78	0.03	3.35	3.35	3.35	3.35	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88312	TC	Special stains group 1	520200	$75.37	$75.37	$82.34	$82.34	1	0.906	0.54	A	0		2.56		2.56		2.56		2.56	0.02	2.58	2.58	2.58	2.58	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88312	26	Special stains group 1	520200	$24.09	$24.09	$26.32	$26.32	1	0.906	0.54	A	0.54		0.22		0.22		0.22		0.22	0.01	0.77	0.77	0.77	0.77	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88313		Special stains group 2	520200	$72.59	$72.59	$79.30	$79.30	1	0.906	0.54	A	0.24		2.2		2.2		2.2		2.2	0.02	2.46	2.46	2.46	2.46	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88313	TC	Special stains group 2	520200	$61.72	$61.72	$67.43	$67.43	1	0.906	0.54	A	0		2.1		2.1		2.1		2.1	0.01	2.11	2.11	2.11	2.11	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88313	26	Special stains group 2	520200	$10.87	$10.87	$11.87	$11.87	1	0.906	0.54	A	0.24		0.1		0.1		0.1		0.1	0.01	0.35	0.35	0.35	0.35	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88314		Histochemical stains add-on	520200	$76.33	$76.33	$83.39	$83.39	1	0.906	0.54	A	0.45		2.09		2.09		2.09		2.09	0.03	2.57	2.57	2.57	2.57	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88314	TC	Histochemical stains add-on	520200	$58.08	$58.08	$63.45	$63.45	1	0.906	0.54	A	0		1.97		1.97		1.97		1.97	0.02	1.99	1.99	1.99	1.99	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88314	26	Histochemical stains add-on	520200	$18.25	$18.25	$19.94	$19.94	1	0.906	0.54	A	0.45		0.12		0.12		0.12		0.12	0.01	0.58	0.58	0.58	0.58	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88319		Enzyme histochemistry	520200	$120.24	$120.24	$131.36	$131.36	1	0.906	0.54	A	0.53		3.5		3.5		3.5		3.5	0.03	4.06	4.06	4.06	4.06	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88319	TC	Enzyme histochemistry	520200	$95.89	$95.89	$104.76	$104.76	1	0.906	0.54	A	0		3.26		3.26		3.26		3.26	0.02	3.28	3.28	3.28	3.28	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88319	26	Enzyme histochemistry	520200	$24.35	$24.35	$26.60	$26.60	1	0.906	0.54	A	0.53		0.24		0.24		0.24		0.24	0.01	0.78	0.78	0.78	0.78	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88321		Consltj&reprt sld prep elswr	520200	$89.11	$75.93	$97.36	$82.95	1	0.906	0.54	A	1.63		1.2		1.2		0.75		0.75	0.07	2.9	2.45	2.9	2.45	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88323		Consltj&reprt matrl prep sld	520200	$107.19	$107.19	$117.11	$117.11	1	0.906	0.54	A	1.83		1.62		1.62		1.62		1.62	0.03	3.48	3.48	3.48	3.48	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88323	TC	Consltj&reprt matrl prep sld	520200	$26.26	$26.26	$28.69	$28.69	1	0.906	0.54	A	0		0.89		0.89		0.89		0.89	0.01	0.9	0.9	0.9	0.9	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88323	26	Consltj&reprt matrl prep sld	520200	$80.94	$80.94	$88.42	$88.42	1	0.906	0.54	A	1.83		0.73		0.73		0.73		0.73	0.02	2.58	2.58	2.58	2.58	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88325		Consltj compre rvw rec reprt	520200	$144.86	$123.76	$158.26	$135.21	1	0.906	0.54	A	