25
Contract : 5753 Vendor : Quest Diagnostics Description Code Unite Price Time Cholesterol 6165 $3.75 24hr Comprehensive Metabolic Panel w/eGFR 944 $6.43 24hr Chlamydia/GC DNA Amplified 17618 $49.10 24hr Drug Screen 7 Panel 800 $8.24 3-5 days Drug Screen 9 Panel 822 $9.46 3-5 days Drug Screen 10 Panel 821 $10.11 3-5 days Hepatitis B Surface Antibody Quantitative 7292 $9.75 24hr Hepatitis C Antibody 1590 $11.33 24hr Hepatic Function Panel 104 $4.93 24hr HIV 1/2 EIA Antibody with Reflexes 3200 $8.68 24hr HPV DNA (High Risk) 110814 $33.48 24hr Herpes Simplex Type 2 lgG, HerpeSelect 100051 $24.44 24hr Lipid Panel 1383 $12.10 24hr Pap, ThinPrep, No RESCRN 10090 $20.00 5 days Pap, ThinPrep, RESCRN 1090 $20.00 5 days Triglycerides 6440 $3.75 24hr TSH, 3rd Generation 7580 $11.75 24hr Urine Culture 2400 $8.43 24hr Varicella-Zoster lgG 123112 $18.00 6 days Surgical pathology, gross and microscpic exam Level IV AC03 $64.43 24-48 hr profile 47 47 $26.54 24hr Nicotine Urine 6224 6224 $25.50 5 days Hepatitis CaB 1590 1590 $11.33 24hr QuantiFERON-TB 4399 $43.35 5 days 8 Panel Drug Screen 819 $8.87 3-5 days Pregnancy, Urine 4723 $8.60 24hr PTT 4023 $4.50 24hr Culture, Wound 2275 $21.00 varies Valproic Acid 7590 $12.00 24hr Vit D, 25 Hydroxy 17306 $58.00 9 days Gram Stain 2025 $5.00 24hr Culture, Aerobic 2300 $16.00 varies Protime + INR 4021 $5.00 24hr Prothrombin Time 111126 $5.00 4 days EBV-VCA IGG AB 140465 $18.25 4 days T3 Free 1430 $5.62 24hr EBV AB IGM 151599 $18.25 4 days Pricing for frequently ordered tests is provided below. For all other tests not listed below, Contractor will provide a 65% discount off of their fee schedule. Contractors Fee Schedule is provided in Exhibit C. For any tests that appear in both the Frequently Ordered Tests List and the Fee Schedule, the pricing provided in the Frequently Ordered Tests List will prevail. Frequently Ordered Tests

Contract : 5753 Vendor : Quest Diagnostics Description ... Quest...Contract : 5753 Vendor : Quest Diagnostics DESCRIPTION CODE PRICE DESCRIPTION CODE PRICE ELECTROLYTES PANEL 42 $3.52

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Page 1: Contract : 5753 Vendor : Quest Diagnostics Description ... Quest...Contract : 5753 Vendor : Quest Diagnostics DESCRIPTION CODE PRICE DESCRIPTION CODE PRICE ELECTROLYTES PANEL 42 $3.52

Contract : 5753Vendor : Quest Diagnostics

Description Code Unite Price TimeCholesterol 6165 $3.75 24hrComprehensive Metabolic Panel w/eGFR 944 $6.43 24hrChlamydia/GC DNA Amplified 17618 $49.10 24hrDrug Screen 7 Panel 800 $8.24 3-5 daysDrug Screen 9 Panel 822 $9.46 3-5 daysDrug Screen 10 Panel 821 $10.11 3-5 daysHepatitis B Surface Antibody Quantitative 7292 $9.75 24hrHepatitis C Antibody 1590 $11.33 24hrHepatic Function Panel 104 $4.93 24hrHIV 1/2 EIA Antibody with Reflexes 3200 $8.68 24hrHPV DNA (High Risk) 110814 $33.48 24hrHerpes Simplex Type 2 lgG, HerpeSelect 100051 $24.44 24hrLipid Panel 1383 $12.10 24hrPap, ThinPrep, No RESCRN 10090 $20.00 5 daysPap, ThinPrep, RESCRN 1090 $20.00 5 daysTriglycerides 6440 $3.75 24hrTSH, 3rd Generation 7580 $11.75 24hrUrine Culture 2400 $8.43 24hrVaricella-Zoster lgG 123112 $18.00 6 daysSurgical pathology, gross and microscpic exam Level IV AC03 $64.43 24-48 hrprofile 47 47 $26.54 24hrNicotine Urine 6224 6224 $25.50 5 daysHepatitis CaB 1590 1590 $11.33 24hrQuantiFERON-TB 4399 $43.35 5 days8 Panel Drug Screen 819 $8.87 3-5 daysPregnancy, Urine 4723 $8.60 24hrPTT 4023 $4.50 24hrCulture, Wound 2275 $21.00 variesValproic Acid 7590 $12.00 24hrVit D, 25 Hydroxy 17306 $58.00 9 daysGram Stain 2025 $5.00 24hrCulture, Aerobic 2300 $16.00 variesProtime + INR 4021 $5.00 24hrProthrombin Time 111126 $5.00 4 daysEBV-VCA IGG AB 140465 $18.25 4 daysT3 Free 1430 $5.62 24hrEBV AB IGM 151599 $18.25 4 days

Pricing for frequently ordered tests is provided below. For all other tests not listed below, Contractor will provide a 65% discount off of their fee schedule. Contractors Fee Schedule is provided in Exhibit C. For any tests that appear in both the Frequently Ordered Tests List

and the Fee Schedule, the pricing provided in the Frequently Ordered Tests List will prevail.

Frequently Ordered Tests

Page 2: Contract : 5753 Vendor : Quest Diagnostics Description ... Quest...Contract : 5753 Vendor : Quest Diagnostics DESCRIPTION CODE PRICE DESCRIPTION CODE PRICE ELECTROLYTES PANEL 42 $3.52

Contract : 5753Vendor : Quest Diagnostics

Description Code Unite Price Time

Pricing for frequently ordered tests is provided below. For all other tests not listed below, Contractor will provide a 65% discount off of their fee schedule. Contractors Fee Schedule is provided in Exhibit C. For any tests that appear in both the Frequently Ordered Tests List

and the Fee Schedule, the pricing provided in the Frequently Ordered Tests List will prevail.

Frequently Ordered Tests

Tissue Transglutam IGA 1549 $68.00 4 daysRA Diagnostic Panel 17669 $102.82 3 daysGroup A Strep Rapid Scn 2031 $7.50 TBDStrep Scn Group A 2032 $7.50 TBDGroup A Strep No Rfx 2034 $7.50 TBDCMV AB Profile 3100 $45.50 24hrCMV IGG AB 3105 $13.00 24hrHIV- 1 WB W/RFX HIV-2 3214 $42.39 TBDHeterophile, Mono Scn 4317 $18.25 24hrSed Rate Westergren 4542 $4.21 24hrHIV-1 AB West Blot 5233 $42.39 TBDLithium 6315 $9.83 24hrHCG, Total, Quant 7275 $24.62 24hrVitamin B12 7610 $49.00 24hrCMV AB IGM 3110 $32.50 24hrCMV AB IGM 12486 $32.50 4 daysWestern Blot HIV-1 3215 $42.39 TBD

65%

$16.95

$7.74

Percentage Discount Allowed off fee schedule for tests not listed

Stat Testing Charge per specimen

Stat Courier Charge

Page 3: Contract : 5753 Vendor : Quest Diagnostics Description ... Quest...Contract : 5753 Vendor : Quest Diagnostics DESCRIPTION CODE PRICE DESCRIPTION CODE PRICE ELECTROLYTES PANEL 42 $3.52

Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEELECTROLYTES PANEL 42 $3.52 HIV1 RNA QNT RLTM PCR CSF 16186 $101.85 PROFILE 68 (SPRUE PANEL) 68 $101.85 INTERFERON BETA 1A 16201 $162.40 PROFILE 88 88 $12.78 INTERFERON BETA 1B AB 16202 $162.40 PROFILE 101 ANEMIA 101 $24.96 BUPRENORPHINE W/O CONF,UR 16207 $60.00 PROFILE 103 ELECTROLYTES 103 $4.73 ANTIMICROBIAL,RIFABUTIN 16208 $64.05 AMA HEPATIC FUNCTION PNL 104 $4.05 MAGNESIUM, 24 HOUR URINE 16213 $24.17 OBSTETRIC PANEL 125 $50.16 OPIATES CONF, UR 16215 $100.00 HEPATITIS B SURVEILLANCE 133 $53.24 MDMA/MDA, QUANT, UR 16216 $100.00 NEEDLESTICK/EXPO PROF 145 145 $44.17 HEPATOCELLULAR CARCINOMA 16222 $143.50 ALLERGEN PROFILE 184 184 $189.00 C-KIT MUTATIONS W/REFLEX 16237 $350.00 RAST FOODS COMPREHENSIVE 187 $119.00 ARBOVIRUS AB PNL, CSF 16240 $241.15 RAST HOUSEHOLD INHALANTS 188 $56.00 INFLUENZA A H1/H3 RT PCR 16251 $104.30 REGIONAL PLANTS PROFILE 189 $98.00 RESPIRATORY PNL W/H1N1 16255 $417.20 PROFILE 193 RAST 193 $182.00 BASE PROF W/CONF, UR 16259 $159.39 MYELOMA PROFILE 222 222 $89.57 BASE PROF W/O CONF, UR 16260 $159.39 AUTOIMMUNE PROFILE 224 224 $154.00 PROCALCITONIN 16265 $85.75 PROFILE 271 PRENATAL 271 $61.18 FUNGITELL(1-3)-B-D-GLUCAN 16283 $96.25 ALLERGEN PROFILE 279 279 $189.00 SRA ASSAY LMWH 16284 $91.00 PROFILE 283 IMMUNE COMPET 283 $198.35 SRA ASSAY FONDAPARINUX 16285 $91.00 C3, C4, COMPLEMENT CH50 284 $65.49 PLATELET AB SCR INDIRECT 16288 $80.50 ALLERGEN GRASSES PROFILE 300 $35.00 QUANT HIV-1 RT PCR (NIH) 16290 $103.25 ALLERGEN WEEDS PROFILE 301 $28.00 GTT GESTATIONAL 4 SPEC 16292 $14.98 ALLERGEN INDOOR INHALANTS 302 $42.00 IGF-1 ELECTROCHEM 16293 $54.25 ALLERGEN TREES PROFILE 303 $35.00 OPIATES EXPANDED,QUANT,UR 16298 $100.00 ALLERGEN MOLDS PROFILE 304 $35.00 FRAGILE X DNA ANLYS FETUS 16300 $133.00 ALLERGEN PEDIATRIC FOOD 305 $35.00 CAMPYLOBACTER SPECIES AG 16302 $33.95 ALLERGEN MEATS PROFILE 306 $28.00 BUPRENORPHINE SCR W/CONF 16310 $21.00 ALLERGEN GRAINS PROFILE 307 $35.00 XSENSE FRAGILE X W/RFLX 16313 $105.00 ALLERGEN PROFILE 311 311 $91.00 BUPRENORPHINE QUANT URINE 16314 $35.00 T-HELPER PANEL 346 $172.83 HEMOGLOBIN A1C WITH EAG 16320 $16.45 IRON,TIBC AND FERRITIN 359 $29.44 OSTEOCALCIN, N-MID 16322 $50.75 HEPATITIS PANEL, ACUTE 365 $98.31 XSENSE(R)FRAGILE X W/RFLX 16326 $327.25 ALLERGEN PROF 392 (RAST) 392 $252.00 LINEZOLID, HPLC 16328 $64.05 GLUCOSE TOLERANCE 2HR 406 $7.60 THROMBOPOIETIN (TPO) 16336 $43.75 GLUCOSE TOLERANCE 1HR 410 $7.32 GENOMIC ALTER PRENATAL 16340 $556.50 GLUCOSE TOLERANCE 2 HOUR 412 $15.79 EML4-ALK GENE FUSION PCR 16344 $192.50 GLUCOSE TOLERANCE 3HR 418 $15.79 HISTAMINE, PLASMA 16354 $47.95 GLUCOSE FAST AND GEST 425 $8.96 S PNEUMONIAE IGG AB,MAID 16374 $108.15 ALLERGEN PROF 427 (RAST) 427 $259.00 C DIFFICILE TOXON B 16377 $42.00 GTT,GESTATIONAL,4 SPEC 428 $15.79 CATECHOLAMINES SUPINE 16381 $52.85 GLUCOSE TOLERANCE 5 HOUR 441 $26.29 CATECHOLAMINES FRAC 16382 $52.85 CSF PROFILE 480 $17.85 CMV IGG/IGM CSF 16385 $59.15 MYELOMA PROFILE 635 635 $132.34 ENCEPHALITIS AB PANEL 16405 $281.40 PROFILE 688 688 $9.49 FENTANYL SCREEN UR W/RFLX 16407 $12.25 ZINC ALUMINUM SERUM 784 $70.70 EBV PANEL, CSF 16420 $104.65 DIARRHEA PROFILE 786 786 $121.07 HIV-1 GENOTYPE TROPISM 16430 $1,690.00 PROFILE 800 7 PANEL TOX 800 $8.24 HIV-1 VIRTUAL PHENOTYPE 16431 $591.50 PROFILE 819 8 PANEL TOX 819 $8.87 PNH W/FLAER 16433 $196.88 PROFILE 821 10 PANEL TOX 821 $10.11 CORTISOL FREE RESPONSE X3 16434 $131.25 PROFILE 822 9 PANEL TOX 822 $9.46 CHRONIC URTICARIA PANEL 16440 $128.10 PROFILE 866 7 PANEL TOX 866 $8.24 JC POLYOMA VIRUS DNA, CSF 16441 $104.30 THYROGLOBULIN PANEL 900 $66.33 JC POLYOMA DNA, CSF 16442 $122.15 RENAL FUNCTION PANEL 916 $4.57 JC POLYOMA VIRUS DNA, UR 16446 $122.15 COMP METAB WITH EGFR 944 $5.27 JC POLYOMA VIRUS DNA, UR 16447 $104.30 THYROID PANEL (T3U,T4,T7) 975 $11.52 TSH RECEPTOR ANTIBODY 16453 $80.50 BASIC METABOLIC 982 $4.22 PROF 1 W/CONF, UR 16454 $259.00 PAP 1 SLIDE (SCRN) 1000 $12.00 PROF 2 W/CONF, UR 16455 $159.39 HUMORAL IMMUNITY STATUS 1048 $316.40 PROF 3 W/CONF, UR 16456 $192.59 PAP INTERP BY DR 1081 $0.84 BASE PROF W/CONF, UR 16457 $159.39 ERA/PRA IMMUNOPEROXIDASE 1088 $89.18 LUNG CANCER MUTATION PNL 16461 $459.90 ERA/PRA IMMUNO NON-BREAST 1089 $96.01 STEPWISE PART 1 16463 $68.25

Quest Fee Schedule

Page 4: Contract : 5753 Vendor : Quest Diagnostics Description ... Quest...Contract : 5753 Vendor : Quest Diagnostics DESCRIPTION CODE PRICE DESCRIPTION CODE PRICE ELECTROLYTES PANEL 42 $3.52

Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

PAP,THIN LYR,RESCRN(DIAG) 1090 $22.66 STEPWISE PART 2 16465 $169.75 PAP,THIN LYR,RESCRN(SCRN) 1091 $69.50 GENOMIC ALTERATIONS 16478 $840.00 FACTOR VII AG. 1112 $180.00 PROF 4 W/CONF, UR 16483 $242.40 AMINOLEVULINIC ACID,RND 1147 $25.20 PROF 4 W/CONF, UR 16484 $242.40 POLIOVIRUS POST VACCINE 1156 $28.18 HISTOPLASMA AB PANEL, CSF 16485 $58.45 11-DEOXYCORTISOL 1205 $57.75 PROF 4 W/O CONF, UR 16486 $242.40 DRAW AND PROCESS REFERRED 1206 $28.50 HYPERSENSITIVITY PNEUMO 16490 $161.70 DRAW AND SHIP SPECIMEN 1216 $65.50 HE4,OVARIAN CANCER MONITR 16500 $89.60 ACETYLCHOLINE RECEPT.BIND 1229 $57.75 INFLM BWL DIS DIFF PANEL 16503 $175.00 FLUVOXAMINE (LUVOX) 1231 $101.00 METHYLMALONIC ACID URINE 16508 $49.70 ACTH, PLASMA 1232 $38.50 KRAS MUTATION ANALYSIS 16510 $203.00 CORTISOL, PRE ACTH 1233 $21.42 PHOSPHOLIPIDS, SERUM 16513 $27.65 CORTISOL, POST ACTH 1236 $21.42 UGT1A1 GENOTYPING 16521 $113.75 ACTH STIMULATION,PRE/POST 1237 $42.84 FISH TOP2A GENE AMP 16523 $157.50 ALUMINUM 1241 $45.85 BIOTINIDASE DEFICIENCY 16526 $262.15 ANDROSTENEDIONE,LC/MS/MS 1253 $58.45 LEPTOSPIRA AB W/RFLX 16529 $33.60 STINGING INSECT,IGE W/O T 1255 $35.00 RETICULIN IGG SCRN W/RFLX 16530 $22.75 ANTI-DNASE 1256 $22.75 1911A>G MUT ANALYSIS 16533 $104.65 GLOMERULAR BASEMENT MEMB. 1259 $49.70 JAK2 EXONS 12-13 MUTATION 16536 $175.00 G6PD QUANTITATIVE 1262 $23.80 BIOTINIDASE ACTIVITY 16537 $35.70 CHROMIUM, RANDOM URINE 1263 $32.55 JAK2 V617F,QL,LEUMETA W/R 16538 $175.00 OXALATE 1267 $127.00 JAK2 V617F MUTATION 16539 $175.00 ARSENIC, QUANTITATIVE 1271 $45.85 BK VIRUS DNA,QL,RT,PCR UR 16553 $107.80 BCR/ABL GENE REARRANGEMEN 1272 $151.20 CPK W/CKMB IF INDICATED 16555 $8.16 MESTINON 1275 $272.00 VITAMIN D 1,25-DIHYDROXY 16558 $79.45 PORPHYRINS,FRACTION, PL 1276 $43.75 THYROGLOBULIN FN ASPIRATE 16559 $31.50 ARSENIC,QUANTITATIVE,UR 1277 $45.85 PTH, INTACT, FNA 16560 $52.50 EPIDERMAL AB W/REFLEX 1279 $17.50 FUNGAL ID,PHENOTYPE & SEQ 16578 $105.00 VITAMIN B-12 BINDING 1286 $27.65 FUNGAL SEQUENCING ITS REG 16579 $105.00 BETA-2-MICROGLOBULIN 1289 $32.55 BK VIRUS DNA,QNT,RT,PCR U 16581 $122.15 ANGIOTENSIN II 1291 $31.15 FISH,LYMPHOID MYB del6q23 16593 $207.55 BETA 2 MICROGLOBULIN 1292 $31.50 TREPONEMA PALLIDUM DNA 16595 $104.30 B. HERMSII IGG/IGM AB 1293 $66.50 C. BURNETII DNA,QL,RLTM 16596 $104.30 BRUCELLA ANTIBODY 1295 $49.00 IODINE, SERUM & PLASMA 16599 $28.35 STRONGYLOIDES IGG ABS 1299 $53.20 IODINE 24-HOUR URINE 16602 $35.00 C1 INHIBITOR, PROTEIN 1301 $33.25 ETHYL GLUCURONIDE SULFATE 16604 $40.95 KETAMINE 1303 $101.00 CYP2C19 GENOTYPING 16605 $542.50 COMPLEMENT C2 1307 $31.50 HUMAN METAPNEUMOVIRUS 16607 $38.15 ADRENAL AB W/RFL TITER 1308 $24.50 HEXA MUTATION ANALYSIS 16612 $441.00 COMPLEMENT C5 1310 $33.60 PHOSPHATIDY IgG,IgA,IgM 16619 $108.50 IGG/ALBUMIN RATIO 1311 $33.25 NUCLEAR MATRIX PROTEINS 16645 $43.75 FUNGAL SUSCEPT MIC PANEL 1312 $188.30 LYME DISEASE AB, TOTAL 16646 $17.50 CA 125 1313 $32.48 CELIAC DISEASE PANEL 1 16652 $124.60 ALPHA 2 ANTIPLASMIN 1315 $35.35 RETT SYN REARRANGE DELDUP 16662 $323.75 CA 19-9 1319 $34.30 FISH, DUPLICATION 22Q11.2 16672 $128.80 CA 27.29 1320 $40.60 PHOSPHATIDYLCHOLINE IGG 16677 $36.17 CALCITONIN 1322 $54.25 PHOSPHATICYLCHOLINE IGM 16678 $36.17 NEOPTERIN 1323 $45.85 PHOSPHATIDYLCHOLINE IGA 16679 $36.17 CARNITINE 1328 $58.45 PHOSPHATIDYLETHANOLA IgG 16680 $36.17 VON WILLEBRANDS FACTOR AG 1332 $51.45 PHOSPHATIDYLETHANOLAM IgM 16681 $36.17 B. HENSELAE IgG,IgM REFLX 1334 $52.15 PHOSPHATIDYLETHANOLAM IgA 16682 $36.17 CATECHOLAMINES, FRACT. 1340 $52.85 HSV AB IGM W/RFL TITER 16684 $26.25 ALLERGEN WHITE ASH 1341 $7.00 PHOSPHATIDYLINOSITOL IgM 16685 $36.17 CATECHOLAMINES, 24 HR UR 1343 $49.35 PHOSPHATIDYLINOSITOL IgA 16686 $36.17 CHLAMYDOPHILA PSITTACI AB 1346 $36.75 EPSTEIN-BARR VIRUS ISH 16688 $57.75 ALLERGEN ITALIAN CYPRESS 1347 $7.00 IGG,IGA INDRCT IMMUNFLOR 16690 $64.75 BACTERIAL ANTIGEN PANEL 1349 $54.43 ORGANIC ACID URINE QUANT 16693 $132.65 CATECHOLAMINES, FRACT 1350 $64.75 HEP B VIRUS DNA, W/RFLX 16694 $113.75 METHYLMALONIC/HOMOCYSTEIN 1356 $98.00 IMMUNOGLOBULIN CSF PROF 16705 $42.00 COPPER, URINE 1364 $26.25 INSCAPE ER/PR/HER2 QNT 16707 $210.00 PLASMINOGEN 1366 $49.00 HIV-1 CORECEPTOR TROPISM 16710 $437.50

