Wyoming Administrative Code › Agency 048 - Health, Department of › Sub-Agency 0048 - Public Health Laboratory › Chapter 1 - RULES AND REGULATIONS FOR THE PUBLIC HEALTH LABORATORY TESTING FEES › Section 1-6 - Fee Schedule for Services

Current through July 13, 2024
The following fees shall apply for each test request
				  submitted:
Chemistry
Fee
Test
						  Description
$14.00
Oral fluid collection kit and 4 drug
						  screen w/confirmation
$9.00
Urine analysis kit and 8 drug screen
						  w/confirmation
$9.50
Blood alcohol collection kit
						  w/confirmation and 10 drug screen
$90.00
20 drug blood screening panel
						  w/alcohol screen and confirmation
$9.00
Ethyl Glucuronide (ETG)
$9.00
Methadone
$9.00
Propoxyphene
$8.00
Cotinine
$23.00
Synthetic marijuana
$23.00
Inhalants
$23.00
Emerging drugs
$9.00
Toxicology screen
$9.00
Toxicology confirmation
Microbiology
Fee
Test
						  Description
CPT code
$8.00
Drinking water total coliform
N/A
$8.00
Drinking water
E.
						  coli
screen
N/A
$4.00
Occult blood feces
82270
$20.00
Immunoassay for blood fecal
82274
$15.00
Chemiluminescent assay
82397
$45.00
Electrophoretic test
82664
$10.00
Assay IgA/IgD/IgG/IgM each
82784
$6.00
IgG 1 2 3 or 4 each
82787
$15.00
Immunoassay nonAntibody
83516
$10.00
Immunoassay dipstick
83518
$15.00
Immunoassay quant nos nonab
83520
$20.00
Western blot test
84181
$20.00
Protein western blot test
84182
$4.00
Bl smear w/o diff wbc count
85008
$5.00
Chromogenic substrate assay
85130
$15.00
Immunoglobulin assay
86023
$5.00
Complement fixation each
86171
$15.00
Fluorescent Antibody screen
86255
$15.00
Fluorescent Antibody titer
86256
$5.00
Heterophile Antibody screen
86308
$5.00
Heterophile Antibody titer
86309
$10.00
Heterophile Antibody absrbj
86310
$15.00
Immunoassay infectious agent
86318
$10.00
Particle agglut antbdy scrn
86403
$10.00
Particle agglut antbdy titr
86406
$40.00
Quantiferon Gold (Tb immun measure)
86480
$3.00
Syphilis test non-trep qual
86592
$5.00
Syphilis test non-trep quant
86593
$6.00
Bacterium Antibody
86609
$15.00
Borrelia
Antibody
86619
$15.00
CMV Antibody
86644
$15.00
CMV Antibody IgM
86645
$20.00
Diphtheria Antibody
86648
$15.00
Encephalitis californ antbdy
86651
$15.00
Encephaltis east eqne anbdy
86652
$15.00
Encephaltis st louis antbody
86653
$15.00
Encephaltis west eqne antbdy
86654
$15.00
Epstein-barr Antibody
86663
$15.00
Epstein-barr nuclear antigen
86664
$15.00
Epstein-barr capsid vca
86665
$10.00
Francisella
						  tularensis
86668
$6.00
Fungus nes Antibody
86671
$15.00
Helicobacter pylori
Antibody
86677
$15.00
Helminth Antibody
86682
$15.00
Herpes simplex nes antbdy
86694
$15.00
HIV-1/hIV-2 1 result screen
86703
$15.00
Hepatitis B Core Antibody total
86704
$15.00
Hepatitis B Core Antibody IgM
86705
$15.00
Hepatitis B Surface Antibody
86706
$15.00
Hepatitis A Antibody total
86708
$15.00
Hepatitis A Antibody IgM
86709
$15.00
Legionella
Antibody
86713
$15.00
Leishmania
Antibody
86717
$15.00
Leptospira
Antibody
86720
$6.00
Mumps Antibody
86735
$15.00
Mycoplasma
Antibody
86738
$15.00
Neisseria
						  meningitidis
86741
$15.00
Parvovirus Antibody
86747
$14.00
Protozoa Antibody nos
86753
$20.00
Rickettsia
Antibody
86757
$6.00
Rubella Antibody
86762
$6.00
Rubeola Antibody
86765
$15.00
Toxoplasma
Antibody
86777
$15.00
Toxoplasma
Antibody
						  IgM
86778
$15.00
Treponema
						  pallidum
86780
$5.00
Trichinella
Antibody
86784
$6.00
Varicella-zoster Antibody
86787
$20.00
West Nile virus ab IgM
86788
$20.00
West Nile virus Antibody
86789
$15.00
Virus Antibody nos
86790
$20.00
Hepatitis C Antibody
86803
$5.00
Specimen infect agnt concntj
87015
$5.00
Feces culture aerobic bact
87045
$5.00
Stool cultr aerobic bact ea
87046
$5.00
Culture othr specimn aerobic
87070
$5.00
Culture aerobic quant other
87071
$5.00
Culture bacteria anaerobic
87073
$5.00
Cultr bacteria except blood
87075
$10.00
Culture anaerobe ident each
87076
$10.00
Culture aerobic identify
87077
$5.00
Culture screen only
87081
$10.00
Culture of specimen by kit
87084
$5.00
Urine culture/colony count
87086
$5.00
Skin fungi culture
87101
$5.00
Fungus isolation culture
87102
$5.00
Fungi identification yeast
87106
