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1 1 Lab Service PRICE PATHOGEN ID PRESUMP ID, URINE CULTUR HSV CULTURE TYPING MIC (MIN INHIB CONC) 7 AMYLASE, SERUM 3 ANA SCREEN/RFX TITER AND DSDNA 4 ANA SCREEN/RFX TITER/COMPREHEN 4 ANA SCREN/REFLEX TITER/PATTERN 4 ANA TITER 11 ANA, SCREEN ONLY (NO TITER) 4 ANTIBODY IDENTIFICATION 8 ASO SCREEN/RFX TITER 8 BASIC METABOLIC PANEL 3 BASIC METABOLIC PANEL(NO GFR) 3 BHCG, QUANTITATIVE 3 BLOOD SMEAR EXAM 3 BMP WITH BUN/CREAT RATIO 3 BORDETELLA PERTUSSIS IGG 50 C REACTIVE PROTEIN 4 C.TRACHOMATIS(NAT),URINE 15 CA CBC W/DIFF 3
2 2 CEA 3 CELIAC DISEASE PANEL 28 CHLAMYDIA TRACHOMATIS(NAT),SWA 15 CK 3 CMP WITH BUN/CREAT RATIO 4 CODFISH IGE (F3) 7 COMP METABOLIC PANEL 4 COMP METABOLIC PANEL (NO GFR) 4 CORN, MAIZE IGE (F8) 7 CRP, HIGH SENSITIVITY 6 CULTURE: AEROBIC 8 CULTURE: AEROBIC/ANAEROBIC 8 CULTURE: BLOOD 9 CULTURE: BODY FLUID 5 CULTURE: GENITAL 7 CULTURE: GROUP A STREP SCN 4 CULTURE: GRP B STREP SCRN 5 CULTURE: MRSA SCREEN 3 CULTURE: RESPIRATORY 5 CULTURE: STOOL 5 CULTURE: THROAT 4 CULTURE: UPPER RESPIRATORY 11 CULTURE: URINE 4 CULTURE:URINE,INCLUDE SUSCEPT 4
3 3 CYTO PATH DR. INTERP 11 CYTO PATH THINPREP PAP 20 CYTO PATH THINPREP PAP WITH 26 DEAMIDATED GLIADIN IGA 6 DHEA SULFATE 5 DIPTHERIA ANTITOXOID ANTIBODY 28 DONOR(FDA)HIV 1/0/2 ANTIBODY 7 EGG WHITE IGE (F1) 7 EGG YOLK IGE (F75) 7 ELECTROLYTE PANEL 3 ESTRADIOL 5 FACTOR V LEIDEN 72 FERRITIN 4 FSH 4 G0145 THINPREP W/IMAGER,MEDICA 26 GLUCOSE (VENOUS) 3 HELICOBACTER PYLORI IGG 7 HEMOGLOBIN (HGB) 3 HEMOGLOBIN A1C 4 HEMOGLOBIN A1C/W GLYCOHEMO 4 HEPATIC FUNCTION PANEL (AMA) 3 HEPATITIS B SURFACE ANTIGEN 7 HEPATITIS PANEL, ACUTE (AMA) 28 HIV 1/2 AG/AB REFLEX CONFIRM 8
4 4 HOMOCYSTEINE 17 HOMOCYSTEINE REFLEX MTHFR 17 HPV DNA (HIGH RISK) 27 HPV DNA (HIGH RISK) WITH PAP 27 HPV DNA (LABCORP) WITH PAP 27 HPV GENOTYPES 16, 18/45 27 HPV,HIGH RISK, DNA 27 HPV,HIGH RISK,DNA DETECTION 27 HSV CULTURE, REFLEX TYPING 14 IGA,TOTAL 6 IRON 3 LH (LUTEINIZING HORMONE) 3 LIPASE 5 LIPID PANEL WITH LDL CALC (AMA 3 LIPIDS WITH LDL DIRECT 5 LYME DISEASE IGG/IGM (WESTERN 24 LYME IGG/IGM ANTIBODY 6 MAGNESIUM, SERUM 3 METHYLENE T H F REDUCTASE (MTH 152 MICROALBUMIN W/ CREAT RATIO, R 9 MICROALBUMIN, RANDOM URINE 9 MILK, COW IGE (F2) 7 MONONUCLEOSIS SCREEN 9 MONONUCLEOSIS SCREEN/RFX EBV I 9
5 5 MUMPS IGG 4 NEISSERIA GONORRHOEAE(NAT),SWA 15 NEISSERIA GONORRHOEAE(NAT),URI 15 PATH EXAM IV PEANUT IGE (F13) 7 POTASSIUM 3 PROGESTERONE 5 PROLACTIN 4 PROTHROMBIN TIME (PT) 3 PSA TOTAL 7 PTH, INTACT 7 PTT, ACTIVATED (APTT) 3 QUANTIFERON- TB GOLD 50 RENAL FUNCTION PANEL 4 RHEUMATOID FACTOR WITH REFLEX 5 RHEUMATOID FACTOR(RF), QUANT 5 RPR SCREEN/ REFLEX TITER/ FTA 3 RUBELLA IGG ANTIBODY,QUANT 4 RUBEOLA IMMUNITY (IGG) 8 SED RATE (ESR) 4 SED RATE, WESTERGREN 3 SHRIMP IGE (F24) 7 SOYBEAN IGE (F14) 7 T-SPOT TB TEST 84
6 6 T3 FREE 4 T3 REVERSE, LC/MS/MS 16 T3 TOTAL 3 T4 (THYROXINE) 3 T4 FREE 5 TESTOSTERONE, TOTAL 6 TETANUS ANTITOXOID ANTIBODY 28 THYROGLOBULIN AB (ANTI-TG) 6 TISSUE TRANSGLUTAMINASE IGA 6 TPO ANTIBODY 6 TRANSFERRIN W/ CALCULATED TIBC 5 TSH 2 TSH REFLEX FT4 AND FT3 2 TSH, REFLEX FREE T4 2 TSH/REFLEX FT4/REFLEX FT3 2 TYPE/RH 6 URIC ACID 3 URINALYSIS, REFLEX CULTURE 3 URINALYSIS, WITH MICROSCOPIC 3 VARICELLA IMMUNITY (IGG) 4 VITAMIN B12 7 VITAMIN D (1,25 DIHYDROXY) 24 VITAMIN D, 25 OH 20 VITAMIN D,25OH (TOTAL D2/D3) 20
7 7 WHEAT IGE (F4) 7
TEST LIST SAMPLE REQUIREMENT. 1 ml serum None
ALBUMIN TEST NAME ALKALINE PHOSPHATASE ALLERGY PROFILE, FOOD 30 allergens ALLERGY PROFILE, INHALANT 30 Allergens ALT AMYLASE ANA ANTI- TG ANTI-GLIADIN IGG ANTI-GLIADIN IGA ANTI-HBS ANTI-HCV ANTI-TPO APOLIPOPROTEIN