Page 5: Contract : 5753 Vendor : Quest Diagnostics Description ... Quest...Contract : 5753 Vendor : Quest Diagnostics DESCRIPTION CODE PRICE DESCRIPTION CODE PRICE ELECTROLYTES PANEL 42 $3.52

Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

CREATINE, URINE 1367 $26.25 HGB A1C W/RFLX GLYCOMARK 16715 $9.00 CYSTINE QUANTITATIVE, UR 1376 $45.50 HSV TYPE 1 & 2 W/INTERP 16720 $57.75 CHLAMYDIA DNA PROBE 1377 $13.13 PYRAZINAMIDE, HPLC 16726 $19.35 GONORRHEA DNA PROBE (GC) 1378 $11.10 RUBELLA RNA,QL,RT,PCR 16730 $104.30 DHEA,LC/MS/MS 1379 $62.30 TAMOXIFEN P450 GENOTYPE 16731 $542.50 CHLAMYDIA DNA SCRN W/RFLX 1380 $37.66 METHYLMALONIC ACID QNT 16732 $49.70 GROUP B STREP DNA PRB CUL 1381 $27.58 QNS HPV HIGH RISK 16737 $32.50 LIPID PANEL 1383 $7.21 C DIF DNA/TOXIN B GENE QL 16739 $104.30 MULTIPLE SCLEROSIS PANEL 1387 $247.00 VIT D,25-HYDROXY,1,25-D 16761 $147.70 ALPHA SUBUNIT 1391 $47.60 SLOS & STSD SCREEN 16764 $166.25 3HR GTT/INSULIN TOLERANCE 1392 $114.63 BRAF MUTATION ANALYSIS 16767 $166.25 PORPHYRINS, 24HR QUANT. 1393 $49.00 YERSINIA ENTEROC IGG,IGA 16768 $59.50 PTH INTACT/IONIZ CALCIUM 1396 $77.00 HLA-A29 DNA TYPING 16773 $66.50 REVERSE T3 1411 $60.90 HLA-B51 DNA TYPING 16775 $66.50 POLIO VIRUS ANTIBODY 1425 $44.10 CF MUTATION SCREEN 16790 $99.75 COXSACKIE A VIRUS PANEL 1428 $56.00 CALPROTECTIN, STOOL 16796 $61.25 HIV 1&2 ANTIBODIES 1429 $26.25 GENOMIC ALTERATIONS CGH 16800 $556.50 T3, FREE 1430 $55.65 HEMOGLOBIN A1C W/EAG 16802 $9.00 MAG AUTOANTIBODY 1431 $44.10 INFLUENZA A H1N1,RT,PCR 16807 $104.30 NEURONAL NUCLEAR (RI) 1432 $70.00 CELLSEARCH TUMOR, COLON 16811 $203.00 YO (PURKINJE CELL) AB 1435 $49.00 CELLSEARCH, PROSTATE 16812 $203.00 NEURONAL NUCLEAR (HU) 1437 $87.50 ANA SCREEN W/REFLEXES 16814 $19.25 HU AND YO AUTOANTIBODY 1438 $136.50 OXALATE, RANDOM URINE 16817 $24.17 GIARDIA ANTIBODIES (IFA) 1439 $58.10 NRAS MUTATION ANALYSIS 16818 $138.25 HEP C SUPPLEMENTAL (RIBA) 1450 $96.25 FETOMATERNAL BLEED, FLOW 16828 $61.25 HALOPERIDOL (HALDOL) 1451 $39.55 FISH, HES/LEUKEMIA 4q12 16837 $181.30 HAEMOPHILUS INFLUENZA B 1454 $34.30 HISTAMINE RELEASE-CHRONIC 16838 $52.50 ANTI GLIADIN ANTIBODIES 1456 $59.50 ANTIMULLERIAN HORMONE 16842 $54.60 HEAVY METALS, URINE 1457 $136.50 CHROMOSOME,NEONATAL BLOOD 16843 $222.25 HISTAMINE, URINE 1461 $57.75 ANTIMIC,ETHAMBUTOL, HPLC 16844 $64.05 LATEX RIA PANEL 1468 $94.30 ALDOSTERONE/PRA-LC/MS/MS 16845 $73.50 IGG SUBCLASSES 1472 $91.35 PLASMA RENIN ACTIVITY 16846 $31.50 INSULIN 1475 $25.66 FISH,NHL,BCL6 3q27 REARNG 16851 $133.00 INSULIN, SPECIMEN 2 1476 $25.66 PROF 2 W/CONF, UR 16852 $159.39 HANTAVIRUS (SIN NOMBRE) 1477 $51.45 PROF 2 W/O CONF, UR 16853 $55.79 A1-ANTITRYP.QNT/PHENO 1480 $67.90 PROF 3 W/CONF, UR 16854 $192.59 GROUP B STREP DNA PRB CUL 1481 $27.58 PROF 3 W/O CONF, UR 16855 $192.59 NEURONTIN (GABAPENTIN) 1483 $31.50 PROF 1 W/CONF, UR 16856 $259.00 INTRINSIC FACTOR BLOCKING 1484 $28.00 PROF 1 W/O CONF, UR 16858 $259.00 INSULIN, SPECIMEN 3 1485 $25.66 PDGFRA MUTATION ANALYSIS 16859 $199.50 CALCIUM,IONIZED 1487 $17.50 BAC ID PHENOTYPIC 16860 $84.00 LEAD, BLOOD 1493 $22.75 INFLUENZA A/B RT-PCR W/RF 16861 $104.30 HSV 1 & 2, IGM 1509 $42.00 FISH,B-CELL LYMPH/LEUKEM 16864 $253.75 DRVVT SCREEN W/REFLEXES 1513 $15.75 SELENIUM, 24 HR URINE 16866 $48.30 THYROID STIM IMMUNO (TSI) 1515 $100.10 SELENIUM, RANDOM URINE 16867 $48.30 LYSOZYME, SERUM 1517 $31.85 HIV-1 INTERGRASE GENOTYPE 16868 $154.00 T4 FREE, DIRECT DIALYSIS 1519 $32.90 FISH,IGH/FGFR3, t(4,14) 16872 $133.00 PARVOVIRUS AB IGG/M,B-19 1524 $49.00 BCR-ABL1 KINASE DOMAIN 16876 $162.75 CHROMOGRANIN A 1527 $38.50 HIV-1,RNA,QUAL,CSF 16879 $122.15 HOMOCYSTEINE CARDIOVASCUL 1529 $56.00 GENOMIC ALTERATIONS POC 16884 $556.50 TRYPTASE 1531 $40.25 AMPHETAMINE, W/CONF, UR 16885 $60.00 HERBICIDES PANEL 1 1534 $211.00 BARBITURATE, W/CONF, UR 16886 $60.00 MENINGOENCEPHALOMYELITIS 1535 $723.10 BENZODIAZEPINES W/CONF,UR 16887 $60.00 CORTICOSTERONE 1536 $35.35 COCAINE SCRN, W/CONF, UR 16888 $60.00 NTX 24HR URINE 1537 $58.80 MARIJUANA MET SCRN W/CON 16889 $60.00 MERCURY 1538 $38.50 METHADONE SCRN W/CONF, UR 16890 $60.00 IMM. COMPLEX BY C1Q BIND. 1540 $37.10 OPIATES SCRN W/CONF, UR 16891 $60.00 MERCURY, URINE 1541 $38.50 OXYCODONE SCRN W/CONF, UR 16892 $60.00 VITAMIN B2 1543 $48.30 PHENCYCLIDINE W/CONF, UR 16893 $60.00 M.HOMINIS/UREAPLASMA CULT 1545 $51.80 PROPOXYPHENE W/CONF, UR 16894 $60.00 METANEPHRINES,FRAC,24HR 1547 $41.65 WILMS TUMOR(WT1)MUT ANLYS 16896 $297.50

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

TISSUE TRANSGLUTAM AB IGA 1549 $42.35 ANAPLASMA IgG, IgM 16897 $23.45 SEX HORMONE BIND/GLOBULIN 1555 $26.25 FENTANYL, QUANT, UR 16900 $100.00 MICROALB 24HR W/CREAT 1556 $16.59 BUPRENORPHINE W/CONF, UR 16901 $60.00 IGA-FIBRONECTIN AGGREGATE 1560 $103.25 CARISOPRODOL , QUANT, UR 16902 $100.00 MYELIN BASIC PROTEIN, CSF 1562 $34.30 TRICYCLIC AD, QUANT, UR 16903 $100.00 DEOXYCORTICOSTERONE 1564 $53.90 GABAPENTIN, QUANT, UR 16904 $100.00 PREGNENOLONE 1566 $37.80 MEPERIDINE, QUANT, UR 16905 $100.00 CANDIDA AB IgG,IgA,IgM 1567 $39.55 TRAMADOL, QUANT, UR 16906 $35.00 MYOGLOBIN 1568 $34.65 PREGABALIN, QUANT, UR 16908 $100.00 ANTI-LKM ANTIBODY 1572 $21.00 MDMA/MDA SCRN W/CONF, UR 16909 $60.00 17-HYDROXYPREGNENOLONE 1573 $47.25 HEROIN METAB, QUANT, UR 16911 $60.00 NEUTROPHIL,OXIDATIVE 1574 $60.90 BARBITURATE CONF, UR 16912 $100.00 HEPATITIS C ANTIBODY 1590 $11.33 XYLOSE, FASTING 16913 $27.30 CHROMIUM, URINE 1593 $32.55 BENZODIAZEPINES CONF, UR 16914 $100.00 INSULIN, SPECIMEN 4 1612 $25.66 COCAINE METAB CONF, UR 16916 $100.00 NEUTROPHIL ANTIBODY,FC 1622 $54.95 MARIJUANA METAB CONF, UR 16917 $100.00 OSMOLALITY, STOOL 1624 $10.41 METHADONE CONF, UR 16918 $100.00 Q FEVER ANTIBODY 1625 $32.55 OXYCODONE CONF, UR 16920 $100.00 C3d IMMUNE COMPLEX 1628 $45.85 PHENCYCLIDINE CONF, UR 16921 $100.00 COCCIDIOIDES CF & ID 1639 $47.95 PROPOXYPHENE CONF, UR 16922 $100.00 STRAITED MUSCLE AB W/RFLX 1649 $29.40 CLOPIDOGREL CYP2C19-12345 16924 $138.25 THYROXINE BINDING GLOBUL 1657 $32.20 MLH1 GENE SEQUENC,HNPCC 16926 $511.00 IGF-1 BINDING PROTEIN 1658 $32.20 MSH2 GENE SEQ HNPCC 16928 $511.00 ALLERGEN, RUSSIAN OLIVE 1664 $39.88 APC GENE DELETION OR DUP 16930 $542.50 THIOTHIXENE (NAVANE) 1669 $96.00 APC GENE SEQUENCING 16934 $630.00 THYROGLOBULIN 1672 $49.53 ASHKENAZI JEWISH PANEL 16936 $1,128.05 TRANSFERRIN 1678 $23.31 MUM1 IHC W/INTERPRETATION 16957 $57.75 VARICELLA-ZOSTER IgG 1699 $29.82 HIV-1 QUANT W/REFLEX 16958 $103.25 VASOACTIVE INT.POLYPEPTID 1705 $71.40 VEGF MUTATION ANALYSIS 16959 $82.25 VITAMIN A 1708 $31.15 INFLUENZA H1N1 (2009) 16962 $87.15 VITAMIN B1 (THIAMINE) 1711 $40.25 STREP PNEUMO IgG 23 MAID 16963 $193.90 VANILLYLMANDELIC ACID 1712 $50.05 FISH,IGH/MAF,t(14,16) 16965 $133.00 PKU HEEL STICK COLLECTION 1714 $6.13 CAH PANEL 6C(FULL SCREEN) 16978 $369.60 VITAMIN K, SERUM 1715 $74.90 CMV DNA ULTRAQUANT 16982 $140.11 VMA, 24 HOUR URINE 1720 $50.05 COLOVANTAGE 16983 $0.00 BORDETELLA PERTUSSIS DFA 1722 $26.25 TRANSFERRIN CARBOHYDRATE 16985 $43.75 CADMIUM, URINE 1728 $56.00 DENGUE VIRUS IGG AVIDITY 16987 $51.80 VERAPAMIL 1729 $104.00 SULFAMETHAZOLE LEVEL HPLC 16990 $64.05 PHENYTOIN, FREE 1731 $17.50 OVA1 16991 $227.50 XYLOSE ABSORPTION, URINE 1732 $27.30 OVA1TM (LH AND FSH) 16992 $274.12 XYLOSE ABSORPTION, BLOOD 1733 $27.30 CLONAZEPAM 17052 $24.68 CADMIUM, BLOOD 1734 $45.85 FORMALDEHYDE 17075 $9.54 HEPATITIS C RNA,QL,PCR 1737 $77.35 LUPUS ANTICOAGULANT EVAL 17079 $31.50 HEPATITIS C RNA PCR QUANT 1740 $147.70 PHENOLPHTHALEIN-FECES 17085 $9.63 CULTURE, ACANTHAMOEBA 1742 $68.25 HIV PHENOSENSE GT 17100 $1,787.00 GLUCAGON 1748 $37.10 CANDIDA AB IMMUNODIFF 17132 $35.70 HEPATITIS C RNA, QT, BDNA 1749 $147.70 HLA TYPING CELIAC DISEASE 17135 $71.75 V.ZOSTER IGM AB 1763 $26.60 CHLAMYDIA GROUP AB IFA 17159 $40.60 IGG SYNTHESIS, CSF 1775 $53.90 FACTOR VIII INHIBITOR 17168 $77.00 HEAVY METALS PANEL,BLOOD 1782 $107.10 JC POLYOMA VIRUS DNA QUAL 17220 $113.05 AMINO ACID, LC/MS, URINE 1783 $183.40 SALMONELLA IDENTIFICATION 17226 $0.00 SELENIUM 1784 $38.85 CLL PROGNOSTIC COMPREHENS 17239 $806.40 IGF BINDING PROTEIN-3 1786 $28.70 CLL PROGNOSTIC LIMITED 17240 $469.00 TICLOPIDINE (TICLID) 1791 $101.00 CLL PROGNOSTIC MONITORING 17290 $386.05 3a-ANDROSTANEDIOL GLUCUR. 1801 $60.55 KAPPA/LAMBDA LIGHT CHAINS 17300 $42.18 VITAMIN E 1802 $26.95 CHLAMYDIA TRACHOMATIS DNA 17303 $21.63 PORPHOBILINOGEN, QUANT 1806 $17.15 NEISSERIA GONORRHOEAE DNA 17304 $21.63 PROINSULIN 1809 $59.85 CHLAMYDIA/N GONORRHOEAE 17305 $43.26 HEPATITIS B CORE AB,IGM 1810 $34.35 VIT D,25-HYDROXY,LC/MS/MS 17306 $68.25 PORPHOBILINOGEN, QUANT 1812 $17.15 ATT QUANT AND MUTATION 17307 $118.65 ASPERGILLUS AB,CF 1816 $35.35 CLL PROG COMPREH KAROTYPE 17312 $534.80

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

CREATINE 1832 $26.25 LACTOFERRIN, QT, STOOL 17321 $64.75 ANTI-DNA SINGLE STRANDED 1834 $45.59 FISH, MANTLE CELL LYMPH 17346 $147.70 PTH-RELATED PROTEIN 1837 $64.40 FISH,FOLLICULAR LYMPHOMA 17347 $147.70 TETRAHYDROALDOSTERONE 1839 $78.75 FISH,B-CELL MALIGNANCY 17348 $138.60 ANTI-THROMBIN III 1848 $29.86 FISH, BURKITT'S/NHL/ALL 17352 $157.50 PYRUVATE 1854 $22.40 FISH,LOCUS-SPECIFIC X1 17355 $126.00 MYASTHENIA GRAVIS PANEL 1862 $87.15 RBC FRAGILITY - INCUBATED 17364 $9.36 CULTURE, CHLAMYDIA 1878 $33.95 THALASSEMIA-HGB COMPLETE 17365 $59.50 17-OH-CORTICOSTEROIDS 24H 1900 $34.30 DONOR, HEP B SURFACE AG 17375 $40.16 17-KETOSTEROIDS W/CR,24HR 1902 $68.60 DONOR, HEP BC TOTAL 17378 $43.75 17-OH-PROGESTERINE,LCMSMS 1903 $39.20 DONOR, HTLV 1-2 AB 17379 $49.53 5-HIAA, 24 HR URINE 1904 $26.25 DONOR, HIV 1-2 AB 17380 $54.08 ALLERGEN, BUMBLE BEE 1918 $48.40 HEP C DONOR 17382 $54.16 C1 INHIBITOR, FUNCTIONAL 1919 $20.30 CHLAMYDIA GC DONOR PANEL 17385 $73.50 CAROTENE (BETA) 1922 $26.60 DONOR, CMV TOTAL 17388 $76.21 ECHOVIRUS ANTIBODY PANEL 1928 $55.30 DONOR, RPR W/RFX SYPH IGG 17389 $33.69 HIV-1 DNA, PCR 1933 $101.50 HLA-DQB1 HIGH RESOLUTION 17394 $131.25 HLA-B27 1937 $47.25 HLA-C HIGH RESOLUTION 17395 $131.25 PARAINFLUENZA AB 1-3 1940 $70.00 HLA-A2 TYPING W/REFLEX 17398 $68.25 JO1 ANTIBODY 1944 $19.25 COLLAGEN TYPE I C-TELOPEP 17406 $48.65 LEAD, URINE 1946 $38.50 RHEUMATOID FACTOR, CSF 17407 $12.25 OXALIC ACID, 24 HR URINE 1951 $24.15 PTT-LA W/REFLEX 17408 $15.75 AMINOLEVULINIC ACID,DELTA 1953 $29.75 AFP, CSF 17409 $26.25 VITAMIN B6 1964 $61.25 AFP, PERITONEAL FLUID 17410 $29.40 TOXOPLASMA AB IGG/IGM 1965 $35.95 CA125, CSF 17416 $44.80 ESTROGEN, FRACTIONATED 1968 $116.90 CA 19-9, CSF 17417 $34.30 PM-1 ANTIBODY 1975 $28.35 CHLAMYDIA & CHLAMYDOPHILA 17419 $36.75 DHEA SULFATE 1986 $52.50 CEA, CSF 17420 $29.40 ESTRADIOL LC/MS/LC 1987 $41.30 CEA, PERITONEAL FLUID 17421 $29.40 CRYOGLOBULIN SCREEN W/RFL 1996 $12.25 CHOLINESTERASE RBC 17430 $19.95 CULTURE AND SMEAR, AFB 2000 $55.58 HIV-1 GENOTYPE PLUS 17480 $157.50 AFB SMEAR 2002 $9.45 HEAVY METALS, URINE 17492 $314.65 CULTURE, ANAEROBIC 2010 $15.37 PROTEIN S ACTIVITY W/RFLX 17494 $60.55 ANAEROBIC SENSITIVITY 2011 $24.12 HERPES SIMPLEX/VZV,RAPID 17495 $68.95 IDENTIFICATION ANAEROBIC 2019 $7.25 IRON, 24 HR URINE 17515 $21.96 ID ONLY, AEROBIC 2020 $7.25 HCG, TOTAL, CSF 17548 $28.00 SENSITIVITY ONLY 2021 $4.80 AFP, PERICARDIAL FLUID 17554 $29.40 BACTERIAL TYPING 2022 $21.60 W NILE VIRUS RNA QUAL PCR 17563 $113.75 BACTERICIDAL LEVEL 2023 $45.15 BORRELIA BURGDORFERI DNA 17570 $93.80 GRAM STAIN 2025 $5.85 HERPES SIMPLEX, DNA (HSV) 17581 $99.75 STOOL FOR WBC 2026 $4.97 CEA, PLEURAL FLUID 17584 $29.40 INDIA INK PREP 2027 $7.84 HCG TOTAL,PERITONEAL FLD 17587 $28.00 ID & SENSITIVITY, BLOOD 2028 $12.39 COMPLEMENT C3,PLEURAL FLD 17593 $34.30 FAT SCREEN, STOOL 2029 $34.13 COMPLEMENT C3,PERITONEAL 17594 $34.30 CLINDAMYCIN DISK INDUCTIO 2030 $4.80 COMPLEMENT C4,PLEURAL FLD 17595 $34.30 GROUP A STREP RAPID SCRN 2031 $16.07 COMPLEMENT C4,PERITONEAL 17596 $34.30 MUSCLE FIBERS FECAL 2033 $29.72 COMPLEMENT C3, SYNOVIAL 17597 $34.30 GROUP A,STREP-NO REFLEX 2034 $16.07 COMPLEMENT C4, SYNOVIAL 17598 $34.30 WET MOUNT 2035 $4.10 LIPASE, PANCREATIC FLUID 17604 $10.41 HUMORAL IMMUNITY EVAL PNL 2070 $189.70 CEA, PERICARDIAL FLUID 17605 $29.40 BLOOD CULTURE, AFB 2120 $22.37 PENICILLIN PROFILE 2 17606 $28.00 CULTURE,FUNGAL BLOOD 2125 $12.92 FENTANYL & NORFENTANYL,UR 17607 $14.00 CULTURE,FUNGUS,OTHER 2150 $28.18 ATYPICAL PNEUMONIA DNA 17610 $254.80 FUNGAL SMEAR, OTHER 2152 $6.30 CELIAC PANEL W/O GLIADIN 17612 $55.30 FUNGAL ID, MOLD 2154 $25.38 C.TRACHOMATIS DNA,SDA 17615 $24.50 FUNGUS CULTURE W/O SMEAR 2155 $11.10 N.GONORRHOEAE DNA,SDA 17617 $24.50 FNG SMEAR,SKN,HAIR,NAIL 2156 $6.30 CHLAMYDIA/N.GONORRHOEAE 17618 $42.00 FUNGAL ID, YEAST 2157 $63.00 MALE INFERTILITY GENETIC 17625 $535.50 CULTURE,NOCARDIA 2158 $11.41 SALMONELLA IGG,IGM,IGA 17631 $32.55 CULT,FUNGUS,SKIN,HAIR,NAI 2175 $27.02 CYTOCHROME P450 2D6/2C19 17634 $367.50 CULTURE, BLOOD ARD 2200 $23.77 CA 19-9, PERITONEAL FLUID 17638 $34.30