2.85		1.72		1.72		1		1	0.13	4.7	3.98	4.7	3.98	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88329		Path consltj drg surg	520200	$49.33	$31.75	$53.90	$34.69	1	0.906	0.54	A	0.67		0.92		0.92		0.32		0.32	0.04	1.63	1.03	1.63	1.03	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88331		Path consltj surg 1 blk 1spc	520200	$91.77	$91.77	$100.26	$100.26	1	0.906	0.54	A	1.19		1.8		1.8		1.8		1.8	0.03	3.02	3.02	3.02	3.02	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88331	TC	Path consltj surg 1 blk 1spc	520200	$35.63	$35.63	$38.93	$38.93	1	0.906	0.54	A	0		1.21		1.21		1.21		1.21	0.01	1.22	1.22	1.22	1.22	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88331	26	Path consltj surg 1 blk 1spc	520200	$56.13	$56.13	$61.32	$61.32	1	0.906	0.54	A	1.19		0.59		0.59		0.59		0.59	0.02	1.8	1.8	1.8	1.8	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88332		Path consltj surg ea add blk	520200	$49.62	$49.62	$54.21	$54.21	1	0.906	0.54	A	0.59		1.03		1.03		1.03		1.03	0.02	1.64	1.64	1.64	1.64	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88332	TC	Path consltj surg ea add blk	520200	$21.86	$21.86	$23.88	$23.88	1	0.906	0.54	A	0		0.74		0.74		0.74		0.74	0.01	0.75	0.75	0.75	0.75	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88332	26	Path consltj surg ea add blk	520200	$27.76	$27.76	$30.33	$30.33	1	0.906	0.54	A	0.59		0.29		0.29		0.29		0.29	0.01	0.89	0.89	0.89	0.89	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88333		Path consltj surg cyto xm 1	520200	$83.30	$83.30	$91.00	$91.00	1	0.906	0.54	A	1.2		1.5		1.5		1.5		1.5	0.03	2.73	2.73	2.73	2.73	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88333	TC	Path consltj surg cyto xm 1	520200	$27.43	$27.43	$29.97	$29.97	1	0.906	0.54	A	0		0.93		0.93		0.93		0.93	0.01	0.94	0.94	0.94	0.94	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88333	26	Path consltj surg cyto xm 1	520200	$55.87	$55.87	$61.04	$61.04	1	0.906	0.54	A	1.2		0.57		0.57		0.57		0.57	0.02	1.79	1.79	1.79	1.79	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88334		Path consltj surg cyto xm ea	520200	$51.04	$51.04	$55.76	$55.76	1	0.906	0.54	A	0.73		0.93		0.93		0.93		0.93	0.01	1.67	1.67	1.67	1.67	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88334	TC	Path consltj surg cyto xm ea	520200	$17.00	$17.00	$18.57	$18.57	1	0.906	0.54	A	0		0.58		0.58		0.58		0.58	0	0.58	0.58	0.58	0.58	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88334	26	Path consltj surg cyto xm ea	520200	$34.04	$34.04	$37.19	$37.19	1	0.906	0.54	A	0.73		0.35		0.35		0.35		0.35	0.01	1.09	1.09	1.09	1.09	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88341		Imhchem/imcytchm ea add antb	520200	$86.28	$86.28	$94.26	$94.26	1	0.906	0.54	A	0.56		2.32		2.32		2.32		2.32	0.01	2.89	2.89	2.89	2.89	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88341	TC	Imhchem/imcytchm ea add antb	520200	$60.66	$60.66	$66.27	$66.27	1	0.906	0.54	A	0		2.07		2.07		2.07		2.07	0	2.07	2.07	2.07	2.07	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88341	26	Imhchem/imcytchm ea add