Contents and Information - Functional Medicine University

Contents and Information

P: 866.999.4041 F: 866.999.9175 W: www.ProfessionalCo-op.com2

Prices Subject to Change without Prior Notice.We Cannot Draw or Ship Specimens for Other Companies.

Professional Co-op® is proud to be celebrating 11 years of Service with Integrity. Ourvision back in 2000 was to make a ordable lab testing available to every quali edpractitioner in America – that continues to be our mission everyday. Please do nothesitate to contact us if you have any questions and one of our friendly sta memberswill be happy to assist you.

Professional Co-op® is pleased to o er BioStation™, a no-cost EHR by Soren Technology.BioStation™ is a web-based medical records solution, which can be accessed fromany web-enabled device. The best part is that the basic system is paid for with low-keyadvertising. The full PCS price compendium, now approaching 2,000 tests includingpanels, is available on BioStation™ for your ordering convenience.

Lab test orders can also be initiated directly through the Professional Co-op website.Requisition forms are no longer needed! The website ordering is convenient and userfriendly. Past orders are archived for easy access to repeat testing. All orderable testcodes, prices, and descriptions are available and updated in real time.

PCS is a part of the healthcare solution and we thank you for your continued support.

LabCorp’s entire Directory of Services isavailable online with technical information ontests. Go to LabCorp.com and click on theI Am a Healthcare Provider tab.

Visit LabTestsOnline.org for peer-reviewedinformation on many lab tests, as well asinformation on disease conditions.

The site is non-pro t and maintained by theAmerican Association for Clinical Chemistry(AACC) and other professional groups. It is a greatresource for both patient and doctor. PCS is proudto be a site sponsor for LabTestsOnline.org.

Visit ClinLabNavigator.com for over 500 detailedtest interpretive guides as well as other helpfulservices and information on speci c diseaseconditions.

This site is produced by Dr. Fred Plapp, MD,Ph.D, a board certi ed Clinical Pathologist atthe renowned St. Luke’s Hospital in KansasCity, MO. PCS is proud to be a site sponsor forClinLabNavigator.com.

Please see the Members tab ofProfessionalCo-op.com for technical informationon many tests in our pricelist. A downloadablePDF version of this pricelist is also available underthis tab listed as PDF Pricelist.

earch For LabCorpDraw Stations

You can nd draw station information at LabCorp.com. Please look under the I Am a Patient tab andclick on Find a Lab to enter a zip code and distance

preference. Online appointment scheduling isnow available for most LabCorp draw stations.

eed More TestInformation?

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Footnote Key

* See Panel Description1 Kit Must be Picked Up and Returned to Draw Station2 Extra Cost of $50 if Re ex Test is Necessary3 Extra Cost of $15 per Organism Sensitivity4 Call Professional Co-op at 866-999-4041 for Collection Kit5 Only Available at Select Draw Stations. Call 866-999-4041 Before Ordering6 Collection Available Monday-Wednesday Only7 Non-Invasive Algorithim to Assess Liver Damage8 Extra Cost of $69 if Re exed to HPV High Risk9 Extra Cost of $240 for Con rmation by Western Blot if Positive

10 Extra Cost of $30 for Urine Culture, if Indicated11 Extra Cost of $59 for tTG, IgG if IgA, Total is decreased.12 Test not performed for persons under the age of 18.13 Must Indicate Height and Weight on Lab Order14 Extra Cost of $15 per Parasite Identi cation

A $7 phlebotomy fee will be added to your total for each patient.

Service with Integrity Since 2001

S

Contents PagesSuper Panel Directory 3

Alphabetical Listing of All Tests 4-14

PCS Super Panel Tests 15-22

PCS Mini Panels 23-25

Test Category Lists 26-38

CPT Codes 39-47

Physician Notes 47-48

Tests requiring fasting are noted as “FASTING” throughoutlistings. Fasting is for 12 hours with water only.

Fasting

Some tests are noted as “AVOID EXERCISE” throughout listings.

Please avoid strenuous exercise for at least 24 to 48 hours priorto collection.

Avoid Exercise

3P: 866.999.4041 F: 866.999.9175 W: www.ProfessionalCo-op.com

Super Panel Directory

PCS™ Super Panels

See Pages 15 - 22 for tests included in panels with CPT codes

Special Coagulation Testing

Professional Co-op® is pleased to now o er special coagulation testing through Esoterix®!Esoterix® is a LabCorp® company that o ers cutting-edge methodologies as well as proprietary tests and discountedpricing that is exclusive to Professional Co-op® members.

Our sta is eager to answer any questions and can provide the Esoterix® Coagulation Test Directory, collectioninstructions, and an Esoterix® requisition form. Esoterix® tests cannot be ordered with a LabCorp requisition andrequire special collection instructions from Professional Co-op directly.

Please call our o ce at 866-999-4041 or email us directly at [email protected] for discounted pricing andspeci c ordering instructions.

Esoterix® tests o ered include:

Ordering Code | Panel Name Test Price202999 Opti-Chem™ $69.00 Fasting

339071 Opti-Plus™ $109.00 Fasting345572 Opti-Plus D™ $133.00 Fasting348421 Opti-Cardio™ $169.00 Fasting349751 Opti-Cardio Plus™ $179.00 Fasting346054 Opti-Plex™ $79.00 Fasting

346041 Opti-K-Plex™ $133.00 Fasting346029 Opti-K-Plex 2™ $179.00 Fasting373428 Opti-Thyro-Plex™ $215.00 Fasting297990 Maxi-Chem™ $65.00 Fasting381822 Mini-Chem™ $40.00 Fasting

365422 Best Value™ $229.00 Fasting502330 Hormone Panel A $150.00502340 Hormone Panel B $165.00

Ordering Code | Panel Name Test Price502510 Hormone Panel C $190.00

502511 Hormone Panel D $205.00503389 Hormone Panel E $165.00503390 Hormone Panel F $269.00341443 S.T.I. Panel $159.00331089 Thyroid Extender Panel™ $89.00

505015 T&B Lymphocyte/NK Cell Panel $129.00815295 Cytokine Panel A $279.00815250 Cytokine Panel B $219.00815494 Cytokine Panel C $139.00815557 Cytokine Panel D $139.00

601778 Allergen Panel - 96 Foods, IgE $259.00600550 Allergen Panel - 96 Foods, IgG $259.00600457 Allergen Panel - Mold, IgG $69.00

ISAC Coagulation Panel Hereditary Thrombosis Risk Panel (HTRP) Platelet Activation by Flow Cytometry Thrombin / Antithrombin Complexes

This is not a COMPLETE listing of tests o ered. Please see our website atwww.ProfessionalCo-op.com for the full PCS Test Directory.

4

Alphabetical Listing

* See Panel Description1 Kit Must be Picked Up and Returned to Draw Station 3 Extra Cost of $15 per Organism Sensitivity4 Call Professional Co-op at 866-999-4041 for Collection Kit

17- -Hydroxyprogesterone 070085 $120.00

ABO Grouping 006056 $12.00

ABO Grouping with Rh Factor 006049 $18.00

Actin (Smooth Muscle) Antibody (ASMA) 006643 $59.00

Adrenal 21-Hydroxylase Autoantibodies 500092 $69.00

Adrenocorticotropic Hormone (ACTH) 004440 $75.00

Aerobic Bacterial Culture 3, 4 008649 $30.00

Albumin, Serum 001081 $5.00

Aldolase 002030 $39.00

Aldosterone, Serum 004374 $79.00

Aldosterone, 24 Hour Urine 1 004291 $79.00

Alkaline Phosphatase, Bone Speci c 513002 $49.00

Alkaline Phosphatase Isoenzymes FASTING 001612 $50.00

Alkaline Phosphatase, Serum FASTING 001107 $5.00

Allergen Panel – 96 Foods, IgE * 601778 $259.00

Allergen Panel – 96 Foods, IgG * 600550 $259.00

Allergen Panel – Mold, IgG * 600457 $69.00

Alpha-1-Antitrypsin, Serum FASTING PREFERRED 001982 $49.00

Alpha-Fetoprotein (AFP), Tumor Marker Not a Screening Test 480012 $19.00

Alpha Subunit, Free 140269 $85.00

ALT (SGPT) 001545 $5.00

Aluminum, Serum or Plasma 071548 $59.00

Ammonia, Plasma FASTING 007054 $59.00

Amylase, Serum 001396 $19.00

Amylase Isoenzymes 123110 $75.00

Angiotensin-Converting Enzyme (ACE) 010116 $45.00

Antiadrenal Antibodies, Quantitative 082024 $49.00

Antibody Screen (Coombs’, Indirect) 006015 $15.00

Antibody Identi cation 006213 $45.00

Anticardiolipin Antibodies (ACA) IgA 161836 $50.00

Anticardiolipin Antibodies (ACA) IgG 161810 $50.00

Anticardiolipin Antibodies (ACA) IgM 161828 $50.00

Anticardiolipin Antibodies (ACA) IgG and IgM 161802 $99.00

Anticardiolipin Antibodies (ACA) IgA, IgG, IgM 161950 $149.00

Anticentromere B Antibodies 164814 $99.00

Antichromatin, IgG Antibodies 012580 $59.00

Antidiuretic Hormone (ADH) Pro le (Includes Osmolality, Serum) 046557 $285.00

Alphabetical Test ListingThis is not a COMPLETE listing of tests o ered. Please see our website at

www.ProfessionalCo-op.com for the full PCS Test Directory.