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

BRUCELLA SCREEN 2215 $11.10 HCG TOTAL, PLEURAL FLUID 17639 $28.00 FRANCISELLA TULARENSIS SC 2220 $11.10 GLUCOSE, PERICARDIAL FLD 17641 $8.75 BACILLUS ANTHRACIS SCREEN 2230 $11.10 CA 19-9, PLEURAL FLUID 17642 $34.30 CULTURE, FLUID 2250 $16.07 CA 19-9, PERICARDIAL FLD 17643 $34.30 CULTURE, GC 2252 $7.21 HCG TOTAL,PERICARDIAL FLD 17644 $28.00 CULTURE, WOUND 2275 $16.07 ALBUMIN, SYNOVIAL FLUID 17646 $7.70 CULTURE, SURGICAL 2277 $16.07 LDH, PERICARDIAL FLUID 17647 $7.35 CULTURE, AEROBIC 2300 $10.22 17 HYDROXYPROGESTERONE 17654 $39.20 HYDROCHLOROTHIAZIDE 2330 $108.00 LDH, SYNOVIAL FLUID 17658 $7.35 RISPERIDONE 2339 $32.20 RHEUMATOID DIAGNOSTIC PNL 17669 $43.75 CULTURE,SPUTUM GRAM STAIN 2350 $16.07 H. PYLORI ANTIBODY, IGG 17670 $38.50 CULTURE, RESPIRATORY 2375 $11.43 H PYLORI IGA ANTIBODY 17671 $38.50 MRSA SCREEN 2381 $4.66 LYMPHO MITOGEN/AG STIMUL 17678 $454.65 CULTURE,URINE,ROUTINE 2400 $11.43 MANTLE CELL LYMPHOMA 17679 $134.75 CULTURE URINE SPECIAL 2404 $10.57 C3A DESARG FRAGMENT 17689 $43.05 CULTURE, STOOL W/RFLX 2500 $30.54 FOLLICULAR LYMPHOMA 17690 $147.00 SALMONELLA/SHIGELLA SCRN 2501 $10.89 H PYLORI AB, IGA & IGG 17691 $77.00 SCABIES EXAM 2502 $6.30 ADENOSINE DEAMINASE PLURL 17696 $52.50 CAMPYLOBACTER CULTURE 2504 $10.89 ADENOSINE DEAMINASE PERTL 17697 $52.50 SHIGA TOXINS W/RFLX CUL 2506 $23.85 ADENOSINE DEAMINASE CSF 17698 $52.50 E COLI 0157 CULTURE 2507 $18.11 CLL IGVH MUTATION STATUS 17702 $148.75 CULTURE, VIBRIO 2510 $29.65 ANGIODEMA PANEL 17706 $77.35 CULTURE, YERSINIA 2520 $29.65 CA 125 W/HAMA TREATMENT 17717 $34.30 STOOL CULTURE FOR VRE 2550 $29.61 COMPLEMENT C3,PERICARDIAL 17718 $34.30 VRSA 2551 $29.61 COMPLEMENT C4,PERICARDIAL 17719 $34.30 STREP GROUP A CULTURE 2600 $4.66 LUPUS ACTIVITY PANEL 2 17725 $65.80 STREP GROUP B CULTURE 2601 $4.66 DONOR, HIV-1/HCV NAT 17746 $160.91 ALLERGEN, CAULIFLOWER IGE 2635 $7.00 AVIAN INFLUENZA H5 GENE 17750 $113.75 ALLERGEN CLOVE (F268) IGE 2638 $36.90 AVIAN INFLUENZA H5 GENE 17751 $113.75 CULTURE, VARICELLA ZOSTER 2691 $45.50 BASIC METABOLIC W/O CAL 17759 $6.03 ALLERGEN, PAPAYA IGE 2720 $7.00 COMP METABOLIC W/EGFR 17760 $5.74 CULTURE, VAGINAL 2800 $14.32 COMP METABOLIC W/O ALT 17761 $5.85 CULTURE, VAGINAL 2801 $10.54 CREATININE CLEARANCE/EGFR 17763 $12.81 OVA AND PARASITES 2900 $18.03 HTLV I/II, WESTERN BLOT 17780 $35.00 GIARDIA LAMBLIA SCREEN 2905 $20.55 UGT1A1 GENE POLYMORPHISMS 17813 $122.50 CRYPTOSPORIDIUM AG STOOL 2930 $29.40 CLL LYMPHOMA DIAGNOSTIC 17817 $0.00 ALLERGEN GREEN PEPPER IGE 2931 $7.00 CLL LYMPHOMA FOLLOW UP 17818 $0.00 OCCULT BLOOD DIAG (1SPEC) 2940 $4.52 HCL LYMPHOMA FOLLOW UP 17819 $0.00 OCCULT BLOOD SCRN (1SPEC) 2945 $4.52 PLASMA CELL NEOPLASIA 17820 $0.00 PINWORM EXAM 2950 $4.52 ACUTE LEUKEMIA FOLLOW UP 17821 $0.00 OCCULT BLOOD DIAG (2SPEC) 2960 $8.61 SLIDE RETURN REQUEST 17828 $5.25 OCCULT BLOOD DIAG (3SPEC) 2961 $12.92 ALDOSTERONE - ACTH 17832 $73.50 OCCULT BLOOD SCRN (2SPEC) 2962 $12.92 FIRST TRIMESTER SCREEN 17833 $47.25 OCCULT BLOOD SCRN (3SPEC) 2963 $12.92 FACTOR V ACTIVITY 17844 $100.80 ANACHOICE W/RFL TITER,IFA 3000 $7.21 FACTOR IX ACT & INHIBITOR 17845 $127.40 ANA WITH PATTERN 3004 $16.49 E.CHAFFEENSIS IgG,IgM 17851 $51.10 ANACHOICE W/REFLEX DS-DNA 3009 $19.25 BCR/ABL REARRANGEMENT 17853 $151.20 ANTI-DNA AB-DOUBLE STRAND 3010 $19.25 FACTOR XI ACT & INHIBITOR 17854 $127.40 ANTI-NUCLEAR ANTIBODY 3013 $12.95 T-CELL RECEPTOR QUANT 17861 $140.00 ANTI-SM (SMITH) 3016 $19.25 T-CELL RECEPTOR QUAL 17862 $102.90 SJOGREN'S ANTIBODIES (ID) 3020 $38.50 GROUP B STREP, PCR 17869 $33.25 SJOGRENS AB (SS-A) 3021 $19.25 FACTOR V PCR (LEIDEN) 17900 $91.00 SJOGRENS (SS-B) 3022 $19.25 FACTOR V HR2 ALLELE MUT 17902 $80.50 SLCERODERMA ABS (SCL-70) 3025 $19.25 FACTOR V MUTATION 17904 $92.75 SLE DIAG PANEL,DRUG INDUC 3027 $49.35 THROMBOPHILIA DNA MUTAT 17907 $200.90 MIXED CONNECT TISS DISEAS 3028 $38.50 FACTOR II MUTATION DNA 17909 $68.25 LUPUS/RHEUMATOID ARTHRIT 3029 $63.00 MTHFR DNA MUTATION 17911 $108.50 EPSTEIN BARR VIRUS 3031 $111.65 PROTEIN C & S ACTIVITY 17942 $225.40 PBC DIAGNOSTIC PANEL,COMP 3032 $150.15 B. BURGDORFERI AB INDEX 17970 $199.85 EUGLOBULIN CLOT LYSIS TME 3043 $25.20 C TRACHOMATIS ABS IGG/A/M 18036 $36.75 THYROGLOBILIN ANTIBODIES 3055 $16.80 CATECHOLAMINES/VMA 24 HR 18061 $89.25

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

M.PNEUMONIAE IGG/IGM EIA 3056 $48.30 DOXEPIN 18078 $31.50 M.PNEUMONIAE AB IGM EIA 3057 $24.15 HBV CORE/PRECORE MUTANT 18144 $181.65 ANTI-TPO ANTIBODY 3060 $14.84 ANTIDIURETIC HORMONE 18243 $65.10 CYANIDE, BLOOD 3091 $31.41 GALACTOSE 1 PHOSPHATE 18333 $235.90 MANGANESE RBC 3095 $40.60 RICKETTSIA ABS IGG,IGM 18359 $72.77 CMV ANTIBODY PROFILE 3100 $41.58 CALCIUM, FECES 18379 $226.50 CMV IGG ANTIBODY 3105 $6.13 C-PEPTIDE, 24 HOUR URINE 18573 $43.40 CMV AB, IGM 3110 $20.79 DRUG & ALCOHOL SCRN, BLD 18581 $122.00 TORCH ANTIBODY PANEL 3150 $89.50 NICKEL, SERUM 18622 $216.50 TORCH AB IGM 3151 $108.71 DRUG SCREEN I, BLOOD 18641 $115.00 RUBELLA ANTIBODY, IGM 3160 $40.60 HYDROCODONE 18663 $178.00 HIV 1/2 AB SCREEN W/RFLXS 3200 $8.94 HYDROMORPHONE QUANT 18664 $184.00 HIV-1 WB W/RFL HIV-2 RFL 3214 $40.43 PROTEIN C ACTIVITY & AG 18757 $102.55 HIV-1 AB CONF WB 3215 $34.83 ARYLSULFATASE A,LEUKOCYTE 18779 $363.60 METAHDONE QUANT/GCMS 3258 $39.55 ALPHA-L-IDURONIDASE 18781 $286.50 BLOMIA TROPICALIS IGE 3299 $7.00 ALPHA-GALACTOSIDASE 18784 $352.40 RESPIRATORY PROFILE-CHILD 3300 $156.45 OCCULT BLOOD, GASTRIC 18806 $6.48 RESPIRATORY PROFILE-ADULT 3305 $108.50 ALDOST/CORT RATIO 4 SITES 18823 $162.26 ENCEPHALITIS AB PROFILE 3310 $115.52 CHLORIDE FECES 18831 $18.20 CONJUNCTIVITIS PANEL 3315 $86.45 CASPOFUNGIN HPLC 18832 $64.05 ADENOVIRUS AB (CF) 3320 $26.25 KPC GENE REAL TIME PCR 18833 $298.00 INFLUENZA TYPE A&B AB 3345 $58.10 P JIROVECII QNT PCR 18834 $349.00 CHOLINESTERASE, PLASMA 3351 $16.28 P JIROVECII QL PCR 18835 $139.30 HELICOBACTER PYLORI IGG 3385 $18.03 KAPPA/LAMBDA LGHT CHN,ISH 18854 $315.00 FUNGAL ANTIBODY PROFILE 3400 $105.00 LEFLUNOMIDE METABOLITE 18865 $171.00 ASPERGILLUS AB, SERUM 3405 $21.00 PREGABALIN 18866 $59.85 HISTOPLASMA AB PROFILE 3413 $55.65 NEUROKININ A SUBSTANCE K 18871 $250.00 COCCIDIOIDES ABS,IGG/IGM 3425 $33.74 K. KINGAE DNA,QUAL 18872 $298.00 COCCIDIOIDES ATBY (ID) 3427 $21.70 ASPERGILLUS DNA 18873 $104.30 CRYPTOCOCCAL AG W/REFLEX 3450 $18.76 IGE ANTIBODY 18877 $17.50 LEGIONELLA DFA 3460 $39.20 D-LACTATE, PLASMA 18878 $322.60 FTA-ABS 3465 $14.84 ACETYLCHOLINE MODULATING 18879 $78.75 HERPES SIMPLEX VIRUS 2 3509 $14.00 ISOSPORA DETECTION FM 18880 $39.55 HERPES SIMPLEX VIRUS 1 3511 $14.00 EVEROLIMUS BLOOD 18883 $149.00 RESP. SYNCYTIAL VIRUS 3515 $28.63 FLUNITRAZEPAM 18886 $87.75 ROTAVIRUS ANTIGEN 3520 $25.66 BK VIRUS DNA, CS 18889 $104.30 CLOST.DIFFICILE TOXIN 3525 $51.50 BK VIRUS DNA, CS 18901 $122.15 TOXOPLASMA IgG ANTIBODY 3679 $14.88 COLORECTAL CANCER PNL 18902 $581.00 FLU ANTIGEN RAPID X2 3714 $15.44 2HR GTT 75GM PREG SCREEN 18927 $11.24 LAMBDA LIGHT CHAIN FREE 3757 $42.00 B.BURGDORFERI ABS, CSF 18941 $61.95 KAPPA LIGHT CHAIN,FREE 3759 $42.00 JAK2 V617F MUTATION QUANT 18950 $175.00 PARASITE IDENTIFICATION 3946 $32.83 MENINGOENCEPHALITIS PNL 18957 $858.90 PARASITE ID,INTESTINAL 3950 $32.83 FLUNITRAZEPAM METAB QUANT 18964 $198.00 PROTHROMBIN ANTIBODY 4000 $55.13 HIV-1 RNA QL TMA W/RFLX 18967 $349.00 FACTOR VIII ACTIVITY 4008 $51.45 MELANOMA MUTATION PNL 18968 $516.25 FACTOR IX ACTIVITY 4009 $66.40 HEROIN METAB 18969 $79.80 ADVANCED D-DIMER 4012 $19.29 OPIATES QT ENHANCED URINE 18976 $259.00 FIBRINOGEN,ACT,CLAUSS 4017 $7.60 ACCUTYPE METFORMIN 18979 $41.03 PROTHROMBIN TIME + INR 4021 $3.22 CHROMOSOME ANALYSIS 18980 $635.00 PTT 4023 $6.30 CHROMOSOME ANYLS HI RES 18983 $781.00 COAGULATION MIXING STUDY 4030 $9.52 FISH, EGFR 19041 $126.00 PROTHROMBIN TIME & PTT 4100 $9.52 DRUG SCREEN COMPREHENSIVE 19044 $36.72 FTA-ABS 4112 $14.84 FISH,DUPLICATION 15q11q13 19045 $128.80 DIC PANEL 4140 $40.81 PLATELET FUNCTION 19052 $45.26 NICOTINE & COTININE 4190 $14.70 VALPROIC ACID,TL & FREE 19058 $45.15 TREPONEMA PALLIDUM AB 4194 $30.10 ER/PR/MIB-1 PARAFFIN BLK 19070 $177.45 N-TELOPEPTIDE SERUM 4266 $79.45 ALLERGEN NUT PANEL 19082 $49.00 COLD AGGLUTININ 4301 $8.68 FISH,BLADDER CA & WASH 19085 $157.50 CRYOGLOBULIN, QUALITATIVE 4305 $6.51 NOROVIRUS RNA, RT-PCR 19098 $71.33 KLEIHAUER-BETKE 4307 $26.22 AMPHETAMINE VERIFICATION 19127 $39.81 ACID HEMOLYSIN 4309 $20.65 MAG ANTIBODY W/REFLEX 19201 $35.00

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

HAPTOGLOBIN 4311 $22.82 TYSABRI AB ELISA 19215 $113.75 HETEROPHILE,MONO SCREEN 4317 $7.11 METHYLENEDIOXAMPHETAMINE 19292 $97.00 RHEUMATOID FACTOR, QUANT. 4325 $5.92 HEPATITIS E IGG, IGM 19337 $61.95 RUBELLA VIRUS IGG AB 4327 $8.30 H PYLORI IHC W/O INTERP 19348 $43.75 STREP ANTIBODIES 4329 $9.66 W NILE VIRUS, NAT DONOR 19412 $113.75 RPR W/REFLEX FTA CONF 4331 $5.15 HYALURONIC ACID 19480 $36.75 SUGAR WATER TEST 4333 $8.40 SPERM AB IGA/IGG 19492 $40.60 VDRL 4335 $9.66 VZV REAL-TIME PCR 19493 $122.15 VDRL TITER, QUANT 4337 $10.29 HSV TYPE 1 & 2, DNA QNT 19502 $113.75 VDRL, CSF 4339 $6.79 JC POLYOMA VIRUS DNA RT 19503 $122.15 RPR MONITOR W/RFL TITER 4341 $5.30 INTERFERON-BETA IGG W/RFL 19509 $61.25 RPR DIAGNOSIS W/REFLEX 4345 $5.30 ANDROSTENEDIONE RESPONSE 19511 $116.90 QUANTIFERON 4399 $22.75 HLA-DQA1 DNA TYPING 19525 $55.13 IGG, CSF 4448 $19.25 HLA DRB3-4-5 DNA TYPING 19526 $55.13 CBC (INCLUDES DIFF/PLTS) 4500 $3.35 ALPHA-FETOPROTEIN/AFP L3 19529 $47.25 COMPLETE BLOOD COUNT 4502 $3.61 BILE ACIDS, FRAC/TL PRGNY 19546 $57.75 CBC W/O PLATELET 4503 $3.20 METANEPHRINES,FRACTIONATD 19548 $64.75 DIFFERENTIAL 4504 $3.15 TRICHOMONAS VAGINALIS RNA 19550 $49.00 DIFFERENTIAL REVIEW 4506 $5.36 CHLAMYDIA/CHLAMYDOPH PNL2 19589 $36.75 EOSINOPHIL COUNT, TOTAL 4508 $4.52 GLYCOMARK 19599 $24.50 EOSINOPHIL,NASAL SMEAR 4509 $6.79 DONOR,CHAGAS (T.CRUZI) 19616 $140.00 WRIGHT STAIN-OCULAR 4510 $8.68 DONOR, CMV TOTAL AB 19618 $67.46 CBC W/DIFF W/O PLATELET 4511 $12.67 FISH, MULTIPLE MYELOMA 19619 $181.30 HEMATOCRIT 4514 $0.82 LIVER FIBROSIS-HEPASCORE 19647 $75.96 BLOOD PARASITE 4515 $6.79 MENORRHAGIA SCREEN 19649 $176.40 HEMOGLOBIN (HGB) 4516 $0.82 SEROTONIN 19651 $66.85 CBC W/PLATELET 4518 $4.12 SEROTONIN, SERUM 19652 $66.85 HEMOGLOBIN & HEMATOCRIT 4520 $3.22 DONOR,CHAGAS SCR W/RFL 19677 $24.94 PLATELET COUNT 4524 $0.82 HPV LOW/HIGH RISK DNA X2 19688 $126.00 PLATELET COUNT 4526 $2.80 DISACCHARIDES 19701 $115.15 RBC 4528 $3.15 HEPTIMAX HCV RNA W/RFLX 19702 $147.70 RETICULOCYTE COUNT 4530 $4.87 RHEUMATOID FACTOR IGA,G,M 19705 $42.00 CORRECTED RETIC COUNT 4531 $4.76 FISH,MYELOMA 13q,14q,17p 19722 $184.54 SICKLE CELL SCREEN 4534 $4.97 HHV6 DNA,QNT,REALTIME,PCR 19723 $122.15 NEUTROPHILS,TOTAL 4535 $0.00 PARVO B19 DNA QNT RT PCR 19724 $122.15 LYMPHOCYTES,TOTAL 4536 $10.33 TOXOPLASMA GONDII QNT RT 19725 $122.15 GRANULOCYTES,TOTAL 4537 $10.82 ADENOVIRUS DNA,QNT,RT,PCR 19726 $122.15 WBC COUNT 4538 $2.59 FISH, ALVEOLAR FKHR 19772 $184.54 SED RATE, WESTERGREN 4542 $4.41 FISH,SYNOVIAL SARCOMA SYT 19773 $184.54 RBC,HGB,HCT 4545 $6.62 HLA-B*5701 TYPING 19774 $68.25 AMPLICHIP CYP450 2D6 2C19 4565 $344.40 AMINO ACIDS,MSUD,LC/MS 19779 $57.75 LAMOTRIGINE 4681 $67.00 ABL T3151 MUTATION,CELL-B 19783 $175.00 ABL T3151 MUTATION,LEUMET 4682 $175.00 VON WILLEBRAND COMP PNL 19790 $270.20 BILIRUBIN, URINE 4701 $1.89 FISH,MDS MYELOID PANEL 19799 $830.20 CELL COUNT AND DIFF,CSF 4705 $8.89 CADMIUM, 24 HOUR URINE 19806 $45.85 SYNOVIAL FLUID PANEL 4707 $13.02 COENZYME Q10 19826 $75.25 EOSINOPHIL, URINE 4715 $7.49 GLUCOSE,GEST 140 CUTOFF 19833 $5.22 PREGNANCY, URINE 4723 $4.66 GLUCOSE FASTING GESTATION 19834 $8.96 REDUCING SUBSTANCES, UR 4725 $3.92 VWD MUTATION ANALYSIS 19837 $406.00 SEMEN ANALYSIS QT,COMPL 4727 $42.00 MYOCARDITIS/PERICARDITIS 19839 $207.90 SEMEN ANALYSIS,QL 4729 $5.95 FISH,ALL +4,+10,+17 19856 $181.30 SPECIFIC GRAVITY 4733 $3.22 FISH HER-2/NEU W/RFLX IHC 19859 $157.50 SYNOVIAL FLUID PROFILE 4734 $23.10 CD57,CD3,CD8,FC 19860 $157.50 CRYSTALS, FLUID 4735 $8.75 HPV GENOTYPES 16 & 18 19865 $23.85 SPERM COUNT 4738 $21.00 ANTIPHOSPHOLIPID SYN DIAG 19872 $171.50 ALPRAZOLAM, SERUM/PLASMA 4741 $45.50 AUTOIMMUNE DIAGNOSTIC PNL 19873 $85.40 SEMEN ANALYSIS, POST EJAC 4744 $5.95 RA DIAGNOSTIC PANEL,COMP 19878 $106.05 CRYSTALS, BILE 4760 $8.75 SJOGRENS SYNDROME DIAG 19880 $117.25 UA COMPLETE W/RFL CULTURE 4770 $3.50 SLE COMPREHENSIVE DIAG 19881 $232.75 PH, URINE 4774 $3.05 SLE DISEASE ACTIVITY PNL 19882 $69.48 UA W/REFLEX MICROSCOPIC 4775 $4.12 SARCOMA MUTATION ANALYSIS 19884 $168.00