antb	520200	$25.62	$25.62	$27.98	$27.98	1	0.906	0.54	A	0.56		0.25		0.25		0.25		0.25	0.01	0.82	0.82	0.82	0.82	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88342		Imhchem/imcytchm 1st antb	520200	$100.65	$100.65	$109.96	$109.96	1	0.906	0.54	A	0.7		2.65		2.65		2.65		2.65	0.02	3.37	3.37	3.37	3.37	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88342	TC	Imhchem/imcytchm 1st antb	520200	$69.04	$69.04	$75.43	$75.43	1	0.906	0.54	A	0		2.35		2.35		2.35		2.35	0.01	2.36	2.36	2.36	2.36	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88342	26	Imhchem/imcytchm 1st antb	520200	$31.61	$31.61	$34.53	$34.53	1	0.906	0.54	A	0.7		0.3		0.3		0.3		0.3	0.01	1.01	1.01	1.01	1.01	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88344		Imhchem/imcytchm ea mlt antb	520200	$153.62	$153.62	$167.83	$167.83	1	0.906	0.54	A	0.77		4.38		4.38		4.38		4.38	0.02	5.17	5.17	5.17	5.17	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88344	TC	Imhchem/imcytchm ea mlt antb	520200	$118.57	$118.57	$129.54	$129.54	1	0.906	0.54	A	0		4.04		4.04		4.04		4.04	0.01	4.05	4.05	4.05	4.05	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88344	26	Imhchem/imcytchm ea mlt antb	520200	$35.05	$35.05	$38.29	$38.29	1	0.906	0.54	A	0.77		0.34		0.34		0.34		0.34	0.01	1.12	1.12	1.12	1.12	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88346		Imfluor 1st 1antb stain px	520200	$128.79	$128.79	$140.70	$140.70	1	0.906	0.54	A	0.74		3.56		3.56		3.56		3.56	0.03	4.33	4.33	4.33	4.33	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88346	TC	Imfluor 1st 1antb stain px	520200	$96.18	$96.18	$105.08	$105.08	1	0.906	0.54	A	0		3.27		3.27		3.27		3.27	0.02	3.29	3.29	3.29	3.29	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88346	26	Imfluor 1st 1antb stain px	520200	$32.61	$32.61	$35.63	$35.63	1	0.906	0.54	A	0.74		0.29		0.29		0.29		0.29	0.01	1.04	1.04	1.04	1.04	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88348		Electron microscopy dx	520200	$435.61	$435.61	$475.90	$475.90	1	0.906	0.54	A	1.51		13.12		13.12		13.12		13.12	0.13	14.76	14.76	14.76	14.76	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88348	TC	Electron microscopy dx	520200	$365.43	$365.43	$399.24	$399.24	1	0.906	0.54	A	0		12.41		12.41		12.41		12.41	0.1	12.51	12.51	12.51	12.51	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88348	26	Electron microscopy dx	520200	$70.17	$70.17	$76.67	$76.67	1	0.906	0.54	A	1.51		0.71		0.71		0.71		0.71	0.03	2.25	2.25	2.25	2.25	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88350		Imfluor ea addl 1antb stn px	520200	$98.56	$98.56	$107.68	$107.68	1	0.906	0.54	A	0.59		2.7		2.7		2.7		2.7	0.02	3.31	3.31	3.31	3.31	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88350	TC	Imfluor ea addl 1antb stn px	520200	$72.27	$72.27	$78.95	$78.95	1	0.906	0.54	A	0		2.46		2.46		2.46		2.46	0.01	2.47	2.47	2.47	2.47	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88350	26	Imfluor ea addl 1antb stn px	520200	$26.29	$26.29	$28.72	$28.72	1	0.906	0.54	A	0.59		0.24		0.24		0.24		0.24	0.01	0.84	0.84	0.84	