TEST NAME TEST CODE PRICESEE FOOTNOTES

5


TEST NAME TEST CODE PRICE

P: 866.999.4041 F: 866.999.9175 W: www.ProfessionalCo-op.com

3 Extra Cost of $15 per Organism Sensitivity 4 Call Professional Co-op at 866-999-4041 for Collection Kit

Anti-DNase B (Streptococcal) Antibodies 096289 $109.00

Anti-dsDNA (Double-Stranded) Antibodies, EIA 096339 $59.00

Antihistone Antibodies 012518 $59.00

Anti-Jo-1 Antibody 161455 $105.00

Anti-Müllerian Hormone (AMH), Serum 500183 $89.00

Antimyelin Associated Glycoprotein, IgG (Mag Ab) 806387 $59.00

Antimyelin Associated Glycoprotein, IgM (Mag Ab) 808973 $79.00

Antinuclear Antibodies (ANA), IFA with FANA Pattern 164947 $29.00

Antipancreatic Islet Cells 160721 $59.00

Antiparietal Cell Antibodies (APCA) 006486 $59.00

Antiphosphatidylserine Antibodies, IgA 117906 $59.00

Antiphosphatidylserine Antibodies, IgG 117952 $59.00

Antiphosphatidylserine Antibodies, IgM 117900 $59.00

Antiphosphatidylserine Antibodies, IgA, IgG, IgM 117994 $175.00

Antiscleroderma-70 Antibodies 018705 $59.00

Antistreptolysin O Antibody (ASO) 006031 $25.00

Antithyroglobulin Antibody (TGA) 006692 $25.00

Apolipoprotein A-1 FASTING 016873 $18.00

Apolipoprotein Assessment (A-1/B/+Ratio) FASTING 216010 $32.00

Apolipoprotein B FASTING 167015 $14.00

Ascaris Allergy, IgE 064618 $5.00

ASO Antibodies (Antistreptolysin O Antibody) 006031 $25.00

AST (SGOT) 001123 $5.00

B-Type Natriuretic Peptide (BNP) 140889 $75.00

Babesia microti Antibodies, IgG and IgM 138315 $89.00

Beta-2 Microglobulin, Serum 010181 $29.00

Beta-2 Microglobulin, Random Urine 010173 $29.00

Bile Acids FASTING 010330 $39.00

Bilirubin, Direct 001222 $5.00

Bilirubin, Total, Direct, and Indirect 001214 $10.00

Blood Culture 3 008300 $50.00

Bordetella pertussis, Nasopharyngeal Culture 4 180224 $50.00

BUN and Creatinine 024778 $9.00

C-Peptide of Insulin 010108 $52.00

C-Reactive Protein (CRP), High Sensitivity (Cardiac) 120766 $19.00

C-Telopeptide, Serum 500089 $79.00

CA 125 (Cancer Antigen) Not a Screening Test 002303 $39.00

CA 15-3 (Cancer Antigen) Not a Screening Test 143404 $29.00

CA 19-9 (Carbohydrate Antigen) Not a Screening Test 002261 $39.00

CA 27.29 (Cancer Antigen) Not a Screening Test 140293 $39.00

Calcitonin FASTING 004895 $109.00

SEE FOOTNOTES

6



TEST NAME TEST CODE PRICECalcium, Serum FASTING 001016 $5.00

Calculi, Urinary (Kidney Stone Analysis) 4 120790 $75.00

Candida albicans Allergy, IgG 663231 $25.00

Carbon Dioxide, Total 001578 $5.00

Carboxyhemoglobin (CO) 007187 $55.00

Carotene, FASTING 001529 $45.00

Catecholamines, Fractionated, Plasma 084152 $45.00

Catecholamines, Urinary Free, 24 Hour Urine 1 004176 $79.00

Catecholamines, Urinary Free, Random Urine 1 316203 $69.00

CBC with Di erential and Platelet Count 005009 $10.00

CCP Antibodies, IgA and IgG (Cyclic Citrullinated Peptide or CPA) 164914 $39.00

CD 4 / CD 8 Ratio Pro le * 505271 $79.00

CD 57 (HNK1) Panel * 505026 $69.00

CEA Not a Screening Test 002139 $25.00

Celiac Disease HLA DQ Association 167082 $179.00

Celiac Disease Pro le * 11 165142 $125.00

Celiac Disease Comprehensive Pro le * 165126 $289.00

Ceruloplasmin (CER) 001560 $29.00

Chlamydia pneumoniae Antibodies, IgG and IgM 138338 $88.00

Chlamydia trachomatis by NAA, Urine 1 188078 $39.00

Chlamydia / Gonococcus by NAA, Urine 1 183194 $79.00

Chloride, Serum 001206 $5.00

Cholinesterase, RBC 007286 $39.00

Cholinesterase, Serum 007211 $39.00

Cholinesterase, Serum and RBC 028290 $78.00

Clostridium di cile Toxins A & B, EIA 1 086207 $69.00

CO2, Total 001578 $5.00

Coenzyme Q10, Total 120251 $79.00

Coccidioides Antibodies, DID 164301 $59.00

Cold Agglutinin Titer, Quantitative 006353 $45.00

Complement C1 Esterase Inhibitor, Serum 004648 $59.00

Complement C2, Serum 161414 $59.00


Complement C3a 004220 $79.00


Complement C4a 004330 $79.00

Complement, Total (CH50) 001941 $69.00

Comprehensive Metabolic Panel (CMP14) * FASTING 322000 $15.00

Coombs’, Direct 006270 $25.00

Coombs’, Indirect (Antibody Screen) 006015 $15.00

Copper, Serum or Plasma 001586 $85.00

* See Panel Description 4 Call Professional Co-op at 866-999-4041 for Collection Kit1 Kit Must be Picked Up and Returned to Draw Station 11 Extra Cost of $59 for tTG, IgG if IgA, Total is decreased.

SEE FOOTNOTES

7



* See Panel Description1 Kit Must be Picked Up and Returned to Draw Station 13 Must Indicate Height and Weight on Lab Order

Cortisol, 24 Hour Urine, HPLC 1 004432 $69.00

Cortisol, AM 104018 $19.00

Cortisol, PM 104026 $19.00

Cortisol, Random 004051 $19.00

C-Peptide of Insulin 010108 $52.00

C-Reactive Protein (CRP), High Sensitivity (Cardiac) 120766 $19.00

Creatinine, Serum 001370 $5.00

Creatinine Clearance, 24 Hour Urine 1, 13 003004 $35.00

Creatine Kinase (CK/CPK) AVOID EXERCISE 001362 $5.00

Creatine Kinase (CK) Isoenzymes AVOID EXERCISE 002154 $50.00

Creatine Kinase (CK), MB 120816 $40.00

Creatine Kinase (CK), Total and MB AVOID EXERCISE 002311 $45.00

Creatinine / Total Protein, Random Urine 003129 $40.00

Cryptosporidium and Isospora, Stool 1 182378 $55.00

C-Telopeptide, Serum 500089 $79.00

Cystatin C FASTING PREFERRED 121251 $79.00

Cytokine Panel A, Plasma, Luminex * 815295 $279.00

Cytokine Panel B, Plasma, Luminex * 815250 $219.00

Cytokine Panel C, Plasma, Luminex * 815494 $139.00

Cytokine Panel D, Plasma, Luminex * 815557 $139.00

Cytomegalovirus (CMV), IgG 006494 $39.00

Cytomegalovirus (CMV), IgM 096727 $39.00

Cytomegalovirus (CMV), IgG and IgM 221085 $78.00

D-Dimer 115188 $65.00

Deoxypyridinoline (DPD) Cross-Links, Random Urine 511105 $49.00

DHEA-Sulfate, ECLIA 004020 $25.00

DHEA-Sulfate, RIA 500161 $25.00

Dihydrotestosterone (DHT), HPLC/MS 500142 $45.00

Drug Screen (Urine Test - 9 Elements) * 788681 $50.00

Endomysial Antibody, IgA 164996 $69.00

Eosinophil Cationic Protein (ECP) 004180 $79.00

Epstein-Barr Pro le (EBV) * 216655 $115.00

Erythrocyte Sedimentation Rate (ESR) - Westergren 005215 $12.00

Estradiol, Serum, ECLIA 004515 $25.00

Estradiol, Serum, LC/MS/MS 500108 $25.00

Estriol, Serum 004614 $29.00

Estrogens, Total, RIA 004549 $29.00

Estrone 004564 $42.00

Ferritin 004598 $10.00

Ferritin, Iron, and TIBC (Total Iron Binding Capacity) FASTING PREFERRED 030825 $22.00

Fibrinogen Activity 001610 $20.00

SEE FOOTNOTES

8



* See Panel Description1 Kit Must be Picked Up and Returned to Draw Station 3 Extra Cost of $15 per Organism Sensitivity4 Call Professional Co-op at 866-999-4041 for Collection Kit 7 Non-Invasive Algorithim to Assess Liver Damage8 Extra Cost of $69 if Re exed to HPV High Risk 13 Must Indicate Height and Weight on Lab Order

FibroSure® - NASH (Fatty Liver Disease Assessment) * 7, 13 550140 $229.00

FibroSure® - ASH (Alcoholic Liver Disease Assessment) * 7, 13 550180 $229.00

FibroSure® - Hepatitis C Virus (HCV Liver Status Assessment) * 7, 13 550123 $189.00

Folate (Folic Acid) FASTING PREFERRED 002014 $16.00

Folate, RBC 266015 $49.00

Follicle-Stimulating Hormone (FSH) 004309 $22.00

FSH & LH (Follicle-Stimulating & Luteinizing Hormones) 028480 $42.00

Fungus Culture with Stain 4 188243 $79.00

GAD-65 Autoantibody (Glutamic Acid Decarboxylase) 143008 $69.00

Gastrin, Serum FASTING 004390 $49.00

Genital Culture 3, 4 008334 $30.00

Gestational Diabetes Evaluation, 1 Hour Screen 102277 $10.00

GGT FASTING 001958 $5.00

Giardia lamblia, Direct Detection EIA 1 182204 $49.00

Gliadin Antibodies, IgA (Deamidated) 161646 $45.00

Gliadin Antibodies, IgG (Deamidated) 161687 $45.00

Gliadin Antibodies, IgA and IgG (Deamidated) 163402 $89.00

Glucose, Plasma FASTING 001818 $5.00

Glucose, Serum FASTING 001032 $5.00

Glucose, 1 Hour Post Prandial 101303 $10.00

Glucose, 2 Hour Post Prandial 002022 $10.00

Glucose 6 Phosphate Dehydrogenase (G6PD) Quant., Blood and RBC 001917 $39.00

Glucose/Insulin Response - 4 Specimens FASTING 146696 $110.00

Glucose Tolerance Test (GTT) - 5 Specimens FASTING 090373 $50.00

Glutathione, Total, Whole Blood 823542 $79.00

Gluten Allergy, IgE 069781 $10.00

Gluten Allergy, IgG 663073 $10.00

Glycohemoglobin (GHB), Total 001693 $22.00

Gonococcus (Neisseria gonorrhoeae) by NAA, Urine 1 188086 $39.00

Chlamydia / Gonococcus by NAA, Urine 1 183194 $79.00

Group A Streptococcus Culture (Beta Strep) 4 008169 $30.00

Group B Streptococcus Culture 4 188128 $30.00

Growth Hormone, RIA 500632 $59.00

Gynecologic Pap Test - Image Guided (IG) 4 193000 $49.00

Gynecologic Pap Test (IG) and HPV High and Low Risk 4 198190 $128.00

Gynecologic Pap Test (IG) w/ re ex to HPV High Risk when ASC-US 4, 8 194540 $49.00

Gynecologic Pap Test (IG) w/ re ex to HPV High Risk 4, 8 196250 $49.00

Gynecologic Pap Test (IG) and GC/ Chlamydia 4 196402 $109.00

Gynecologic Pap Test (IG) and Chlamydia 4 197676 $79.00

Gynecologic Pap Test (IG) and GC/ Chlamydia and HPV High Risk 4 192153 $178.00

Gynecologic Pap Test (IG) and GC/ Chlamydia, re ex to HPV High Risk 4, 8 196565 $109.00

SEE FOOTNOTES

9



* See Panel Description 1 Kit Must be Picked Up and Returned to Draw Station5 Only Available at Select Draw Stations. Call Before Ordering 7 Non-Invasive Algorithim to Assess Liver Damage8 Extra Cost of $69 if Re exed to HPV High Risk 9 Extra Cost of $65 for Con rmation by Western Blot if Positive12 Test not performed for persons under the age of 18. 13 Must Indicate Height and Weight on Lab Order

