8._Updated_Price_List_Attachment_7.xlsx

XLSX spreadsheet 27 KB Posted Jul 28, 2017

Attached to: Lab Testing Services
Solicitation number: FA8601-17-R-0060
Issued by: Department of the Air Force Materiel Command Lifecycle Management Center Wright Patterson Air Force Base

About this file

From the source

Attachment 7, Please use this updated price list as it has more information to help provide a more complete proposal.

View the file

Other files

File	Type	Posted
5._FAR_52.222-25_Attachment_4.pdf	PDF	Jul 27, 2017
2._Provisions_&_Clauses_Redacted.pdf	PDF	Jul 27, 2017
7._FAR_52.212-3_Attachment_6.pdf	PDF	Jul 27, 2017
3._Performance_Work_Statement.pdf	PDF	Jul 27, 2017
6._FAR_52.209-2_Attachment_5.pdf	PDF	Jul 27, 2017
8._AP_Price_List_Attachment_7.xlsx	XLSX spreadsheet	Jul 27, 2017
4._FAR_52.222-22_Attachment_3.pdf	PDF	Jul 27, 2017

On GovTribe

Work with this file

Download the original file
Contacts named in this file
Similar government files
Ask GovTribe AI about this file

Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Sheet1 Please provide a price for all tests. If there is a test you cannot or do not perform, please mark "N/A" in the Unit Price column. Please note that these quantities are only an estimate