0.84	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88355		M/phmtrc alys skeletal musc	520200	$130.11	$130.11	$142.15	$142.15	1	0.906	0.54	A	1.85		2.38		2.38		2.38		2.38	0.03	4.26	4.26	4.26	4.26	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88355	TC	M/phmtrc alys skeletal musc	520200	$54.27	$54.27	$59.29	$59.29	1	0.906	0.54	A	0		1.84		1.84		1.84		1.84	0.02	1.86	1.86	1.86	1.86	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88355	26	M/phmtrc alys skeletal musc	520200	$75.84	$75.84	$82.86	$82.86	1	0.906	0.54	A	1.85		0.54		0.54		0.54		0.54	0.01	2.4	2.4	2.4	2.4	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88356		Analysis nerve	520200	$215.29	$215.29	$235.20	$235.20	1	0.906	0.54	A	2.8		4.22		4.22		4.22		4.22	0.06	7.08	7.08	7.08	7.08	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88356	TC	Analysis nerve	520200	$103.44	$103.44	$113.01	$113.01	1	0.906	0.54	A	0		3.5		3.5		3.5		3.5	0.05	3.55	3.55	3.55	3.55	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88356	26	Analysis nerve	520200	$111.85	$111.85	$122.19	$122.19	1	0.906	0.54	A	2.8		0.72		0.72		0.72		0.72	0.01	3.53	3.53	3.53	3.53	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88358		Analysis tumor	520200	$120.93	$120.93	$132.12	$132.12	1	0.906	0.54	A	0.95		3.06		3.06		3.06		3.06	0.03	4.04	4.04	4.04	4.04	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88358	TC	Analysis tumor	520200	$76.37	$76.37	$83.43	$83.43	1	0.906	0.54	A	0		2.6		2.6		2.6		2.6	0.01	2.61	2.61	2.61	2.61	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88358	26	Analysis tumor	520200	$44.56	$44.56	$48.68	$48.68	1	0.906	0.54	A	0.95		0.46		0.46		0.46		0.46	0.02	1.43	1.43	1.43	1.43	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88360		Tumor immunohistochem/manual	520200	$106.97	$106.97	$116.86	$116.86	1	0.906	0.54	A	0.85		2.7		2.7		2.7		2.7	0.02	3.57	3.57	3.57	3.57	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88360	TC	Tumor immunohistochem/manual	520200	$69.34	$69.34	$75.75	$75.75	1	0.906	0.54	A	0		2.36		2.36		2.36		2.36	0.01	2.37	2.37	2.37	2.37	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88360	26	Tumor immunohistochem/manual	520200	$37.63	$37.63	$41.11	$41.11	1	0.906	0.54	A	0.85		0.34		0.34		0.34		0.34	0.01	1.2	1.2	1.2	1.2	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88361		Tumor immunohistochem/comput	520200	$104.34	$104.34	$114.00	$114.00	1	0.906	0.54	A	0.95		2.5		2.5		2.5		2.5	0.02	3.47	3.47	3.47	3.47	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88361	TC	Tumor immunohistochem/comput	520200	$64.94	$64.94	$70.95	$70.95	1	0.906	0.54	A	0		2.21		2.21		2.21		2.21	0.01	2.22	2.22	2.22	2.22	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88361	26	Tumor immunohistochem/comput	520200	$39.40	$39.40	$43.05	$43.05	1	0.906	0.54	A	0.95		0.29		0.29		0.29		0.29	0.01	1.25	1.25	1.25	1.25	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88362		Nerve teasing preparations	520200	$208.15	$208.15	$227.41	$227.41	1	0.906	0.54	A	2.17		4.66		4.66		4.66		4.66	0.08	6.91	