Haptoglobin, Serum AVOID EXERCISE 001628 $39.00

HCG, Beta, Serum (Human Chorionic Gonadotropin), Quantitative 004416 $25.00

Helicobacter pylori Antibodies, IgA, IgG, IgM 163683 $55.00

Helicobacter pylori Stool Antigen 1 180764 $69.00

Helicobacter pylori Urea Breath Test 5, 12 180836 $89.00

Hemochromatosis, DNA Analysis 511345 $265.00

Hemogloblin (HGB) A1c 001453 $20.00

Hemoglobinopathy Pro le & Solubility (HGB Electrophoresis) * 121679 $79.00

Hemoglobin Solubility (Sickle Cell Test) 005223 $49.00

Hepatic Function Panel * FASTING 322755 $15.00

Hepatitis 5 (HP5) Panel * 303744 $90.00

Hepatitis A, Total Antibodies (For Acute use IgM) 006726 $25.00

Hepatitis A, IgM 006734 $34.00

Hepatitis B Core Antibody, IgM 016881 $25.00

Hepatitis B Core Antibody, Total 006718 $19.00

Hepatitis B Surface Antibody 006395 $19.00

Hepatitis B Surface Antigen 006510 $19.00

Hepatitis C Virus (HCV) Antibody 140659 $29.00

Hepatitis C Virus (HCV) FibroSure ® * 7, 13 550123 $189.00

Hepatitis C Virus (HCV), Real Time PCR (Viral Load) 550080 $179.00

Hereditary Hemochromatosis, DNA Analysis 511345 $265.00

Herpes Simplex (HSV) Type I Speci c, IgG 164897 $50.00

Herpes Simplex (HSV) Type II Speci c, IgG 163147 $65.00

Herpes Simplex (HSV) Types I and II Speci c, IgG 138815 $99.00

Herpes Varicella Zoster, IgG (Chicken Pox) 096206 $39.00

HIV (Re exes to Western Blot if Positive) 9 083824 $25.00

HLA B 27 Disease Association 006924 $69.00

HLA DQ Association (Celiac Disease) 167082 $179.00

HLA DRB, DQB, Typing 012542 $199.00

HNK1 (CD 57) Panel * 505026 $69.00

Homocysteine FASTING PREFERRED 706994 $25.00

H. pylori Antibodies, IgA, IgG, IgM 163683 $55.00

H. pylori Stool Antigen 1 180764 $69.00

H. pylori Urea Breath Test 5, 12 180836 $89.00

Human Herpes Virus Type 6 (HHV-6), IgG 161075 $129.00

Human Herpes Virus Type 6 (HHV-6), IgM 138529 $165.00

IA2 Autoantibodies 141531 $99.00

IgA, Total Antibodies FASTING 001784 $15.00

IgE, Total Antibodies FASTING 002170 $15.00

IgG, Total Antibodies FASTING 001776 $15.00

IgM, Total Antibodies FASTING 001792 $15.00

SEE FOOTNOTES



10 * See Panel Description 1 Kit Must be Picked Up and Returned to Draw Station

IgA, E, G, M, Total Antibodies FASTING 002295 $59.00

IGF-1 (Insulin-Like Growth Factor) 010363 $39.00

IGF, Binding Protein 3 (Insulin-Like Growth Factor) 140152 $89.00

Immuno xation (IFE), Serum FASTING 001685 $35.00

Immuno xation (IFE) and Protein Electrophoresis, Serum FASTING 001495 $89.00

Inhibin B 146795 $245.00

Insulin Autoantibodies (IAA) 141598 $49.00

Insulin FASTING 004333 $25.00

Insulin, 1 Hour 014357 $25.00

Insulin, 2 Hour 312114 $25.00

Post Prandial Mini Panel * FASTING 337823 $39.00

Interleukin 1 (IL-1 ), Serum 805255 $79.00

Interleukin 2 (IL-2), Serum, ELISA 140912 $39.00






Interleukin 12p70 (IL-12p70), Serum, ELISA 805263 $64.00


Interferon (INF ), Serum, ELISA 805259 $79.00

Cytokine Panel A, Plasma, Luminex * 815295 $279.00

Cytokine Panel B, Plasma, Luminex * 815250 $219.00

Cytokine Panel C, Plasma, Luminex * 815494 $139.00

Cytokine Panel D, Plasma, Luminex * 815557 $139.00

Intrinsic Factor Blocking Antibodies 010413 $79.00

Iodine, Serum or Plasma 070034 $49.00

Iron, Serum FASTING PREFERRED 001339 $5.00

Iron/TIBC (Total Iron Binding Capacity) FASTING PREFERRED 001321 $12.00

Kidney Stone Analysis 1 120790 $75.00

Kidney Stone Formation Risk Panel with Saturation, 24 Hour Urine * 1 306266 $269.00

LDH, Isoenzymes AVOID EXERCISE 001842 $50.00

LDH, Serum AVOID EXERCISE 001115 $5.00

Lead, Blood (Adult) 007625 $35.00

Lead, Blood (Pediatric) 717009 $35.00

Leptin 146712 $55.00

LH (Luteinizing Hormone) 004283 $22.00

Lipase, Serum 001404 $30.00

Lipid Panel * FASTING 235010 $15.00

Lipoprotein (a) 120188 $19.00

Lipoprotein Phenotyping FASTING 235036 $62.00

SEE FOOTNOTES




11* See Panel Description1 Kit Must be Picked Up and Returned to Draw Station 3 Extra Cost of $15 per Organism Sensitivity4 Call Professional Co-op at 866-999-4041 for Collection Kit 14 Extra Cost of $15 per Parasite Identi cation

Lithium, Serum 007708 $35.00

Lower Respiratory Culture 3, 4 180810 $30.00

Lupus Anticoagulant (PTT-LA) 117002 $65.00

Luteinizing Hormone (LH) 004283 $22.00

Lyme Antibodies Total and IgM Responses, EIA 223586 $69.00

Lyme Disease, PCR 550012 $269.00

Lyme Disease, Western Blot 163600 $37.00

Magnesium, Serum 001537 $5.00

Magnesium, RBC 080283 $25.00

MMP - 9 (Matrix Metalloproteinase - 9) 500124 $59.00

Melanocyte–Stimulating Hormone (MSH) 010421 $79.00

Methylmalonic Acid, Serum 706961 $89.00

Methylmalonic Acid, Random Urine 716365 $85.00

Microalbumin / Creatinine Ratio, Urine 140285 $39.00

Mineral Pro le, RBC * 811394 $289.00

Mitochondrial (M2) Antibody 006650 $59.00

MMR (Measles, Mumps, Rubella) 058495 $99.00

Mononucleosis, Qualitative 006189 $19.00

MTHFR (Methylenetetrahydrofolate Reductase Thermolabile Variant), DNA Analysis 511238 $99.00

Mycoplasma pneumoniae, IgG 163741 $55.00

Mycoplasma pneumoniae, IgM 163212 $55.00

Mycoplasma pneumoniae, IgG and IgM 163758 $99.00

NMR Lipopro le ® FASTING 884247 $65.00

N-Telopeptide, Random or 24 Hour Urine 1 511097 $49.00

Occult Blood, Fecal, Immunoassay 1 182949 $49.00

Osmolality, Serum 002071 $36.00

Osteocalcin 010249 $49.00

Ova and Parasites Exam, Stool 1, 14 008623 $29.00

Ovarian Antibodies, IgG 808616 $59.00

Pancreatic Islet Cell Antibody 160721 $59.00

Parathyroid Hormone (PTH) FASTING PREFERRED 335398 $45.00

Parietal Cell Antibodies (APCA) 006486 $59.00

Partial Thromboplastin Time (PTT), Activated 005207 $15.00

Partial Thromboplastin Time (PTT), Lupus Anticoagulant 117002 $65.00

Phosphorus, Serum FASTING 001024 $5.00

PLAC Test ® (Lipoprotein Associated Phospholipase A2) 123240 $59.00

Platelet Antibody, Direct 500054 $99.00

Platelet Count, Citrated Blood 115345 $10.00

Porphyrins, Quantitative, 24 Hour Urine 1 003194 $49.00

Potassium, Serum FASTING 001180 $5.00

Pregnancy Test, Serum 004416 $25.00

SEE FOOTNOTES




12

Pregnenolone, MS 140707 $49.00

Prenatal Pro le * 202945 $54.00

Progesterone, Serum, ECLIA 004317 $25.00

Progesterone, Serum, HPLC/MS 500167 $25.00

Prolactin 004465 $29.00

Prostate-Speci c Antigen (PSA), Serum 010322 $25.00

Prostate-Speci c Antigen (PSA), Total and Free 480947 $42.00

Prostatic Acid Phosphatase (PAP) Not a Screening Test 004747 $45.00

Protein Electrophoresis, 24 Hour Urine 1 003368 $69.00

Protein Electrophoresis, Random Urine 354928 $49.00

Protein Electrophoresis, Serum 001487 $39.00

Protein Electrophoresis and Immuno xation (IFE), Serum FASTING 001495 $89.00

Protein, Total 001073 $5.00

Prothrombin Time (PT/INR) 005199 $15.00

Prothrombin Time (PT/INR) + Partial Thromboplastin Time (PTT), Activated 020321 $30.00

PSA, Serum 010322 $25.00

PSA, Total and Free 480947 $42.00

QuantiFERON-TB Gold (Tuberculosis Screening Test) 182873 $125.00

Renal Function Panel * FASTING 322777 $15.00

Renin Activity, Plasma 002006 $115.00

Reticulocyte Count 005280 $12.00

Reverse T3 070104 $35.00

Rheumatoid Arthritis Factor 006502 $25.00

Rocky Mountain Spotted Fever (Rickettsia rickettsii), IgG 016592 $69.00

RPR (Syphilis) 006072 $20.00

Saccharomyces cerevisiae, IgA and IgG (Crohn's Disease) 164657 $99.00

Sedimentation Rate (ESR) - Westergren 005215 $12.00

Serotonin, Serum 120204 $89.00

Serotonin, Whole Blood 120089 $89.00

Sex Hormone Binding Globulin 082016 $39.00

Sexually Transmitted Infection Panel * 341443 $159.00

Sickle Cell Test (Hemoglobin Solubility) 005223 $49.00

Sjögren’s Antibodies (Anti-SS-A/Anti-SS-B) 012708 $79.00

Sodium, Serum 001198 $5.00

Soluble Liver Antigen, IgG 007441 $75.00

Soluble Transferrin Receptor 143305 $69.00

Spermatozoa Antibodies 808813 $79.00

Stool Culture 1, 3 008144 $85.00

Syphilis Screen 006072 $20.00

T3, Reverse 070104 $35.00

T3, Total (Triiodothyronine, Total) 002188 $15.00

* See Panel Description3 Extra Cost of $15 per Organism Sensitivity 1 Kit Must be Picked Up and Returned to Draw Station

SEE FOOTNOTES



13* See Panel Description 10 Extra Cost of $30 for Urine Culture, if Indicated3 Extra Cost of $15 per Organism Sensitivity 4 Call Professional Co-op at 866-999-4041 for Collection Kit

T3, Free (Triiodothyronine, Free) 010389 $20.00

T4, Free, Direct (Thyroxine, Free) 001974 $20.00

T4, Free, Direct, and T3, Free 214540 $40.00

T4, Total (Thyroxine, Total) 001149 $7.00

T and B Lymphocyte / Natural Killer Cell (CD56) Panel * 505015 $129.00

Testosterone, Total and Free, HPLC/MS 070038 $69.00

Testosterone, Total, Serum, LC/MS-MS 070001 $29.00

Thyroid Antithyroglobulin Antibody (TGA) 006692 $25.00

Thyroid Autoantibodies (TPO and TGA) 006684 $49.00

Thyroid Extender Panel * 331089 $89.00

Thyroid Panel with Thyroid-Stimulating Hormone (TSH) * 000620 $22.00

Thyroid Peroxidase Antibodies (TPO) 006676 $25.00

Thyroid-Stimulating Hormone (TSH) 004259 $12.00

Thyroid-Stimulating Hormone (TSH); Free T4, Direct; Free T3 376137 $52.00

Thyroid-Stimulating Immunoglobulin (TSI) 140749 $99.00

Thyrotropin Receptor Antibody, Serum 010314 $79.00

Thyroxine Binding Globulin (TBG) 001735 $45.00

Thyroxine, Free (T4, Free), Direct 001974 $20.00

Thyroxine, Total (T4, Total) 001149 $7.00

Thyroxine, Free (T4, Free), Direct and Triiodothyronine, Free (T3, Free) 214540 $40.00