ICL Integrative Laboratory Services Test Menu Contact ICL Client Care x300
Alletess Food Sensitivity Fingerstick 96 Foods IgG with or without Wellness Program 184 Foods IgG with or without Wellness Program Alletess Food Allergy/Sensitivity Serum 96 Foods IgG with or without Wellness
Specific Panels. Celiac disease panel. Pancreas Panel:
Specific Panels Celiac disease panel Anti Endomysium IgA Anti Endomysium IgG Anti Gliadin IgA Anti Gliadin IgG Anti Transglutaminase IgA Anti Transglutaminase IgG Total IgA Total IgG Stool analysis +Sudan
1. Purpose 1.1. To define testing locations, schedule and order priority for each test performed in the core laboratory.
Department Of Pathology GEN.1017.03 Integrated Test Schedule Version# 5 Department Specimen Processing POLICY NO. 1938 PAGE NO. 1 OF 6 Printed copies are for reference only. Please refer to the electronic
Tests by age. specific inherited syndromes and inflammatory bowel disease
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1 ACID FAST BACILLISTAIN 100 10.48 1,048.00 8.00 800.00 2 AFP, TUMOR (CHIRON) 10 9.04 90.40 7.00 70.00 3 AMYLASE 160 3.13 500.80 2.75 440.00 4 BASIC METAB PNL 1,800 1.44 2,592.00 1.95 3,510.00 5 BZV IGGAB
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To be used for the ease of test requisitioning on select patients only; all components may be ordered separately
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28. Bilirubin (total, total conjugated, unconjugated, direct and indirect).
1. 17-OH-Progesterone. 2. 5α-dihydrotestosterone (DHT). 3. Adrenocorticotropic Hormone ACTH. 4. Alanine Transaminase (ALT, SGPT). 5. Albumin, qualitative. 6. Aldosterone. 7. Allergen Specific IgG Antibody.
Analyte Specimen Demographic Reference Range Units
Acetone Negative titer Alanine aminotransferase (ALT/SGPT) 10-49 U/L Albumin 3.2-4.8 g/dl Alcohol < 10 Alpha-fetoprotein (AFP) < 1.3-8.1 ng/ml Alkaline phosphatase 0 7 days 7 30 days 1 3 3 6 6 12 1 3 3
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* Collection & Handling Fees billed separately - see Lab Fee Schedule for pricing- pricing subject to change
OFFICE VISITS Community Fee Range Student Discounted Rate Primary Care Visit $120-.00-$277.00 $20.00 Special Visit $120.00 - $295.00 $45.00 WOMEN S HEALTH (Additional Fees May Apply) Well Woman Exam w/pap
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Blood Bank Prepare RBCs for Transfusion (aka Crossmatch) N/A No Antibody Screen ordered Antibody Screen Direct Antiglobulin Test (DAT) Polyspecific DAT Positive polyspecific DAT IgG DAT, C3 DAT Fetal Cell
Service Name SQ Test Code Specimen of Choice Minimum Volume Specimen Stability Testing Schedule Special Instructions SST / NAFL PLASMA
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Reference ranges are quoted on all reports where appropriate for the test carried out. The reference range and reporting units, including any interpretive information, is specific to the methodology used
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$12.00 $10.00 $19.00 $15.00 $49.00 $45.00 $59.00 $39.00 $89.00 $79.00 $69.00 $49.00 $75.00 $69.00 $49.00 $30.00 $69.00 $65.00 $ $129.
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*** To get the most out of this report and the consultation, send us blood test results that cover as many of the following markers as possible:
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