| Blood typing ABO CPT 86900 • Laboratory | $5 | $5 | $5 |
| Blood typing Rh CPT 86901 • Laboratory | $5 | $5 | $5 |
| Urine culture bacterial colony count CPT 87086 • Laboratory | $5 | $5 | $5 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $5 | $5 | $5 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $5 | $5 | $5 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $5 | $5 | $5 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $5 | $5 | $5 |
| Strep A assay with optic observation CPT 87880 • Laboratory | $5 | $5 | $5 |
| Cytopathology concentration technique CPT 88108 • Pathology | $109 | $109 | $109 |
| Cytopathology cell enhancement technique CPT 88112 • Pathology | $194 | $194 | $194 |
| Cytopathology cervical/vaginal interpretation physician CPT 88141 • Pathology | $37 | $37 | $37 |
| Cytopathology cervical/vaginal manual screen CPT 88164 • Pathology | $25 | $25 | $25 |
| Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology | $62 | $62 | $62 |
| Molecular cytogenetics DNA probe each CPT 88271 • Pathology | $34 | $34 | $34 |
| Cytogenetics molecular interpretation CPT 88291 • Pathology | $44 | $44 | $44 |
| Surgical pathology gross and micro exam level II CPT 88302 • Pathology | $71 | $71 | $71 |
| Surgical pathology gross and micro exam level III CPT 88304 • Pathology | $94 | $94 | $94 |
| Surgical pathology gross and micro exam level IV CPT 88305 • Pathology | $98 | $98 | $98 |
| Surgical pathology gross and micro exam level V CPT 88307 • Pathology | $169 | $232 | $295 |
| Surgical pathology gross and micro exam level VI CPT 88309 • Pathology | $413 | $413 | $413 |
| Special stain group I for microorganisms CPT 88312 • Pathology | $126 | $126 | $126 |
| Special stain group II CPT 88313 • Pathology | $90 | $90 | $90 |
| Frozen section pathology first specimen CPT 88331 • Pathology | $145 | $145 | $145 |
| Frozen section pathology each additional CPT 88332 • Pathology | $67 | $67 | $67 |
| Immunohistochemistry each antibody CPT 88341 • Pathology | $46 | $46 | $46 |
| Immunohistochemistry first antibody CPT 88342 • Pathology | $77 | $110 | $143 |
| Morphometric analysis tumor quantitative CPT 88360 • Pathology | $177 | $177 | $177 |