6.91	6.91	6.91	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88362	TC	Nerve teasing preparations	520200	$107.78	$107.78	$117.75	$117.75	1	0.906	0.54	A	0		3.66		3.66		3.66		3.66	0.03	3.69	3.69	3.69	3.69	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88362	26	Nerve teasing preparations	520200	$100.37	$100.37	$109.66	$109.66	1	0.906	0.54	A	2.17		1		1		1		1	0.05	3.22	3.22	3.22	3.22	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88363		Xm archive tissue molec anal	520200	$21.40	$17.30	$23.38	$18.90	1	0.906	0.54	A	0.37		0.31		0.31		0.17		0.17	0.02	0.7	0.56	0.7	0.56	0	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88364		Insitu hybridization (fish)	520200	$115.31	$115.31	$125.97	$125.97	1	0.906	0.54	A	0.7		3.15		3.15		3.15		3.15	0.02	3.87	3.87	3.87	3.87	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88364	TC	Insitu hybridization (fish)	520200	$84.58	$84.58	$92.40	$92.40	1	0.906	0.54	A	0		2.88		2.88		2.88		2.88	0.01	2.89	2.89	2.89	2.89	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88364	26	Insitu hybridization (fish)	520200	$30.73	$30.73	$33.57	$33.57	1	0.906	0.54	A	0.7		0.27		0.27		0.27		0.27	0.01	0.98	0.98	0.98	0.98	1	ZZZ	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88365		Insitu hybridization (fish)	520200	$155.30	$155.30	$169.66	$169.66	1	0.906	0.54	A	0.88		4.31		4.31		4.31		4.31	0.03	5.22	5.22	5.22	5.22	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88365	TC	Insitu hybridization (fish)	520200	$116.40	$116.40	$127.17	$127.17	1	0.906	0.54	A	0		3.96		3.96		3.96		3.96	0.02	3.98	3.98	3.98	3.98	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88365	26	Insitu hybridization (fish)	520200	$38.90	$38.90	$42.49	$42.49	1	0.906	0.54	A	0.88		0.35		0.35		0.35		0.35	0.01	1.24	1.24	1.24	1.24	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88366		Insitu hybridization (fish)	520200	$238.80	$238.80	$260.89	$260.89	1	0.906	0.54	A	1.24		6.75		6.75		6.75		6.75	0.05	8.04	8.04	8.04	8.04	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88366	TC	Insitu hybridization (fish)	520200	$182.81	$182.81	$199.72	$199.72	1	0.906	0.54	A	0		6.22		6.22		6.22		6.22	0.03	6.25	6.25	6.25	6.25	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88366	26	Insitu hybridization (fish)	520200	$55.99	$55.99	$61.17	$61.17	1	0.906	0.54	A	1.24		0.53		0.53		0.53		0.53	0.02	1.79	1.79	1.79	1.79	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88367		Insitu hybridization auto	520200	$97.69	$97.69	$106.73	$106.73	1	0.906	0.54	A	0.73		2.51		2.51		2.51		2.51	0.03	3.27	3.27	3.27	3.27	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88367	TC	Insitu hybridization auto	520200	$67.46	$67.46	$73.70	$73.70	1	0.906	0.54	A	0		2.29		2.29		2.29		2.29	0.02	2.31	2.31	2.31	2.31	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88367	26	Insitu hybridization auto	520200	$30.23	$30.23	$33.03	$33.03	1	0.906	0.54	A	0.73		0.22		0.22		0.22		0.22	0.01	0.96	0.96	0.96	0.96	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88368		Insitu hybridization manual	520200	$133.32	$133.32	$145.65	$145.65	1	0.906	0.54	A	0.88		3.56		3.56		3.56		3.56	0.03	4.47	4.47	4.47	4.47	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88368	TC	Insitu hybridization manual	520200	$94.71	$94.71	$103.48	$103.48	1	0.906	0.54	A	0		3.22		3.22		3.22		3.22	0.02	3.24	3.24	3.24	3.24	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
