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W <br />120 racy 1 <br />LABCORP LABORATORY C <br />HARGES <br />PRIMARY CARE CLINIC <br />CURRENT <br />PROPOSED <br />000810 <br />Vitamin B-12 and Folate <br />20.00 <br />40.00 <br />001016 <br />Calcium, Serum <br />2.00 <br />4.00 <br />001057 <br />Uric Acid, Serum <br />2.00 <br />4.00 <br />001149 <br />Thyroxine (T4) <br />2.25 <br />4.50 <br />001156 <br />T3 Uptake <br />2.25 <br />4.50 <br />001172 <br />Triglycerides <br />2.00 <br />4.00 <br />001321 <br />Iron and TIBC <br />6.00 <br />12.00 <br />001396 <br />Amylase, Serum <br />6.00 <br />12.00 <br />001453 <br />Hemoglobin Alc <br />9.00 <br />18.00 <br />001818 <br />Glucose, Plasma <br />2.00 <br />4.00 <br />002139 <br />CEA <br />16.00 <br />32.00 <br />002188 <br />Tniodothyronine (T3) <br />4.00 <br />8.00 <br />004259 <br />TSH <br />4.50 <br />9.00 <br />004465 <br />Prolactin <br />12.00 <br />24.00 <br />004515 <br />Estradiol <br />20.00 <br />40.00 <br />004556 <br />hCG, Beta Subunit, Qual, Serum <br />6.00 <br />12.00 <br />005009 <br />CBC with DifferentiaI/Platelet <br />2.50 <br />5.00 <br />005199 <br />Prothrombin Time (PT) <br />3.00 <br />6.00 <br />005215 <br />Sedimentation Rate-Westergren <br />4.00 <br />8.00 <br />005280 <br />Reticulocyte Count <br />3.50 <br />7.00 <br />006072 <br />RPR <br />5.00 <br />10.00 <br />006189 <br />Mononucleosis Test, Qual <br />7.00 <br />14.00 <br />006254 <br />Antinuclear Antibodies (ANA) <br />9.00 <br />18.00 <br />007260 <br />Valproic Acid (Depakote), S <br />10.00 <br />20.00 <br />007336 <br />Theophylline, Serum <br />12.00 <br />24.00 <br />007385 <br />Digoxin (Lanoxin), Serum <br />10.00 <br />20.00 <br />007401 <br />Phenytoin (Dilantin), Serum <br />10.00 <br />20.00 <br />007419 <br />Carbamazepine (Tegretol), Serum <br />1200 . <br />24.00 <br />007708 <br />Lithium (Eskalith), Serum <br />9.00 <br />18.00 <br />007823 <br />Phenobarbital, Serum <br />10.00 <br />20.00 <br />008847 <br />Urine Culture, Routine <br />9.00 <br />18.00 <br />010322 <br />Prostate-specific Ag, Serum <br />10.00 <br />20.00 <br />028480 <br />FSH and LH <br />25.00 <br />50.00 <br />051102 <br />Fe+TIBC+Fer+Retic <br />13.50 <br />27.00 <br />083824 <br />Panel083824 <br />12.00 <br />24.00 <br />162289 <br />H. Pylori IgG, ABS <br />12.00 <br />24.00 <br />192005 <br />Gynecologic Mono-Layer Pap <br />25.00 <br />50.00 <br />235010 <br />Lipid Panel with LDUHDL Ratio <br />7.00 <br />14.00 <br />322000 <br />Comp. Metabolic Panel (14) <br />3.95 <br />7.90 <br />322744 <br />Hepatitis Panel (4) <br />45.00 <br />90.00 <br />322755 <br />Hepatic Function Panel (7) <br />2.90 <br />5.80 <br />322758 <br />Basic Metabolic Panel (8) <br />3.05 <br />6.10 <br />322777 <br />Renal Panel (10) <br />135 <br />6.70 <br />323589 <br />HFP7+IAC+CBC/D/Pit <br />5.55 <br />11.10 <br />799452 <br />799452 5 Drug Bund <br />18.90 <br />37.80 <br />Pregnancy Test <br />15.00 day clinic <br />20.00 eve clinic <br />STD testing and CD testing will continue to be performed at the State Lab for Public <br />Health (SLPH). <br />Most day clinic lab testing is sent to SLPH. LabCorp testing for day clinic is based on <br />a sliding fee scale. <br />