TIBC + Iron, Serum FASTING PREFERRED 001321 $12.00

Tissue Transglutaminase (tTG), IgA 164640 $59.00

Tissue Transglutaminase (tTG), IgG 164988 $59.00

Toxoplasma gondii, IgG 006478 $59.00

Toxoplasma gondii, IgM 096651 $59.00

Toxoplasma gondii, PCR 138602 $199.00

Transferrin FASTING PREFERRED 004937 $15.00

Triiodothyronine, Free (T3, Free) 010389 $20.00

Triiodothyronine, Total (T3, Total) 002188 $15.00

Troponin I 120832 $129.00

TSH (Thyroid-Stimulating Hormone) 004259 $12.00

TSH; Free T4, Direct; Free T3 376137 $52.00

TSI (Thyroid-Stimulating Immunoglobulin) 140749 $99.00

Tuberculosis Screening Test 182873 $125.00

Tumor Growth Factor -1 (TGF- 1) 905036 $99.00

Tumor Necrosis Factor (TNF ), Serum 140673 $49.00

Upper Respiratory Culture 3, 4 008342 $30.00

Urea Nitrogen (BUN), Serum 001040 $5.00

Urinalysis, Routine 003038 $10.00

Urinalysis, Complete with Re ex to Urine Culture with Sensitivity 3, 10 377069 $10.00

Uric Acid, Serum FASTING 001057 $5.00

SEE FOOTNOTES




14

Urine Culture, Routine with Sensitivity 3 008847 $30.00

VAP™ Cholesterol Test * FASTING 804500 $69.00

Varicella Zoster, IgG (Chicken Pox) 096206 $39.00

Vascular Endothelial Growth Factor (VEGF), Plasma 117006 $99.00

Vasoactive Intestinal Polypeptide (VIP), Plasma 010397 $99.00

Vitamin A, Serum FASTING 017509 $45.00

Vitamin B-1 (Thiamine), Plasma 121178 $49.00

Vitamin B-3 (Niacin), Plasma 070115 $99.00

Vitamin B-5 (Pantothenic Acid), Plasma 070086 $99.00

Vitamin B-6 (Pyridoxal 5-Phosphate), Plasma 004655 $59.00

Vitamin B-7 (Biotin), Serum or Plasma 070097 $99.00

Vitamin B-12, Serum FASTING PREFERRED 001503 $16.00

Vitamin B-12 and Folate (Folic Acid), Serum FASTING PREFERRED 000810 $32.00

Vitamin C, Serum or Plasma 001479 $49.00

Vitamin D, 1,25 Dihydroxy (Calcitriol) 081091 $45.00

Vitamin D, 25-Hydroxycalciferol 081950 $29.00

Vitamin D, 25-Hydroxycalciferol and Vitamin D, 1,25 Dihydroxy (Calcitriol) 080325 $74.00

Vitamin E, Serum or Plasma 081000 $49.00

Vitamin K1, Serum or Plasma 121200 $79.00

Zinc, Serum or Plasma 001800 $49.00

Zinc, RBC 070029 $49.00

NOTES:

SEE FOOTNOTES

* See Panel Description 3 Extra Cost of $15 per Organism Sensitivity

Professional Co-op® Super Panels



Custom Super Panels are non-reimbursable tests for insurance purposes. It may be possible to getreimbursement for some of the individual components depending on the type of policy and based onproper diagnostic codes. CPT codes are furnished if you want to bill insurance through your o ce.

Please Note: CPT codes are not diagnostic or ordering codes.

Opti-Chem™Ordering Code: 202999 Cost: $69.00 Fasting/Avoid Exercise

Includes - Glucose, Serum; Uric Acid, Serum; BUN; Creatinine, Serum; Sodium, Serum; Potassium,Serum; Chloride, Serum; Carbon Dioxide, Total; Calcium, Serum; Phosphorus, Serum; Magnesium,Serum; Protein, Total, Serum; Albumin, Serum; Globulin, Total; A/G Ratio; Bilirubin, Total; AlkalinePhosphatase, Serum; LDH; AST (SGOT); ALT (SGPT); GGT; Iron, Serum; Cholesterol, Total;Triglycerides; HDL Cholesterol; VLDL Cholesterol Calculation; LDL Cholesterol Calculation; TotalCholesterol/HDL Ratio; LDL/HDL Ratio; TSH; Thyroxine (T4), Total; T3 Uptake; Free Thyroxine Index;CBC with Di erential and Platelet Count.

CPT Codes85025 CBC / Di erential & Platelet Count 84100 Phosphorus, Serum82977 GGT 84436 T483540 Iron 84443 TSH80061 Lipid Panel 84479 T3 Uptake83735 Magnesium 84550 Uric Acid80053 Metabolic Panel, Comprehensive 81003 Urinalysis83615 LDH

Opti-Plus™Ordering Code: 339071 Cost: $109.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus Hb A1c; TIBC & % Iron Saturation;Ferritin; C-Reactive Protein (High Sensitivity).

CPT Codes– see Opti-Chem for other codes83036 Hemoglobin A1c 83550 TIBC/% Saturation86141 C-Reactive Protein, High Sensitivity 82728 Ferritin

16

Contents and InformationProfessional Co-op® Super Panels


Opti-Plus D™Ordering Code: 345572 Cost: $133.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus Hb A1c; TIBC & % Iron Saturation;Ferritin; C-Reactive Protein (High Sensitivity); 25-Hydroxy Vitamin D.

CPT Codes– see Opti-Chem for other codes82306 Vitamin D, 25-Hydroxycalciferol 83036 Hemoglobin A1c83550 TIBC/% Saturation 82728 Ferritin86141 C-Reactive Protein, High Sensitivity

Opti-Cardio™Ordering Code: 348421 Cost: $169.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus Hb A1c; TIBC & % Iron Saturation;Ferritin; C-Reactive Protein (High Sensitivity); 25-Hydroxy Vitamin D; Homocysteine; FibrinogenActivity.

CPT Codes– see Opti-Chem for other codes83036 Hemoglobin A1c 83550 TIBC/% Saturation86141 C-Reactive Protein, High Sensitivity 82728 Ferritin82306 Vitamin D, 25-Hydroxycalciferol 83090 Homocysteine85384 Fibrinogen Activity

Opti-Cardio Plus™Ordering Code: 349751 Cost: $179.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Cardio™ Panel plus Insulin, Fasting.

CPT Codes– see Opti-Chem for other codes83036 Hemoglobin A1c 83550 TIBC/% Saturation86141 C-Reactive Protein, High Sensitivity 82728 Ferritin82306 Vitamin D, 25-Hydroxycalciferol 83090 Homocysteine85384 Fibrinogen Activity 83525 Insulin, Fasting

Opti-Plex™Ordering Code: 346054 Cost: $79.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus Triiodothyronine (Total T3).

CPT Codes– see Opti-Chem for other codes84480 Triiodothyronine, Total



Opti-K-Plex™Ordering Code: 346041 Cost: $133.00 Fasting/Avoid Exercise

Includes - All the components of an Opti-Chem™ Panel plus Triiodothyronine (Total T3); Hb A1c;Ferritin; TIBC & % Iron Saturation; 25-Hydroxy Vitamin D. This panel does not include C-ReactiveProtein (High Sensitivity).

CPT Codes– see Opti-Chem for other codes83036 Hemoglobin A1c 83550 TIBC/% Saturation82728 Ferritin 84480 Triiodothyronine, Total82306 Vitamin D, 25-Hydroxycalciferol

Opti-K-Plex 2™Ordering Code: 346029 Cost: $179.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus Triiodothyronine (Total T3); Hb A1c;Ferritin; TIBC & % Iron Saturation; 25-Hydroxy Vitamin D; C-Reactive Protein (High Sensitivity);Homocysteine; Fibrinogen Activity.

CPT Codes– see Opti-Chem for other codes83036 Hemoglobin A1c 83550 TIBC/% Saturation82728 Ferritin 84480 Triiodothyronine, Total82306 Vitamin D, 25-Hydroxycalciferol 83090 Homocysteine85384 Fibrinogen Activity 86141 C-Reactive Protein, High Sensitivity

Opti-Thyro-Plex™Ordering Code: 373428 Cost: $215.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus Triiodothyronine (Total T3); Hb A1c;Ferritin; TIBC & % Iron Saturation; 25-Hydroxy Vitamin D; C-Reactive Protein (High Sensitivity);Homocysteine; Fibrinogen Activity; Thyroid Peroxidase Ab (TPO); Thyroid Antithyroglobulin Ab(TGA); T4, Free; T3, Free.

CPT Codes85025 CBC / Di erential & Platelet Count 84100 Phosphorus, Serum82977 GGT 84436 T483540 Iron 84443 TSH80061 Lipid Panel 84479 T3 Uptake86376 TPO Ab 86800 TGA84481 T3, Free 84439 T4, Free83735 Magnesium 84550 Uric Acid80053 Metabolic Panel, Comprehensive 81003 Urinalysis83615 LDH

18



Mini-Chem™Ordering Code: 381822 Cost: $40.00 Fasting/Avoid Exercise

Includes - Glucose, Serum; Uric Acid, Serum; BUN; Creatinine, Serum; BUN:Creatinine Ratio; Sodium,Serum; Potassium, Serum; Chloride, Serum; Carbon Dioxide, Total; Calcium, Serum; Phosphorus, Serum;Protein, Total, Serum; Albumin, Serum; Globulin, Total; A/G Ratio; Bilirubin, Total; Alkaline Phosphatase,Serum; LDH; AST (SGOT); ALT (SGPT); Iron, Serum; Cholesterol, Total; Triglycerides; HDL Cholesterol; VLDLCholesterol Calculation; LDL Cholesterol Calculation; Total Cholesterol/HDL Cholesterol Ratio; CBC withDi erential and Platelet Count.

CPT Codes85025 CBC / Di erential and Platelet Count 83540 Iron80061 Lipid Panel 84100 Phosphorus, Serum80053 Metabolic Panel, Comprehensive 84550 Uric Acid83615 LDH

Best Value™Ordering Code: 365422 Cost: $229.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel plus IgA, Total, Quantitative; IgE, Total, Quantitative;IgG, Total, Quantitative; IgM, Total, Quantitative; Cortisol; ANA, IFA with FANA Pattern; Beta-2 Microglobulin,Random Urine; Beta-2 Microglobulin, Serum; C-Reactive Protein, High Sensitivity; Glucose 6PD, Quant., Blood,& RBC; Iron/ TIBC; Ferritin; Creatine Kinase, Total

CPT Codes80053 Metabolic Panel, Comprehensive80061 Lipid Panel81003 Urinalysis82977 GGT83615 LDH83735 Magnesium, Serum84100 Phosphorus Serum84436 T484443 TSH84479 T3 Uptake85025 CBC/ Di erential with Platelet Count84550 Uric Acid, Serum82784 IgA, Total, Quantitative

82785 IgE, Total, Quantitative82784 IgG, Total, Quantitative82784 IgM, Total, Quantitative82533 Cortisol86038 ANA, IFA with FANA Pattern82232 Beta-2 Microglobulin, Random Urine82232 Beta-2 Microglobulin, Serum86140 C-Reactive Protein, High Sensitivity82955, 85041 Glucose 6PD, Quant., Blood, & RBC83540, 83550 Iron/ TIBC82728 Ferritin82550 Creatine Kinase, Total

Maxi-Chem™Ordering Code: 297990 Cost: $65.00 Fasting/Avoid Exercise

Includes - All the components of the Opti-Chem™ Panel EXCEPT does not include Urinalysis, Magnesium orTSH; but does include Ferritin.