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

UA WITH MICROSCOPIC 4780 $6.18 HIV-1 RNA, QT BY BDNA 19886 $119.35 URINALYSIS 4781 $3.50 RNP ANTIBODY 19887 $19.25 URINALYSIS,DIPSTICK 4785 $3.50 HTLV I/II DNA, PCR 19896 $109.90 COPPER, LIVER 4859 $49.00 CORTISOL SALIVA LC/MS/MS 19897 $24.50 ALUMINUM WHOLE BLOOD 4862 $48.30 RNA POLYMERASE III AB 19899 $26.25 SELENIUM 4875 $48.30 LSD QUANTITATION 19917 $49.53 DIAZEPAM 4926 $34.30 HODGKINS LYMPHOMA PNL IHC 19936 $560.00 MEXILETINE SERUM/PLASMA 4934 $90.00 ASPERGILLUS IGG,A,M,EIA 19941 $133.00 TRAZODONE 4960 $30.80 C-KIT MUTATION, LEUMETA 19960 $350.00 ANTICARDIOLIPIN AB 5026 $65.10 COCCIDIOIDES AB TP & F ID 19963 $24.15 ALLERGY REGION XVII+ IgE 5031 $182.00 INFLUENZA TYPE A IGG/IGM 19973 $25.20 GLU TOL GESTATIONAL 4 SPC 5085 $15.79 LIPOPROTEIN FRCTN PNL 2 19979 $63.00 COUMADIN 5103 $21.96 DES-GAMMA-CARBOXY-PT 19982 $96.25 GASTRIN 5121 $25.55 HISTOPLASMA ANTIGEN,URINE 19994 $46.90 HEPATITIS Be PANEL 5166 $40.46 TROFILE TROPISM ASSAY 19995 $2,825.00 RETIC CNT & HGB COMPONENT 5172 $33.25 HUMAN IMMUNODEFICIENCY 19996 $2,825.00 ANTICARDIOLIPIN IGG/IGM 5281 $43.40 CULTURE ID EA ORGANISM 40003 $0.88 HISTOPLASMA AB, CSF 5297 $31.50 URINE CULT PRESUMPTIVE ID 40004 $1.33 IGG SUBCLASS 4 5428 $19.60 SENSITIVITY MICRO 40006 $1.33 MACROAMYLASE, SERUM 5499 $47.60 CULTURE,FUNGAL YEAST ID 40007 $12.64 METHAQUALONE, SERUM 5912 $39.81 CULTURE,FUNGAL MOLD ID 40008 $12.64 ACETONE, SEMI-QUANTITATIV 6005 $3.50 SENSITIVITY DISK (KB) 40015 $1.30 ACETONE, QUAL, URINE 6006 $3.50 ID, SEROGROUPING 40017 $1.33 ALBUMIN 6015 $3.08 BETA LACTAMASE 40019 $0.67 ALK PHOS ISOENZYMES 6020 $26.95 HLA-B 1502 TYPING 40045 $131.25 ALKALINE PHOSPHATASE 6025 $3.08 FISH,CHROMOSOME CLARISURE 40047 $115.50 AMMONIA 6030 $21.25 PROLACTIN,DILUTUON STUDY 40049 $45.50 AMYLASE 6040 $6.02 FISH, ALL, EXTENDED PANEL 40050 $1,002.40 AMYLASE, URINE 6050 $5.04 FISH,ALL,PRE-B PANEL 40052 $487.90 AMYLASE, RANDOM URINE 6052 $14.95 FISH,MALT LYMPHOMA 18q21 40053 $208.60 BLOOD GASES- ARTERIAL 6055 $32.90 FISH,MALT LYMPHOMA AP12 40056 $208.60 BICARBONATE 6070 $4.97 FISH,MALT LMP rea 18q21 40057 $208.60 BILIRUBIN, DIRECT 6075 $3.08 TOX SCRN-MARIJUAN&VOLATIL 40059 $32.52 BILIRUBIN,INFANT 6080 $4.20 CLONAZEPAM 7-AMINO CLONZ 40064 $58.45 BILIRUBIN, TOTAL INFANT 6081 $3.75 FENTANYL/NORFENTANYL 40065 $14.00 BILIRUBIN TOTAL & DIRECT 6086 $4.24 BREAST CANCER PANEL 40080 $218.75 BILIRUBIN, TOTAL 6090 $3.08 INFLUENZA TYPE B AB, IGM 40081 $12.60 UREA NITROGEN PERITONEAL 6102 $7.74 INFLUENZA TYPE A, IGM 40082 $12.60 UREA NITROGEN (BUN) 6103 $3.08 HIV-1 RNA,QNT,RL TM,PCR 40085 $103.25 BUN,POST DIALYSIS 6104 $3.75 EBV VCA IGG AB,IFA 40465 $11.64 BUN/CREAT RATIO W/EGFR 6105 $4.20 EPSTEIN BARR AB ACIF 40485 $24.50 BUN AND CREATININE 6106 $4.20 HSV-2 INHIBITION STUDY 40597 $88.90 CALCIUM 6110 $3.08 LCM, IFA 40625 $53.55 CA RANDOM URINE W/CREAT 6118 $13.79 CHIKUNGUNYA ABS W/REFLEX 40680 $60.55 CALCIUM, PEDIATRIC URINE 6119 $13.79 S PNEUMONIAE IGG AB X14 40682 $116.90 ALLERGEN FISH ALLERY PROF 6122 $21.00 PRIMIDONE 40751 $13.74 ALLERGEN SHELLFISH PROF. 6123 $28.00 S.PNEUMONIAE IGG (7) MAID 40752 $87.50 ALLERGEN SEAFOOD PANEL 6124 $28.00 PNEUMOCOCCAL IgG VACCINE 40765 $76.30 ADULT RESPIRATORY PANEL 6125 $154.00 BARBITURATES CFM, MECON 40864 $39.81 UPPER RESPIRATORY,CHILD 6126 $105.00 ALLERGEN WILD RICE 42210 $39.88 ALLERGEN FOOD PANEL 6127 $56.00 B.PERTUSSIS AB IGG, MAID 42250 $44.10 URD PANEL #2, ADULT 6128 $119.00 B. PERTUSSIS IgG-IgA MAID 42255 $70.00 ALLERGEN ARIXONA PANEL 6129 $189.00 MITOCHONDRIAL AB W/RFLX 42481 $21.00 ELECTROLYTES, URINE 6134 $15.26 CMV IGG AVIDITY,ELISA 42600 $43.05 CHLORIDE 6145 $3.08 AMINO ACID, LC/MS, CSF 42630 $183.40 CHLORIDE, RANDOM URINE 6156 $13.97 ALLERGEN, LIMA BEAN 43510 $48.40 ELECTROLYTES, URINE 6157 $23.00 CAPILLARY VENIPUNCTURE 43555 $6.13 CHOLESTEROL 6165 $3.08 AMNIOTIC FLUID BILIRUBIN 45614 $15.75 CARBON DIOXIDE (CO2) 6175 $3.08 HEMOSIDERIN,QL 46441 $16.94 CPK 6180 $11.90 TROPHERYMA WHIPPLEI DNA 46500 $63.00 CREATININE CLEAR W/EGFR 6186 $13.44 M TUBERCULOSIS PCR 47277 $104.30

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

CREATININE, 24 HR URINE 6190 $10.15 M TUBERCULOSIS PCR 47298 $104.30 CREATININE, RANDOM URINE 6191 $10.15 ENTEROVIRUS RNA EVAL 47300 $128.63 CREATININE W/EGFR 6200 $3.08 URINALYSIS 47755 $3.50 HEPARIN INDUCED PLT AB 6201 $43.40 BABESIA MICROTI DNA PCR 47800 $120.75 CREATININE,AMNIOTIC FLUID 6205 $24.15 HIV-2 PROVIRAL DNA, QUAL 49000 $113.05 CSF CHEMISTRIES 6210 $8.96 HIV MONITOR ATAZANAVIR 50477 $35.00 CREATININE W/O eGFR 6220 $3.75 TETANUS ANTITOXOID AB 50922 $37.80 GLUCOSE FASTING 6221 $3.75 AMPHOTERICIN B HPLC 51426 $69.30 GLUCOSE 2 HOUR 6229 $3.75 ANTIFUNGAL SERUM LEVEL 51523 $69.30 GGTP 6240 $3.08 KETOCONAZOLE LEVEL, BA 51685 $45.15 GLUCOSE,90 MINUTE 6244 $3.75 LEGIONELLA/DETECTION DFA 51705 $67.55 GLUCOSE, FASTING 6245 $3.75 SALMONELLA SEROTYPING 51735 $47.25 GLUCOSE,RANDOM 6247 $3.08 SYNERGY STUDIES,ANTIMICRO 51740 $88.90 GLUCOSE,1 HOUR 6248 $3.75 AMOXICILLIN LEVEL, BA 51760 $45.15 GLUCOSE, 2 HOUR P.P. 6249 $3.75 CEPHAZOLIN LEVEL, BA 51795 $45.15 GLUCOSE, CSF 6250 $3.75 CEFUROXIME LEVEL, BA 51835 $45.15 GLUCOSE TOLERANCE 2 HR 6251 $8.75 CEPHALEXIN LEVEL, BA 51840 $45.15 GLUCOSE 2.5 HOUR 6253 $3.75 HEPATITIS Be ANTIBODY 51896 $19.25 GLUCOSE,FASTING MATERNAL 6258 $3.75 KANAMYCIN LEVEL, BA 51910 $45.15 GLUCOSE,GEST SCREEN (50G) 6259 $5.22 HEPATITIS Be ANTIGEN 51912 $19.25 GLUCOSE,2 HOUR MATERNAL 6260 $5.22 METRONIDAZOLE LEVEL 51920 $43.40 GLUCOSE,3 HOUR MATERNAL 6261 $5.22 VORICONAZOLE, ANTIFUNGAL 51929 $66.50 HDL CHOLESTEROL 6275 $3.92 MINOCYCLINE LEVEL, BA 51930 $45.15 IRON 6285 $3.86 NAFCILLIN LEVEL, BA 51940 $45.15 IRON AND IRON BINDING CAP 6290 $7.72 OXACILLIN LEVEL, BA 51955 $45.15 LACTIC ACID (LACTATE) 6291 $17.85 PENICILLIN LEVEL, BA 51960 $45.15 ALBUMIN/GLOBULIN RATIO 6295 $7.49 ISONIAZID, HPLC 51963 $62.30 LD (LACTIC DEHYDROGENASE) 6300 $3.08 PIPERACILLIN LEVEL, BA 51965 $45.15 DIRECT LDL 6307 $5.11 GANCICLOVIR LEVEL 51967 $69.30 LIPASE 6310 $14.60 ANTIRETROVIRAL AMPRENAVIR 51971 $69.30 LITHIUM 6315 $8.79 INDINAVIR, ANTIRETROVIRAL 51972 $69.30 MAGNESIUM 6335 $8.40 NELFINAVIR,ANTIRETROVIRAL 51973 $69.30 OSMOLALITY, URINE 6340 $11.03 SAQUINAVIR 51974 $69.30 OSMOLALITY, SERUM 6345 $1.89 ANTIRETROVIRAL NEVIRAPINE 51976 $69.30 PH 6350 $10.43 KALETRA, ANTIRETROVIRAL 51987 $69.30 PH, STOOL 6355 $4.87 TETRACYCLINE LEVEL, BA 51990 $45.15 PHOSPHORUS 6363 $3.08 TICARCILLIN LEVEL, BA 51995 $45.15 PHOSPHATE, RANDOM URINE 6366 $13.79 DELAVIRDINE,ANTIRETROVIRL 51999 $69.30 PHOSPHATE, PEDIATRIC UR 6367 $13.79 N MENINGITIDIS SEROTYPING 52025 $45.15 POTASSIUM 6380 $3.08 H INFLUENZAE SEROTYPING 52030 $42.00 POTASSIUM, RANDOM URINE 6386 $13.97 TRIMETHOPRIM/SULFAMETHOX 52060 $45.15 PROTEIN/CREAT RATIO, URIN 6390 $13.97 AZTREONAM LEVEL, BA 52105 $45.15 PROTEIN, TOTAL 6400 $3.08 NEOMYCIN LEVEL, BA 52140 $45.15 PROTEIN, TL, RANDOM URINE 6406 $13.97 MEASLES ANTIBODY (IgG) 52449 $21.91 PROTEIN, TOTAL, CSF 6410 $5.22 M.PNEUMONIAE AB IGG EIA 52555 $24.15 PROTEIN, SYNOVIAL FLUID 6411 $3.92 ANTIVIRAL,ACYCLOVIR 53180 $115.50 ALBUMIN, PERICARDIAL FLD 6412 $8.09 ANTIVIRAL,FOSCARNET 53185 $115.50 ALBUMIN, PERITONEAL FLUID 6413 $8.09 ANTIVIRAL,GANCICLOVIR 53190 $115.50 ALBUMIN, PLEURAL 6414 $8.09 CONFIRMED DRUG PROF #52 53807 $10.22 AST (SGOT) 6415 $3.08 HIV-1 ANTIBODY & RPR 54002 $12.78 AMYLASE, PLEURAL FLUID 6416 $11.10 IMMIGRATION PANEL 54003 $17.43 CREATININE,PERITONEAL FLD 6417 $24.15 ALLERGEN, TUNA, IGG 55220 $43.50 GLUCOSE, PERITONEAL FLUID 6418 $9.21 LEVOFLOXACIN LEVEL 56175 $43.40 GLUCOSE, PLEURAL FLUID 6419 $9.21 ALLERGEN, PINTO BEAN IGE 56310 $39.88 ALT (SGPT) 6420 $3.08 CONF. DRUG PROFILE#57 X10 56377 $32.52 PROTEIN,TL,PERICARDIAL FL 6421 $11.03 MANGANESE-SERUM/PLASMA 56838 $28.00 PROTEIN,TL,PERITONEAL FLD 6422 $11.03 HSV ANTIGEN DETECTION 58552 $29.75 PROTEIN TL,PLEURAL FLUID 6423 $11.03 PROTEIN S ACTIVITY 58891 $52.89 AMYLASE, PERITONEAL FLUID 6424 $11.10 TESTOSTERONE, FREE 58958 $48.30 SODIUM 6425 $3.08 TISSUE PLASMINOGEN ACTIV 59717 $52.50 SODIUM AND POTASSIUM 6426 $4.20 PLASMINOGEN 59915 $42.00

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

ANION GAP PANEL 6427 $5.11 PROTEIN C ACTIVITY 60061 $40.71 GLUCOSE, AMNIOTIC 6429 $9.21 BLASTOMYCES AB CF, (CSF) 60180 $35.70 SODIUM, RANDOM URINE 6431 $15.37 ALLERGEN, BANANA 60350 $7.74 CHOLESTEROL,PERITONEAL FL 6432 $7.74 ALLERGEN, BREWERS YEAST 60517 $39.88 CHOLESTEROL, PLEURAL FLD 6433 $7.74 HERPES SIMPLEX1-2 IGG CSF 60555 $103.00 TRIGLYCERIDES, PERITONEAL 6434 $7.74 NMO EVALUATION W/REFLEX 60796 $540.60 PROTEIN,TOTAL & A/G RATIO 6435 $4.20 ALLERGEN, GOAT EPITHELIUM 61275 $7.00 TRIGLYCERIDES,PLEURAL FLD 6436 $7.74 ALLERGEN,GUINEA PIG EPITH 61341 $7.00 LIPASE JP DRAINAGE 6437 $14.60 ERYTHROPOIETIN 61403 $46.73 LDH, PERITONEAL FLUID 6438 $7.74 GROWTH HORMONE, HUMAN 61445 $34.13 LDH, PLEURAL FLUID 6439 $7.74 HGH 2 SPECIMENS 61502 $65.03 TRIGLYCERIDES 6440 $3.08 HGH 3 SPECIMENS 61503 $97.55 LIPASE PERITONEAL FLUID 6441 $14.60 HGH 4 SPECIMENS 61504 $130.06 LIPASE,PLEURAL FLUID 6442 $14.60 HGH 5 SPECIMENS 61505 $162.58 UREA CLEARANCE 6445 $11.31 HGH 6 SPECIMENS 61506 $195.09 UREA NITROGEN, URINE 6450 $3.92 HGH 7 SPECIMEN 61507 $227.61 URIC ACID 6455 $3.08 HGH 8 SPECIMEN 61508 $260.12 URIC ACID, RANDOM URINE 6464 $13.79 HGH 9 SPECIMEN 61509 $292.64 URIC ACID, PEDIATRIC UR 6466 $13.79 HGH 10 SPECIMEN 61510 $325.15 TRIGLYCERIDES W/VLDL CALC 6470 $30.03 CHLORIDE,24HR UR NO CREAT 61551 $3.82 LIPO FRAC,ION MOBIL W/RFL 6472 $63.00 ALLERGEN LEMON 61598 $7.00 ALPHA-1-ANTITRYPSIN 6505 $18.55 PIGEON DROPPINGS IgE 62174 $7.00 COMPLEMENT C3 6515 $12.43 RABBIT EPITHELIUM 62232 $7.00 MICROALBUMIN RNDM W/CREAT 6517 $22.51 ALLERGEN MAPLE SUGAR 62710 $35.40 COMPLEMENT C4 6520 $18.55 CLOSTRIDIUM TOX B SCREEN 63628 $45.50 STONE ANALYSIS NON-KIDNEY 6525 $25.20 POTASSIUM 24HR NO CREAT 63851 $3.82 C4a LEVEL 6536 $100.60 PROTEIN,TL 24HR W/O CREAT 64051 $3.82 COMPLEMENT, TOTAL (CH 50) 6540 $34.51 SODIUM 24HR NO CREATININE 64301 $3.82 CPK W/CPK-MB IF INDICATED 6556 $12.01 LEGIONELLA URINARY AG 64477 $33.60 PROTEIN ELECT-CSF 6561 $41.30 CELL COUNT, FLUID 64706 $5.60 PROTEIN ELECTRO. URINE 6570 $23.73 MUMPS VIRUS ANTIBODY, IGG 64766 $3.59 PROTEIN ELECTROPHORESIS 6571 $30.07 TEICHOIC ACID AB SCREEN 65383 $22.75 ALBUMIN, CSF 6603 $19.25 TRYPSINOGEN 65552 $34.65 GLYCOHEMOGLOBIN (HGB A1C) 6605 $9.27 CULT,VIRUS,BODY FL,TISSUE 65847 $63.00 LDH, CSF 6606 $3.92 URIC ACID SYNOVIAL FLUID 66105 $3.75 HEMOGLOBIN A2 6617 $22.05 CALCIUM, 24 HOUR URINE 66115 $7.46 HEMOGLOBIN F 6618 $22.05 CHLORIDE, 24-HOUR URINE 66155 $7.46 HEMOGLOBINOPATHY EVAL 6619 $22.05 PH, FLUID 66350 $10.43 IMMUNOFIXATION W/IGG,A,M 6625 $59.05 PHOSPHATE, 24 HR URINE 66365 $7.46 IMMUNOFIXATION, SERUM 6630 $54.25 POTASSIUM, 24-HOUR URINE 66385 $7.63 IMMUNOFIXATION, URINE 6635 $52.05 PROTEIN, TL,24-HOUR URINE 66405 $7.46 IMMUNOFIXATION, URINE 6636 $58.38 SODIUM, 24-HOUR URINE 66430 $7.63 IGA 6640 $9.87 URIC ACID, 24 HR URINE 66460 $7.46 IGG 6645 $12.95 CLOMIPRAMINE 66605 $38.15 IGM 6650 $12.95 HONEY BEE VENOM IgG 67272 $12.95 IMMUNOGLOBULINS, QUANT. 6655 $35.77 ALLERGEN PAPER WASP IgG 67314 $12.95 CPK ISOENZYMES 6657 $34.65 YELLOW HORNET VENOM IgG 67397 $12.95 METHEMOGLOB./SULFHEMOGLOB 6675 $155.20 TSH ULTRASENSITIVE 67580 $19.08 OLIGOCLONAL BANDS 6690 $32.55 ALPHA-1 ANTITRYPSIN PHENO 67702 $45.50 HEMOGLOBIN, PLASMA 6703 $21.70 CYCLOBENAZPRINE 67975 $94.00 PREALBUMIN 6720 $22.72 ALLERGEN, GREEN BEAN 68312 $7.74 PROTEIN ELECTRO. SERUM 6725 $19.85 ALLERGEN, GERBIL 68403 $7.00 VISCOSITY, SERUM 6755 $15.40 PENICILLOYL G, IGE 68510 $14.00 CERULOPLASMIN 6770 $19.08 FELBAMATE 68999 $26.25 APOLIPOPROTEIN A1,B 6775 $9.03 PROTEINASE-3 AB 69682 $35.00 APOLIPOPROTEIN A-1 6776 $4.52 MYELOPEROXIDASE AB 69690 $35.00 APOLIPOPROTEIN B 6777 $4.52 TACROLIMUS & SIROLIMUS 70006 $99.40 ANGIOTENSIN ENZ 6896 $73.50 TACROLIMUS,HS,LC/MS/MS 70007 $54.25 FETAL FIBRONECTIN 7004 $107.45 FACTOR VIII ACTIVITY 70050 $51.45 AFP,TUMOR MARKER 7007 $21.56 VON WILLEBRAND TYPE 2N 70068 $77.00 QUAD SCREEN 7008 $169.75 BLASTOMYCES AB PNL CF&ID 70070 $44.10