CPT	DESCRIPTION	Quantity (per year)	Unit of Issue (ea.)	Cost per Service Count	Total
81206	BCR/ABL1 (t(9;22)) (eg, chronic myelogenous leukemia) translocation analysis; major breakpoint, qualitative or quantitative	3			$ - 0
81207	minor breakpoint, qualitative or quantitative	1			$ - 0
81210	BRAF (v-raf murine sarcoma viral oncogene homolog B1) (eg, colon cancer), gene analysis, V600E variant	15			$ - 0
81211	BRCA1&2 SEQ & COM DUP/DEL	3			$ - 0
81212	BRCA1&2 185&5385&6174 VAR	3			$ - 0
81213	BRCA1&2 UNCOM DUP/DEL VAR	3			$ - 0
81214	BRCA1 FULL SEQ & COM DUP/DEL	3			$ - 0
81215	BRCA1 GENE KNOWN FAM VARIANT	3			$ - 0
81217	BRCA2 GENE KNOWN FAM VARIANT	3			$ - 0
81225	Cyp2c19 gene com variants	3			$ - 0
81235	EGFR (epidermal growth factor receptor) (eg, non-small cell lung cancer) gene analysis, common variants (eg, exon 19 LREA deletion, L858R, T790M, G719A, G719S, L861Q)	15			$ - 0
81245	FLT3 (fms-related tyrosine kinase 3) (eg, acute myeloid leukemia), gene analysis, internal tandem duplication (ITD) variants (ie, exons 14, 15)	5			$ - 0
81261	IGH@ (Immunoglobulin heavy chain locus) (eg, leukemias and lymphomas, B-cell), gene rearrangement analysis to detect abnormal clonal population(s); amplified methodology (eg, polymerase chain reaction)	5			$ - 0
81263	IGH@ (Immunoglobulin heavy chain locus) (eg, leukemia and lymphoma, B-cell), variable region somatic mutation analysis	5			$ - 0
81264	IGK REARRANGEABN CLONAL POP	1			$ - 0
81267	Chimerism (engraftment) analysis, post transplantation specimen (eg, hematopoietic stem cell), includes comparison to previously performed baseline analyses; without cell selection	1			$ - 0
81270	JAK2 (Janus kinase 2) (eg, myeloproliferative disorder) gene analysis, p.Val617Phe (V617F) variant	2			$ - 0
81275	KRAS (v-Ki-ras2 Kirsten rat sarcoma viral oncogene) (eg, carcinoma) gene analysis, variants in codons 12 and 13	5			$ - 0
81290	MCOLN1 GENE	1			$ - 0
81291	MTHFR GENE	1			$ - 0
81292	MLH1 (mutL homolog 1, colon cancer, nonpolyposis type 2) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis	1			$ - 0
81293	known familial variants	1			$ - 0
81294	MLH1 GENE DUP/DELETE VARIANT	15			$ - 0
81295	MSH2 (mutS homolog 2, colon cancer, nonpolyposis type 1) (eg, hereditary non-polyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis	15			$ - 0
81296	known familial variants	1			$ - 0
81297	MSH2 GENE DUP/DELETE VARIANT	15			$ - 0
81298	MSH6 (mutS homolog 6 [E. coli]) (eg, hereditary nonpolyposis colorectal cancer, Lynch syndrome) gene analysis; full sequence analysis	15			$ - 0
81299	MSH6 GENE KNOWN VARIANTS	15			$ - 0
81300	MSH6 GENE DUP/DELETE VARIANT	15			$ - 0
81301	Microsatellite instability analysis (eg, hereditary nonpolyposis colorectal cancer, Lynch syndrome) of markers for mismatch repair deficiency (eg, BAT25, BAT26), includes comparison of neoplastic and normal tissue, if performed	15			$ - 0
81302	MECP2 GENE FULL SEQ	1			$ - 0
81303	MECP2 GENE KNOWN VARIANT	1			$ - 0
81304	MECP2 GENE DUP/DELET VARIANT	1			$ - 0
81310	NPM1 (nucleophosmin) (eg, acute myeloid leukemia) gene analysis, exon 12 variants	1			$ - 0
81315	PML/RARalpha, (t(15;17)), (promyelocytic leukemia/ retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; common breakpoints (eg, intron 3 and intron 6), qualitative or quantitative	1			$ - 0
81316	PML/RARALPHA 1 BREAKPOINT	1			$ - 0
81317	PMS2 GENE FULL SEQ ANALYSIS	1			$ - 0
81318	PMS2 KNOWN FAMILIAL VARIANTS	1			$ - 0
81319	PMS2 GENE DUP/DELET VARIANTS	1			$ - 0
81321	PTEN GENE FULL SEQUENCE	1			$ - 0
81340	TRB@ GENE REARRANGE AMPLIFY	1			$ - 0
81342	TRG GENE REARRANGEMENT ANAL	1			$ - 0
81350	UGT1A1 (UDP glucuronosyltransferase 1 family, polypeptide A1) (eg, irinotecan metabolism), gene analysis, common variants (eg, 28, 36, *37)	1			$ - 0
81400	MOPATH PROCEDURE LEVEL 1	0			$ - 0
81401	Molecular pathology procedure, Level 2 (eg, 2-10 SNPs, 1 methylated variant, or 1 somatic variant [typically using nonsequencing target variant analysis], or detection of a dynamic mutation disorder/triplet repeat)	0			$ - 0
81402	Molecular pathology procedure, Level 3 (eg, >10 SNPs, 2-10 methylated variants, or 2-10 somatic variants [typically using non-sequencing target variant analysis], immunoglobulin and T-cell receptor gene rearrangements, duplication/deletion variants of 1 exon, loss of heterozygosity [LOH], uniparental disomy [UPD])	0			$ - 0
81403	Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons)	0			$ - 0
81404	Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation disorder/triplet repeat by Southern blot analysis)	3			$ - 0
81405	Molecular pathology procedure, Level 6 (eg, analysis of 6-10 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 11-25 exons, regionally targeted cytogenomic array analysis)	1			$ - 0
81406	MOPATH PROCEDURE LEVEL 7	0			$ - 0
81407	MOPATH PROCEDURE LEVEL 8	0			$ - 0
81408	MOPATH PROCEDURE LEVEL 9	0			$ - 0
81445	Oncovantage	3			$ - 0
81479	UNLISTED MOLECULAR PATHOLOGY PROCEDURE	3			$ - 0
86152	Cell enumeration using immunologic selection and ident in fluid spec (circulating tumor cells)	1			$ - 0
86153	Cell enumer using immun sel and ident in fluid spec; physician interp & report, when required	1			$ - 0