CPT Codes85025 CBC / Di erential and Platelet Count 82728 Ferritin82977 GGT 83540 Iron83615 LDH 84100 Phosphorus, Serum80061 Lipid Panel 84479 T3 Uptake84436 T4 84550 Uric Acid80053 Metabolic Panel, Comprehensive



Hormone Panel DOrdering Code: 502511 Cost: $205.00

Includes - Pregnenolone; Estradiol; Total Estrogens; DHEA-Sulfate; Testosterone, Total;Progesterone plus Testosterone, Free.

CPT Codes - see Hormone Panel B for other codes84402 Testosterone, Free

Hormone Panel AOrdering Code: 502330 Cost: $150.00

Includes - Pregnenolone; Total Estrogens; DHEA-Sulfate; Testosterone, Total; Progesterone.

CPT Codes84140 Pregnenolone 84144 Progesterone82672 Total Estrogens 84403 Testosterone, Total82627 DHEA-Sulfate

Hormone Panel COrdering Code: 502510 Cost: $190.00

Includes - Pregnenolone; Total Estrogens; DHEA-Sulfate; Testosterone, Total; Progesterone plusTestosterone, Free.

CPT Codes - see Hormone Panel A for other codes84402 Testosterone, Free

Hormone Panel BOrdering Code: 502340 Cost: $165.00

Includes - Pregnenolone; Estradiol; Total Estrogens; DHEA-Sulfate; Testosterone, Total;Progesterone.

CPT Codes84140 Pregnenolone 82627 DHEA-Sulfate82670 Estradiol 84144 Progesterone82672 Total Estrogens 84403 Testosterone, Total

20



Hormone Panel FOrdering Code: 503390 Cost: $269.00

Includes - Testosterone, Free; Testosterone, Total; Estradiol; Sex Hormone Binding Globulin; FSH;LH; DHEA-Sulfate; Progesterone; Pregnenolone; Total Estrogens.

CPT Codes84402 Testosterone, Free 84403 Testosterone, Total82670 Estradiol 84270 Sex Hormone Binding Globulin83001 FSH 83002 LH82627 DHEA-Sulfate 84144 Progesterone84140 Pregnenolone 82672 Total Estrogens

Sexually Transmitted Infection PanelOrdering Code: 341443 Cost: $159.00

Includes - Gonococcus / Chlamydia – NAA; HIV- EIA; HSV- Type 2; RPR (Syphilis).*Extra Cost of $65 for HIV con rmation by Western Blot if positive.

CPT Codes87491 Gonococcus, NAA 86696 HSV- Type 287591 Chlamydia, NAA 86592 RPR86703 HIV, EIA

Thyroid Extender Panel™Ordering Code: 331089 Cost: $89.00

Includes - Thyroid Peroxidase Ab(TPO); Thyroid Antithyroglobulin Ab (TGA); T4, Free; T3, Free.

CPT Codes86376 TPO Ab 86800 TGA84481 T3, Free 84439 T4, Free

Hormone Panel EOrdering Code: 503389 Cost: $165.00

Includes - Testosterone, Free; Testosterone, Total; Estradiol; Total Estrogens; DHEA-Sulfate;Progesterone.

CPT Codes84402 Testosterone, Free 84403 Testosterone, Total82670 Estradiol 82672 Total Estrogens82627 DHEA-Sulfate 84144 Progesterone



T & B Lymphocyte & Natural Killer Cell (CD56) PanelOrdering Code: 505015 Cost: $129.00

Includes - Absolute and % CD 19; Absolute and %CD 3; Absolute and %CD 4 Helper; Absolute and%CD 8 Supressor; CD4:CD8 ratio; Absolute and % Natural Killer (CD 56); WBC; Lymphocytes.

CPT Codes 86355, 86357, 86359, 86360

Cytokine Panel BOrdering Code: 815250 Cost: $219.00

Includes - Interleukin 2; Interleukin 4; Interleukin 5; Interleukin10; Interferon ; Tumor NecrosisFactor .

CPT Codes 83520 (x6)

Cytokine Panel COrdering Code: 815494 Cost: $139.00

Includes - Interleukin 2; Interleukin 12(p70); Interferon ; Tumor Necrosis Factor .


Cytokine Panel DOrdering Code: 815557 Cost: $139.00

Includes - Interleukin 4; Interleukin 5; Interleukin 6; Interleukin 10.


Cytokine Panel AOrdering Code: 815295 Cost: $279.00

Includes - Interleukin 2; Interleukin 4; Interleukin 5; Interleukin 6; Interleukin10; Interleukin12(p70); Interferon ; Tumor Necrosis Factor .

CPT Codes 83520 (x8) * This Test is Performed by Luminex Methodology

* This Test is Performed by Luminex Methodology



22



Allergen Panel - 96 Foods, IgGOrdering Code: 600550 Cost: $259.00

Includes - Almond; Apple; Asparagus; Avocado; Banana; Barley (Whole Grain); Basil; Bayleaf (Laurel);Green Bean; Lima Bean; Pinto Bean; Beef; Red Beet; Blueberry; Broccoli; Cabbage; Cantaloupe;Carrot; Casein; Cashew Nut; Cauli ower; Celery; Cheese (Processed American); Cheddar Cheese;Parmesan Cheese; Swiss Cheese; Chicken; Cinnamon; Clam; Chocolate/Cocoa; Coconut; Cod sh;Co ee; Corn; Crab; Cucumber; Dill; Eggplant; Egg White; Egg Yolk; Garlic; Ginger; Gluten; Grape;Grapefruit; Honey; Lamb; Lemon; Lime; Lettuce; Lobster; Malt; Milk (Cow); Goat’s Milk; Mushroom;Mustard; Oat; Green Olive; Onions; Orange; Oregano; Green Pea; Peach; Peanut; Pear; Black Pepper;Chili Pepper; Green Bell Pepper; Pineapple; Pork; Potato (Sweet); Potato (White); Rice; Rye; Sa owerSeed; Salmon; Scallop; Sesame Seed; Shrimp; Soybean; Spinach; Pumpkin/Summer Squash;Strawberry; Cane Sugar; Sun ower Seed; Tea; Tomato; Tuna; Turkey; Walnut; Watermelon; Wheat;Whey; Baker’s Yeast; Brewer’s Yeast; Yogurt.

CPT Codes 86001(x96)

Allergen Panel - Mold, IgGOrdering Code: 600457 Cost: $69.00

Includes - Penicillium notatum; Cladosporium herbaru; Aspergillus fumigatus; Mucor racemosus;Candida albicans; Alternaria tenuis; Botrytis cinerea; Helminthosporium hald; Stemphyliumbotryosu; Rhizopus nigricans; Aureobasiduim pullul; Epicoccum purpurasce; Fusaruim oxysporum;Aspergillus niger.


Allergen Panel - 96 Foods, IgEOrdering Code: 601778 Cost: $259.00

Includes - Almond; Apple; Asparagus; Avocado; Banana; Barley (Whole Grain); Basil; Bayleaf (Laurel);Green Bean; Lima Bean; Pinto Bean; Beef; Red Beet; Blueberry; Broccoli; Cabbage; Cantaloupe;Carrot; Casein; Cashew Nut; Cauli ower; Celery; Cheese (Processed American); Cheddar Cheese;Parmesan Cheese; Swiss Cheese; Chicken; Cinnamon; Clam; Chocolate/Cocoa; Coconut; Cod sh;Co ee; Corn; Crab; Cucumber; Dill; Eggplant; Egg White; Egg Yolk; Garlic; Ginger; Gluten; Grape;Grapefruit; Honey; Lamb; Lemon; Lime; Lettuce; Lobster; Malt; Milk (Cow); Goat’s Milk; Mushroom;Mustard; Oat; Green Olive; Onions; Orange; Oregano; Green Pea; Peach; Peanut; Pear; Black Pepper;Chili Pepper; Green Bell Pepper; Pineapple; Pork; Potato (Sweet); Potato (White); Rice; Rye; Sa owerSeed; Salmon; Scallop; Sesame Seed; Shrimp; Soybean; Spinach; Pumpkin/Summer Squash;Strawberry; Cane Sugar; Sun ower Seed; Tea; Tomato; Tuna; Turkey; Walnut; Watermelon; Wheat;Whey; Baker’s Yeast; Brewer’s Yeast; Yogurt.


23

PCS® Mini Panels


Selected Mini Panel Descriptions

CD 4 / CD 8 Cell Ratio Pro le Ordering Code: 505271 Cost: $79.00CPT Codes: 86360Includes: Absolute and % CD 4; Absolute and % CD 8; Complete Blood Count with Di erential and Platelets.

CD 57 (HNK1 Panel) Ordering Code: 505026 Cost: $69.00CPT Codes: 86357, 86356Includes: Absolute and % CD 8; Absolute and % CD 57; Complete Blood Count with Di erential and Platelets.

Celiac Disease Pro le Ordering Code: 165142 Cost: $125.00CPT Codes: 82784, 83516, 86255Includes: Endomysial Antibody, IgA; Immunoglobulin A (IgA), Total; Tissue Transglutaminase (tTG), IgA.Extra cost of $59 for tTG, IgG if IgA,Total is decreased.

Please review our Selected Mini Panels. We have reduced prices and added some new panels for yourconvenience. CPT codes are furnished if you choose to bill insurance through your o ce.

Please note: CPT codes are not diagnostic codes or ordering codes.

Drug Screen (9 Elements) Ordering Code: 788681 Cost: $50.00CPT Codes: 80101 (x9)Includes: Amphetamines; Barbiturates; Benzodiazepines; Cannabinoid; Cocaine; Opiates; Methadone;Propoxyphene; Phencyclidine; Creatinine, Urine; pH, Urine. *All components are con rmed by GC/MS

Epstein-Barr Pro le Ordering Code: 216655 Cost: $115.00CPT Codes: 86663, 86664, 86665 (x2)Includes: EBV, Ab VCA (Viral Capsid Antigen), IgM; EBV Early Antigen Ab, IgG; EBV Ab VCA, IgG; EBV NuclearAntigen Ab, IgG; Interpretation.

Celiac Disease Comprehensive Pro le Ordering Code: 165126 Cost: $289.00CPT Codes: 82784, 83516 (x4), 86255Includes: Endomysial Antibody, IgA; Deamidated Gliadin Abs, IgA and IgG; Immunoglobulin A (IgA), Total;Tissue Transglutaminase (tTG), IgA and IgG.

