CPT Codes & Prices
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TEST |
CPT CODES [unit] |
SPECIFICS |
PRICE |
| Mitochondrial DNA (mtDNA) Point Mutations |
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| Single mtDNA point mutation |
83891[1], 83892[1], 83894[1], 83898[1], 8391226[1] |
Per point mutation |
$300 |
Frequent mtDNA point mutations Panel
(3243, 3256, 3271, 8344, 8356, 8993, 13513) |
83891[1], 83892[7], 83894[7], 83898[7], 8391226[1] |
Per panel |
$1,200 |
| MELAS mtDNA point mutations Panel
(3243, 3256, 3271, 3291, 5814, 8356, 13513) |
83891[1], 83892[7], 83894[7], 83898[7], 8391226[1] |
Per panel |
$1,200 |
| MERRF mtDNA point mutations Panel
(3243, 8344, 8356, 8363) |
83891[1], 83892[4], 83894[4], 83898[4], 8391226[1] |
Per panel |
$750 |
| NARP/MILS mtDNA point mutations Panel
(8993*, 9176, 13513) |
83891[1], 83892[6], 83894[3], 83898[3], 8391226[1]
*if 8993 pos., sequencing for C or G change 83904[1] |
Per panel |
$600
+ $50* |
| PEO mtDNA point mutation Panel
(3243, 3256, 5703) |
83891[1], 83892[3], 83894[3], 83898[3], 8391226[1] |
Per panel |
$600 |
| LHON mtDNA point mutation Panel
(3460, 11778, 14484) |
83891[1], 83892[3], 83894[3], 83898[3], 8391226[1] |
Per panel |
$600 |
| Cardiomyopathy mtDNA point mutation Panel
(3243, 3260, 3303, 4269, 4300, 8363, 9997) |
83891[1], 83892[7], 83894[7], 83898[7], 8391226[1] |
Per panel |
$1,200 |
| Mitochondrial Whole Genome Sequencing |
Contact Laboratory |
Whole Genome |
Contact Lab |
| Mitochondrial Enzymes (Respitarory chain enzymes) |
82657[6], 84311[6], 8391226[1] |
6-enzyme battery |
$550 |
| Southern Blot for mtDNA deletions (Muscle) |
83891[1], 83892[1], 83894[1], 83896[1], 83907[1], 8391226[1] |
Per test |
$495 |
| Southern Blot for mtDNA deletions (Blood) |
83891[1], 83892[1], 83894[1], 83896[1], 8391226[1] |
Per test |
$445 |
| Quantitative PCR for depletion (Muscle) |
83891[1], 83896[2], 83900[1], , 83907[1], 8391226[1] |
Per test |
$515 |
| Coenzyme Q10 Muscle |
82491[1], 8391226[1] |
Per test |
$250 |
| Coenzyme Q10 Blood |
82491[1], 8391226[1] |
Per test |
$125 |
| Thymidine Phosphorylase (MNGIE) |
83907[1], 84165[1], 8416526[1], 84311[1], 8391226[1] |
Per test |
$247 |
| Glycogenoses Enzymes |
82657[1], 84311[1], 8391226[1] |
Per enzyme |
$175 |
| Carnitine palmitoyltransferase II (CPT II) enzyme |
82658[1], 84311[1], 8391226[1] |
Per enzyme |
$175 |
| Glycogenoses Enzymes Panel 3 enzymes
(PGK, PGAM, LDH) |
82657[3], 84311[3], 8391226[1] |
Per Panel |
$325 |
| Glycogenoses Enzymes Panel 6 enzymes
(PPL, PFK, PHK, PGK, PGAM, LDH) |
82657[6], 84311[6], 8391226[1] |
Per Panel |
$550 |
| McArdle’s (PPL) Single Mutation R49X or G204S |
83891[1], 83892[1], 83894[1], 83898[1], 8391226[1] |
Per Test |
$300 |
| McArdle’s (PPL) Mutations R49X and G204S |
83891[1], 83892[2], 83894[2], 83898[2], 8391226[1] |
Combined Panel |
$450 |
| Phosphofructokinase (PFK) Exon 5 mutation |
83891[1], 83892[1], 83894[1], 83898[1], 8391226[1] |
Per Test |
$300 |
| Carnitine palmitoyl transferase II
(Ser113Leu mutation) |
83891[1], 83892[1], 83894[1], 83898[1], 8391226[1] |
Per Test |
$300 |
| Phosphoglycerate mutase (PGAM) Gene Sequencing |
83891[1], 83892[2], 83894[1], 83898[3], 83904[3], 8391226[1] |
Per Test |
$600 |
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