88368	26	Insitu hybridization manual	520200	$38.60	$38.60	$42.17	$42.17	1	0.906	0.54	A	0.88		0.34		0.34		0.34		0.34	0.01	1.23	1.23	1.23	1.23	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
G0416		Prostate biopsy, any mthd	520200	$331.07	$331.07	$361.70	$361.70	1	0.906	0.54	A	3.6		7.27		7.27		7.27		7.27	0.09	10.96	10.96	10.96	10.96	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
G0416	TC	Prostate biopsy, any mthd	520200	$169.50	$169.50	$185.18	$185.18	1	0.906	0.54	A	0		5.76		5.76		5.76		5.76	0.04	5.8	5.8	5.8	5.8	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
G0416	26	Prostate biopsy, any mthd	520200	$161.57	$161.57	$176.52	$176.52	1	0.906	0.54	A	3.6		1.51		1.51		1.51		1.51	0.05	5.16	5.16	5.16	5.16	1	XXX	0	0	0	0	0	0	0	0	9		32.3465		99	NA	NA	0	0	0
87624		Hpv high-risk types		$35.09
88175		Cytopath c/v auto fluid redo		$26.61

2023PriceSchedule

LIN	subLIN	CPT	Mod	Description	Unit Price	Discount Price	Quantity	Est Total
0001
0001	AA	80503		Path clin consltj sf 5-20	$24.81	$24.81	1	$24.81	80503
0001	AB	85060		Blood smear interpretation	$21.53	$21.53	30	$645.90	85060
0001	AC	85097		Bone marrow interpretation	$63.34	$63.34	10	$633.40	85097
0001	AD	88104		Cytopath fl nongyn smears	$71.68	$71.68	1	$71.68	88104
0001	AE	88104	TC	Cytopath fl nongyn smears	$46.36	$46.36	1	$46.36	88104-TC
0001	AF	88104	26	Cytopath fl nongyn smears	$25.32	$25.32	1	$25.32	88104-26
0001	AG	88106		Cytopath fl nongyn filter	$63.19	$63.19	1	$63.19	88106
0001	AH	88106	TC	Cytopath fl nongyn filter	$46.07	$46.07	1	$46.07	88106-TC
0001	AI	88106	26	Cytopath fl nongyn filter	$17.12	$17.12	1	$17.12	88106-26
0001	AJ	88108		Cytopath concentrate tech	$62.64	$62.64	8	$501.12	88108
0001	AK	88108	TC	Cytopath concentrate tech	$42.38	$42.38	1	$42.38	88108-TC
0001	AL	88108	26	Cytopath concentrate tech	$20.27	$20.27	1	$20.27	88108-26
0001	AM	88112		Cytopath cell enhance tech	$60.96	$60.96	100	$6,096.00	88112
0001	AN	88112	TC	Cytopath cell enhance tech	$35.93	$35.93	20	$718.60	88112-TC
0001	AO	88112	26	Cytopath cell enhance tech	$25.03	$25.03	1	$25.03	88112-26
0001	AP	88125		Forensic cytopathology	$26.05	$26.05	1	$26.05	88125
0001	AQ	88141		Cytopath c/v interpret	$22.65	$22.65	375	$8,493.75	88141
0001	AR	88160		Cytopath smear other source	$74.43	$74.43	1	$74.43	88160
0001	AS	88160	TC	Cytopath smear other source	$51.05	$51.05	1	$51.05	88160-TC
0001	AT	88160	26	Cytopath smear other source	$23.38	$23.38	1	$23.38	88160-26
0001	AU	88161		Cytopath smear other source	$75.02	$75.02	3	$225.06	88161
0001	AV	88161	TC	Cytopath smear other source	$51.93	$51.93	1	$51.93	88161-TC
0001	AW	88161	26	Cytopath smear other source	$23.09	$23.09	1	$23.09	88161-26