CPT	DESCRIPTION	Quantity	Unit of Issue (ea.)	Cost per Service Count	Total
82013	ACETYLCHOLINESTERASE				$ - 0
82106	ALPHA-FETOPROTEIN; AMNIOTIC FLUID				$ - 0
82232	BETA-2 MICROGLOBULIN				$ - 0
82657	ENZYM ACTIV-CELLS/TISS NES; NONRAD				$ - 0
83033	HGB; F QUAL TEST FECAL				$ - 0
84702	GONADOTROPIN CHORIONIC; QUAN				$ - 0
84999	UNLISTED CHEMISTRY PROCEDURE				$ - 0
85060	BLD SMEAR PERIPHRL INTRPT W/REPORT	5			$ - 0
85097	BONE MARROW; SMEAR INTERPT ONLY				$ - 0
85540	LEUKOCYTE ALKALINE PHOSPHATASE W/C				$ - 0
86336	INHIBIN A				$ - 0
86356	MONONUCLEAR CELL ANTIGEN,QUANTITATIVE,EACH ANTIGEN				$ - 0
87480	AGT-DNA/RNA; CANDIDA SPECIES-DIREC				$ - 0
87481	AGT-DNA/RNA; CANDIDA SPECIES-AMPLI				$ - 0
87491	AGT-DNA/RNA; CHLAMYDIA TRACH-AMPLI				$ - 0
87510	AGT-DNA/RNA; GARDNERELLA VAG-DIREC				$ - 0
87511	AGT-DNA/RNA; GARDNERELLA VAG-AMPLI				$ - 0
87529	AGT-DNA/RNA; HERPES SIMPLEX-AMPLI				$ - 0
87591	AGT-DNA/RNA; NEISSER GONORRHEA-AMP				$ - 0
87623	HPV LOW RISK				$ - 0
87624	HPV HIGH RISK				$ - 0
87625	HPV 16/18 GENOTYPE				$ - 0
87653	INFECTIOUS AGENT DETECTION BY NUCLEIC ACID(DNA OR RNA); STREP, GROUP B, AMPLIFI				$ - 0
87660	INFECT AGENT DETECT BY NUCLEIC ACID TRICHOMONAS VAGINALIS DIRECT PROBE TECH.				$ - 0
87661	TRICHOMONAS VAGINALIS AMPLIF				$ - 0
87798	AGT-DNA/RNA; NOS-AMPLIFIED PROBE				$ - 0
88104	CYTOPATH NO CERV/VAG; SMEARS W/INT				$ - 0
88104-TC	CYTOPATH NO CERV/VAG; SMEARS W/INT - TC Only				$ - 0
88106	CYTOPATH FL NONGYN, FILTER				$ - 0
88106-TC	CYTOPATH FL NONGYN, FILTER - TC Only				$ - 0
88107	CYTOPATH NO CERV/VAG; PREP W/INTRP				$ - 0
88108	CYTOPATH CONCENTRA-SMEARS & INTERP				$ - 0
88108-TC	CYTOPATH CONCENTRA-SMEARS & INTERP - TC Only				$ - 0
88112	CYTOPATH, SELECTIVE CELL. ENH. TECH W/ INTRPRTTN EXPT CERV OF VAG CERV OR VAG.				$ - 0
88112-TC	CYTOPATH, SELECTIVE CELL. ENH. TECH W/ INTRPRTTN EXPT CERV OF VAG CERV OR VAG. - TC Only				$ - 0
88120	CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; MANUAL				$ - 0
88120 26	CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; MANUAL - PC				$ - 0
88120 TC	CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; MANUAL - TC				$ - 0
88121	CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; USING COMPUTER-ASSISTED TECHNOLOGY				$ - 0
88121 26	CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; MANUAL - PC				$ - 0