FibroSure® - NASH (Algorithm to Assess FattyLiver-Induced Liver Damage - Noninvasive)

Ordering Code: 550140 Cost: $229.00

CPT Codes: 82172, 82247, 82465, 82947, 82977, 83010, 83883, 84450, 84460, 84478Includes: A2-Macroglobulin; Haptoglobin; Apolipoprotein A1; Bilirubin, Total; GGT; ALT (SGPT);AST (SGOT); Cholesterol, Total; Glucose, Serum; Triglycerides; Interpretations.

*Must Indicate Height and Weight on Lab Order

24

PCS® Mini Panels


Hepatitis Panel (HP5) Ordering Code: 303744 Cost: $90.00

CPT Codes: 86704, 86706, 86708, 86803, 87340Includes: Hepatitis A Total Abs; Hepatitis B Surface Ag; Hepatitis B Surface Ab; Hepatitis B Core TotalAb; Hepatitis C Ab.

Hepatic Function Panel Ordering Code: 322755 Cost: $15.00

CPT Codes: 80076Includes: Albumin, Serum; Alkaline Phosphatase, Serum; ALT (SGPT); AST(SGOT); Bilirubin, Direct;Bilirubin, Total; Protein, Total, Serum.

Lipid Panel Ordering Code: 235010 Cost: $15.00

CPT Code: 80061Includes: Total Cholesterol; HDL; LDL; VLDL; HDL:LDL Ratio; Triglycerides.

FibroSure® - ASH (Algorithm to Assess Alcohol-Induced Liver Damage - Noninvasive)


CPT Codes: 82172, 82247, 82465, 82947, 82977, 83010, 83883, 84450, 84460, 84478Includes: A2-Macroglobulin; Haptoglobin; Apolipoprotein A1; Bilirubin, Total; GGT; ALT (SGPT);AST (SGOT); Cholesterol, Total; Glucose, Serum; Triglycerides; Interpretations.

Hepatitis C FibroSure® (Algorithm to AssessHCV-Induced Liver Damage - Noninvasive)


CPT Codes: 82172, 82247, 82977, 83010, 83883, 84460Includes: A2-Macroglobulin; Haptoglobin; Apolipoprotein A1; Bilirubin, Total; GGT; ALT (SGPT);AST (SGOT); Cholesterol, Total; Glucose, Serum; Triglycerides; Interpretations.

Kidney Stone Formation Risk Panel withSaturation, 24 Hour Urine


CPT Codes: 81003, 82131, 82140, 82340, 82436, 82507, 82570, 83735, 83935, 83945, 84105, 84133, 84300Includes: Calcium, Urine; Sodium, Urine; Phosphorus, Urine; Uric Acid, Urine; Potassium, Urine;Chloride, Urine; Citric Acid (Citrate), Urine; Oxalates, Urine; Magnesium, Urine; Sulfate, Urine; Cystine,Urine; Osmolality, Urine; Creatinine, Urine; pH, Urine; Ammonia, Urine; Calcium Oxalate, Urine;Brushite, Urine; Monosodium Urate, Urine; Struvite, Urine; Saturation Ratios.



FASTING

25

PCS® Mini Panels


Metabolic Panel, Comprehensive (14) Ordering Code: 322000 Cost: $15.00

CPT Codes: 80053Includes: A/G ratio; Albumin; Alkaline Phosphatase; ALT (SGPT); AST (SGOT); Bilirubin, Total; BUN; BUN:Creatinineratio; Calcium; Carbon Dioxide; Chloride; Creatinine; Globulin; Glucose; Potassium; Total Protein; Sodium.

Renal Function Panel Ordering Code: 322777 Cost: $15.00

CPT Code: 80069Includes: Albumin; BUN; BUN:Creatinine Ratio; Calcium; Carbon Dioxide; Chloride; Creatinine;Glucose; Phosphorus; Potassium; Sodium.

Thyroid Panel with TSH Ordering Code: 000620 Cost: $22.00

CPT Codes: 84443, 84436, 84479Includes: T4, Total; T3 Uptake; Free Thyroxine Index (FTI); TSH.

Prenatal Pro le Ordering Code: 202945 Cost: $54.00

CPT Codes: 85025, 86592, 86762, 86850, 86900, 86901, 87340Includes: Hep B Surface Ag; RPR; Rubella Antibodies, IgG; ABO Blood Grouping; Rh Factor; AntibodyScreen; CBC with Di erential and Platelet Count.

Mineral Pro le, RBC Ordering Code: 811394 Cost: $289.00

CPT Codes: 82495, 82525, 83018 (x2), 83785, 84255, 84630, 83735Includes: Chromium; Cobalt; Copper; Manganese; Molybdenum; Selenium; Zinc.

VAP™ Cholesterol Test Ordering Code: 804500 Cost: $69.00

CPT Codes: 83701, 84478Includes: LDL Cholesterol; HDL Cholesterol; VLDL Cholesterol; Cholesterol, Total; Triglycerides; Non-HDL Cholesterol (LDL+VLDL); ApoB100-calculation; LDL-R (Real)-Cholesterol; Lipoprotein(a); IDLCholesterol; Remnant Lipoprotein (IDL+VLDL3); Probable Metabolic Syndrome Evaluation; HDL-2(Most Protective); HDL-3 (Less Protective); VLDL-3 (Small Remnant); LDL1 Pattern A; LDL2 Pattern A;LDL3 Pattern B; LDL4 Pattern B; LDL Density Pattern.

FASTING

FASTING

FASTING

26

Test Category Lists


Test Category ListsAdrenal Function500092 – Adrenal 21-Hydroxylase Autoantibodies

004440 – Adrenocorticotropic Hormone (ACTH)

004374 – Aldosterone, Serum

004291 – Aldosterone, 24 Hour Urine

010116 – Angiotensin-Converting Enzyme (ACE)

082024 – Antiadrenal Antibodies, Quantitative

084152 – Catecholamines, Fractionated, Plasma

004176 – Catecholamines, Fractionated, Urinary Free, 24 Hour Urine

316203 – Catecholamines, Fractionated, Urinary Free, Random Urine

004432 – Cortisol, 24 Hour Urine, HPLC

104018 – Cortisol, AM

104026 – Cortisol, PM

004051 – Cortisol, Random

010421 – Melanocyte–Stimulating Hormone (MSH)

002006 – Renin Activity, Plasma

Anemia Related Testing001222 – Bilirubin, Direct

001214 – Bilirubin, Total, Direct, and Indirect

005009 – CBC with Di erential and Platelet Count

004598 – Ferritin, Serum

030825 – Ferritin, Iron, and TIBC (Total Iron Binding Capacity) – Fasting Preferred

002014 – Folate (Folic Acid) – Fasting Preferred

266015 – Folate, RBC

010413 – Intrinsic Factor Blocking Antibodies, Serum

001339 – Iron, Serum - Fasting – Fasting Preferred

001321 – Iron / TIBC (Total Iron Binding Capacity) – Fasting Preferred

706961 – Methylmalonic Acid (MMA), Serum

716365 – Methylmalonic Acid (MMA), Urine

005280 – Reticulocyte Count

004937 – Transferrin – Fasting Preferred

001503 – Vitamin B12 – Fasting Preferred

000810 – Vitamin B12 and Folate – Fasting Preferred

Bacterial Testing008649 – Aerobic Bacterial Culture

096289 – Anti-DNase B (Streptococcal) Antibodies

006031 – Antistreptolysin O Antibodies (ASO)

008300 – Blood Culture, Routine

180224 – Bordetella pertussis, Nasopharyngeal Culture

183194 – Chlamydia / Gonococcus by NAA, Urine

27

Test Category Lists


Bacterial Testing, continued138338 – Chlamydia pneumoniae Antibodies, IgG and IgM

188078 – Chlamydia trachomatis by NAA, Urine

006353 – Cold Agglutinin Titer, Quantitative

086207 – Clostridium di cile Toxins A & B, EIA

188086 – Gonococcus (Neisseria gonorrhoeae) by NAA, Urine

008169 – Group A Streptococcus Culture (Beta Strep)

188128 – Group B Streptococcus Culture

008334 – Genital Culture

163683 – Helicobacter pylori Antibodies, IgM, IgG, IgA

180764 – Helicobacter pylori Stool Antigen

180836 – Helicobacter pylori Urea Breath Test

180810 – Lower Respiratory Culture

223586 – Lyme Antibodies, Total and IgM Responses, EIA

550012 – Lyme Disease, PCR

163600 – Lyme Disease, Western Blot

163758 – Mycoplasma pneumoniae, IgG and IgM

163741 – Mycoplasma pneumoniae, IgG

163212 – Mycoplasma pneumoniae, IgM

182873 – QuantiFERON – TB Gold (Tuberculosis Screening Test)

016592 – Rocky Mountain Spotted Fever (Rickettsia rickettsii), IgG

006072 – RPR (Syphilis)

341443 – Sexually Transmitted Infection Panel – See Super Panel Description

008144 – Stool Culture

006478 – Toxoplasma gondii, IgG

096651 – Toxoplasma gondii, IgM

138602 – Toxoplasma gondii, PCR

008342 – Upper Respiratory Culture

003038 – Urinalysis, Routine

377069 – Urinalysis with Re ex to Urine Culture and Sensitivity

008847 – Urine Culture with Sensitivity

Bone Related Tests001107 – Alkaline Phosphatase, Serum

001612 – Alkaline Phosphatase, Isoenzymes, Serum

513002 – Alkaline Phosphatase, Bone Speci c

500089 – C-Telopeptide, Serum

001016 – Calcium, Serum – Fasting

511105 – Deoxypyridinoline (DPD) Cross-links, Random Urine

004515 – Estradiol, Serum, ECLIA

500108 – Estradiol, Serum, LC/MS/MS

004549 – Estrogens, Total, RIA

28

Test Category Lists


Bone Related Tests, continued006924 – HLA B27 Disease Association

511097 – N-Telopeptide, Random or 24 Hour Urine

010249 – Osteocalcin

335398 – Parathyroid Hormone – PTH

001024 – Phosphorus, Serum – Fasting

004317 – Progesterone, ECLIA

500167 – Progesterone, HPLC/MS

070001 – Testosterone, Total, Serum, LC/MS-MS

070038 – Testosterone, Total and Free, HPLC/MS

081950 – Vitamin D, 25-Hydroxycalciferol

Cardiovascular Function016873 – Apolipoprotein A-1 – Fasting

216010 – Apolipoprotein (A1/B/+Ratio) – Fasting

167015 – Apolipoprotein B – Fasting

140889 – B-Type Natriuretic Peptide (BNP)

007187 – Carboxyhemoglobin (CO)

120766 – C-Reactive Protein (CRP), High Sensitivity (Cardiac)

001362 – Creatine Kinase (CK/CPK), Total – Avoid Exercise

002154 – Creatine Kinase (CK) Isoenzymes – Avoid Exercise

120816 – Creatine Kinase (CK), MB

002311 – Creatine Kinase (CK), MB and Total – Avoid Exercise

115188 – D-Dimer

001610 – Fibrinogen Activity

706994 – Homocysteine – Fasting Preferred

001115 – LDH, Serum – Avoid Exercise

001842 – LDH Isoenzymes – Avoid Exercise

235036 – Lipid Electrophoresis (Lipoprotein Phenotyping) – Fasting

235010 – Lipid Panel – Fasting

120188 – Lipoprotein (a)