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

ALDOSTERONE URINE 7010 $36.75 BENZODIAZEPINES 70071 $36.40 ALLERGEN ALMOND 7020 $7.00 OLANZAPINE 70073 $99.75 AMIKACIN RANDOM 7025 $26.67 MEPERIDINE & NORMEPRIDINE 70074 $7.35 AMIKACIN, PEAK LEVEL 7027 $26.67 LIPID PNL W/NON-HDL CHOL 70083 $21.26 AMIKACIN, TROUGH LEVEL 7029 $26.67 CYCLOSERINE LEVEL, HPLC 70114 $62.30 ALLERGEN WORMWOOD 7030 $7.00 BIOTINIDASE 70132 $35.70 ALLERGEN CURULARIA LUNATA 7031 $7.00 SALMONELLA & BRUCELLA 70140 $75.95 ALLERGEN BIRCH 7032 $7.00 FEBRILE ANTIBODIES PNL 70141 $105.70 ALLERGEN PHOMA BETAE 7033 $7.00 FEBRILE/FRANCISELLA PANEL 70142 $140.70 ALLERGEN AUREO. PULLULANS 7034 $7.00 DONOR, IVF MALE PANEL 70143 $634.99 ALLERGEN, COW DANDER 7035 $7.00 DONOR, TISSUE DONOR PANEL 70145 $462.00 ALLERGEN TURKEY FEATHERS 7036 $7.00 STEM CELLS DONOR PANEL 70146 $570.24 ALLERGEN CHICKEN FEATHERS 7037 $7.00 DONOR,IVF FEMALE PANEL 70147 $526.75 ALLERGEN DUCK FEATHERS 7038 $7.00 ANCA W/MPO/PR3 W/REFLEX 70159 $105.00 PROTEIN S ANTIGENIC/FUNCT 7039 $122.85 ANCA SCREEN 70171 $35.00 HEPATITIS B CORE AB,TOTAL 7040 $17.75 MUMPS VIRUS RNA,QL,RT,PCR 70172 $104.30 ALLERGEN HELMINTH HALODES 7041 $7.00 PML/RARA t(15:17) QUANT 70182 $117.60 HEPATITIS A IGM ANTIBODY 7045 $34.35 17-KS FRCT PEDS URINE 70184 $68.60 ALLERGEN BARLEY 7060 $7.00 ENTERVIRUS/PARECHOVIRUS 70189 $126.00 ALLERGEN BERMUDA GRASS 7065 $7.00 MSH2,IHC W/INTERP 70197 $57.75 ALLERGEN BAYBERRY 7066 $7.00 21-HYDROXYLASE AB 70265 $178.00 ALLERGEN COCKLEBUR 7068 $7.00 ALLERGEN, ASPARAGUS IGE 70995 $36.90 ALLERGEN MARSHELDER 7069 $7.00 ALLERGEN, BAY LEAF IGE 71258 $48.40 ALLERGEN WILLOW 7070 $7.00 C-PEPTIDE 71298 $55.97 ALLERGEN WINGSCALE 7071 $39.88 TACROLIMUS (FK506) 71330 $54.25 ALLERGEN BLUEGRASS 7075 $7.00 PSA (FREE AND TOTAL) 71744 $40.36 ALLERGEN BROME GRASS 7085 $7.00 C-PEPTIDE RESPONSE,2 SPEC 72302 $111.93 CARBAMAZEPINE (TEGRETOL) 7100 $18.27 C-PEPTIDE RESPONSE,3 SPEC 72303 $167.90 CEA ABBOTT 7110 $29.40 C-PEPTIDE RESPONSE,4 SPEC 72304 $223.86 ALLERGEN COMMON RAGWEED 7111 $7.00 C-PEPTIDE RESPONSE,5 SPEC 72305 $279.83 ALLERGEN ENGLISH PLANTAIN 7112 $7.00 C-PEPTIDE RESPONSE,6 SPEC 72306 $335.79 ALLERGEN SHEEP SORREL 7113 $7.00 C-PEPTIDE RESPONSE,7 SPEC 72307 $391.76 ALLERGEN BOX MAPLE ELDER 7114 $7.00 C-PEPTIDE RESPONSE,8 SPEC 72308 $447.72 ALLERGEN CHICKEN MEAT 7115 $7.00 C-PEPTIDE RESPONSE,9 SPEC 72309 $503.69 ALLERGEN ALDER 7116 $7.00 WHITE FACED HORNET VENOM 74179 $12.95 ALLERGEN WALNUT TREE 7117 $7.00 PSA W/REFLEX TO FREE 74551 $27.20 ALLERGEN WHITE PINE 7118 $7.00 ALLERGEN, PAPRIKA IGE 75630 $7.00 ALLERGEN EUCALYPTUS 7119 $7.00 CHLORIDE RANDOM NO CREAT 76155 $3.82 ALLERGEN KOCHIA 7122 $7.00 POTASSIUM RANDOM NO CREAT 76385 $3.82 ALLERGEN ACACIA 7123 $7.00 SODIUM,RANDOM NO CREAT 76430 $3.82 HOUSE DUST GREER 7124 $7.00 ALLERGEN TANGERINE IGE 77313 $48.40 ALLERGEN CODFISH 7125 $7.00 YELLOW JACKET IgG 77685 $12.95 ALLERGEN SALMON 7126 $7.00 ALLERGEN,RABBIT EPITHEL. 80710 $48.40 ALLERGEN MUSTARD 7127 $7.00 CHLAMYDIA PNEU CULTURE 81030 $23.98 ALLERGEN BEEF 7128 $7.00 MUMPS VIRUS DIRECT DETECT 81180 $47.25 ALLERGEN PEA 7129 $7.00 THYROGLOBULIN TUMOR SERUM 83069 $151.68 ALLERGEN GARLIC 7131 $7.00 PHOSPHATIDYLCHOLINE ABS 83170 $108.50 ALLERGEN APPLE 7132 $7.00 THALLIUM,24 HR URINE 84723 $39.55 ALLERGEN YEAST 7133 $7.00 PROTEIN C & S PANEL 85480 $93.59 ALLERGEN ONION 7134 $7.00 PLATELET ANTIBODY PROFILE 86264 $140.35 CORTISOL, A.M. 7135 $21.42 ALLERGEN SULFAMETHOXAZOL 87610 $48.40 ALLERGEN EGG YOLK 7136 $7.00 CC PAYMENT HOLDING 90002 $0.00 ALLERGEN CELERY 7137 $7.00 ANA IF RA DIAG PNL W/RFLX 90071 $63.00 CORTISOL 7138 $21.42 ANA IFA W/RFX LUPUS/SLE 90072 $17.50 ALLERGEN, TEA 7139 $7.00 ANA IFA W/RFL TIT/PAT/SCL 90073 $17.50 CORTISOL, P.M. 7140 $21.42 ANA IFA W/RFX CON TISSUE 90074 $17.50 DEXAMETHASONE SUPPRESSION 7141 $64.26 ANA SCREEN (IFA) SJOGRENS 90077 $70.00 ACTH STIMULATION, 3 SPEC 7144 $64.26 ACCUTYPE IL28B 90251 $113.75 CORTISOL FR LC/MS/MS 24HR 7145 $48.65 HSV 2 IGG TYPE SPECIFIC 100051 $18.79 ALLERGEN COTTONWOOD 7150 $7.00 ASIALO GM-1 ANTIBODY IGM 103598 $36.40 ALLERGEN COW'S MILK 7160 $7.00 XYLOSE, BLOOD 1HR POST 104521 $28.67

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

ALLERGEN CRAB 7165 $7.00 SOY MILK FORMULA PROTIEN 105125 $23.80 ALLERGEN CASHEW 7167 $7.00 LYME DNA PCR CSF OR SF 108472 $93.80 CRP, QUANTITATIVE 7170 $16.80 BETA2-GLYCOPROTEIN G,A,M 110002 $81.90 ALLERGEN DANDELION 7180 $7.00 ORGANIC ACID, QUALITATIVE 110087 $46.90 ALLERGEN CLAM 7181 $7.00 MYASTHENIA GRAVIS PANEL 2 110104 $194.25 ALLERGEN WALNUT FOOD 7182 $7.00 B. BURGDORFERI, DNA 110109 $93.80 ALLERGEN, SCALLOP 7183 $7.00 LACTOFERRIN, STOOL 110156 $43.75 DIGOXIN (LANOXIN) 7185 $11.62 EBV DNA QUANT 110186 $89.25 ALLERGEN EGG WHITE 7195 $7.00 LORAZEPAM 110202 $32.20 ALLERGEN ELM TREE 7200 $7.00 ALLOPURINOL & METABOLITE 110213 $125.00 ESTRADIOL 7205 $38.26 INTRACELLULAR MARKERS 110248 $54.60 ALLERGEN FALSE RAGWEED 7220 $7.00 PORPHYRINS, TOTAL 110290 $27.30 FERRITIN 7225 $9.27 PARAINFLUENZA ANTIGEN DFA 110322 $35.00 FOLATE 7230 $19.95 OVARIAN ANTIBODY SCREEN 110328 $25.90 FSH 7235 $24.99 ELASTASE-1, FECAL 110446 $78.40 GENTAMICIN, RANDOM 7239 $26.67 HLA-DR4 110454 $52.50 GENTAMICIN, PEAK LEVEL 7242 $26.67 HIV-1 VIRTUAL PHENOTYPE 110469 $154.00 GENTAMICIN, TROUGH LEVEL 7244 $26.67 ALLERGEN LIME IGE 110483 $7.00 ALLERGEN GOLDENROD 7255 $7.00 CYTOCHROME GENOTYPE 110490 $120.75 ALLERGEN GOOSE FEATHERS 7260 $7.00 PHEOCHROMOCYTOMA EVAL 110520 $98.00 HEP B SURFACE ANTIGEN 7269 $17.75 HEPATITIS B GENOTYPE 110529 $138.60 HEPATITIS B SURFACE AG 7270 $18.28 HEPTIMAX (TM) 110565 $147.70 HCG, TOTAL, QUANTITATIVE 7275 $19.57 CYSTATIN C 110570 $37.80 UPPER RESPIRATORY, ADULT 7280 $161.00 GAD/ICA 512/INSULIN AB 110584 $157.50 UPPER RESPIRATORY,CHILD 7281 $84.00 CMV DNA QNT REAL TIME PCR 110600 $119.70 ALLERGEN MINOR FOOD PROF 7282 $70.00 RESPIRATORY ALLERGY, II 110644 $182.00 ALLERGEN PERENNIAL PANEL 7283 $35.00 RESPIRATORY ALLERGY,RG XI 110653 $189.00 HEPATITIS A TOTAL 7285 $7.00 RESPIRATORY ALLERGY,XII 110654 $175.00 HEPATITIS BS AB QUAL 7290 $17.75 RESPIRATORY ALLERGY,XIII 110655 $189.00 HEPATITIS B SURFACE AB QT 7292 $41.67 CHILDHOOD ALLERGY + IGE 110659 $105.00 CYCLOSPORINE WHOLE MOLE. 7300 $44.52 ALLERGEN FOOD PROFILE 110714 $84.00 ALLERGEN HORSE DANDER 7310 $7.00 HPV HIGH RISK CAPTURE DNA 110814 $33.48 ALLERGEN HOUSE DUST 7315 $7.00 CYSTINE, QUANTITATIVE 110947 $45.50 IGE 7320 $21.00 RITUXAN SENSITIVITY 110981 $52.50 ALLERGEN JOHNSON GRASS 7330 $7.00 WEST NILE VIRUS, RT-PCR 110992 $113.75 LIDOCAINE 7335 $18.38 CARBITAL QUANTITATION 111019 $163.00 LH (LUTEINIZING HORMONE) 7340 $23.04 GLIPIZIDE 111079 $130.00 LH W/FSH AND RATIO 7342 $46.62 ELECTROLYTES, STOOL 111124 $55.30 ALLERGEN, M. RACEMOSUS 7345 $7.00 W. NILE VIRUS, RT-PCR,CSF 111190 $113.75 ALLERGEN MESQUITE 7350 $7.00 FACTOR IX AG. 111205 $175.00 RESPIRATORY ALLERGY PROF 7351 $168.00 ANTI-SULFATIDE ANTIBODIES 111210 $420.00 MULBERRY TREE, ALLERGEN 7355 $7.00 GLIADIN ANTIBODY (IGG) 111212 $29.75 PRIMIDONE/PHENOBARBITAL 7360 $49.14 MAGNESIUM, PEDIATRIC 111220 $24.17 ALLERGEN OAK 7365 $7.00 OXALIC ACID, PEDIATRIC 111222 $24.17 SUBSTANCE ABUSE PNL 6-50+ 7374 $8.00 LCHAD MUTATION ANALYSIS 111244 $113.40 ALLERGEN OATS 7375 $7.00 THROMBOPHILIA MUTATION 111261 $200.90 OLIVE TREE, ALLERGEN 7380 $7.00 COBALT QUANTITATION 111290 $91.00 ALLERGEN ORANGE 7385 $7.00 PEROXISOMAL PANEL, SERUM 111319 $282.70 ALLERGEN ORCHARD GRASS 7390 $7.00 COLCHICINE 111320 $425.00 ALLERGEN PEANUT 7395 $7.00 THROMBOPHILIA, INHERITED 111327 $369.95 ALLERGEN PECAN 7400 $7.00 PROTEIN S PANEL 111343 $221.55 ALLERGEN PENICILLIUM 7405 $7.00 THROMBOTIC MARKER PANEL 111345 $137.55 CHILDHOOD ALLERGY PANEL 7406 $105.00 ARSENIC HAIR 111409 $167.80 ALLERGEN PERENNIAL RYE 7410 $7.00 ACHR BLOCKING AUTOAB 111412 $57.75 ALLERGEN D. PTERONYSSINUS 7411 $7.00 GANGLIOSIDE GM-1 IGG/IGM 111510 $52.50 ALLERGEN COCKROACH 7412 $7.00 C1Q COMPLEMENT COMPONENT 111615 $34.06 ALLERGEN CANDIDA ALBICANS 7413 $7.00 ALLERGEN,FERRET EPITHEL. 111724 $7.00 ALLERGEN MTN JUNIPER 7414 $7.00 ALPHA GLOBIN COMMON MUT 111751 $161.00 PHENOBARBITAL 7415 $17.47 ALLERGEN, CAYENNE PEPPER 111880 $39.88 PHENYTOIN 7420 $12.39 CORTICOTROPIN RELEASING H 112136 $75.25 ALLERGEN PORK 7430 $7.00 7-DEHYDROCHOLESTEROL 112306 $236.00

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

ALLERGEN POTATO 7435 $7.00 GLYCOSAMINOGLYCANS, URINE 112358 $100.00 PREGNANCY, QUALITATIVE 7440 $5.73 HEPATITIS D VIRUS AB PNL 112401 $106.75 PREG,QUAL,W/REFLX,QUANT 7441 $5.56 IODINE PANEL 112503 $31.50 PROGESTERONE 7445 $26.29 ANGIOEDEMA PROFILE 1 112535 $107.80 PROLACTIN 7450 $18.03 VAP CHOLESTEROL 112800 $173.00 PSA, TOTAL (SCREENING) 7455 $28.02 DEXTROMETHORPHAN 112915 $104.00 PSA, TOTAL, DIAGNOSTIC 7458 $27.20 RICKETTSIA (RMSF) ABS 113022 $35.00 ALLERGEN RICE 7470 $7.00 ALLERGEN, SWORDFISH IgE 113055 $7.00 ALLERGEN RUSSIAN THISTLE 7475 $7.00 CITRIC ACID, 24 HOUR UR 113095 $70.70 ALLERGEN RYE 7480 $7.00 URR PANEL 113310 $7.14 ALLERGEN,MUGWORT 7485 $7.00 MDMA & METABOLITE 113321 $21.70 ALLERGEN SOYBEAN 7505 $7.00 FUNGAL ANTIBODY PANEL CSF 113400 $178.50 ALLERGEN SYCAMORE 7510 $7.00 RUBEOLA IGM 113610 $33.25 INSULIN RESPONSE,2 SPECIM 7511 $51.31 PHENOL,UR 113620 $94.00 T3, TOTAL 7515 $31.50 FREE KAPPA & LAMBDA 113883 $112.46 INSULIN RESPONSE,3 SPECIM 7516 $76.97 HIV-1/HIV-2 AB WB/IB 114100 $70.00 INSULIN RESPONSE,4 SPECIM 7517 $102.62 5 FLUOROCYTOSINE 114135 $173.40 INSULIN RESPONSE,5 SPECIM 7518 $128.28 SELENIUM 114180 $79.00 INSULIN TOLERANCE 5 HOUR 7519 $153.93 SILVER QUANTITATION 114200 $87.00 T3 UPTAKE 7520 $8.03 VASCULAR ENDOLTHELIAL GF 114512 $78.75 INSULIN RESPONSE,7 SPECIM 7521 $179.59 VWF PROTEASE ACTIV W/RFX 114532 $77.00 INSULIN RESPONSE,8 SPECIM 7522 $205.24 SEROTONIN RELEASE ASSAY 114627 $91.00 INSULIN RESPONSE,9 SPCMEN 7523 $230.90 A-1 ANTITRYPSIN, FECES 114628 $39.90 T4 (THYROXINE),TOTAL 7525 $11.31 PRADER-WILLI/ANGELMAN SYN 114662 $138.25 FREE T4 7528 $14.68 BETA GLOBIN COMPLETE 114974 $244.30 HOMOCYSTEINE(NUTRITIONAL) 7529 $56.00 CMV GENOTYPE 114980 $138.60 ALLERGEN GIANT RAGWEED 7535 $7.00 ALLERGEN, PINENUT IGE 115010 $7.74 TESTOSTERONE 7545 $37.52 ADIPONECTIN 115060 $62.48 THEOPHYLLINE 7550 $13.06 LEGIONELLA DNA,QL,RT,PCR 115062 $104.30 ALLERGEN TIMOTHY GRASS 7555 $7.00 RETT SYNDROME MUTATION 115088 $388.50 TOBRAMYCIN, RANDOM 7559 $26.71 THYROID CASCADING REFLEX 115102 $26.60 TOBRAMYCIN, PEAK LEVEL 7562 $26.71 POLYCHLORINATED BIPHENYLS 115103 $36.40 TOBRAMYCIN, TROUGH LEVEL 7564 $26.71 CYSTIC FIBROSIS D1152H 115335 $61.60 ALLERGEN TOMATO 7575 $7.00 IMMUNE CELL FUNCTION 115435 $96.25 ALLERGEN LAMB MEAT 7576 $7.00 TA90 IMMUNE COMPLEX 115524 $47.95 ALLERGEN DOG DANDER 7577 $7.00 DPD GENE MUTATION ANALYSI 115538 $122.50 ALLERGEN LOBSTER 7578 $7.00 RHEUMATOID FACTOR IGA 115682 $14.00 ALLERGEN BLUE MUSSEL 7579 $7.00 ZAP-70 116000 $80.50 TSH,ULTRASENSITIVE 7580 $4.64 CELLSEARCH, BREAST 116011 $203.00 TSH ULTRASENSITIVE INFANT 7583 $19.08 WEST NILE VIRUS AB, IGM 116012 $19.60 TSH W/REFLEX TO FREE T4 7584 $19.08 WEST NILE VIRUS IGM, CSF 116013 $19.60 ALLERGEN TUNA 7585 $7.00 BULLOUS PEMPHIGOID AG 116034 $19.25 VALPROIC ACID (DEPAKENE) 7590 $18.27 MANNOSE BINDING LECTIN 116039 $35.00 VANCOMYCIN, RANDOM 7594 $18.76 RSV RNA, QUALITATIVE PCR 116047 $105.00 VANCOMYCIN, PEAK 7597 $18.76 AVIAN FLU VIRUS RNA PCR 116090 $113.75 VANCOMYCIN, TROUGH 7599 $18.76 RESPIRATORY VIRUS PANEL 116094 $458.50 PTH, INTACT W/CALCIUM 7600 $59.50 FAMILIAL MEDITERRANEAN 116141 $175.00 PTH INTACT W/O CALCIUM 7602 $55.76 FIRST TRI SCREEN hCG 116145 $68.25 VITAMIN B12 7610 $21.96 PHENYLKETONURIA MUTATION 116152 $875.00 VITAMIN B12/FOLATE 7611 $56.70 CRP HIGH SENSITIVITY 116182 $21.00 WESTERN RAGWEED 7615 $7.00 CHROMAGRANIN A 116379 $44.45 ALLERGEN WHEAT 7620 $7.00 H PYLORI IGG AND IGM AB 116442 $77.00 ALDOSTERONE, LC/MS/MS 7630 $62.30 IODINE, RANDOM URINE 116601 $35.00 QUINIDINE 7710 $20.79 PHOSPHATIDYLINOSITOL IgG 116684 $36.17 ALLERGEN SHRIMP 7720 $7.00 PIK3CA MUTATION ANALYSIS 116897 $138.25 ALLERGEN MEADOW FESCUE 7725 $7.00 CYP1B1 MUTATION ANALYSIS 117205 $199.50 ALLERGEN CULTIVATED RYE 7730 $7.00 CRP, CSF 117401 $22.75 ALLERGEN DERMATO. FARINAE 7735 $7.00 CA 27.29, CSF 117419 $34.30 ALLERGEN LAMB'S QUARTERS 7740 $7.00 AFP, PLEURAL FLUID 117555 $29.40 ALLERGEN, RED TOP GRASS 7741 $7.00 THIOSULFATE, URINE 117892 $171.00 ALLERGEN, CLADOSPORIUM 7750 $7.00 ISLET CELL AB W/RFL TITER 118202 $29.40