88121 TC	CYTOPATHOLOGY, IN SITU HYBRIDIZATION (EG, FISH), URINARY TRACT SPECIMEN WITH MORPHOMETRIC ANALYSIS, 3-5 MOLECULAR PROBES, EACH SPECIMEN; MANUAL - TC				$ - 0
88125	CYTOPATHOLOGY, FORENSIC				$ - 0
88125 26	CYTOPATHOLOGY, FORENSIC - PC				$ - 0
88125 TC	CYTOPATHOLOGY, FORENSIC - TC				$ - 0
88141	CYTOPATH CERV/VAG; REQ INTERPT PHY				$ - 0
88142	CYTPTH CERV/VAG; MANUAL SCRN-SUPRV				$ - 0
88160	CYTPATH SMEARS; SCREEN & INTRPT				$ - 0
88160-TC	CYTPATH SMEARS; SCREEN & INTRPT - TC Only				$ - 0
88161	CYTOPATH SMEAR; PREP/SCREEN/INTERP				$ - 0
88161-TC	CYTOPATH SMEAR; PREP/SCREEN/INTERP - TC Only				$ - 0
88162-TC	CYTOPATH SMEAR: PREP/SCREEN/INTREP EXT STUDY - TC Only				$ - 0
88164	CYTOPATH SLIDES-CERV/VAG; MAN SCRN				$ - 0
88172	CYTOPATHOLOGY,EVAL FINE NEEDLE ASP;IMM CYTO STUDY TO DET ADE FOR DX,FIRST EVAL				$ - 0
88172-TC	CYTOPATHOLOGY,EVAL FINE NEEDLE ASP;IMM CYTO STUDY TO DET ADE FOR DX,FIRST EVAL - TC Only				$ - 0
88173	EVAL FINE NEEDL ASPIRAT;INTRPT/REP				$ - 0
88173-TC	EVAL FINE NEEDL ASPIRAT;INTRPT/REP - TC Only				$ - 0
88174	CYTOPATH, CERV/VAG COLLECTED IN PRES FLUID, AUTOMATED THIN LAYER PREP				$ - 0
88175	W/ SCREENING BY AUTOMATED SYSTEM & MAN. RESCREENING, UNDER PHYS. SPRVSN				$ - 0
88177	CYTOPATHOLOGY, EVAL FINE NEEDLE ASPIRATE; INTERPRETATION & REPORT				$ - 0
88177 26	CYTOPATHOLOGY, EVAL FINE NEEDLE ASPIRATE; INTERPRETATION & REPORT - PC				$ - 0
88177 TC	CYTOPATHOLOGY, EVAL FINE NEEDLE ASPIRATE; INTERPRETATION & REPORT - TC				$ - 0
88182	FLO CYTOMETRY; CELL CYCLE/DNA ANAL				$ - 0
88182-26	FLO CYTOMETRY; CELL CYCLE/DNA ANAL - PC Only				$ - 0
88182-TC	FLO CYTOMETRY; CELL CYCLE/DNA ANAL - TC Only				$ - 0
88184	FLOW CYMETRY, CELL SURF., CYTOPLASMIC, OR NUC. MARKER, TC ONLY, 1ST MARKER				$ - 0
88185	EACH ADDITIONAL MARKER (LIST SEPERATELY IN ADDITION TO CODE FOR FIRST MARKER)				$ - 0
88187	FLOW CYMETRY, INTERPRETATION, 2 TO 8				$ - 0
88188	9 TO 15 MARKERS				$ - 0
88189	16 OR MORE MARKERS				$ - 0
88230	TISS CULT NON-NEOPLASM; LYMPHOCYTE				$ - 0
88233	TISS CULT NON-NEOPLASM; SKIN				$ - 0
88235	TISS CULT NON-NEOPLAS; AMNIOT FLUI				$ - 0
88237	TISS CULT NEOPLASM; MARROW/BLD CEL				$ - 0
88239	TISS CULTURE NEOPLASM; SOLID TUMOR				$ - 0
88249	CHROMOSOME ANALYSIS 100				$ - 0
