Hearing Genetic Testing Test Codes CPT Codes Sample Type Cost TAT
OtoSCOPE® panel OTOSC09 81430, 81431 8 - 10 cc EDTA whole blood (room temperature)
OR
10 μg DNA from whole blood (minimum concentration: 50 ng/μl)
OR
Saliva OR Buccal Swabs (contact MORL at morl@uiowa.edu for details)		 $1950 6 weeks   
Usher panel (10 genes; Next Generation Sequencing (NGS) panel and copy number variant analysis) USH01 81404(x2), 81407(x3),
81408 (x2), 81479(x3)		 $1950 6 weeks
GJB2/GJB6 (Connexin 26/30) GJB2_6 81252 / 81254 $356 8 weeks
GJB2/GJB6 (Connexin 26/30) familial GJB2_6F 81253 $220 8 weeks
MT-RNR1- C1494T and A1555G variants MTRNR1 81401 – MT-RNR1 $185 8 weeks
MT-TL1-A3243G variant MTTL1 81401 – MT-TL1 $185 8 weeks
MT-TS1-A7445G variant MTTS1 81401 – MT-TS1 $185 8 weeks
OtoSCOPE® Familial Variant Testing (cost is per person/per gene) OTOSCFAM 81403 $220

6 weeks  *excludes copy number variant detection
HEAR VUS Program: Variant reclassification program for qualifying families HEARVUS 81403 --- 6 weeks

Gene Specific Testing: Please contact MORL prior to ordering to discuss availability, test methods, and cost.

   Single gene testing may be available for hearing loss genes included on the current OtoSCOPE panel. Please contact MORL Please contact MORL
Kidney Genetic Testing Test Codes CPT Codes Sample Type Cost TAT
Genetic Renal Panel including MLPA (DNA test for TTP, aHUS, HUS, DDD, C3G and other complement diseases): (CFH, CFI, CD46 (MCP), CFB, CFHR5, C3, THBD, ADAMTS13, PLG, DGKE, G6PD, MMACHC, WT1 and two C5 variants associated with poor Eculizumab response (p.Arg885Cys and p.Arg885His)) GRP08
81479, 81405		 8 - 10 cc EDTA whole blood (room temperature)
OR
10 μg DNA from whole blood (minimum concentration: 50 ng/μl)		 $3000 3 weeks
MLPA (screening the CFH-CFHR5 genomic region) MLPA02 81405 $686 3 weeks
Genetic Renal Panel Familial Variant Testing (cost is per person/per gene) GRPFAM 81403 $220 2 weeks
Functional/Biomarker Tests - Panels Test Codes CPT Codes Sample Type Cost TAT
C3G Functional Panel (Includes the three micro-panels below [Complement Antibody Panel, Complement Biomarker Panel, Complement Pathway Panel]; appropriate for the initial evaluation of C3G patients, i.e. DDD or C3GN) 08C3GFP 86161 (x5), 83516 (x2), 86160 (x10), 83520, 86334, 86162

2 ml frozen serum
AND
2 ml frozen EDTA plasma

 $4458 4 weeks
TMA Functional Panel
11 tests - CH50, APFA, C3b Deposition Assay, FHAA, C3, C4, FB, Bb, Soluble C5b-9 (sMAC), FI and FH levels.		 08TMAFP 83516, 83520, 86160 (x6), 86161(x2), 86162 $2337 4 weeks
Complement Antibody Micro-Panel
6 tests - Fluid Phase Activity Assay (IFE), FB autoantibody, FH autoantibody, C3Nef (C3CSA), C5Nef (C3CSAP), C4Nef; appropriate for
following antibody levels		 02AMP 83516 (x2), 86161(x3), 86334

2 ml frozen serum

 $1812 4 weeks
Complement Biomarker Micro-Panel
11 tests - C3, C3c, C4, FB, Ba, Bb, C5, Properdin, soluble C5b-9, FI, and FH Levels; appropriate for following biomarker levels)		 03CBMP 83520, 86160 (x10)

2 ml frozen serum
AND
2 ml frozen EDTA plasma

 $2605 4 weeks
Complement Pathway Micro-Panel
3 tests - CH50, APFA, C3b Deposition Assay); appropriate for following complement activity and complement blockade)		 03CPMP 86161 (x2), 86162

2 ml frozen serum

 $639 4 weeks
Functional Tests - a la carte - Serum (1 ml frozen) Test Codes CPT Codes Sample Type Cost TAT
CH50 07CH50 86161

1 ml frozen serum per test
(if ordering more than 6 tests please provide at least 2ml total for all tests)

 $119 2 weeks
Alternative Pathway Functional Assay (APFA) 06APFA 86161 $220 2 weeks
C3b Deposition Assay 01C3BDA 86162 $300 4 weeks
Hemolytic Assay 06HA 86162 $352 4 weeks
Fluid Phase Activity Assay (IFE) 07FPA 86334 $200 4 weeks
FH Autoantibody Testing 07FHAA 83516 $356 4 weeks
FB Autoantibody Testing 07FBAA 83516 $356 2 weeks
C3Nef (C3CSA) 06C3NEF 86161 $250 4 weeks
C5Nef (C3CSAP) 06C5NEF 86161 $250 4 weeks
C4Nef 06C4NEF 86161 $400 4 weeks
Biomarker Tests - a la carte - EDTA Plasma (1 ml frozen) Test Codes CPT Codes Sample Type Cost TAT
C3 Level - frozen red-top serum 07C3L 86160

1 ml frozen plasma (unless otherwise noted) per test
(if ordering more than 6 tests please provide at least 2ml total for all tests)

 $110 2 weeks
C3c Level 06C3CL 86160 $358 4 weeks
C4 Level - frozen red-top serum 07C4L 86160 $110 2 weeks
Factor B Level (FB) 07FBL 86160 $165 2 weeks
Ba Level 06BAL 86160 $275 2 weeks
Bb Level 06BBL 86160 $275 2 weeks
C5 Level 06C5L 86160 $300 2 weeks
Properdin Level 06PL 86160 $330 2 weeks
Soluble C5b-9 (sMAC) 06SMAC 83520 $352 2 weeks
Factor I Level (FI) 07FIL 86160 $165 2 weeks
Factor H Level (FH) 06FHL 86160 $165 2 weeks
ADAMTS-13 Assays - Citrated Plasma (1 ml frozen) Test Codes CPT Codes Sample Type Cost TAT
ADAMTS-13 Activity Assay 01ATS13 85397 1 ml frozen citrated plasma $400 24 hours 
ADAMTS-13 Activity Assay w/ reflex to ADAMTS-13 Inhibitor Assay if activity <25% 01ATS13RFX 85397, 85335 $800 24 hours

Prices & tests offered subject to change on an quarterly basis. Effective 7/1/2021

Ship all samples to: Dr. Richard Smith
Molecular Otolaryngology & Renal Research Laboratories
The University of Iowa
285 Newton Rd., 5270 CBRB
Iowa Ci ty, IA 52242		 NO weekend deliveries
University of Iowa Shipping and Receiving Department is CLOSED on weekends & holidays

The Clinical Diagnostics Service of the Molecular Otolaryngology and Renal Research Laboratories is a Joint Commission-approved CLIA-accredited diagnostic laboratory.