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

ALLERGEN ALTERNARIA TENIU 7755 $7.00 RETINOL BINDING PROTEIN 118366 $26.95 ALLERGEN MAIZE/CORN F8 7760 $7.00 ANGIOTENSIN CONV. ENZYME 118572 $24.15 ALLERGEN CHOCOLATE 7765 $7.00 ANACHOICE CASCADING RFLX 119946 $19.25 ADULT ALLERGY PANEL 7780 $84.00 CELIAC DISEASE COMP PNL 119955 $55.30 ADULT FOOD PANEL 7781 $42.00 C-KIT MUTATION,CELL-BASED 119961 $350.00 CHILD FOOD PANEL 7782 $38.68 LYMPHOCYTE MITOGEN SCREEN 120392 $141.40 FOLATE, RBC 7805 $46.94 GLUCOSE, URINE 120476 $53.80 FOLATE,RBC (NO SERUM) 7807 $26.99 TREPONEMA PALLIDUM PNL 120493 $40.60 ALLERGEN CAT EPITHELIUM 7825 $7.00 LACTIC ACID, BODY FLUID 120504 $49.00 ALLERGEN ASPERGILLUS 7830 $7.00 BILIRUBIN, TOTAL, FLUID 120510 $47.00 ALLERGEN PIGWEED 7845 $7.00 NATURAL KILLER CELL ASSAY 120595 $137.20 ALLERGEN SCALE, LENSCALE 7846 $7.00 ASIALO GM1 ANTIBODIES 121001 $76.65 FTI 7925 $19.34 MAG ANTIBODY DUAL ELISA 121004 $94.15 CHOLINESTERASE W/DIB 7961 $25.55 GM1 ANTIBODIES, IGG,A,M 121050 $74.20 AMPHETAMINES UR SCREEN 8001 $2.34 PARANEOPLASTIC SYNDROME 121051 $101.50 BARBITURATES UR SCREEN 8002 $2.34 CHLORAMPHENICOL 121062 $71.00 BENZODIAZAPINES UR SCREEN 8003 $2.34 TRYPSIN 121105 $44.84 COCAINE METAB UR SCREEN 8004 $2.34 CITRIC ACID-RANDOM URINE 121207 $74.24 METHADONE URINE SCREEN 8005 $2.34 CORTISOL FREE SERUM/PLAS 121469 $43.75 OPIATES URINE SCREEN 8006 $2.34 ALPRAZOLAM 121592 $22.66 PCP URINE SCREEN 8008 $2.34 HOMOVANILLIC ACID,RANDOM 121807 $36.75 CANNABINOIDS UR SCREEN 8009 $2.34 DOPAMINE, PLASMA 122160 $52.50 ETHANOL URINE SCREEN 8011 $2.34 VITAMIN B1, BLOOD 122191 $40.25 PROPOXYPHENE UR SCREEN 8012 $2.34 EPINEPHRINE PLASMA 122301 $50.75 OXYCODONE URINE SCREEN 8013 $2.34 ESTROGEN, TOTAL 122541 $44.10 PRO 800 URINE DRUG SCREEN 8017 $73.85 FECAL FAT, QUALITATIVE 122707 $30.98 PRO 819 URINE DRUG SCREEN 8018 $79.52 RAPAMYCIN 122721 $45.15 PRO 821 URINE DRUG SCREEN 8019 $90.65 NONESTERIFIED FATTY ACIDS 122749 $27.65 CREATININE, URINE 8021 $2.50 MYOGLOBIN,URINE,QUANT 122917 $17.05 AMPHETAMINE UR SCRN W/CON 8041 $2.34 FRUCTOSAMINE 122947 $20.30 BARBITURATES UR SCR W/CON 8042 $2.34 LGV DIFFERENTIATION PANEL 123005 $84.00 BENZODIAZEPINES UR W/CON 8043 $2.34 HEP B VIRUS PRECORE TAG 123025 $161.00 COCAINE METAB UR W/CON 8044 $2.34 VARICELLA ZOSTER IGG/IGM 123112 $53.20 METHADONE UR SCRN W/CONF 8045 $2.34 ALLERGEN, COTTON SEED 123862 $7.00 OPIATES UR SCREEN W/CONF 8046 $2.34 ALLERGEN, FLOUNDER 123893 $7.00 PCP UR SCRN W/CONFIRM 8048 $2.34 IGM, CSF 124711 $19.25 THC UR SCRN W/CONFIRM 8049 $2.34 INHIBIN A 124786 $59.50 PROPOXYPHENE UR W/CONFIRM 8052 $2.34 KI67,ER,PR,HER2-BREAST 125401 $180.64 OXYCODONE UR SCRN W/CON 8053 $2.34 KI67/ER/PR/HER2 W/O RFX 125402 $180.64 HEMOGLOBIN A1C W/MPG 8181 $9.00 ER,PR,HER2-NEU,BREAST 125405 $163.77 PROFILE 8192 UR/BLD ALC 8192 $20.37 ALLERGEN RASPBERRY IgE 126281 $7.00 ANTITHROMBIN III W/REFLEX 8267 $54.78 CIC 126472 $128.45 ACETAMINOPHEN,QT-TYLENOL 8300 $23.49 NOREPINEPHRINE 126666 $50.75 DISOPYRAMIDE, QUANTITATIV 8320 $43.75 PANCREATIC POLYPEPTIDE 127219 $83.06 ETHOSUXIMIDE, QUANTITATIV 8330 $32.90 IGF BINDING PROTEIN-2 127233 $28.70 PROCAINAMIDE WITH NAPA 8350 $22.58 MAGNESIUM, RANDOM URINE 127447 $24.17 MEPHENYTOIN,QT-MESANTION 8380 $89.00 HEPATITIS D RNA, QUAL 127500 $113.05 ACYLCLOVIR, HPLC 8398 $62.30 POTASSIUM, RBC 128241 $23.10 TEMAZEPAM 8436 $137.00 HEPATITIS G VIRUS RNA 128500 $113.05 LOXAPINE 8540 $206.00 SODIUM, FECES 129520 $18.90 COTININE SCREEN,URINE 8542 $78.00 MITOCHONDRIA M2 AB (IGG) 130321 $21.00 SULFONAMIDE 8561 $29.40 TRANSCORTIN 130338 $26.95 EBV NUCLEAR AG (EBNA) 8564 $26.95 CARBAMAZEPINE,FREE 130642 $21.09 BUPROPRION 8592 $122.00 TRYPTOPHAN, LC/MS 130718 $52.50 ALCOHOL/VOLATILES 8600 $10.68 TESTOSTERONE,BIOAVAILABLE 130741 $96.25 CARBOXYHEMOGLOBIN 8606 $17.40 ASIALO GM-1 ANTIBODY IGG 130898 $40.25 HIPPURIC ACID, URINE 8614 $89.00 ALLERGEN YOGURT 131510 $39.88 GIARDIA ANTIGEN EIA STOOL 8625 $21.09 AT III ACTIVITY (AT3) 131765 $57.51 PENTOBARBITAL,QT-NEMBUTAL 8650 $29.44 HGB S QUANT INCLUDES A1&F 131852 $28.00 SALICYLATE, QT (ASPIRIN) 8666 $9.00 FIBRIN DEGRADATION PROD 132524 $26.95 AMPHETAMINES UR CONFIRM 8705 $35.00 HEPARIN, UNFRACTIONATED 132748 $47.25

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

BARBITURATES UR CONFIRM 8710 $35.00 COPPER, FREE 133311 $89.00 BENZODIAZEPINES UR CON 8717 $35.00 VARICELLA ZOSTER DNA 134052 $78.40 CAFFEINE 8720 $22.54 CHROMATIN ANTIBODIES IgG 134088 $31.15 COCAINE METAB UR CONFIRM 8740 $35.00 MAG ANTIBODY 134134 $40.25 PROTEIN C ACTIVITY W/RFLX 8754 $52.19 INHIBIN B 134445 $55.30 METHADONE UR CONFIRMATION 8760 $35.00 TOXOPLASMA GONDII,DNA,QL 134451 $103.60 OPIATES URINE CONFIRM 8775 $35.00 TUMOR NECROSIS FACTOR 134485 $52.50 PCP URINE CONFIRMATION 8780 $35.00 ANGIOTENSIN CONV. ENZYME 134692 $24.15 PROPOXYPHENE UR CONFIRM 8790 $35.00 CHLAMYDOPHILA PNEUM ABS 134722 $38.50 THC URINE CONFIRMATION 8799 $35.00 A. NIGER, ALLERGEN IGE 134938 $7.00 FLUPHENAZINE 8815 $99.00 QUETIAPINE, QUANTITATION 135299 $46.55 IRON, LIVER 8828 $50.40 UPPER RESPIRATORY (ADULT) 135552 $175.00 PROTEIN S ACTIVITY W/RFLX 8838 $60.55 CHILDHOOD ALLERGY PROF 135562 $126.00 ETHANOL UR SCRN W/CONFIRM 8901 $2.34 PSYCHOTHERAPEUTIC SCREEN 136249 $28.00 ALCOHOL,ETHYL,BLOOD 8903 $12.53 WEST NILE VIRUS IGG IGM 136596 $39.20 ETHANOL UR CONFIRMATION 8906 $35.00 WEST NILE VIRUS CSF IGG/M 136597 $39.20 ISOPROPANOL,BLOOD 8907 $24.85 GANGLIOSIDE GD1B IGM 136614 $26.25 ACETONE,BLOOD 8908 $22.75 GANGLIOSIDE GD1B IGG AB 136622 $35.00 MIXING CORRECTION STUDY 8922 $18.90 MYELIN ASSOC GLYCOPROTEIN 136648 $37.80 ETHYLENE GLYCOL, SERUM 8955 $17.40 INSULIN, FREE (BIOACTIVE) 136700 $33.25 L/S RATIO WITH PG 8960 $62.55 DOPAMINE, RANDOM URINE 137331 $43.75 FETAL LUNG MATURITY (FLM) 8965 $19.15 B-NATRIURETIC PEPTIDE 137386 $45.15 MECONIUM DRUG SCREEN 8996 $58.31 HYDROXYPOLINE, LC/MS 137558 $50.40 RENAL FUNCTION W/O eGFR 9161 $5.64 FLUORIDE 137802 $13.41 EPSTEIN BARR VIRUS AB PNL 9197 $80.85 METHOTREXATE 137937 $29.33 GHB ACID SCREEN, URINE 9342 $207.00 ALLERGEN,CASEIN(COW MILK) 138100 $12.95 METABOLIC PNL W/O eGFR 9441 $5.88 ALLERGEN PUMPKIN SEED IGG 138310 $62.50 ABO BLOOD GROUP/ Rh TYPE 9500 $13.65 COCCIDIOIDES AB, CSF 139170 $26.25 PRENATAL ABO GROUP/RH TYP 9502 $13.65 GAD-65 AUTOANTIBODY 139261 $52.50 ABO GROUP/RH CORD BLOOD 9504 $13.65 PTH ANTIBODY 139287 $58.45 DIRECT ANTIGLOBULIN TEST 9520 $5.60 FUNGUS CULTURE W/REFLEX 139515 $20.30 DIRECT ANTIGLOBULIN,CORD 9521 $5.60 BRUCELLA AB AGGLUTINATION 140020 $31.85 DIRECT ANTIGLOBULIN IGG 9523 $11.00 ENTAMOEBA HISTOLYTICA AB 140105 $38.15 COOMBS, INDIRECT 9525 $6.51 PLATELET ANTIBODY DIRECT 140129 $59.85 FETAL SCREEN 9535 $13.83 ARBOVIRUS IgM AB PANEL 140145 $121.80 RH PHENOTYPE 9540 $30.17 STREPTOCOCCUS GRP B AG 140160 $38.50 ANTIBODY SCREEN 9550 $6.51 S PNEUMONIAE AG DETECTION 140170 $37.10 ANTIBODY IDENTIFICATION 9553 $10.43 NEISSERIA GONORRHOEAE AB 140200 $39.90 ANTIBODY TITER 9555 $15.93 BRUCELLA ABORTUS AB PANEL 140205 $45.50 ALLERGY PANEL 12,ANIMAL 9581 $35.00 CAL. ENCEPHALITIS AB, IGG 140220 $38.15 ANTIGEN ID 9650 $7.81 TRYPANOSOMA CRUZI PANEL 140245 $79.45 TOXICOLOGY SCRN,BLD & UR 9810 $69.23 TRYPANOSOMA CRUZI IGG 140250 $44.10 METABOLIC PNL W/O eGRF 9821 $5.46 TRYPANOSOMA CRUZI IGM 140255 $44.10 ELUATE 9986 $9.94 COCCIDIOIDES ANTIBODY CF 140280 $33.46 TORCH PANEL (IgG & IgM) 10008 $189.00 COXSACKIE B (1-6) AB, CF 140335 $56.00 PAP,INTRP,NO RESCRN(SCRN) 10015 $13.00 CYSTICERCUS ANTIBODY 140350 $46.55 CAH PANEL 11,NEONATAN 10046 $166.60 DENGUE FEVER ABS,IGG/IGM 140400 $54.25 ORGANIC ACIDS QUAL URINE 10049 $46.90 E. EQUINE ENCEPHALITIS 140417 $59.85 ACETOACETATE 10060 $148.00 E EQUINE ENCEPHALITIS IGG 140420 $34.30 HCV RNA, QUANT, TMA 10073 $147.70 EBV-VCA IGG ANTIBODY 140465 $27.30 MALARIA ANTIBODY SCREEN 10089 $230.00 FILARIA IGG4 ANTIBODY 140495 $61.95 PAP,T LYR,NO RESCRN(DIAG) 10090 $22.66 ALLERGEN, RABBIT MEAT 140510 $48.40 PAP,T LYR,NO RESCRN(SCRN) 10091 $69.50 HERPESVIRUS 7 IgG AB 140542 $59.85 PROPYLENE GLYCOL 10122 $121.00 HERPES VIRUS 7 IGG, IGM 140543 $114.80 TAT COMPLEX 10162 $38.85 HERPESVIRUS IGG, AB IFA 140544 $61.25 PHOSPHATIDYLSERINE AB IGA 10163 $24.85 HERPES SIMPLEX AB PNL 140551 $75.95 ALBUTEROL QUANTITATION 10165 $223.00 LEISHMANIASIS ANTIBODY 140610 $45.15 HBV DNA, QUAL RT PCR 10179 $77.00 DEXAMETHASONE, QUANT 140624 $32.55 CITALOPRAM 10184 $144.00 HEAVY METALS,UR RANDOM 140627 $133.00 MYASTHENIA GRAVIS PNL 3 10211 $229.95 LCM, IGG 140630 $30.10 S. CEREVISIAE IGG 10294 $35.00 LYMPH CHORIOMEN IGM 140635 $32.55

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

S. CEREVISIAE IGA 10295 $35.00 B BURGDORFERI IGG, WB 140645 $42.00 CAH PANEL 6B COMPREHENSIV 10299 $423.50 BORRELIA BURGDORFERI IGG 140655 $33.60 AMPHETAMINES D/L RATIO UR 10329 $239.00 B. BURGDORFERI AB PANEL 140677 $58.45 PREKALLIKREIN ACTIVITY 10334 $40.25 SUBSTANCE P 140699 $106.05 ARSENIC URINE, RANDOM 10357 $45.85 M. PNEUMONIAE AB 140730 $32.90 AMINO ACIDS, LC/MS 10401 $183.40 S PNEUMO IGG SEROTYPES 12 140762 $104.30 ANTIMONY, BLOOD 10410 $79.00 BURKHOLDERIA PSEUDOMALLEI 140775 $37.45 PHOSPHATIDYLINOSITOL AB 10480 $108.50 B. PSEUDOMALLEI IGG/IGM 140777 $68.01 ALLERGEN BLUEBERRY IGE 10482 $7.00 RICKETTSIA ANTIBODY PANEL 140840 $73.50 B-TRYPTASE 10497 $100.00 ST. LOUIS ENCEPHALITIS AB 140895 $65.45 BACTRIM PROFILE 10498 $135.00 ST LOUIS ENCEPHALITIS IGG 140900 $38.15 ASPIRIN RESISTANCE 10518 $43.75 SCHISTOSOMA IGG ANTIBODY 140915 $47.60 MAGNESIUM, RBC 10551 $42.53 TOXOCARA ANTIBODY 140945 $50.05 AMBIEN SERUM/PLASMA 10590 $145.00 FRANCISELLA TULARENSIS AB 140995 $42.70 BERYLLIUM, QUANTITATION 10638 $82.00 W. EQUINE ENCEPHALITIS 141045 $70.70 BETA-2 TRANSFERRIN 10640 $122.68 W EQUINE ENCEPHALITIS IGG 141046 $39.90 SOTALOL 10641 $117.00 WEIL-FELIX 141050 $37.80 BETA-HYDROXYBUTYRIC ACID 10642 $92.00 P53 ONCOPROTEIN 141061 $53.90 BICARBONATE, URINE 10645 $82.00 DNA CELL CYCLE ANALYSIS 141566 $63.00 RESPIRATORY ALLERGY PROF 10657 $168.00 ESTRADIOL, FREE 141772 $60.55 MYCOPHENOLIC ACID 10662 $42.53 HUMAN ANTI-MOUSE ANTIBODY 141882 $73.50 FACTOR X ACTIVITY 10663 $53.20 CORTISONE 24 HR URINE 141889 $70.00 PLATELET GLYCOPROTEIN AB 10678 $57.75 dsDNA AB, IFA 142069 $20.30 DIPHTHERIA ANTITOXOID AB 10682 $44.10 ANTI-SMOOTH ANTIBODY 142085 $24.15 HUMAN PLT AG 1 GENOTYPE 10707 $89.25 HEPATITIS E ANTIBODY, IGM 142125 $35.00 TICK ID/RFLX LYME DIS DNA 10710 $52.15 HDL CHOLESTEROL SUBCLASS 142374 $25.90 BRODIFACOUM, QUANT 10717 $171.00 CAMPYLOBACTER JEJUNI AB 142388 $51.45 BROMIDE 10720 $89.00 ALLERGEN, SUGAR CANE 142410 $13.96 CARDIOLIPIN AB SCREEN 10793 $19.25 GANGLIOSIDE GQ1b ANTIBODY 142547 $37.45 LIPOPROTEIN a (LPa) 10800 $36.75 17 KETOSTEROIDS FRAC-UR 142929 $72.03 PAP,T LYR,INTRP,RSCN-DIAG 10911 $23.50 PARVOVIRUS,DNA,PCR 143010 $49.70 PAP,TLYR,W/INTRP W/RESCRN 10920 $93.30 CARDIOLIPIN ABS (IGG,A,M) 143072 $186.00 PAP,T LYR,INTRP,NO RESCRN 10921 $23.50 ALLERGEN REGIONAL PNL F 143729 $70.00 HLA-B CLASS I DNA TYPING 10950 $41.30 NATURAL KILLER CELLS 143786 $26.95 HLA-A CLASS I DNA TYPING 10951 $41.30 ALLERGY-REGIONAL J PANEL 143844 $70.00 HLA-DRB1 CLASS II DNA TYP 10952 $55.13 ALLERGY-PERENNIAL PROFILE 144032 $56.00 HLA-DQB1 CLASS II DNA TYP 10953 $55.13 ALLERGY-ANIMAL PANEL 144073 $28.00 ER/PR/HER2 W/RFL HER2 10970 $213.50 ALLERGEN, CILANTRO IGE 144110 $48.40 PSA, POST PROSTATECTOMY 10976 $30.10 FREE T3 AND FREE T4 144438 $113.05 MYLOTARG SENSITIVITY CD33 10977 $52.50 PHOSPHATIDYLSERINE IGG/M 145392 $54.25 CAMPATH 1H (CD52) 10980 $52.50 PYRUVATE, CSF 145784 $40.65 MAG & GM1 ANTIBODY PANEL 11004 $159.60 CAH PANEL 7 146201 $141.40 SURFACE LIGHT CHAINS 11015 $80.50 M PNEUMONIAE PCR 146300 $113.05 FSH PEDIATRIC 11024 $31.50 PROTEIN S, TOTAL ANTIGEN 146771 $62.30 ETHYLENE GLYCOL MONOBUTYL 11038 $125.00 BK VIRUS DNA, QUANT PCR 147900 $130.90 CIRCULATING IMM COMP DET 11040 $188.30 BK VIRUS DNA, PCR 148900 $116.55 HUMORAL IMMUNE EVALUATION 11043 $142.80 PROGESTERONE, LC/MS/MS 148908 $25.90 THROMBIN TIME 11045 $26.25 METAPNEUMOVIRUS RNA RTPCR 149200 $130.90 THROMBOSIS PANEL 11051 $196.35 M. TUBERCULOSIS COMPLEX 149724 $65.80 BK/JC VIRUS DNA, QUAL PCR 11068 $128.80 M. TUBERCULOSIS COMPLEX 149732 $65.80 TISSUE TRANSGLUTAMINASE 11070 $42.35 HIV MONITR - TENOFOVIR 150040 $45.50 ENDOMYSIAL ABS IGG & IGA 11073 $84.70 E HISTOLYTICA ANTIGEN 150105 $38.15 PROTEIN S ANTIGEN FREE 11087 $63.70 COMPLEMENT FACTOR B-C3PA 150145 $31.71 VW TYPE 2N SEQUENCE ANALY 11090 $675.00 HISTOPLASMA CAPSULATUM ID 150161 $52.50 HEXOSAMINIDASE A & TOTAL 11091 $240.60 IMIPENEM LEVEL 150255 $45.15 FUNGUS CULTURE PROGRESSIV 11105 $22.82 PNEUMOCYSTIS JIROVECI DFA 151015 $29.40 ANGIOTENSIN II TYPE 1 11118 $65.10 MIC SUSCEPTIBILITY AFB 151187 $45.15 LDH ISOENZYMES 11122 $36.75 CULTURE, B. PERTUSSIS 151555 $32.20 GASTRIC ANALYSIS, SINGLE 11143 $10.92 5-FLUCYTOSINE LEVEL 151590 $44.10 CRYOFIBRINOGEN 11150 $23.80 EBV IGM VIRAL CAPSID AG 151599 $26.95 ANTI-CCP ANTIBODY 11173 $31.50 LYME DISEASE PANEL W/BAND 151732 $37.24