88261	CHROMO ANALY; CT 5 CEL 1 KAROTYPE				$ - 0
88262	CHROMO ANALY; CT 15-20 CELL 2 KARY				$ - 0
88263	CHROMO ANALY; CT 45 CEL MOSAICISM				$ - 0
88264	CHROMOSOME ANALY; ANALY 20-25 CELL				$ - 0
88267	CHROMO ANALY AMNIO FLUID CT 15 CEL				$ - 0
88269	CHROMO ANAL AMNIO FLD CT 6-12 COLN				$ - 0
88271	MOLEC CYTOGEN; DNA PROBE EA				$ - 0
88272	MOLEC CYTOGEN; CHROMOSOM HYBRID 3-				$ - 0
88273	CYTOGEN; CHROMOSOM HYBRID 10-3O CE				$ - 0
88274	CYTOGEN; INTERPHASE HYBRID 25-99				$ - 0
88275	CYTOGEN; INTERPHASE HYBRID 100-300				$ - 0
88280	CHROMOSOME ANALY; ADD KARYOTYPES E				$ - 0
88283	CHROMO ANALY; ADD SPECIALIZED BAND				$ - 0
88285	CHROMO ANALY; ADD CELLS COUNTED EA				$ - 0
88289	CHROMO ANALY; ADD HIGH RESOLUTION				$ - 0
88300	SURGICAL PATHOLOGY LEVEL I				$ - 0
88300-26	SURGICAL PATHOLOGY LEVEL I - PC Only				$ - 0
88300-TC	SURGICAL PATHOLOGY LEVEL I - TC Only				$ - 0
88302	SURGICAL PATHOLOGY LEVEL II				$ - 0
88302-26	SURGICAL PATHOLOGY LEVEL II - PC Only				$ - 0
88302-TC	SURGICAL PATHOLOGY LEVEL II - TC Only				$ - 0
88304	SURGICAL PATHOLOGY LEVEL III				$ - 0
88304-26	SURGICAL PATHOLOGY LEVEL III - PC Only				$ - 0
88304-TC	SURGICAL PATHOLOGY LEVEL III - TC Only				$ - 0
88305	SURGICAL PATHOLOGY LEVEL IV	10			$ - 0
88305-26	SURGICAL PATHOLOGY LEVEL IV - PC Only				$ - 0
88305-TC	SURGICAL PATHOLOGY LEVEL IV - TC Only				$ - 0
88307	SURGICAL PATHOLOGY LEVEL V				$ - 0
88307-26	SURGICAL PATHOLOGY LEVEL V - PC Only				$ - 0
88307-TC	SURGICAL PATHOLOGY LEVEL V - TC Only				$ - 0
88309	SURGICAL PATHOLOGY LEVEL VI				$ - 0
88309-26	SURGICAL PATHOLOGY LEVEL VI - PC Only				$ - 0
88309-TC	SURGICAL PATHOLOGY LEVEL VI - TC Only				$ - 0
88311	DECALCIFICATION PROC				$ - 0
88311-26	DECALCIFICATION PROC - PC Only				$ - 0
88311-TC	DECALCIFICATION PROC - TC Only				$ - 0
88312	SPECIAL STAINS; GRP I FOR MICROORGANISMS, INCLUDING INTERPRETATIONS & REPORT	10			$ - 0
88312-26	SPECIAL STAINS; GRP I FOR MICROORGANISMS, INCLUDING INTERPRETATIONS & REPORT - PC Only				$ - 0
88312-TC	SPECIAL STAINS; GRP I FOR MICROORGANISMS, INCLUDING INTERPRETATIONS & REPORT - TC Only	5			$ - 0
88313	SPEC STAINS; GROUP II, ALL OTH EX IMMUNOCYTO & IMMUNOPEROX STA, INC INT/REP	10			$ - 0
88313-26	SPEC STAINS; GROUP II, ALL OTH EX IMMUNOCYTO & IMMUNOPEROX STA, INC INT/REP - PC Only				$ - 0