0001	AX	88172		Cytp dx eval fna 1st ea site	$51.39	$51.39	1	$51.39	88172
0001	AY	88173		Cytopath eval fna report	$154.15	$154.15	55	$8,478.25	88173
0001	AZ	88173	TC	Cytopath eval fna report	$90.96	$90.96	1	$90.96	88173-TC
0001	BA	88173	26	Cytopath eval fna report	$63.19	$63.19	1	$63.19	88173-26
0001	BB	88177		Cytp fna eval ea addl	$27.24	$27.24	1	$27.24	88177
0001	BC	88182		Cell marker study	$142.71	$142.71	1	$142.71	88182
0001	BD	88184		Flowcytometry/ tc 1 marker	$68.22	$68.22	99	$6,753.78	88184
0001	BE	88185		Flowcytometry/tc add-on	$19.93	$19.93	2380	$47,433.40	88185
0001	BF	88187		Flowcytometry/read 2-8	$32.96	$32.96	1	$32.96	88187
0001	BG	88188		Flowcytometry/read 9-15	$55.81	$55.81	1	$55.81	88188
0001	BH	88189		Flowcytometry/read 16 & >	$76.14	$76.14	99	$7,537.86	88189
0001	BI	88300		Surgical path gross	$14.66	$14.66	15	$219.90	88300
0001	BJ	88300	TC	Surgical path gross	$10.72	$10.72	1	$10.72	88300-TC
0001	BK	88300	26	Surgical path gross	$3.93	$3.93	1	$3.93	88300-26
0001	BL	88302		Tissue exam by pathologist	$29.46	$29.46	20	$589.20	88302
0001	BM	88302	TC	Tissue exam by pathologist	$23.33	$23.33	115	$2,682.95	88302-TC
0001	BN	88302	26	Tissue exam by pathologist	$6.14	$6.14	1	$6.14	88302-26
0001	BO	88304		Tissue exam by pathologist	$37.94	$37.94	105	$3,983.70	88304
0001	BP	88304	TC	Tissue exam by pathologist	$27.72	$27.72	315	$8,731.80	88304-TC
0001	BQ	88304	26	Tissue exam by pathologist	$10.22	$10.22	1	$10.22	88304-26
0001	BR	88305		Tissue exam by pathologist	$65.05	$65.05	3760	$244,588.00	88305
0001	BS	88305	TC	Tissue exam by pathologist	$31.24	$31.24	1665	$52,014.60	88305-TC
0001	BT	88305	26	Tissue exam by pathologist	$33.81	$33.81	1	$33.81	88305-26
0001	BU	88307		Tissue exam by pathologist	$256.04	$256.04	195	$49,927.80	88307
0001	BV	88307	TC	Tissue exam by pathologist	$182.10	$182.10	12	$2,185.20	88307-TC
0001	BW	88307	26	Tissue exam by pathologist	$73.93	$73.93	1	$73.93	88307-26
0001	BX	88309		Tissue exam by pathologist	$383.85	$383.85	25	$9,596.25	88309
0001	BY	88309	TC	Tissue exam by pathologist	$253.32	$253.32	3	$759.96	88309-TC
0001	BZ	88309	26	Tissue exam by pathologist	$130.54	$130.54	1	$130.54	88309-26
0001	CA	88311		Decalcify tissue	$18.37	$18.37	95	$1,745.15	88311
0001	CB	88311	TC	Decalcify tissue	$7.21	$7.21	8	$57.68	88311-TC
0001	CC	88311	26	Decalcify tissue	$11.16	$11.16	1	$11.16	88311-26
0001	CD	88312		Special stains group 1	$99.46	$99.46	107	$10,642.22	88312
0001	CE	88312	TC	Special stains group 1	$75.37	$75.37	36	$2,713.32	88312-TC
0001	CF	88312	26	Special stains group 1	$24.09	$24.09	1	$24.09	88312-26
0001	CG	88313		Special stains group 2	$72.59	$72.59	175	$12,703.25	88313
0001	CH	88313	TC	Special stains group 2	$61.72	$61.72	10	$617.20	88313-TC
0001	CI	88313	26	Special stains group 2	$10.87	$10.87	1	$10.87	88313-26
0001	CH	88314		Histochemical stains add-on	$76.33	$76.33	1	$76.33	88314
0001	CK	88319		Enzyme histochemistry	$120.24	$120.24	1	$120.24	88319
0001	CL	88321		Consltj&reprt sld prep elswr	$89.11	$89.11	2	$178.22	88321