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

18-HYDROXYCORTISOL FREE U 11178 $80.15 AMPICILLIN LEVEL 151765 $45.15 PRO BNP,N-TERMINAL 11188 $45.15 HELICOBACTER PYLORI IGM 151771 $110.00 PROSTAGLANDIN D2 11201 $300.00 CEFTAZIDIME LEVEL 151815 $45.15 FRUCTOSE, SEMEN 11224 $54.64 CEFTRIAXONE 151830 $45.15 RICKETTSIAL DISEASE PANEL 11233 $113.40 CLINDAMYCIN LEVEL,BA 151865 $45.15 KAPPA/LAMBDA LIGHT CHAIN 11234 $84.00 DICLOXACILLIN 151885 $45.15 ONTAK SENSITIVITY (CD25) 11237 $52.50 DOXYCYCLINE 151890 $45.15 SENSORIMOTOR NEUROPATHY 11264 $1,995.00 ERYTHROMYCIN LEVEL 151895 $45.15 HEPATITIS B DNA,QNT PCR 11265 $113.75 STREPTOMYCIN LEVEL HPLC 151962 $69.30 CLONAZEPAM, URINE 11270 $85.00 RIFAMPIN LEVEL 151964 $69.30 LUPUS ERYTHEMATOSUS PNL 11272 $104.65 HEPATITIS D AB TOTAL 152001 $32.55 HIV-2 AB,IMMUNOBLOT 11279 $35.00 LEPTOSPIRA CULT & STAIN 152015 $72.10 PLACENTAL LACTOGEN, HUMAN 11283 $52.71 S PNEUMONIAE SEROTYPING 152020 $61.95 GLIADIN ANTIBODY IGA 11288 $29.75 TOXIC SHOCK ANTIBODY PNL 152050 $113.40 FECAL GLOBIN 11290 $21.00 ACANTHAMOEBA STAIN 152075 $45.15 FECAL GLOBIN (MEDICARE) 11293 $21.00 CIPROFLOXACIN 152120 $45.15 CYTOCHROME P450 2C9 GENOT 11294 $70.06 AZITHROMYCIN LEVEL 152135 $45.15 INVASIVE TROPHOBLAST AG 11303 $55.30 INFLUENZA TYPE A ANTIBODY 152290 $29.05 LAMBERT-EATON SYNDROME AB 11306 $284.90 INFLUENZA TYPE B ANTIBODY 152308 $29.05 TROPONIN 11309 $36.40 INSULIN AUTOANTIBODY 152324 $52.50 CALCIUM,24HR NO CREATININ 11313 $14.02 CRYPTOSPORIDIUM ANTIGEN 152500 $25.90 OXALIC ACID, 24 HR URINE 11318 $14.02 PARVOVIRUS B19 IgM AB 152746 $24.50 MAGNESIUM, 24 HR URINE 11322 $14.02 PHOSPHATIDYLSERINE AB PNL 152952 $79.10 SARS CORONAVIRUS,RNA,QL 11324 $91.00 ESTRONE SULFATE 153551 $62.30 C4 BINDING PROTEIN 11335 $31.50 ALLERGEN ANCHOVY IGE 153810 $48.40 HOMOVANILLIC ACID 11346 $36.75 ANTI-TSH ANTIBODY 153843 $41.30 HEPATITIS C VIRAL RNA 11348 $147.70 VARICELLA ZOSTER AB, IGG 154031 $26.60 P O ANTIBODIES 11350 $132.00 ALLERGY-FOOD PROFILE 154189 $35.00 C. TRACHOMATIS RNA TMA 11361 $21.00 ALLERGEN HONEY BEE VENOM 154319 $7.00 N. GONORRHOEAE RNA, TMA 11362 $21.00 ALLERGY-MINOR FOOD + IGE 154494 $91.00 B PERTUSSIS/PARAPERT DNA 11365 $119.00 NEURONAL NUCLEAR AB (HU) 154700 $87.50 HIV-1 gp4 ENVELOPE G-TYPE 11367 $154.00 CAH PANEL 4 154809 $227.15 PLASMINOGEN ACTIVATOR INH 11368 $69.30 ALLERGEN SWEET POTATO 154810 $36.90 LH PEDIATRICS 11391 $28.70 COBALT, 24 HR URINE 154882 $41.30 OROTIC ACID, URINE 11426 $53.62 CAH PANEL 3 154890 $0.00 ALLERGEN, CATFISH IgE 11432 $36.90 BACTERIAL MENINGITIS PNL 155053 $68.95 SACCHAROMYCES CEREVISIAE 11445 $84.00 INSECT VENOM ALLERGEN PNL 155327 $35.00 DDT W/DDD & DDE QUANT 11470 $114.00 CAH PANEL 1 155368 $231.00 HERPESVIRUS 6 ABS,IGG/IGM 11492 $34.30 RET PROTO ONCOGENE MUTAT. 155426 $153.30 HSV VIRUS 1/2 IGG,TYP SPC 11499 $55.87 AFB PCR,CULT,SMR SPUTUM 155434 $128.80 STAT FEE 11519 $7.81 BISMUTH, RANDOM URINE 155988 $16.80 TRAVEL ALLOWANCE 11521 $14.60 COBALT, BLOOD 156259 $43.40 5-HIAA, 24 HOUR URINE 11523 $26.25 MANGANESE, WHOLE BLOOD 156812 $31.50 ANGIODEMA EVALUATION 11529 $93.45 MANGANESE, URINE 156846 $28.00 ALLERGEN SUNFLOWER SEED 11565 $48.40 MERCURY,RANDOM 156895 $38.50 ACID PHOS,PROSTATIC (RIA) 11576 $20.49 NICKEL 157059 $29.75 COMPLEMENT C2 PROTEIN 11605 $155.60 COCCI IMMITIS ID,DNA 157500 $62.48 NICKEL, URINE 11618 $29.75 ZINC, RBC 157612 $29.05 PROTEIN C ANTIGENIC 11649 $52.85 ALLERGEN, BELL PEPPER IgE 157710 $36.90 PROTEIN S ANTIGENIC 11659 $129.50 OSMOTIC GAP FECES 24 HR. 157715 $34.39 BONE SPECIFIC ALK PHOS 11687 $40.81 OSMOTIC GAP FECES RANDOM 157718 $34.39 ANTI-HISTONE ANTIBODY 11702 $30.10 ADENOVIRUS AG DETECTION 158255 $31.15 STACHYBOTRYS ATRA PANEL 11712 $167.30 ADENOVIRUS ANTIGEN DFA 158289 $31.15 MACROGLOBULIN (ALPHA-2) 11732 $34.76 VZV ANTIGEN DETECTION 158818 $19.25 MOLD PROFILE IGG 11750 $217.50 KAPPA-LAMBDA LIGHT CHAIN 159162 $21.70 STAPH AUREUS SCREEN-MRSA 11752 $5.83 ALLERGEN ALFALFA 159710 $36.90 ANTI-RETICULIN ANTIBODY 11764 $45.50 PLASMINOGEN ACTIVATOR INH 159766 $38.50 DEPYRIDAMOLE 11777 $95.00 VWF MULTIMERIC ANALYSIS 160137 $74.90 STACHYBOTRYS IGE 11782 $48.40 RISTOCETIN COFACTOR 160145 $50.05 ALLERGEN C. GLOBOSUM 11783 $48.40 ASPERGILLUS AB CF, (CSF) 160150 $38.85 HYPERSEN PNEUMONITIS 11784 $59.15 COXSACKIE A ABS, CSF 160330 $59.50

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

ALLERGEN HORSE HAIR 11804 $39.88 CRYPTOCOCCUS AG DETECTION 160345 $31.85 CULTURE,HSV,RAPID 11841 $24.15 CYSTICERCUS ANTIBODY, CSF 160350 $50.05 LEUCINE AMINOPEPTIDASE 11842 $22.40 ALLERGEN, AVOCADO 160355 $7.74 LIPASE,URINE 11872 $14.00 E EQUINE ENCEPHALITIS IGM 160425 $37.80 LIPID ASSOC SIALIC ACID 11875 $27.65 ECHOVIRUS ANTIBODY PANEL 160435 $58.80 ALLERGEN ERYTHROMYCIN IGE 11877 $48.40 ALLERGEN, BLACK PEPPER 160459 $7.35 CHLORPROMAZINE 11882 $101.00 ALLERGEN, B. CINEREA IGE 160491 $7.00 BABESIA/LYME AB PANEL,IFA 11900 $101.50 ALLERGEN BROCCOLI IGE 160525 $7.00 LIPOPROTEIN ELECTROPHORES 11929 $23.80 HERPESVIRUS 6 IGM AB 160535 $43.05 5-HIAA, RANDOM URINE 11930 $36.40 INFLUENZA A&B, CSF 160585 $47.25 VMA, 24 HOUR URINE 11934 $39.90 CASEIN, ALLERGEN 160624 $7.00 GOLD 11944 $38.61 B BURGDORFERI IGG CSF 160655 $37.10 COMPLEMENT C6 11950 $35.70 ALLERGEN,AMERICAN CHEESE 160673 $7.35 C7,SERUM 11952 $33.95 MEASLES IGG ANTIBODY, CSF 160690 $35.35 COMPLEMENT C8 11954 $33.95 MUMPS IGG ANTIBODY 160710 $37.45 COMPLEMENT C9 11956 $33.95 MUMPS IGM ANTIBODY 160715 $37.45 ESCITALOPRAM QUANTITATION 11965 $144.00 M. PNEUMONIAE AB, CF(CSF) 160730 $36.40 ESTRIOL, SERUM 11972 $35.70 ALLERGEN COFFEE 160830 $7.00 TDT(TERMINAL TRANSFERASE) 12059 $43.12 ST LOUIS ENCEPHALITIS IGM 160905 $39.20 GLYBURIDE 12060 $107.00 BARTONELLA IGG ANTIBODY 160925 $58.80 SOL. TRANSFERRIN RECEPTOR 12073 $66.50 BARTONELLA IGM ANTIBODY 160926 $58.80 HUMORAL IMMUNITY 12 SERO 12078 $332.85 ANTINEURONAL NUCLEAR AB 161006 $65.45 ENTEROVIRUS PANEL II 12080 $185.15 VARICELLA ZOSTER VIRUS AB 161015 $41.65 FORMIC ACID 12134 $90.00 VARICELLA ZOSTER AB CSF 161025 $68.60 FOSPHENYTOIN, QUANT 12136 $121.00 W EQUINE ENCEPHALITIS 161046 $43.40 FUROSEMIDE, URINE 12140 $108.00 W EQUINE ENCEPHALITIS IGM 161047 $43.40 GLUTETHIMIDE 12160 $104.00 ALLERGEN, FIRE ANT 161176 $7.74 PHENYLALANINE 12162 $30.80 ALLERGEN GLUTEN 161259 $7.00 BACTERIAL ANTIGEN 12245 $161.35 ALLERGEN GRAPEFRUIT 161317 $7.00 DRUG ABUSE SCREEN, RIA 12287 $31.28 ALLERGEN, HAMPSTER 161358 $7.00 E GRANULOSUS AB, IGG 12321 $61.25 HAZELNUT, ALLERGEN 161366 $7.00 METHYLPHENIDATE (RITALIN) 12338 $43.02 ALLERGEN HAZELNUT TREE 161374 $7.00 ER/PR/HER2 NEU NONBREAST 12407 $0.00 ALLERGEN KIWI FRUIT IGE 161549 $7.00 CLOSTRIDIUM DIFFICILE CUL 12411 $36.40 ALLERGEN, LETTUCE IgE 161614 $7.00 INFLUENZA A&B DETECTION 12423 $58.10 ALLERGEN, MALTI IgE 161663 $7.00 TRICHINELLA ANTIBODY 12427 $44.10 ALLERGEN, MANGO FRUIT 161671 $7.00 IRON, URINE RANDOM 12430 $187.20 ALLERGEN MELONS 161721 $7.00 ITRACONAZOLE,QUANTITATION 12460 $312.00 ALLERGEN MOUSE EPITHELIUM 161796 $7.00 HIV-2 AB,EIA W/RFL WB 12477 $26.25 ALLERGEN, PAPER WASP 161986 $7.00 BLASTOMYCES AB,CF 12511 $32.20 ALLERGEN PEACH 162059 $7.00 ALLERGEN APRICOT 12563 $7.00 ALLERGEN PEAR 162075 $7.00 BILE ACIDS FRACTIONAT/TL 12593 $57.75 ALLERGEN, PECAN NUT IgE 162083 $7.74 CMV CULTURE 12627 $64.75 ALLERGEN PINEAPPLE 162182 $7.00 ALLERGEN GINGER 12644 $7.00 QUEEN PALM, ALLERGEN 162224 $7.00 RESPIRATORY SYNCYTIAL AB 12646 $36.05 ALLERGEN RAT EPITHELIUM 162240 $7.00 DIGITOXIN 12650 $23.45 NTX RANDOM URINE 162287 $58.80 MERCAPTOPURINE 12660 $155.00 VALPROIC ACID, FREE 162442 $33.46 IBUPROFEN 12668 $10.50 S. BOTRYOSUM, ALLERGEN 162521 $7.00 MERCURY 12670 $61.00 STRAWBERRY, ALLERGEN 162570 $7.00 PROFILE 12711 OBSTETRIC 12711 $50.16 ALLERGEN, TROUT 162687 $7.00 METFORMIN 12740 $133.00 ALLERGEN, TURKEY MEAT IgE 162711 $7.00 COLORADO TICK FEVER 12799 $58.10 WHITE FACE HORNET 162802 $7.00 SILVER, BLOOD 12818 $116.20 ALLERGEN, YELLOW HORNET 162885 $7.00 BILE ACIDS TOTAL 12833 $56.50 AUSTRALIAN PARROT DROP 163040 $7.74 NEUROTENSIN 12882 $200.00 FTA, IFA, CSF 163486 $30.10 METHOCARBAMOL 12900 $89.00 C DIFFICILE A&B 163636 $39.20 THIOCYANATE 12949 $20.13 ADULT ALLERGY PROFILE #2 165552 $140.00 VITAMIN B5 PANTOTHENIC AC 13028 $175.00 CYTOMEGALOVIRUS DNA PCR 166334 $101.50 HCV RNA, QUAL W/REFLEX 13040 $77.35 ALDOLASE 166985 $14.70 IGD 13055 $41.30 ALLERGEN, CHERRY IgE 167199 $7.74 ZINC PROTOPORPHYRIN 13073 $26.25 ALLERGEN CUCUMBER IGE 167249 $7.00

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

MIRTAZAPINE QUANTITATION 13075 $104.00 POTASSIUM, FECES 167926 $18.20 HTLV 1/2 AB, EIA 13113 $73.50 HELICOBACTER PYLORI IGA 168002 $38.50 NEFAZODONE 13145 $87.00 ALLERGEN JUNIPER WESTERN 168310 $39.88 CULTURE, LEGIONELLA 13151 $41.65 ALLERGEN CINNAMON 168379 $7.00 CULTURE, M. PNEUMONIAE 13164 $30.10 ALLERGEN, GRAPE IgE 168411 $7.00 RUBELLA AB'S IGG/IGM 13176 $59.50 ALLERGEN, HALIBUT 168429 $7.00 PAROXETINE 13187 $96.00 ALLERGEN MUSHROOM 168486 $7.00 PHENOSENSE HIV COMP 13200 $1,220.00 ALLERGEN SPINACH 168569 $7.00 TESTOSTERONE, FREE 13259 $36.40 ALLERGEN, SQUID IGE 168585 $7.00 INTERFERON ALPHA 13290 $60.55 CA 15-3 168759 $34.30 PARALDEHYDE & METABOLITE 13310 $99.00 CLOZAPINE 168965 $26.25 HISTOPLASMA ANTIBODY,CF 13340 $33.95 B BURGDORFERI IgG,IgM ABS 170340 $82.25 APC RESISTANCE 13365 $19.22 RHEUMATOID FACTOR, FLUID 170352 $28.70 CARDIOLIPIN SCRN W/RFX 13371 $19.25 ALLERGEN BASIL 171183 $7.00 ANTICARDIOLIPIN AB IGA 13374 $21.70 ALLERGEN, RED KIDNEY BEAN 171290 $7.00 IGF-II 13383 $35.26 ALLERGEN CABBAGE 171696 $7.00 FUNGAL PNL W/CRYPTOCOCCUS 13400 $135.45 ALLERGEN CHESTNUT IGE 172199 $7.00 BLASTOMYCES AB ID SERUM 13410 $28.35 ALLERGEN DILL 172801 $7.00 HISTOPLASMA AB IMMUNODIFF 13415 $21.70 ALLERGEN, GOAT MILK IgE 173403 $7.00 ALLERGEN, SPRUCE IGE 13426 $7.00 ALLERGEN LENTIL 174583 $7.00 PERCHLOROETHYLENE 13430 $100.00 HEREDITARY HEMOCHROMATOSI 175021 $137.55 FREE T3 TRACER DIALYSIS 13434 $70.00 ALTERNARIA TENUIS IGG 175120 $43.50 UBT COLLECTION FEE 13444 $9.21 ALLERGEN ALT TENUIS IGA 175130 $86.97 ALPHA-1-ACID GLYCOPROTEIN 13498 $23.10 ASPERGILLUS FUMIGATUS IG 175220 $37.04 ARBOVIRUS IGG AB PROFILE 13522 $124.25 ASPERGILLUS PRECIPITANT 175225 $64.17 NEURON SPECIFIC ENOLASE 13535 $31.97 ALLERGEN A FUMIGATIS IGA 175230 $86.97 COLLECTION/TRANSPORT FEE 13553 $35.00 CLADOSPORIUM HERBARUM IGG 175420 $43.50 VENIPUNCTURE 13555 $3.47 H HALOIDES IGG 175520 $43.50 VONWILLEBRAND DISEASE PNL 13558 $227.85 ALLERGEN OREGANO IGE 175523 $7.00 RESPIRATORY VIRAL W/REFLX 13563 $22.75 OYSTER, ALLERGEN 175580 $7.00 PHENOBARBITAL FREE&BOUND 13582 $138.00 MUCOR RACEMOSUS IGG 175620 $43.50 MUMPS/RUBELLA/RUBEOLA IGM 13590 $102.55 PENICILLIUM NOTATUM IGG 175720 $43.50 MUMPS AB IGM 13595 $28.70 ALLERGEN P NOTATUM IGA 175730 $70.00 HSV 1 IGG TYPE SPECIFIC 13636 $37.08 ALLERGEN, CHICK PEA IGE 175739 $7.00 B HENSELAE ABS IGG/IGM 13637 $41.30 CHILI PEPPER, ALLERGEN 175911 $7.00 CATECHOLAMINES, URINE 13639 $49.35 ALLERGEN PISTACHIO 176133 $7.00 ENDOMYSIAL AB IGA W/RFL 13677 $30.10 PRIVET TREE, ALLERGEN 176323 $7.00 BETA2-GLYCOPROTEIN I IGG 13678 $27.30 CEPH ACREMONIUM IGG 176820 $43.50 BETA2 GLYCOPROTEIN I IGM 13749 $27.30 ALLERGEN ASPERG NIGER IGG 177320 $43.50 HPV, DNA (HUMAN PAPILL) 13760 $66.50 ALLERGEN ASP NIGER IGA 177330 $86.97 CHROMIUM 13782 $34.65 ALLERGEN WHEY 177743 $7.00 PLATINUM 13783 $139.00 RETICULIN IGA 178002 $22.75 RUBEOLA AB IGG IGM 13820 $66.50 STACHYBOTRYS IgG 178220 $64.00 INTERLEUKIN 6 13828 $78.75 ASPERGILLUS VERSICOLOR 178620 $43.50 HEPATITIS E ANTIBODY IGG 13838 $26.95 ASPERGILLUS AMSTELODAMI 178720 $64.17 HSV 1/2 IGG,HSV IGM W/RFL 13843 $86.45 HELMINTH SATIVUM 179510 $63.40 LACTIC ACID, CSF 13844 $18.48 SUCCYNYLCHOLINE IGG 179920 $43.50 CULTURE,HSV,W/RFL TYPING 13881 $23.45 SUCCINYLCHOLINE IGA 179930 $70.00 ANTI-MYOCARDIAL AB W RFX 13892 $22.75 GALACTOSE-1-PHOSPHATE 180337 $416.40 CHLORIDE, CSF 14004 $6.74 AMYLASE, PANCREATIC 180376 $126.70 ZINC, URINE 14026 $24.85 MEN2 (2A,2B,FMTC) MUT SCR 180573 $701.20 FLECAINIDE 14035 $19.25 ALLERGEN,RABBIT HAIR 180610 $39.88 ANCA VASCULITIDES 14044 $87.50 CHLAMYDIA TRACHOMATIS DFA 181035 $26.25 PEG PREC IGG IMMUNE COMPL 14081 $17.15 C DIFF TOXIN AB,NEUTRALIZ 181055 $64.75 ESTRONE, SERUM 14100 $39.90 NOROVIRUS, EIA (STOOL) 181106 $42.00 MANGANESE, URINE 14106 $28.00 ACYLGLYCINES QUANT,URINE 181249 $396.70 PORPHYRINS FRACTIONATED 14117 $34.65 SULFATE,URINE 181815 $134.90 ESTROGEN FRACTIONATION 14122 $81.20 ALLERGEN,RAT PROTEINS 181910 $48.40 ZINC, PLASMA 14154 $24.85 CYCLOSPORA DETECTION 182000 $46.20 IMIPRAMINE 14158 $37.80 TRICHOMONAS CULTURE 182001 $42.70 SILICON QUANTITATION 14190 $95.00 ALLERGEN,RAT UR PROTEINS 182010 $48.40

