| Hearing Genetic Testing | CPT Codes | Cost | TAT |
|---|---|---|---|
| OtoSCOPE® panel | 81430, 81431 | $1500 | 3-4 months |
| Usher panel: USH1 genes: MYO7A, USH1C, CDH23, PCDH15, USHIG, CIB2; USH2 genes: USH2A, GPR98, WHRN (DFNB31); USH3 genes: CLRN) | 81404(x2), 81407(x3), 81408(x2), 81479(x3) | $1500 | 3-4 months |
| GJB2/GJB6 (Connexin 26/30) | 81252 / 81254 | $324 | 8 weeks |
| GJB2/GJB6 (Connexin 26/30) familial | 81253 | $200 | 8 weeks |
| MTRNR1- C1494T and A1555G mutations | 81401 – MTRNR1 | $168 | 8 weeks |
| MTTL1-A3243G mutation | 81401 – MTTL1 | $168 | 8 weeks |
| MTTS1-A7445G mutation | 81401 – MTTS1 | $168 | 8 weeks |
| Familial Mutation Testing | 81403 | $200 | 8 week |
| Kidney Genetic Testing | CPT Codes | Cost | TAT |
|---|---|---|---|
| Genetic Renal Panel (appropriate for patients with TMA, TTP, aHUS, DDD and C3GN) - genes included: CFH, CFI, MCP, CFB, CFHR5, C3, THBD, ADAMTS13, PLG, DGKE, and MLPA | 81479(x11) | $3,000 | 28 days - average TAT |
| MLPA (screen for deletions of CFHR1-CFHR3) | 81479 | $624 | 8-12 weeks |
| Familial Mutation Testing | 81403 | $200 | 2 weeks |
| Special Functional and Biomarker Testing | CPT Codes | Cost | TAT |
|---|---|---|---|
| TMA Functional Panel (FH autoantibody, Hemolytic Assay, CH50, APFA, FH, FI, FB, C3, C4, ADAMTS-13 & sC5b-9) | 83516, 83520, 85397, 86160(x5), 86161(x2), 86162 | $2,272 | 4 weeks |
| C3G Functional Panel ( FB autoantibody, FH autoantibody, HemolyticAssay, C3NeF, C4Nef , CH50, APFA, C3, C3c, FB, Ba, Bb, C5, Properdin & sC5b-9) | 83516(x2), 83520, 86160(x7), 86161(x5), 86162, 86235(x3), 86334 | $4,063 | 4 weeks |
| FB Autoantibody Testing | 83516 | $324 | 4 weeks |
| FH Autoantibody Testing | 83516 | $324 | 2 weeks |
| Hemolytic Assay | 86161 | $320 | 4 weeks |
| Alternative Pathway Functional Assay (APFA) | 86161 | $200 | 2 weeks |
| Ba Level | 86160 | $250 | 2 weeks |
| Bb Level | 86160 | $250 | 2 weeks |
| CH50 | 86162 | $108 | 2 weeks |
| C3 Level | 86160 | $100 | 2 weeks |
| C3c Level available beginning 1/1/2016 | 86160 | $325 | 4 weeks |
| C3d Level no longer available as of 1/1/2016 | 86160 | $325 | 6 weeks |
| C4 Level | 86160 | $100 | 2 weeks |
| C5 Level | 86160 | $300 | 2 weeks |
| Properdin Level | 86160 | $300 | 2 weeks |
| Factor B Level (FB) | 86160 | $150 | 2 weeks |
| Factor H Level (FH) | 86160 | $120 | 2 weeks |
| Factor I Level (FI) | 86160 | $130 | 2 weeks |
| ADAMTS-13 Activity Assay | 85397 | $400 | 24 hours |
| ADAMTS-13 Inhibitor Assay | 85397, 85335 | $400 | 24 hours |
| ADAMTS-13 Activity with Inhibitor Assay | 85397, 85335 | $550 | 24 hours |
| C3Nef (by C3CSA, C3CSAP & IFE) | 86235(x2), 86161(x2), 86334 | $392 | 4 weeks |
| C4Nef | 86235, 86161 | $400 | 4 weeks |
| Soluble C5b-9 (sMAC) | 83520 | $320 | 2 weeks |
Prices & tests offered subject to change on an quarterly basis. Effective 1/1/2016