001537 – Magnesium, Serum

080283 – Magnesium, RBC

511238 – MTHFR (Methylenetetrahydrofolate Reductase Thermolabile Variant), DNA Analysis

884247 – NMR Lipopro le® – Fasting

005207 – Partial Thromboplastin Time (PTT), Activated

123240 – PLAC Test ™

001180 – Potassium, Serum – Fasting

005199 – Prothrombin Time (PT/INR)

020321 – Prothrombin Time (PT/INR) + Partial Thromboplastin Time (PTT), Activated

120832 – Troponin I

804500 – VAP® Cholesterol Test – Fasting – See Mini Panel Description

29

Test Category Lists


Cytokines, Complements and Speci c Immune Testing004648 – Complement C1 Esterase Inhibitor, Serum

161414 – Complement C2, Serum


004220 – Complement C3a



001941 – Complement, Total (CH50)

004180 – Eosinophil Cationic Protein (ECP)

012542 – HLA DRB, DQB, Typing

002295 – IgA, E, G, M, Total Antibodies – Fasting

001784 – IgA, Total Antibodies – Fasting

002170 – IgE, Total Antibodies – Fasting

001776 – IgG, Total Antibodies – Fasting

001792 – IgM, Total Antibodies – Fasting

001685 – Immuno xation (IFE), Serum – Fasting

001495 – Immuno xation (IFE) and Protein Electrophoresis, Serum – Fasting

805259 – Interferon (INF ), Serum, ELISA

805255 – Interleukin 1 (IL-1 ), Serum

140912 – Interleukin 2 (IL-2), Serum, ELISA






805263 – Interleukin 12p70 (IL-12p70), Serum, ELISA


815295 – Cytokine Panel A, Plasma, Luminex – See Super Panel Description

815250 – Cytokine Panel B, Plasma, Luminex – See Super Panel Description

815494 – Cytokine Panel C, Plasma, Luminex – See Super Panel Description

815557 – Cytokine Panel D, Plasma, Luminex – See Super Panel Description

905036 – Tumor Growth Factor -1 (TGF- 1)

140673 – Tumor Necrosis Factor (TNF ), Serum, ELISA

Fungal Testing600457 – Allergy Panel – Mold, IgG – See Super Panel Description

663231 – Candida albicans Allergy, IgG

164301 – Coccidioides Antibodies, DID

188243 – Fungus Culture with Stain

164657 – Saccharomyces cerevisiae , IgA and IgG

General In ammatory Markers164947 – Antinuclear Antibodies (ANA), IFA with FANA Pattern

30

Test Category Lists


General In ammatory Markers, continued120766 – C-Reactive Protein, High Sensitivity (Cardiac)

006502 – Rheumatoid Arthritis Factor

005215 – Sedimentation Rate (ESR)

Glucose Metabolism160721 – Antipancreatic Islet Cells

010108 – C-Peptide of Insulin

143008 – GAD-65 Autoantibody (Glutamic Acid Decarboxylase)

102277 – Gestational Diabetes Evaluation, 1 Hour Screen

101303 – Glucose, 1 Hour Post Prandial

002022 – Glucose, 2 Hour Post Prandial

001818 – Glucose, Plasma – Fasting

001032 – Glucose, Serum – Fasting

146696 – Glucose/Insulin Response – 4 Specimens – Fasting

090373 – Glucose Tolerance (GTT) – 5 Specimens – Fasting

001693 – Glycohemoglobin (GHB), Total

001453 – Hemoglobin (HGB) A1c

141531 – IA2 Autoantibodies

014357 – Insulin, 1 Hour

312114 – Insulin, 2 Hour

004333 – Insulin – Fasting

141598 – Insulin Antibodies (IAA)

146712 – Leptin

Food Sensitivity / Celiac Disease Testing600550 – Allergy Panel – 96 Foods, IgG – See Super Panel Description

167082 – Celiac Disease HLA DQ Association

165142 – Celiac Disease Pro le – See Mini Panel Description

165126 – Celiac Disease Comprehensive Pro le – See Mini Panel Description

164996 – Endomysial Antibody, IgA

161646 – Gliadin Antibodies, IgA (Deamidated)

161687 – Gliadin Antibodies, IgG (Deamidated)

163402 – Gliadin Antibodies, IgG and IgA (Deamidated)

069781 – Gluten Allergy, IgE

663073 – Gluten Allergy, IgG

164657 – Saccharomyces cerevisiae , IgA and IgG (Crohn’s Disease)

164640 – Tissue Transglutaminase (tTG), IgA

164988 – Tissue Transglutaminase (tTG), IgG

Hematology/ Blood Products

006056 – ABO Grouping

006049 – ABO Grouping with Rh Factor

Test Category Lists


Hematology/ Blood Products, continued006015 – Antibody Screen (Indirect Coombs’)

006213 – Antibody Identi cation

007187 – Carboxyhemoglobin (CO)

005009 – CBC with Di erential and Platelet Count

505271 – CD4/CD8 Ratio Pro le

505026 – CD57 (HNK1) Panel

006270 – Coombs’, Direct

006015 – Antibody Screen (Indirect Coombs’)

001917 – Glucose 6 Phosphate Dehydrogenase (G6PD), Quant., Blood and RBC

823542 – Glutathione, Serum

121679 – Hemoglobinopathy Pro le & Solubility (HGB Electrophoresis)

005223 – Hemoglobin Solubility (Sickle Cell Test) (Sickle Cell Test)

117002 – Lupus Anticoagulant (PTT- LA)

005207 – Partial Thromboplastin Time (PTT), Activated

500054 – Platelet Antibody, Direct

115345 – Platelet Count, Citrated Blood

005199 – Prothrombin Time (PT/INR)

020321 – Prothrombin Time (PT/INR) + Partial Thromboplastin Time (PTT), Activated

005280 – Reticulocyte Count

005215 – Sedimentation Rate (ESR)

505015 – T and B Lymphocyte / Natural Killer Cell (CD 56) Panel – See Super Panel Description

Hepatic/Pancreatic Function001081 – Albumin, Serum

002030 – Aldolase, Serum

001107 – Alkaline Phosphatase, Serum – Fasting

001612 – Alkaline Phosphatase Isoenzymes – Fasting

001982 – Alpha-1-Antitrypsin, Serum – Fasting Preferred

480012 – Alpha-Fetoprotein (AFP), Tumor Marker, Serum

001545 – ALT (SGPT)

007054 – Ammonia, Plasma – Fasting

001396 – Amylase, Serum

123110 – Amylase, Isoenzymes

160721 – Antipancreatic Islet Cells

001123 – AST (SGOT)

010330 – Bile Acids – Fasting

001222 – Bilirubin, Direct

001214 – Bilirubin, Total, Direct, and Indirect

002303 – CA 125 (Cancer Antigen)

001560 – Ceruloplasmin (CER)

010108 – C-Peptide of Insulin

32

Test Category Lists


Hepatic/Pancreatic Function, continued004598 – Ferritin

030825 – Ferritin, Iron, and TIBC (Total Iron Binding Capacity) – Fasting Preferred

001610 – Fibrinogen Activity

550140 – FibroSure® - NASH (Fatty Liver Disease Assessment) – See Mini Panel Description

550180 – FibroSure® - ASH (Alcoholic Liver Disease Assessment) – See Mini Panel Description

550123 – FibroSure® - Hepatitis C Virus (HCV Liver Status Assessment) – See Mini Panel Description

004390 – Gastrin, Serum – Fasting

001958 – GGT – Fasting

823542 – Glutathione, Total, Whole Blood

001628 – Haptoglobin – Avoid Exercise

322755 – Hepatic Function Panel – See Mini Panel Description

303744 – Hepatitis 5 (HP5) Panel – See Mini Panel Description

006726 – Hepatitis A, Total Antibodies (For Acute use IgM)

006734 – Hepatitis A, IgM

006395 – Hepatitis B Surface Antibody

006510 – Hepatitis B Surface Antigen

016881 – Hepatitis B Core Antibody, IgM

006718 – Hepatitis B Core Antibody, Total

140659 – Hepatitis C Virus (HCV) Antibody

550123 – Hepatitis C Virus (HCV) FibroSure® – See Mini Panel Description

550080 – Hepatitis C Virus (HCV), Real Time PCR (Viral Load)

511345 – Hereditary Hemochromatosis, DNA Analysis


004333 – Insulin – Fasting


001339 – Iron, Serum – Fasting Preferred

001321 – Iron/TIBC (Total Iron Binding Capacity) – Fasting Preferred

001115 – LDH – Avoid Exercise

001842 – LDH Isoenzymes – Avoid Exercise

001404 – Lipase, Serum

002071 – Osmolality, Serum

003194 – Porphyrins, Quantitative, 24 Hour Urine

003368 – Protein Electrophoresis, 24 Hour Urine

354928 – Protein Electrophoresis, Random Urine

001487 – Protein Electrophoresis, Serum

001495 – Protein Electrophoresis and Immuno xation (IFE), Serum – Fasting

001073 – Protein, Total

007441 – Soluble Liver Antigen, IgG

143305 – Soluble Transferrin Receptor

004937 – Transferrin – Fasting Preferred

33

Test Category Lists


Mold Toxicity004440 – Adrenocorticotropic Hormone (ACTH)

161836 – Anticardiolipin Antibodies (ACA), IgA

161810 – Anticardiolipin Antibodies (ACA), IgG

161828 – Anticardiolipin Antibodies (ACA), IgM

161802 – Anticardiolipin Antibodies (ACA), IgG & IgM

161950 – Anticardiolipin Antibodies (ACA), IgA, IgG, IgM

046557 – Antidiuretic Hormone (ADH) Pro le (Includes Osmolality, Serum)



104018 – Cortisol, AM

104026 – Cortisol, PM

161646 – Gliadin Antibodies, IgA (Deamidated)

161687 – Gliadin Antibodies, IgG (Deamidated)

163402 – Gliadin Antibodies, IgG and IgA (Deamidated)

012542 – HLA DRB, DQB, Typing

146712 – Leptin

500124 – MMP-9 (Matrix Metalloproteinase - 9)

010421 – Melanocyte–Stimulating Hormone (MSH)

905036 – Tumor Growth Factor -1 (TGF- 1)

117006 – Vascular Endothelial Growth Factor (VEGF), Plasma

010397 – Vasoactive Intestinal Polypeptide (VIP), Plasma

Parasite Testing064618 – Ascaris Allergy, IgE

138315 – Babesia microti Antibodies, IgG and IgM

182378 – Cryptosporidium and Isospora, Stool

182204 – Giardia lamblia, Antigen by EIA

008623 – Ova/ Parasite Exam – Stool

Pituitary Function004440 – Adrenocorticotropic Hormone (ACTH)


500632 – Growth Hormone, RIA

004309 – Follicle-Stimulating Hormone (FSH)

028480 – Follicle-Stimulating Hormone and Luteinizing Hormone (FSH and LH)

010363 – IGF-1 (Insulin-Like Growth Factor)

140152 – IGF, Binding Protein 3

004283 – Luteinizing Hormone (LH)

004465 – Prolactin, Serum

004259 – Thyroid-Stimulating Hormone (TSH)

Renal Function004374 – Aldosterone, Serum

34

Test Category Lists


Renal Function, continued004291 – Aldosterone, 24 Hour Urine


010181 – Beta-2 Microglobulin, Serum

010173 – Beta-2 Microglobulin, Random Urine

024778 – BUN and Creatinine


120790 – Calculi, Urinary (Kidney Stone Analysis)