0001	CM	88323		Consltj&reprt matrl prep sld	$107.19	$107.19	1	$107.19	88323
0001	CN	88325		Consltj compre rvw rec reprt	$144.86	$144.86	1	$144.86	88325
0001	CO	88329		Path consltj drg surg	$49.33	$49.33	1	$49.33	88329
0001	CP	88331		Path consltj surg 1 blk 1spc	$91.77	$91.77	5	$458.85	88331
0001	CQ	88332		Path consltj surg ea add blk	$49.62	$49.62	10	$496.20	88332
0001	CR	88333		Path consltj surg cyto xm 1	$83.30	$83.30	1	$83.30	88333
0001	CS	88334		Path consltj surg cyto xm ea	$51.04	$51.04	1	$51.04	88334
0001	CT	88341		Imhchem/imcytchm ea add antb	$86.28	$86.28	900	$77,652.00	88341
0001	CU	88341	TC	Imhchem/imcytchm ea add antb	$60.66	$60.66	300	$18,198.00	88341-TC
0001	CV	88341	26	Imhchem/imcytchm ea add antb	$25.62	$25.62	1	$25.62	88341-26
0001	CW	88342		Imhchem/imcytchm 1st antb	$100.65	$100.65	450	$45,292.50	88342
0001	CX	88342	TC	Imhchem/imcytchm 1st antb	$69.04	$69.04	150	$10,356.00	88342-TC
0001	CY	88342	26	Imhchem/imcytchm 1st antb	$31.61	$31.61	1	$31.61	88342-26
0001	CZ	88346		Imfluor 1st 1antb stain px	$128.79	$128.79	1	$128.79	88346
0001	DA	88348		Electron microscopy dx	$435.61	$435.61	1	$435.61	88348
0001	DB	88360		Tumor immunohistochem/manual	$106.97	$106.97	52	$5,562.44	88360
0001	DC	88361		Tumor immunohistochem/comput	$104.34	$104.34	3	$313.02	88361
0001	DD	88365		Insitu hybridization (fish)	$155.30	$155.30	1	$155.30	88365
0001	DE	88368		Insitu hybridization manual	$133.32	$133.32	1	$133.32	88368
0001	DF	88344		Imhchem/imcytchm ea mlt antb	$153.62	$153.62	52	$7,988.24	88344
0001	DG	G0416		Prostate biopsy, any mthd	$331.07	$331.07	5	$1,655.35	G0416
0001	DH	G0416	TC	Prostate biopsy, any mthd	$169.50	$169.50	1	$169.50	G0416-TC
0001	DI	G0416	26	Prostate biopsy, any mthd	$161.57	$161.57	1	$161.57	G0416-26
0001	DJ	88175		Cytopath c/v auto fluid redo	$26.61	$26.61	200	$5,322.00	88175
0001	DK	87624		Hpv high-risk types	$35.09	$35.09	200	$7,018.00	87624
0001	DL	Additional Laboratory Test Not Listed
Estimated Total Line Item 0001								$675,051.56
0002	.033 FTE Board Certified/Board Eligible Pathologist to perform on-site Pathology Services				$140.00	$140.00	$70.00	$9,800.00
	Pathologist: Joel Anderson, NPI 1629121686
	Pathologist: Daniel Dang, NPI 1215203039
	Pathologist: Faye Giangiacomo, NPI 1851595854
Estimated Total for Line Item 0002								$9,800.00

Sheet10

LIN	sLIN	CPT	Description	CMS Price	Qty	Discount %
0001
0001	AA	80503	Path clin consltj sf 5-20	$24.81	1	___%
0001	AB	85060	Blood smear interpretation	$21.53	30	___%
0001	AC	85097	Bone marrow interpretation	$63.34	10	___%
0001	AD	88104	Cytopath fl nongyn smears	$71.68	1	___%
0001	AE	88104-TC	Cytopath fl nongyn smears	$46.36	1	___%
0001	AF	88104-26	Cytopath fl nongyn smears	$25.32	1	___%
0001	AG	88106	Cytopath fl nongyn filter	$63.19	1	___%
0001	AH	88106-TC	Cytopath fl nongyn filter	$46.07	1	___%
0001	AI	88106-26	Cytopath fl nongyn filter	$17.12	1	___%
0001	AJ	88108	Cytopath concentrate tech	$62.64	8	___%

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Jan 23, 2025.