Effective October 16, 2017 we are offering our new tests for Lyme IGXSpot, Lyme Borreliosis, and Tick-borne Relapsing Fever Borreliosis The new ImmunoBlot tests have replaced the original Western Blot tests in most panels. The original Western Blot IgG and IgM will still be offered as individual tests. Prior to selecting your tests/panels, please review the components listed within each panel. Updated Prices for all tests and panels (effective October 16, 2017) are also listed on the new Test Requisition Form. LYME PANELS (Borrelia burgdorferi) LPA LYME PANEL A $546.00 Lyme Western Blot IgM Lyme Western Blot IgG *IB1 LYME IMMUNOBLOT PANEL 1 $490.50 *IB2 LYME IMMUNOBLOT PANEL 2 $686.00 *IB3 LYME IMMUNOBLOT PANEL 3 $752.50 LPCR1 LYME PCR PANEL 1 $371.00 *LU1 LYME URINE PANEL 1 $468.00 Lyme Dot Blot - 3 urine samples Lyme PCR - 3 urine samples-pooled 87449 x3 Lyme Individual Tests (Borrelia burgdorferi) *300 Lyme IgXSpot 86356 $295.00 *325 Lyme ImmunoBlot IgM $225.00 *335 Lyme ImmunoBlot IgG $225.00 *230 Lyme G/M/A IFA Screen $ 95.00 183 Lyme Serology IgG/IgM $ 95.00 195 Lyme Serology IgM $ 95.00 170 C6 Peptide B. burgdorferi $120.00 188 Lyme Western Blot IgM $125.00 189 Lyme Western Blot IgG $125.00 *488 31 kda Epitope IgM $125.00 *489 31 kda Epitope IgG $125.00 *800 Lyme Dot Blot Assay (LDA) 1 sample 87449 $ 85.00 *802 Lyme Dot Blot Assay (LDA) 2 samples 87449 x 2 $170.00 *805 Lyme Dot Blot Assay (LDA) 3 samples 87449 x 3 $255.00 453 Lyme Multiplex PCR Serum $265.00 456 Lyme Multiplex PCR Whole Blood $265.00 450 Lyme Multiplex PCR Urine $265.00 465 Lyme Multiplex PCR Urine, Pooled $265.00 *462 Lyme Multiplex PCR Miscellaneous (Tissue, Breast Milk, etc.) $295.00 BS-WS-001 REV.003 10-16-2017 *Tests/Panels are not yet available for New York Residents Page 1 of 5
TICK-BORNE RELAPSING FEVER Borrelia (TBRF) *TBRF1 TBRF Panel 1 $686.00 *TBRF2 TBRF Panel 2 $371.00 Tick-Borne Relapsing Fever Individual Tests (TBRF) *585 TBRF Western Blot IgM $175.00 *595 TBRF Western Blot IgG $175.00 *345 TBRF ImmunoBlot IgM $225.00 *355 TBRF ImmunoBlot IgG $225.00 Relapsing Fever Borrelia and B. burgdorferi sensu lato real-time PCR *556 Relapsing Fever PCR - Whole Blood $265.00 *573 Relapsing Fever PCR - Serum $265.00 *559 Relapsing Fever PCR - Urine $265.00 *562 Relapsing Fever PCR - Urine (pooled 3 samples) $265.00 *568 Relapsing Fever PCR - Miscellaneous (Tissue, Breast Milk, etc.) $295.00 BORRELIOSIS PANELS combines Lyme and TBRF testing *LTP1 Lyme/TBRF Panel 1 $895.50 *LTP2 Lyme/TBRF Panel 2 $991.25 *LTP3 Lyme/TBRF Panel 3 $1335.75 BS-WS-001 REV.003 10-16-2017 *Tests/Panels are not yet available for New York Residents Page 2 of 5