001370 – Creatinine , Serum

003004 – Creatinine Clearance, 24 Hour Urine

003129 – Creatinine/Total Protein, Random Urine

121251 – Cystatin C – Fasting Preferred

306266 – Kidney Stone Formation Evaluation, 24 Hour Urine – See Mini Panel Description

140285 – Microalbumin/Creatinine Ratio, Urine

002071 – Osmolality, Serum


322777 – Renal Function Panel – Fasting – See Mini Panel Description

002006 – Renin Activity, Plasma

001040 – Urea Nitrogen (BUN)

001057 – Uric Acid, Serum – Fasting

003038 – Urinalysis, Routine

377069 – Urinalysis, Complete with Re ex to Urine Culture with Sensitivity

008847 – Urine Culture with Sensitivity

Sex Hormones / Fertility Testing500092 – Adrenal 21-Hydroxylase Autoantibodies

070085 – 17- -Hydroxyprogesterone

500183 – Anti-Müllerian Hormone (AMH), Serum

500142 – Dihydrotestosterone (DHT), HPLC/MS

004697 – DHEA-Sulfate, ECLIA

500161 – DHEA-Sulfate, RIA

004515 – Estradiol, Serum, ECLIA

500108 – Estradiol, Serum, LC/MS/MS

004614 – Estriol, Serum, ICMA

004549 – Estrogens, Total, RIA

004564 – Estrone, Serum, RIA

004309 – Follicle-Stimulating Hormone (FSH)

028480 – Follicle-Stimulating Hormone and Luteinizing Hormone (FSH and LH)

146795 – Inhibin B

146712 – Leptin

004283 – Luteinizing Hormone (LH)

35

Test Category Lists


Sex Hormones / Fertility Testing, continued004416 – HCG, Beta, Serum (Human Chorionic Gonadotropin), Quantitative

502330 – Hormone Panel A – See Super Panel Description

502340 – Hormone Panel B – See Super Panel Description

502510 – Hormone Panel C – See Super Panel Description

502511 – Hormone Panel D – See Super Panel Description

503389 – Hormone Panel E – See Super Panel Description

503390 – Hormone Panel F – See Super Panel Description

140707 – Pregnenolone, MS

202945 – Prenatal Pro le – See Mini Panel Description

004317 – Progesterone, ECLIA

500167 – Progesterone, HPLC/MS

004465 – Prolactin, Serum

082016 – Sex Hormone Binding Globulin, Serum

070001 – Testosterone, Total, Serum, LC/MS-MS

070038 – Testosterone, Total and Free, HPLC/MS

Speci c Autoantibodies500092 – Adrenal 21-Hydroxylase Autoantibodies

082024 – Antiadrenal Antibodies, Quantitative

161836 – Anticardiolipin Antibodies (ACA), IgA

161810 – Anticardiolipin Antibodies (ACA), IgG

161828 – Anticardiolipin Antibodies (ACA), IgM

161802 – Anticardiolipin Antibodies (ACA), IgG and IgM

161950 – Anticardiolipin Antibodies (ACA), IgA, IgG, IgM

164814 – Anticentromere B Antibodies

012580 – Antichromatin, IgG Antibodies

096339 – Anti-dsDNA (Double-Stranded) Antibodies, EIA

012518 – Antihistone Antibodies

161455 – Anti-Jo-1 Antibody

806387 – Antimyelin Associated Glycoprotein (Mag Ab), IgG

808973 – Antimyelin Associated Glycoprotein (Mag Ab), IgM

164947 – Antinuclear Antibodies (ANA), IFA with FANA Pattern

160721 – Antipancreatic Islet Cells

117906 – Antiphosphatidylserine, IgA

117952 – Antiphosphatidylserine, IgG

117900 – Antiphosphatidylserine, IgM

117994 – Antiphosphatidylserine, IgA, IgG, IgM

018705 – Antiscleroderma-70 Antibodies

164914 – CCP Antibodies, IgA and IgG (Cyclic Citrullinated Peptide or CPA)

143008 – GAD-65 Autoantibody (Glutamic Acid Decarboxylase)


36

Test Category Lists


Speci c Autoantibodies, continued


010413 – Intrinsic Factor Blocking Antibodies

006650 – Mitochondrial (M2) Antibody

808616 – Ovarian Antibodies, IgG

006486 – Parietal Cell Antibodies (APCA)

500054 – Platelet Antibody, Direct

006502 – Rheumatoid Arthritis Factor

012708 – Sjögren’s Antibodies (Anti-SS-A/Anti-SS-B)

808813 – Spermatozoa Antibodies

006692 – Thyroid Antithyroglobulin Antibodies (TGA)

006684 – Thyroid Autoantibodies (TPO and TGA)

006676 – Thyroid Peroxidase Antibodies (TPO) – For patients with TPO <600

140749 – Thyroid-Stimulating Immunoglobulin (TSI)

010314 – Thyrotropin Receptor Antibodies

Thyroid Function004895 – Calcitonin – Fasting

070034 – Iodine, Serum or Plasma

070104 – Reverse T3

010389 – T3, Free (Triiodothyronine, Free)

002188 – T3, Total (Triiodothyronine, Total)

001974 – T4, Free, Direct (Thyroxine, Free)

001149 – T4, Total (Thyroxine, Total)

214540 – T3, Free (Triiodothyronine, Free) and T4, Free, Direct (Thyroxine, Free)

006692 – Thyroid Antithyroglobulin Antibody (TGA)

006684 – Thyroid Autoantibodies (TPO and TGA)

331089 – Thyroid Extender Panel – See Super Panel Description

000620 – Thyroid Panel with TSH – See Mini Panel Description

006676 – Thyroid Peroxidase Antibodies (TPO)

004259 – Thyroid-Stimulating Hormone (TSH)

140749 – Thyroid-Stimulating Immunoglobulin (TSI)

010314 – Thyrotropin Receptor Antibody, Serum

001735 – Thyroxine Binding Globulin (TBG)

376137 – TSH. T4, Free , Direct, and T3, Free

Tumor Markers / Cancer Related Testing with Tissue Type004440 – Adrenocorticotropic Hormone (ACTH) - Pituitary

480012 – Alpha-Fetoprotein (AFP), Serum – Liver, Ovary, Testis

140269 – Alpha Subunit, Free – Testis

002303 – CA 125 (Cancer Antigen) – Ovary

143404 – CA 15-3 (Cancer Antigen) – Breast

37

Test Category Lists


Tumor Markers / Cancer Related Testing with Tissue Type, continued

002261 – CA 19-9 (Carbohydrate Antigen) – Colorectal

140293 – CA 27.29 (Cancer Antigen) – Breast

004895 – Calcitonin – Thyroid – Fasting

002139 – CEA – Colorectal, Gastric, Lung

004390 – Gastrin, Serum – Gastric – Fasting

004416 – HCG, Beta, Serum (Human Chorionic Gonadotropin), Quantitative – Pituitary, Testis, Ovary

500632 – Growth Hormone, RIA – Pituitary

500124 – MMP-9 (Matrix Metalloproteinase - 9) – Tumor Metastasis

010322 – Prostate-Speci c Antigen (PSA), Total – Prostate

480947 – Prostate-Speci c Antigen (PSA), Free and Total – Prostate

004747 – Prostatic Acid Phosphatase – Prostate

120204 – Serotonin, Serum – Carcinoid Syndrome

120089 – Serotonin, Whole Blood – Carcinoid Syndrome

140749 – Thyroid-Stimulating Immunoglobulin (TSI) – Thyroid

Viral Testing

006494 – Cytomegalovirus (CMV), IgG

096727 – Cytomegalovirus (CMV), IgM

221085 – Cytomegalovirus (CMV), IgG and IgM

216655 – Epstein-Barr Pro le (EBV) – See Mini Panel Description

006726 – Hepatitis A, Total Antibodies

006734 – Hepatitis A, IgM

006395 – Hepatitis B Surface Antibody

006510 – Hepatitis B Surface Antigen

016881 – Hepatitis B Core Antibody, IgM

006718 – Hepatitis B Core Antibody, Total

140659 – Hepatitis C Virus (HCV) Antibody

550123 – Hepatitis C Virus (HCV) FibroSure® – See Mini Panel Description

550080 – Hepatitis C Virus (HCV), Real Time PCR (Viral Load)

303744 – Hepatitis 5 Panel (HP5) – See Mini Panel Description

164897 – Herpes Simplex Type I Speci c, IgG

163147 – Herpes Simplex Type II Speci c, IgG

138815 – Herpes Simplex Types I and II Speci c, IgG

096206 – Herpes Varicella Zoster, IgG (Chicken Pox)

083824 – HIV, Re ex to Western Blot on Positives

161075 – Human Herpes Virus Type 6 (HHV-6), IgG

138529 – Human Herpes Virus Type 6 (HHV-6), IgM

058495 – MMR (Measles, Mumps, & Rubella) Immunity

006189 – Mononucleosis, Qualitative

341443 – Sexually Transmitted Infection Panel – See Super Panel Description

38

Test Category Lists


Vitamin and Mineral Related Tests071548 – Aluminum, Serum or Plasma


001578 – Carbon Dioxide, Total

001529 – Carotene, - Fasting

001560 – Ceruloplasmin (CER)

001206 – Chloride, Serum

120251 – Coenzyme Q10, Total

001586 – Copper, Serum or Plasma

002014 – Folate (Folic Acid) – Fasting Preferred

010413 – Intrinsic Factor Blocking Antibodies, Serum

070034 – Iodine, Serum or Plasma

007625 – Lead (Adult)

717009 – Lead (Pediatric)

007708 – Lithium, Serum

001537 – Magnesium, Serum

080283 – Magnesium, RBC

706961 – Methylmalonic Acid (MMA), Serum

716365 – Methylmalonic Acid (MMA), Urine

811394 – Mineral Pro le, RBC – See Mini Panel Description

511238 – MTHFR (Methylenetetrahydrofolate Reductase Thermolabile Variant), DNA Analysis


001180 – Potassium, Serum

001198 – Sodium, Serum

017509 – Vitamin A, Serum – Fasting

121178 – Vitamin B1 (Thiamine), Plasma

070115 – Vitamin B-3 (Niacin), Plasma

070086 – Vitamin B-5 (Pantothenic Acid), Plasma

004655 – Vitamin B-6 (Pyridoxal 5-Phosphate), Plasma

070097 – Vitamin B-7 (Biotin), Serum or Plasma

001503 – Vitamin B12 – Fasting Preferred

000810 – Vitamin B12 and Folate – Fasting Preferred

001479 – Vitamin C, Serum or Plasma

081950 – Vitamin D, 25-Hydroycalciferol

081091 – Vitamin D 1, 25 Dihydroxy (Calcitriol)

080325 – Vitamin D, 25-Hydroxycalciferol + Vitamin D, 1,25 Dihydroxy (Calcitriol)

081000 – Vitamin E, Serum or Plasma

121200 – Vitamin K1, Serum or Plasma

001800 – Zinc, Serum or Plasma

070029 – Zinc, RBC

Please visit www.ProfessionalCo-op.com to download a PDF copy of this Pricelist!


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Laboratory ServicesPricelist #11

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Contents and Information - Functional Medicine University

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