88313-TC	SPEC STAINS; GROUP II, ALL OTH EX IMMUNOCYTO & IMMUNOPEROX STA, INC INT/REP - TC Only	10			$ - 0
88314	SPEC STAIN; HISTOCHEM STAIN W/FROZ SECT, INC INT/REP				$ - 0
88314-26	SPEC STAIN; HISTOCHEM STAIN W/FROZ SECT, INC INT/REP - PC Only				$ - 0
88314-TC	SPEC STAIN; HISTOCHEM STAIN W/FROZ SECT, INC INT/REP - TC Only				$ - 0
88319	DETERM HSTOCHEM/CYTCHEM ID ENZYM E				$ - 0
88319-TC	DETERM HSTOCHEM/CYTCHEM ID ENZYM E - TC Only				$ - 0
88321	CONS & REPRT REF SLIDES PREP ELSEW	400			$ - 0
88323	CONS & REPRT REF MAT REQ PREP SLID	100			$ - 0
88323-26	CONS & REPRT REF MAT REQ PREP SLID - PC Only				$ - 0
88323-TC	CONS & REPRT REF MAT REQ PREP SLID - TC Only				$ - 0
88325	CONS COMP W/REVW RECORD/SPECMN/REP				$ - 0
88331	PATH CONS DURNG SURG; FROZEN 1 SPE				$ - 0
88331-26	PATH CONS DURNG SURG; FROZEN 1 SPE - PC Only				$ - 0
88331-TC	PATH CONS DURNG SURG; FROZEN 1 SPE - TC Only				$ - 0
88332-TC	EACH ADD TIS BLOCK W/FROZ SEC(LIST SE IN ADD TO CODE FOR PRIM PROC);+88331 - TC Only				$ - 0
88333-TC	PATHOLOGY CONS DURING SURG, CYTOLOGIC EXAM INITIAL SITE - TC Only				$ - 0
88334-TC	CYTO EXAM EACH ADD SITE(LIST SEP IN ADD TO CODE FOR PRIM PROC);+88331 OR 88333 - TC Only				$ - 0
88341	Immunohisto antibody slide	400			$ - 0
88341TC	Immunohisto antibody slide	100			$ - 0
8834126	Immunohisto antibody slide				$ - 0
88342	IMMUNOCYTOCHEMISTRY EA ANTIB - initial stain	400			$ - 0
88342-26	IMMUNOCYTOCHEMISTRY EA ANTIB - initial stain - PC Only				$ - 0
88342-TC	IMMUNOCYTOCHEMISTRY EA ANTIB - initial stain - TC Only	50			$ - 0
88343	IMMUNOCYTOCHEMISTRY EA ANTIB - each add'l stain	50			$ - 0
88343-26	IMMUNOCYTOCHEMISTRY EA ANTIB - each add'l stain - PC Only				$ - 0
88343-TC	IMMUNOCYTOCHEMISTRY EA ANTIB - each add'l stain - TC Only				$ - 0
88344	Immunohisto antibody slide				$ - 0
88344-26	Immunohisto antibody slide				$ - 0
88344-TC	Immunohisto antibody slide				$ - 0
88346	IMMUNOFLUOR STUDY EA ANTIB; DIRECT				$ - 0
88346-26	IMMUNOFLUOR STUDY EA ANTIB; DIRECT - PC Only				$ - 0
88346-TC	IMMUNOFLUOR STUDY EA ANTIB; DIRECT - TC Only				$ - 0
88347	IMMUNOFLUOR STUDY EA ANTIB; INDIRE				$ - 0
88347-26	IMMUNOFLUOR STUDY EA ANTIB; INDIRE - PC Only				$ - 0
88347-TC	IMMUNOFLUOR STUDY EA ANTIB; INDIRE - TC Only				$ - 0
88348	ELECTRON MICRO; DX				$ - 0
88348-26	ELECTRON MICRO; DX - PC Only				$ - 0