CENTRAL NERVOUS SYSTEM PANEL *CSF1 CSF Panel 1 $500.00 Lyme Dot Blot Assay CSF Lyme PCR CSF TBRF PCR - CSF 87449 Central Nervous System Individual Tests (Cerebral Spinal Fluid) *810 Lyme Dot Blot Assay CSF 87449 $95.00 459 Lyme (B. burgdorferi ) PCR CSF $265.00 *565 TBRF PCR - CSF $265.00 281 Bartonella henselae PCR CSF 87471 $265.00 986 Rickettsia PCR Panel CSF 87797, 87798 x 2 $230.00 (Only R. rickettsii will be reported for NY Resident*) CO-INFECTION PANELS *TBD1 Tick-Borne Disease Panel $1346.25 *CP1 Co-Infection Panel 1 $816.00 Rickettsia rickettsii IgG IFA *CP2 Co-Infection Panel 2 $816.00 BS-WS-001 REV.003 10-16-2017 *Tests/Panels are not yet available for New York Residents Page 3 of 5
*CP3 Co-Infection Panel 3 $992.00 Bartonella FISH CP4 Co-Infection Panel 4 $680.00 CP5 Co-Infection Panel 5 $816.00 BABESIOSIS PANELS BAB1 Babesia Panel 1 $518.50 Babesia PCR Panel *BAB2 Babesia Panel 2 $654.50 Babesia PCR Panel Babesiosis Individual Tests 200 B. microti IgG & IgM IFA x2 $160.00 *720 B. duncani IgG & IgM IFA x2 $160.00 640 Babesia FISH (RNA) $220.00 663 Babesia PCR Panel Whole Blood $230.00 BS-WS-001 REV.003 10-16-2017 *Tests/Panels are not yet available for New York Residents Page 4 of 5
BARTONELLOSIS PANEL *BART1 Bartonella Panel 1 $518.50 Bartonella PCR Whole Blood Bartonella FISH* 87471 Bartonellosis Individual Tests 285 Bartonella henselae IgG & IgM IFA x2 $160.00 280 Bartonella henselae PCR Whole Blood 87471 $230.00 *289 Bartonella FISH $220.00 RICKETTSIOSIS PANEL RP1 Rickettsia Panel 1 $331.50 Rickettsia PCR Panel (Only R. rickettsii will be reported for NY Resident*) Rickettsiosis Individual Tests (Rocky MountainSpotted Fever) 965 Rickettsia rickettsii/typhi IgG IFA x2 $160.00 998 Rickettsia PCR Whole Blood $230.00 (Only R. rickettsii will be reported for NY Resident*) EHRLICHIOSIS PANEL EP1 Ehrlichia Panel 1 $663.00 Ehrlichia chaffeensis (HME) PCR Whole Blood Anaplasma phagocytophilum (HGA) PCR Whole Blood Ehrlichiosis Individual Tests 203 Ehrlichia chaffeensis (HME) IgG & IgM IFA x2 $160.00 770 Ehrlichia chaffeensis (HME) PCR Whole Blood 87797, 87798 $230.00 206 Anaplasma phagocytophilum (HGA) IgG & IgM IFA x2 $160.00 775 Anaplasma phagocytophilum (HGA) PCR Whole Blood 87797, 87798 $230.00 IMMUNOLOGY *275 CD57 86356 $155.00 *295 Chlamydophila pneumoniae IgG ELISA 86631 $ 85.00 *296 Chlamydophila pneumoniae IgA ELISA 86631 $ 85.00 Test Panels are tailored to meet the needs of the referring healthcare practitioner. Test Panel discounts apply only to tests ordered at the same time. IGeneX, Inc. accepts Personal Checks, Money Orders, Visa, MasterCard, Discover, and American Express. Canadian/International Residents: NO Personal Checks accepted. Visa, MasterCard, Discover, American Express, Money Orders in US Dollars. *Tests/Panels are not yet available for New York Residents Please Note: Only tests that are medically reasonable and necessary for the diagnosis or treatment of a Medicare patient will be reimbursed. The Office of the Inspector General -OIG takes the position that a physician who orders medically unnecessary tests for which Medicare reimbursement is claimed may be subject to civil penalties under the False Claims Act. BS-WS-001 REV.003 10-16-2017 *Tests/Panels are not yet available for New York Residents Page 5 of 5