$5.00
Fungi identification mold
87107
$5.00
Mycoplasma
87109
$10.00
Mycobacteria
culture
87116
$10.00
Mycobacteric identification
87118
$25.00
DNA/RNA direct probe
87149
$40.00
DNA/RNA amplified probe
87150
$50.00
Culture type pulse field gel (PFGE)
87152
$50.00
DNA/RNA sequencing
87153
$4.00
Macroscopic exam arthropod
87168
$4.00
Macroscopic exam parasite
87169
$4.00
Pinworm exam
87172
$5.00
Tissue homogenization cultr
87176
$8.00
Ova and parasites smears
87177
$5.00
Microbe susceptible diffuse
87181
$5.00
Microbe susceptible disk
87184
$10.00
Microbe susceptible mic
87186
$10.00
Microbe susceptible mlc
87187
$3.00
Smear fluorescent/acid stai
87206
$5.00
Smear special stain
87207
$15.00
Smear complex stain
87209
$3.00
Smear wet mount saline/ink
87210
$25.00
Assay toxin or antitoxin
87230
$15.00
Cryptosporidium
ag if
87272
$15.00
Legionella micdadei
ag if
87277
$15.00
Legion pneumophilia
ag if
87278
$15.00
Pneumocystis carinii
ag if
87281
$16.32
Antibody detection nos if
87299
$15.00
Adenovirus ag eia
87301
$15.00
Aspergillus
ag eia
87305
$15.00
Chylmd trach
ag eia
87320
$15.00
Cryptococcus neoform
ag eia
87327
$15.00
Cryptosporidium
ag
						  eia
87328
$15.00
Giardia
ag eia
87329
$15.00
Cytomegalovirus ag eia
87332
$15.00
E. coli
0157 ag eia
87335
$15.00
H. pylori
stool eia
87338
$15.00
H. pylori
ag eia
87339
$15.00
Hepatitis B Surface Antigen
87340
$15.00
Histoplasma capsul
ag
						  eia
87385
$15.00
Influenza A/B ag eia
87400
$15.00
Resp syncytial ag eia
87420
$15.00
Rotavirus ag eia
87425
$15.00
Shiga-like toxin ag eia
87427
$15.00
Ag detect nos eia mult
87449
$13.00
Ag detect nos eia single
87450
$13.00
Ag detect polyval eia mult
87451
$40.00
Bartonella
DNA amp
						  probe
87471
$40.00
Lyme dis DNA amp probe
87476
$40.00
Candida
DNA amp probe
87481
$40.00
Chylmd pneum
DNA amp
						  probe
87486
$12.00
Chylmd trach
DNA amp
						  probe
87491
$14.00
Chylmd trach
and
N. gono
DNA amp probe
87491
$40.00
C. diff
amplified
						  probe
87493
$40.00
Cytomeg DNA amp probe
87496
$40.00
Enterovirus probe&revrs trns
87498
$20.00
Influenza DNA amp prob 1+
87501
$20.00
Influenza DNA amp probe
87502
$100.00
Nfct agent detection gi
87505
$150.00
IaDNA-DNA/RNA probe tq 6-11
87506
$250.00
IaDNA-DNA/RNA probe tq 12-25
87507
$40.00
Hepatitis B DNA amp probe
87516
$50.00
Hepatitis B DNA quant
87517
$25.00
Hepatitis C RNA dir probe
87520
$40.00
Hepatitis C probe&rvrs trnsc
87521
$55.00
Hepatitis C revrs trnscrp
87522
$45.00
Hsv DNA amp probe
87529
$45.00
HIV-1 probe&reverse trnscrpj
87535
$115.00
HIV-1 quant&revrse trnscrpj
87536
$25.00
Legion pneumo
DNA dir
						  prob
87540
$40.00
Legion pneumo
DNA amp
						  prob
87541
$56.82
Legion pneumo
DNA
						  quant
87542
$20.00
Mycobacteria
DNA dir
						  probe
87550
$40.00
Mycobacteria
DNA amp
						  probe
87551
$20.00
M.tuberculo
DNA dir
						  probe
87555
$40.00
M.tuberculo
DNA amp
						  probe
87556
$20.00
M.avium-intra
DNA dir
						  prob
87560
$40.00
M.avium-intra
DNA amp
						  prob
87561
$40.00
M.pneumon
DNA amp
						  probe
87581
$12.00
N.gonorrhoeae
DNA amp
						  prob
87591
$45.00
HPV low-risk types
87623
$45.00
HPV high-risk types
87624
$45.00
HPV types 16 & 18 only
87625
$100.00
Resp virus 3-11 targets
87631
$150.00
Resp virus 6-11 targets
87632
$200.00
Resp virus 12-25 targets
87633
$47.76
Staph a
DNA amp probe
87640
$47.76
Mr-
Staph
DNA amp
						  probe
87641
$27.29
Strep
A DNA dir probe
87650
$47.76
Strep
A DNA amp probe
87651
$47.76
Strep
B DNA amp probe
87653
$45.00
Trichomonas vaginalis
amplif
87661
$25.00
Detect agent nos DNA dir
87797
$35.00
Pertussis (PCR)
87798
$40.00
Norovirus molecular
87798
$40.00
Detect agent nos DNA amp
87798
$55.00
Detect agent nos DNA quant
87799
$50.00
Detect agnt mult DNA direc
87800
$95.00
Detect agnt mult DNA ampli
87801
$16.32
Strep
B assay w/optic
87802
$30.00
HIV antigen w/HIV antibodies
87806
$15.00
RSV assay w/optic
87807
$15.00
Adenovirus assay w/optic
87809
$6.00
Group A
Strep
assay
87880
$16.32
Agent nos assay w/optic
87899
$300.00
Genotype DNA/RNA Hep C
87902
$250.00
Genotype DNA Hepatitis B
87912
$26.88
Protein analysis w/probe
88372
$15.00
HIV-1/HIV-2 confirm
86703-92