88348-TC	ELECTRON MICRO; DX - TC Only				$ - 0
88349	ELECTRON MICRO; SCANNING				$ - 0
88349-26	ELECTRON MICRO; SCANNING - PC Only				$ - 0
88349-TC	ELECTRON MICRO; SCANNING - TC Only				$ - 0
88355	MORPHOMETRIC ANALYSIS; SKELETAL MUSCLE				$ - 0
88355 26	MORPHOMETRIC ANALYSIS; SKELETAL MUSCLE - PC				$ - 0
88355 TC	MORPHOMETRIC ANALYSIS; SKELETAL MUSCLE - TC				$ - 0
88356	MORPHOMETRIC ANALYSIS; NERVE				$ - 0
88356 26	ELECTRON MICROSCOPY; SCANNING - PC				$ - 0
88356 TC	ELECTRON MICROSCOPY; SCANNING - TC				$ - 0
88358	MORPHOMETRIC ANALY; TUMOR				$ - 0
88358-26	MORPHOMETRIC ANALY; TUMOR - PC Only				$ - 0
88358-TC	MORPHOMETRIC ANALY; TUMOR - TC Only				$ - 0
88360	MORPH ANALYSIS, TUMOR IMMUNOHISTOCHEM QUANT OR SEMIQUANT, EA ANTIBODY; MANUAL	10			$ - 0
88360-26	MORPH ANALYSIS, TUMOR IMMUNOHISTOCHEM QUANT OR SEMIQUANT, EA ANTIBODY; MANUAL - PC Only				$ - 0
88360-TC	MORPH ANALYSIS, TUMOR IMMUNOHISTOCHEM QUANT OR SEMIQUANT, EA ANTIBODY; MANUAL - TC Only				$ - 0
88361	TUMOR IMMUNOHISTOCHEMISTRY QUANTITATIVE OR SEMIQUANTITATIVE	85			$ - 0
88361-26	TUMOR IMMUNOHISTOCHEMISTRY QUANTITATIVE OR SEMIQUANTITATIVE - PC Only				$ - 0
88361-TC	TUMOR IMMUNOHISTOCHEMISTRY QUANTITATIVE OR SEMIQUANTITATIVE - TC Only				$ - 0
88362-TC	NERV TEASING PREP - TC Only				$ - 0
88365	TISS IN SITU HYBRIDIZ INTRPT & REP	5			$ - 0
88365-26	TISS IN SITU HYBRIDIZ INTRPT & REP - PC Only				$ - 0
88365-TC	TISS IN SITU HYBRIDIZ INTRPT & REP - TC Only				$ - 0
88367-TC	MORPHOMETRIC ANALYSIS, IN SITU HYBRIDIZATION, EA PROBE, USING COM ASSTD TECH. - TC Only				$ - 0
88368	MORPH ANALYSIS, IN SITU HYBRID EA PROBE;MANUAL				$ - 0
88368-26	MORPH ANALYSIS, IN SITU HYBRID EA PROBE;MANUAL - PC Only				$ - 0
88368-TC	MORPH ANALYSIS, IN SITU HYBRID EA PROBE;MANUAL - TC Only				$ - 0
88380-TC	MICRODISSECTION(IE,SAMPLE PREP OF MICROSCOPICALLY IDENT TARGET); LASER CAPTURE - TC Only				$ - 0
88381-TC	MICRODISSECTION; MANUAL - TC Only				$ - 0
88387	TISSUE EXAM MOLECULAR STUDY				$ - 0
88387 26	TISSUE EXAM MOLECULAR STUDY - PC				$ - 0
88387 TC	TISSUE EXAM MOLECULAR STUDY - TC				$ - 0
88388	TISSUE EXAM MOLECULAR STUDY - ADD ON				$ - 0
88388 26	TISSUE EXAM MOLECULAR STUDY - ADD ON - PC				$ - 0
88388 TC	TISSUE EXAM MOLECULAR STUDY - ADD ON - TC				$ - 0
88377	M/phmtrc alys ishquant/semiq	15			$ - 0

