Medical Procedure Costs

81360

Gene analysis (zinc finger CCCH-type, RNA binding motif and

Pathology/Laboratory

$193

—

81361

Gene analysis (hemoglobin, subunit beta) for common variant

Pathology/Laboratory

$175

—

81362

Gene analysis (hemoglobin, subunit beta) for known familial variant

Pathology/Laboratory

$375

—

81363

Gene analysis (hemoglobin, subunit beta) for duplication/deletion variant

Pathology/Laboratory

$202

—

81364

Gene analysis (hemoglobin, subunit beta) full sequence analysis

Pathology/Laboratory

$325

—

81370

HLA class I and II typing low resolution HLA-A, -B, -C, -DRB1/3/4/5 and -DQB1

Pathology/Laboratory

$402

—

81371

HLA class I and II typing, low resolution HLA-A, -B, and -DRB1

Pathology/Laboratory

$405

—

81372

HLA class I typing low resolution

Pathology/Laboratory

$404

—

81373

HLA class I typing low resolution one locus

Pathology/Laboratory

$127

—

81374

HLA class I typing, low resolution one antigen equivalent

Pathology/Laboratory

$74

—

81375

HLA class II typing low resolution HLA-DRB1/3/4/5 and -DQB1

Pathology/Laboratory

$221

—

81376

HLA class II typing low resolution one locus

Pathology/Laboratory

$122

—

81377

HLA class II typing low resolution one antigen equivalent

Pathology/Laboratory

$95

—

81378

HLA class I and II typing high resolution HLA-A, -B, -C, and -DRB1

Pathology/Laboratory

$346

—

81379

HLA Class I typing high resolution

Pathology/Laboratory

$335

—

81380

HLA class I typing high resolution one locus

Pathology/Laboratory

$177

—

81381

HLA class I typing high resolution one allele or allele group

Pathology/Laboratory

$170

—

81382

HLA class II typing high resolution one locus

Pathology/Laboratory

$124

—

81383

HLA class II typing high resolution one allele or allele group

Pathology/Laboratory

$109

—

81400

Molecular pathology procedure level 1

Pathology/Laboratory

$64

—

81401

Molecular pathology procedure level 2

Pathology/Laboratory

$137

—

81402

Molecular pathology procedure level 3

Pathology/Laboratory

$150

—

81403

Molecular pathology procedure level 4 genetic analysis

Pathology/Laboratory

$185

—

81404

Molecular pathology procedure level 5 genetic analysis

Pathology/Laboratory

$275

—

81405

Molecular pathology procedure level 6 genetic analysis

Pathology/Laboratory

$301

—

81406

Molecular pathology procedure level 7 genetic analysis

Pathology/Laboratory

$283

—

81407

Molecular pathology procedure level 8 genetic analysis

Pathology/Laboratory

$846

—

81408

Molecular pathology procedure level 9 genetic analysis

Pathology/Laboratory

$2,000

—

81410

Test for detecting genes associated with heart disease, genomic sequence

Pathology/Laboratory

$504

—

81411

Test for detecting genes associated with heart disease, duplication/deletion

Pathology/Laboratory

$1,350

—

81412

Test for detecting genes for disorders related to Ashkenazi Jews, genomic

Pathology/Laboratory

$2,449

—

81413

Test for detecting genes associated with heart disease, genomic sequence

Pathology/Laboratory

$585

—

81414

Test for detecting genes associated with heart disease, duplication/deletion

Pathology/Laboratory

$585

—

81415

Test for detecting exome, sequence analysis

Pathology/Laboratory

$4,780

—

81416

Test for detecting exome, sequence analysis, each comparator exome

Pathology/Laboratory

$12,000

—

81417

Reevaluation test of previously obtained exome sequence

Pathology/Laboratory

$320

—

81418

Genomic sequence analysis panel of at least 6 genes associated with drug

Pathology/Laboratory

$917

—

81419

Gene analysis panel for evaluation of genes associated with epilepsy

Pathology/Laboratory

$2,449

—

81420

Test for detecting genes associated with fetal disease, aneuploidy genomic

Pathology/Laboratory

$759

—

81422

Test for detecting genes associated with fetal disease, microdeletion(s)

Pathology/Laboratory

$759

—

81425

Test for detecting genes associated with disease, genome sequence analysis

Pathology/Laboratory

$5,031

—

81426

Test for detecting genes associated with disease, genome sequence analysis,

Pathology/Laboratory

$2,710

—

81427

Reevaluation test of previously obtained genome sequence

Pathology/Laboratory

$2,338

—

81430

Test for detecting genes causing hearing loss genomic sequence analysis panel,

Pathology/Laboratory

$1,625

—

81431

Test for detecting genes causing hearing loss, duplication/deletion analysis

Pathology/Laboratory

$680

—

81432

Test for detecting genes associated with inherited breast cancer-related

Pathology/Laboratory

$1,304

—

81434

Gene analysis (retinal disorders), genomic sequence

Pathology/Laboratory

$598

—

81435

Test for detecting genes associated with inherited colon cancer-related

Pathology/Laboratory

$1,304

—

81437

Test for detecting genes associated with inherited neuroendocrine tumor-related

Pathology/Laboratory

$1,304

—

81439

Test for detecting genes associated with inherited disease of heart muscle

Pathology/Laboratory

$585

—

My Cost List