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

HEAVY METALS COMPREHENSIV 14200 $199.85 FATTY ACID ESSENTIAL 182426 $444.60 STRONTIUM 14212 $61.00 PARROT DROPPINGS IGG 182620 $43.50 17 HYDROXYPROGESTERONE 14215 $78.40 EOSINOPHIL CATIONIC PROT 182891 $42.00 SULFONAMIDES, UNDIFFERENT 14245 $107.00 N-METHYLHISTAMINE URINE 183011 $207.30 COPPER 14250 $26.25 HEREDITARY PANCREATITIS B 183019 $487.00 HYPOGLYCEMIC PANEL, QUAL 14261 $110.00 GANGLIOSIDE ANTIBODY PNL 183089 $221.20 CELIAC DISEASE AB PNL 14263 $147.35 CAH PANEL 9 183139 $230.30 CHROMIUM, BLOOD 14278 $34.65 H PYLORI IGG,IGM,IGA AB'S 183253 $115.50 LEAD, RANDOM URINE 14297 $48.30 MYCOBAC PCR RESPIRATORY 183329 $128.80 INTERLEUKIN-1 BETA 14309 $78.75 MYCOBAC PCR NON-RESP 183378 $128.80 TYROSINE 14368 $41.02 CRYPTOCOCCUS ANTIBODY 184210 $24.85 GLUCOSE, SYNOVIAL FLUID 14410 $8.75 MUMPS ANTIBODY PANEL 185845 $54.25 ASORBIC ACID (VITAMIN C) 14425 $39.55 IGA SUBCLASSES 186181 $38.50 ZINC RANDOM URINE 14437 $35.00 TRICYCLIC ANTIDEPRESSANT 186249 $28.00 IGA, CSF 14447 $19.25 ISLET CELL AG 512 AUTOABS 186736 $52.50 ALUMINUM, 24 HR UR 14451 $32.55 DHEA URINE 186934 $73.50 LIMULUS AMEBOCYTE LYSATE 14453 $42.53 ALLERGEN FLAXSEED IGE 187910 $48.40 THROMBIN CLOTTING TIME 14459 $26.25 YELLOW JACKET VENOM ALRGN 190220 $70.50 FACTOR XIII, FUNCTIONAL 14461 $60.27 WHITE FACED HORNET ALRGN 190420 $70.50 TIAGABINE QUANTITATION 14479 $20.85 YELLOW HORNET VENOM ALRGN 190520 $70.50 TIN, TOTAL 14485 $109.00 FIRE ANTS VENOM ALLERGEN 190620 $70.70 TITANIUM 14486 $116.00 LIPIDS, TOTAL STOOL 191700 $44.80 BONE MARROW ENFRAG STUDY 14487 $126.00 RPR QUANTITATIVE TITER 192656 $8.75 KAPPA/LAMBDA LIGHT CHAINS 14492 $44.42 ALLERGEN, BLACK ANT (IGE) 193310 $48.40 TOPIRAMATE (TOPAMAX) 14518 $33.25 LSD,URINE 194247 $40.43 LP-PLA2 14530 $62.48 HEPATITIS D ANTIGEN 195265 $30.80 ACYLCARNITINE, PLASMA 14531 $60.20 T4 ANTIBODY 195802 $41.30 CULTURE, MYCOBACTERIUM 14554 $63.00 INTERLEUKIN 2 RECEPTOR 196545 $70.00 ALUMINUM, RANDOM URINE 14561 $45.85 CRYPTOCOCCUS AG W/REFLEX 198186 $30.45 STREPTOCOCCUS GROUP A DNA 14565 $26.25 HPV LOW/HIGH RISK W/RFLX 198641 $47.71 BD AFFIRM VPIII MICROBIAL 14577 $88.20 PROTEIN C & S AG FACT VII 300032 $314.00 CHROMOSOME ANALYSIS 14599 $466.00 FACTOR VIII ANTIGEN 300208 $180.00 5' NUCLEOTIDASE 14624 $19.02 FACTOR X INHIBITOR 300725 $275.00 CARDIOLIPIN ANTIBODY, IGG 14662 $21.70 PLATELET NEUTRALIZATION 300805 $145.00 CARDIOLIPIN ANTIBODY, IGM 14663 $21.70 MILK PRECIPITIN PANEL 401668 $122.93 Y CHROMOSOME MICRODELETIO 14679 $113.89 BIRD FANCIER'S PANEL 401707 $200.77 FISH ALL/NHL MYC-BA 8q24 14706 $133.00 ABPA 401710 $108.40 ANAPLASMA/EHRLICHIA PNL 14720 $74.55 STACHYBOTRYS CHARTARUM 401713 $87.68 TRAZODONE SERUM/PLASMA 14732 $81.00 BUILDING RELATED ALLERGY 402409 $154.70 L. PNEUMOPHILIA IGG 14739 $32.24 ALLERGEN SO COASTAL CALIF 402541 $227.30 C-PEPTIDE STIMULATION X4 14747 $133.00 ALLERGEN ARID SOUTHWEST 402548 $177.05 URANIUM, URINE 24 HOUR 14751 $137.00 HYMENOPTERA ALLERGY PANEL 402619 $166.04 CAH COMMON MUTATIONS 14755 $166.25 T-LYMPH/CD4/CBC 457059 $162.72 VENLAFAXINE & METABOLITE 14769 $233.00 CIPROFLOXACIN, PROGENE 501352 $190.00 ALLERGEN ASPEN TREE 14778 $39.88 PROGENE, IBUPROFEN 501360 $104.25 VITAMIN B3 14780 $172.00 ACETAMINOPHEN, PROGENE 501361 $190.00 THALLIUM, BLOOD 14790 $39.55 PROGENE, LVS-ASPIRIN 501365 $190.00 PSA, POST PROSTATECTOMY 14808 $30.10 PROGENE, DICLOFENAC 501369 $190.00 LIPID PANEL W/REFLEX DLDL 14852 $8.72 PROGENE, AMOXICILLIN 501381 $190.00 ZIPRASIDONE 14860 $120.00 SHOX DNA GENE MUTATION 504005 $425.00 RESP CULTURE W/REFLEX 14867 $63.00 LATEX, H.BRAZILIENSIS 1161580 $7.00 HEPARIN IND THROMBOPENIA 14874 $134.75 FUSARIUM MONILIFORME IGG 1175120 $43.50 COPPER URINE, RANDOM 14877 $36.40 LISTERIA ANTIBODY 1510022 $47.95 ZONISAMIDE 14884 $34.65 FISH,CHROM 20q DELETION 10055N $128.80 ANTIPHOSPHOLIPID AB PANEL 14890 $219.10 FISH, AML1/ETO, t(8:21) 10106N $138.60 FLUCONAZOLE 14904 $69.30 FISH,UROVYSION BLADDER 10107N $157.50 CADMIUM EXPOSURE PANEL 14915 $104.65 FANCONI ANEMIA DNA MUTAT 10221N $85.75 ASPERGILLUS ANTIGEN 14950 $40.95 NIEMANN-PICK DNA MUTATION 10222N $78.75 METANEPHRINES,FRAC,RANDOM 14961 $51.84 BLOOM SYNDROME DNA MUTAT 10224N $82.25 BASIC METABOLIC W/EGFR 15044 $5.46 CELL CULT,ADDT'L PRENATAL 10225N $30.80 COMP. METABOLIC W/EGFR 15045 $5.88 CF DNA ANALYSIS - FETUS 10226N $110.25

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

RENAL FUNCTION PNL W/EGFR 15046 $5.64 HUNTINGTON DISEASE MUTAT 10247X $122.50 CFTR INTRON 8 POLY T 15053 $99.75 MATRNL CELL CONTAMINATION 10262N $105.00 FLUOXETINE 15066 $28.00 CYSTIC FIBROSIS DNA MUTAT 10458N $99.75 PORPHYRINS, FRACTIONATED 15078 $31.85 FISH,SUBTELOMERIC REGION 10468N $385.00 GASTRIC PARIETAL CELL AB 15114 $18.20 BCR ABL PCR W/REFLEX GENE 10510N $151.20 PSA, TOTAL 15119 $27.20 FISH, AML, CBFB/MTH 11 10635X $133.00 KAPPA/LAMBDA LIGHT CHAINS 15122 $84.00 CHROMOSOME FOLLOW-UP BLD 10708X $222.25 HJ SOUTHWESTERN PNL + IGE 15134 $112.00 ASHKENAZI JEWISH PANEL 10910X $789.25 LEVETIRACETAM 15142 $22.84 C. FIBROSIS RARE MUTATION 10913X $89.95 HJ SOUTHWESTERN PROFILE 15144 $91.00 CYSTIC FIBROSIS 2 EXON 10915X $170.80 ALLERGY NUT MIX 15183 $30.94 CYSTIC FIBROSIS RARE MUT 10917X $862.75 ALLERGEN YELLOW JACKET 15193 $7.00 ALLERGEN GLUTEN, IGG 11084X $17.71 PARVOVIRUS B19, IGG 15261 $24.50 FISH, SKY MARKER CHROM 11122X $525.00 HEPARIN-INDUCED PLT AB 15334 $43.40 MCAD MUTATION ANALYSIS 11176X $97.65 ALPHA-1 ANTITRYPSIN MUT 15340 $96.25 MUCOLIPIDOSIS TYPE IV MUT 11192X $103.25 TAY SACHS ENZY. CARRIER 15350 $342.90 FISH, CLL/ALL, BCR/ABL 12070X $136.50 BISMUTH 15374 $26.25 CHROMOSOMES,AMNIOTIC FLD 14590X $253.40 SPIRONOLACTONE&METABOLITE 15383 $127.00 CHROMOSOMES & AFP W/RFL 14591X $144.96 RHEUMATOID FACTOR 15384 $15.75 CHROM, CHORIONIC VILLUS 14592X $298.20 PERNICIOUS ANEMIA DIAGNOS 15413 $100.45 CHROMOSOME, TISSUE 14593X $348.60 EPSTEIN BARR AG AB IGG 15447 $31.50 CHROM ANALYSIS HI RESOLUT 14595X $273.35 HLA-C CLASS I DNA TYPING 15463 $131.25 CHROM ANALYSIS, BLOOD 14596X $222.25 IGVH MUTATION ANALYSIS 15480 $148.75 CHROMOSOME, MOSAICISM 14597X $248.50 HLA CLASS I A,B,C DNA TYP 15484 $123.90 CHROM ANALYSIS, BREAKAGE 14598X $246.75 HLA DR,DQ CLASS II DNA TY 15485 $110.25 CHROM,HEMATOL MALIGNANCY 14600X $271.60 TESTOSTERONE,FREE/TOTAL 15487 $62.30 CHROMOSOME, CLL/LPD 14601X $271.60 BETA-2 MICROGLOBULIN, CSF 15500 $37.80 FISH, PRENATAL SCR ANEUV 14604X $148.75 SURESWAB VAGINOS-VAGINIT 15509 $780.00 FISH, PRADER-WILLI 14605X $126.00 URORISK DIAG. PROFILE 15515 $112.00 FISH, ANGELMAN 14608X $126.00 INFLUENZA TYPE B IGG,IGM 15518 $25.20 FISH, WILLIAMS 14609X $126.00 HYDROCODONE & METABOLITE 15532 $42.18 FISH,DIGEORGE VELOCARDIO 14610X $126.00 VON WILLEBRAND COMP PNL 2 15540 $315.70 FISH, SMITH-MAGENIS 14611X $126.00 LYME DISEASE DNA, CSF 15564 $104.30 FISH, MILLER-DIEKER 14612X $126.00 HLA-B27, DNA TYPING 15584 $66.50 FISH, WOLF-HIRSCHHORN 14613X $126.00 STONERISK DIAGNOSTIC 15671 $147.00 FISH, CRI DU CHAT 14614X $126.00 MICROSPORIDIA SMEAR 15676 $23.45 FISH, KALLMANN 14615X $126.00 RSV ANTIGEN DETECTION 15697 $24.50 FISH AML M3 PML/RARA TRAN 14617X $126.00 HLA A,B CLASS I DNA TYP 15757 $82.60 FISH ALL TEL/AML1 TRANSLO 14618X $126.00 LYME DISEASE DNA, B 15777 $104.30 FISH X/Y POST BONE MARROW 14619X $236.25 BABESIA MICROTI IgG IgM 15819 $25.20 FISH,HER-2/NEU,PARAFFIN 14620X $157.50 BRAZIL NUT 15836 $7.00 FISH, N-MYC NEUROBLASTOMA 14621X $126.00 ALLERGEN BUCKWHEAT 15837 $7.00 FISH,PRODUCTS OF CONCEPT 14820X $238.00 ALLERGEN COCONUT 15838 $7.74 MSH2 MUT 1 EXON HNPCC 14981X $140.00 ALLERGEN SESAME SEED 15841 $7.00 MSH6 MUTATION HNPCC 14982X $630.00 LYME DISEASE DNA, UR 15868 $104.30 MSH6 MUTATION 1 EXON 14983X $140.00 HERPES VIRUS 8 DNA PCR 15873 $104.30 MLH1 MUTATION ONE EXON 14984X $140.00 C4 BINDING PROTEIN, PLSMA 15914 $31.50 MLH1 & MSH2 MUTAT HNPCC 14986X $1,022.00 LIVER CYTOSOL ANTIBODIES 15922 $55.30 MICROSATELLITE HNPCC 14989X $175.00 HPV DNA, HIGH RISK 15949 $61.25 BCL-1/JH t(11,14) GENE 14991X $134.75 ALLERGEN CARROT 15961 $7.00 CBFB MYH11 INV (16) PCR 14992X $117.60 ANGIOEDEMA PANEL,ACQUIRED 15963 $90.06 PML/RARA t(15,17) QUANT 14994X $117.60 LUNG HEMORRHAGE NEPHRITIS 15971 $137.20 AML1/ETO t(8,21) QT PCR 14995X $117.60 CELIAC DISEASE PANEL 15980 $85.05 BCL2/JH t(14,18) GENE 15007X $147.00 CELIAC DISEASE COMP,INFNT 15981 $85.05 LYME DISEASE DNA, TICK 15510X $113.05 TESTOSTERONE, LC/MS/MS 15983 $54.25 STONERISK DIAG. PROFILE 15567X $95.20 HERPES VIRUS 6 DNA QUAL 16001 $70.70 STONERISK CITRATE 15568X $37.10 CHLAMYDIA PNEUMONIAE, PCR 16003 $63.00 STONERISK CYSTINE 15569X $35.00 B-CELL GENE REARRANGEMENT 16005 $105.00 ARIPIPRAZOLE 15922X $76.07 PCNA ANTIBODY 16010 $29.75 TCR GENE REARRANGEMENT 15930X $102.90 VMA,METANEPHRINE,CATECHOL 16013 $144.55 FAMILIAL DYSAUTONOMIA DNA 16040X $85.75 CYSTINURIA PROFILE,QN 24H 16016 $275.40 FACTOR VII R353Q MUTATION 16180X $104.65

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Contract : 5753Vendor : Quest Diagnostics

DESCRIPTION CODE PRICE DESCRIPTION CODE PRICEQuest Fee Schedule

FACTOR XI MUTATION ANALYS 16023 $120.75 BUPRENORPHINE, QUANT, UR 16213X $100.00 VW FACTOR ACTIVITY 16028 $42.00 SPECIMEN VALIDITY TEST,UR 16278X $64.00 ABL KINASE MUTATION 16029 $140.00 BOVINE THROMBIN INHIBITOR 16373X $23.63 ABL KINASE MUTATION 16031 $140.00 RESPIRATORY VIRUS PNL IV 16473X $643.65 DESMOGLEIN ANTIBODIES 16033 $29.75 ZINC RANDOM URINE W/CREAT 16502X $45.15 B BURGDORFERI AB PANEL 16034 $78.75 NG,RNA,TMA,RECTAL 16504X $21.00 AMYLASE ISOENZYMES 16036 $31.15 CT,RNA,TMA,RECTAL 16505X $21.00 ANTIMONY 16037 $79.00 CT/NG,RNA,TMA,RECTAL 16506X $42.00 ADENOVIRUS DNA QUAL PCR 16046 $105.00 P53 MUT ANALYSIS LEUMETA 16515X $402.50 FACTOR VIII ACTIVITY 16049 $51.45 PM ALCOHOL METAB CONF UR 16910X $60.00 MLH1 & MSH2 MUTATIONS 16051 $182.00 AMPHETAMINE CONF, UR 16913X $100.00 RTH MUTATION ANALYSIS 16053 $271.25 MORPHINE-TOTAL, UR 17712X $163.00 BENZTROPINE, QUANTITATION 16055 $94.00 TPMT ACTIVITY 18831X $128.10 ACHONDROPLASIA MUTATION 16061 $95.55 OXYCODONE/METAB 18885X $34.21 MAPLE SYRUP DISEASE 16067 $123.55 GAUCHER DISEASE DNA MUT 43539N $129.50 GLYCOGEN STORAGE DISEASE 16069 $112.00 AFP AMNIOTIC FLD W/REFLEX 4713N $30.10 MULTIPLE MYELOMA,FISH 16077 $166.25 CANAVAN DISEASE MUT ANALY 54577N $157.50 CYSTIC FIBROSIS CFTR GENE 16080 $140.00 CHROMIUM, BLOOD 6085X $16.45 INFLUENZA TYPE A&B RNA 16086 $104.30 C TRACHOMATIS TMA THROAT 70048X $21.00 PARAINFLUENZA VIR RNA X3 16087 $149.10 NG GONORRHOEAE,TMA,THROAT 70049X $21.00 CENTROMERE B ANTIBODY 16088 $19.25 CT/NG, RNA, TMA, THROAT 70051X $42.00 HIV DETECTION PANEL 16090 $115.85 HEPATITIS B CORE AB 7040E $21.70 EGFR MUTATION ANALYSIS 16091 $199.50 MLL (11q23) GENE REARRANG 84269N $126.00 TOXOPLASMA ABS, IGG/IGM 16092 $63.35 FISH, NEONATAL 84350N $140.00 DNA (DS) AB HIGH AVIDITY 16093 $20.30 SICKLE CELL DNA, FETUS 84541N $157.50 FONDAPARINUX SODIUM 16103 $53.20 B-CELL GENE REARRANGEMENT 84731N $70.35 FISH,EWING/PNET/ESWR1 16112 $120.75 ACETYLCHOLINESTERASE 84897N $41.65 FISH, ALCL,ALK,2p23 16114 $120.75 MICRODELETION SYNDROME 88039N $166.25 FISH, OLIGODENDROGLIOMA 16115 $168.00 SNHD EXPOSURE PANEL 9000E $82.50 ALPHA-GLOBIN GENE SEQ 16116 $213.50 TISSUE EXAM 302 AC01 $37.00 B-CELL REAARANGEMENT QUAN 16118 $77.00 TISSUE EXAM 304 AC02 $40.00 B-CELL REARRANGEMENT QUAL 16119 $70.35 TISSUE EXAM 305 AC03 $45.00 MACROPROLACTIN 16122 $49.00 TISSUE EXAM 307 AC04 $138.20 ALPHA-GLOBIN DETECTION 16124 $201.25 CHEMISTRIES (10) CHEM10 $4.57 RAS MUTATION LEUMETA 16127 $192.50 CHEMISTRIES (11) CHEM11 $4.75 ras MUTATION CELL BASED 16128 $192.50 CHEMISTRIES (12) CHEM12 $4.92 ALLERGEN ARIZONA PNL&IGE 16129 $210.00 CHEMISTRIES (13) CHEM13 $5.10 BULLOUS PEMPHIGOID BP230 16136 $24.50 CHEMISTRIES (14) CHEM14 $5.27 PANCREATIC EXOCRINE CELL 16143 $35.70 CHEMISTRIES (15) CHEM15 $5.46 PROTEASOME ACTIVITY 16144 $22.75 CHEMISTRIES (16) CHEM16 $5.63 ALPHA-1 ANTITRYPSIN PHENO 16145 $74.20 CHEMISTRIES (17) CHEM17 $5.86 MACULAR DEGENERATION MUT 16155 $175.00 CHEMISTRIES (18) CHEM18 $6.10 NPM(EXON12)MUTATION,ANALY 16158 $108.50 CHEMISTRIES (19) CHEM19 $6.32 NPM(EXON12)MUTATION,LEUME 16159 $108.50 CHEMISTRIES (2) CHEM2 $3.17 CYTOCHROME P450 & VKROC1 16160 $175.00 CHEMISTRIES (20) CHEM20 $6.56 FIBROBLAST GROWTH FACTOR 16171 $43.75 CHEMISTRIES (21) CHEM21 $6.79 JAK2 MUTATION (LEUMETA) 16175 $175.00 CHEMISTRIES (3) CHEM3 $3.35 BETA-2 ADRENERGIC 16176 $104.65 CHEMISTRIES (4) CHEM4 $3.52 FACTOR XIII V34L MUTATION 16178 $104.65 CHEMISTRIES (5) CHEM5 $3.70 BETA-FIBRINOGEN 455G>A 16182 $104.65 CHEMISTRIES (6) CHEM6 $3.87 MPL W515/7MPL S505 MUT 16184 $199.50 CHEMISTRIES (7) CHEM7 $4.05 HIV-1 RNA,QUALITATIVE TMA 16185 $122.15 CHEMISTRIES (8) CHEM8 $4.22

CHEMISTRIES (9) CHEM9 $4.40