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A B C D E F G H I J K L M
N O P Q R S T U V W X Y Z
Test Specimen Requirements CPT Code Method Fee
Acetaminophen
(Tylenol)

Quantitative - serum

Qualitative - urine




1 ml serum or plasma

(0.5 ml min)

10 ml urine




82003



SPEC

GC/MS




62.50

47.50

Acetone 3 ml blood(NaF,oxalate)
(1 ml min.)

Serum or plasma acceptable.

82010 GC-FID 39.00
Alcohol Ethyl

(Ethanol)

1 ml serum or plasma
(1 ml min)

Cleanse collection site with non-alcoholic agent. Serum, plasma or urine acceptable
82055 GC-FID 48.00
Alcohol, Legal
(Ethanol) .




Legal Fee
3 ml blood (NaF, oxalate)
(1 ml min)

Cleanse collection site with non-alcoholic agent. Serum, plasma, urine acceptable
82055 GC-FID 75.00





65.00
Alcohol, Isopropyl
(I
sopropanol)
3 ml blood (NaF, oxalate)
(1 ml min)

Cleanse collection site with non-alcoholic agent.Serum, plasma or urine acceptable
84600 GC-FID 42.95
Alcohol, Methyl
(M
ethanol)
3 ml blood (NaF, Oxalate)

(1 ml min)

Cleanse collection site with non-alcoholic agent. Serum, or plasma also acceptable

84600 GC-FID 45.00
Alprazolam
(X
anax)

Quantitative (serum)


Qualitative (urine)




4 ml serum or plasma
(2 ml min)

10 ml urine




80154



GC-TSD

GC-TSD GC/MS



63.50

42.50
Amikacin
(Amikin)
3 ml serum or plasma

(1.5 ml min)

80150 HPLC 89.00
Amiodarone (Cordarone) & Desmethylamiodarone 4 ml serum or plasma

(2 ml min)

80299 HPLC 75.00
Amitriptyline
(Elavil)

Quantitative - serum




Quantitative - urine




5 ml serum or plasma
(3 ml min)

No serum separator gels

10 ml urine




80152



GC-TSD




GC-TSD



82.50




52.50
Amobarbital

Quantitative - serum


Qualitative - urine


2 ml serum or plasma
(2 ml min)

10 ml urine


82205


GC-TSD


GC-TSD GC/MS


52.00


32.95
Amoxapine
(Asendin)

Quantitative - serum


Qualitatvie - urine



5 ml serum or plasma
(3 ml min)

15 ml urine



80299



GC-FID


GC/MS



69.95


42.50
Amphetamine

Quantitative - serum

Qualitative - urine



20 ml random urine

15 ml random urine


80299
80101


GC-TSD
GC/MS


62.50

54.50
Amphetamine
Confirmation

(Qualitative)

20 ml random urine 80102 GC/MS 79.00
Anafranil
(C
lomipramine)

Quantitative - serum

Qualitative - urine




5 ml serum or plasma

(3 ml min)

15 ml urine




80299

80101




GC-TSD

GC-TSD
GC/MS




75.50

52.95

Anticonvulsant Screen

Qualitative - urine



25 ml urine

Carbamazepine, Gabapentin, Lamotrigine, Phenytoin, Primidone, Valproic Acid


80101


GC-TSD

GC/MS



65.50
Antidepressants Screen (TCA)

Qualitative - urine
25 ml urine

Amitriptyline, Desipramine, Imiamine, Nortriptyline,
Cyclobenzaprine, Fluoxetine (Prozac), Doxepin, Seroquel
80101 GC/MS 69.50
Ativan
(L
orazepam)

Quantitative - serum

Qualitative - urine




4 ml serum or plasma

(2 ml min)

15 ml urine




80154



GC-TSD



GC-TSD
GC/MS



77.50



45.50
Aventyl
(Nortriptyline)

Quantitative - serum




Qualitative - urine



5 ml serum or plasma
(3 ml min)

No serum separator gels

15 ml urine



80182



GC-TSD




GC-TSD GC/MS



72.00




49.95

 


   

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