TEST CODES	DESCRIPTION	Quantity	Unit of Issue (ea.)	Cost per Service Count	Total
0019537	TSH WITH HAMA TREATMENT	30			$ - 0
0950669	MIXING STUDIES	7			$ - 0
0950083	PLATELET FUNC SCR	7			$ - 0
0005022	REDUC SUB, FECES QL	7			$ - 0
0950084	ADP	6			$ - 0
0907190	THYROGLOBULIN AB	6			$ - 0
0907239	LEU & LYM 21 MARKERS	4			$ - 0
0907234	LEU & LYM 16 MARKERS	3			$ - 0
0907240	LEU & LYM 22 MARKERS	3			$ - 0
0907244	LEU & LYM 26 MARKERS	3			$ - 0
0900182	PLAT AGG W/RIST-MVH	3			$ - 0
0951036	TACROLIMUS	3			$ - 0
0975865	ADD'L IMMUNOSTAIN X 2	2			$ - 0
0907165	BLOOD SMEAR	2			$ - 0
0903601	BONE MARROW SMEAR	2			$ - 0
0907167	DECALCIFICATION	2			$ - 0
0950584	FISH (QUALITATIVE) X 1	2			$ - 0
0905454	IMMUNOPEROXIDASE	2			$ - 0
0907241	LEU & LYM 23 MARKERS	1			$ - 0
0905871	LEVEL IV - 2 SPECS	2			$ - 0
0975897	ADD'L FISH QUAL X 1	1			$ - 0
0975873	ADD'L IMMUNOSTAIN X 10	1			$ - 0
0950473	FACTOR V INHIBITOR	1			$ - 0
0907131	FACTOR XA	1			$ - 0
0907231	LEU & LYM 13 MARKERS	1			$ - 0
0907242	LEU & LYM 24 MARKERS	1			$ - 0
0907243	LEU & LYM 25 MARKERS	1			$ - 0
0906524	MICROORG STAIN X 3	1			$ - 0
0906529	NONMICROORG STAINS 3	1			$ - 0
0951488	S2 CYTOCHEMICAL STAIN	1			$ - 0
2012710	Aggressive B-Cell Lymphoma Rflx, Tissue	1			$ - 0
2006102	ALK by FISH, Lung	1			$ - 0
0093271	Bone Marrow/PBL Culture Bill	3			$ - 0
2002440	EGFR by Pyrosequencing	2			$ - 0
0090299	Epithelial Skin Antibodies	12			$ - 0
0050591	Ganglioside (GM1) Antibodies, IgG/IgM	1			$ - 0
2004998	Ganglioside (GM1/GD1b/GQ1b) Abs, IgG/IgM	1			$ - 0
0051033	Ganglioside Antibodies, Combined IgG/IgM	5			$ - 0
2010757	Hereditary Cancer Pan, Del/Dup	1			$ - 0
0051367	Hypochondroplasia (FGFR3) 2 Mutations	1			$ - 0
0055557	IGH-CCND1 (BCL-1/JH) t(11;14) PCR	2			$ - 0
2000770	IHC BillG Nerve Fiber PGP9.5	6			$ - 0
0070413	Inhibin B	1			$ - 0
0096043	Lymphocyte Mitogen Proliferation	6			$ - 0
2002499	MLH1 Methylation by PCR	3			$ - 0
2002360	MPD Panel by FISH	1			$ - 0
2009318	MYD88 L265P Mutation Detection by PCR	2			$ - 0
2011117	Myeloid Malignancies Mutation Panel NGS	2			$ - 0
2004221	N-methyl-D-Aspartate Rcptr Ab, IgG, Ser	5			$ - 0
2005164	N-methyl-D-Aspartate Receptor Ab, CSF	1			$ - 0
2013008	PJI Detection (Synovasure)	4			$ - 0
2012018	Skeletal Dysplasia Sequencing	1			$ - 0
2007991	Solid Tumor Mutation Panel by NGS	2			$ - 0
0051139	Specimen Identity	6			$ - 0

File details come from the government source that posted it. Updated Nov 14, 2017.