86738

Mycoplasma, Ab

333,00

86762

Rubella virus IgG and IgM

161,00

86778

Toxoplasma IgM

99,00

86789

West Nile virus IgG and IgM

516,00

86790

Virus/bacteria Ab, not otherwise specified

266,00

86800

Thyroglobulin, Ab

401,00

86803

Hepatitis C, Ab

48,00

86805

Lymphocytotoxicity assay, visual crossmatch; with titration

425,00

86813

HLA typing, A, B, C

2 178,00

86817

HLA typing, DR/DQ

2 817,00

86821

HLA typing, MLC (mixed lymphocyte culture)

2 817,00

86880

DAT (Direct Antiglobulin Test) / Coombs

194,00

86900

Blood typing, including RH

126,00

86901

Rh test

158,00

86903

Blood typing and Rh, Ab, screen

552,00

86904

Blood typing and Rh, Ab

1 092,00

86905

Blood typing; RBC antigens, other than ABO or Rh (D)

1 664,00

86940

Hemolysins and agglutinins, screen

572,00

87001

Animal inoculation, eg, tuberculosis

572,00

87040

Blood culture and susceptibility

119,00

87045

Feces culture

158,00

87070

Culture, other source, excluding blood/urine/feces

119,00

87081

Urine culture, non quantitative

158,00

87086

Urine culture, quantitative

320,00

87088

Urine culture and susceptibility

179,00

87106

Fungi culture

158,00

87109

Mycoplasma culture

239,00

87110

Chlamydia culture

486,00

87116

Mycobacteria culture and identification

519,00

87118

Mycobacterial definitive identification, MTb

264,00

87140

Fluorescence or darkfield microscopy

158,00

87177

Ova and parasites, direct smear, identification - feces

120,00

87181

Susceptibility studies, antimicrobial agent, per agent

158,00

87190

Susceptibility studies, antimycobacterial agent, mycobacteria

354,00

87205

Smear interpretation, stain for bacteria, fungi, parasites or cell types

120,00

87207

Smear, special stain for parasites

158,00

87250

Virus isolation, including nucleic acid identification, polymerase chain reaction, PCR

609,00

87252

Virus isolation, tissue culture

194,00

87253

Virus isolation and identification, tissue culture, any method

965,00

87278

Legionella Ag - urine

236,00

87299

Immunofluorescent study; not otherwise specified

333,00

87340

Hepatitis B surface antigen (HBsAg), any method, including immunofluorescent study

134,00

87350

Hepatitis Be antigen (HBeAg), any method, including immunofluorescent study

111,00

87449

Infectious agent antigen detection, not otherwise specified

549,00

87472

Bartonella henselae and Bartonella quintana, quantification

419,00

87517

Hepatitis B virus DNA/RNA, quantitative

743,00

87522

Hepatitis C virus DNA/RNA, quantitative

1 382,00

87536

HIV-1 DNA/RNA, quantitative

1 934,00

87539

HIV-2 DNA/RNA, quantitative

1 934,00

87556

Mycobacteria tuberculosis, AMTD

665,00

87590

Gonorrhoeae smear

0,00

87620

Papillomavirus (HPV) - tissue, including biopsy

2 745,00

87622

HPV (Human Papillomavirus) smear

573,00

88036

Necropsy (autopsy), limited, gross and/or microscopic; regional

965,00

88130

Sex chromatin identification, Barr bodies

194,00

88141

Pap smear, cervical/vaginal, cytopathology, including sampling

162,00

88160

Cytopathology examination and interpretation

266,00

88230

Karyotype, leukocyte culture

1 668,00

88233

Karyotype, tissue culture

2 153,00

88240

Cryopreservation of cells (eg, bone marrow), per year

2 094,00

88299

B &T cell receptor gene rearrangment analysis

1 559,00

88305

Histologic examination, microscopy and interpretation

266,00

88313

Bone marrow sampling and iron stain

606,00

88319

Histochemistry/cytochemistry stain for enzyme identification

266,00

88346

Immunofluorescent study, each antibody; direct method

1 410,00

88347

Immunofluorescent study, each antibody; indirect method

1 410,00

88348

EM (Electron microscopy), diagnostic

4 727,00

89051

Cell count - body fluids, eg, CSF, joint fluid, excluding blood

188,00

89258

Cryopreserved embryos storage for 5 years

965,00

89259

Cryopreservation, sperm, one year, up to 5 test tubes/straws

1 062,00

89280

Assisted oocyte fertilization, microtechnique

6 395,00

89290

Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre-implantation genetic diagnosis)

13 776,00

89300

Semen analysis; presence and/or motility of sperm including Huhner test (post coital)

363,00

89320

Semen analysis, complete (volume, count, motility, and differential)

222,00

89325

Sperm Ab

354,00

90371

HBIg (Hepatitis B immune globulin), IM

6 093,00

90375

Rlg (Rabies immune globulin), IM and/or subcutaneous

4 166,00

90384

Rho(D) immune globulin (Rhlg), Anti-D

743,00

90585

BCG (Bacillus Calmette-Guerin) vaccine for tuberculosis

0,00

90586

BCG vaccine for bladder, live, for intravesical use, per treatment, including material

1 344,00

90749

Immune globulin (Ig), not otherwise specified

158,00

90772

Subcutaneous/IM injection, therapeutic/prophylactic/diagnostic

54,00

90862

Pharmacological management/review, mental health

162,00

90870

Electroconvulsive therapy

1 656,00

90880

Hypnotherapy

198,00

90882

Psychosocial intervention - follow up

191,00

90889

Psychiatric medical opinion

908,00

90901

Biofeedback training

588,00

90935

Hemodialysis procedure, per treatment

1 818,00

90945

Dialysis procedure other than hemodialysis (eg, peritoneal dialysis)

822,00