FWIC Laboratory Prices

Self-Pay Laboratory and X-ray Pricing

***All payments are due at time of service for Self-Pay patients
***These prices are not insurance prices and insurance will not be billed if paying as Self-Pay

Laboratory Test Self Pay Cost Laboratory Test Self Pay Cost
Amylase $25.00 Upper Respiratory Culture $80.00 +++
ANA  without reflex code 164855 $45.00 Uric Acid $40.00
ANA with Reflex code 164863 $50.00 Urine Culture Comprehensive $65.00
Antinuclear Antibodies Direct $30.00 Urine Dip $10.00
Albumin/Creatinine Ratio $30.00 Variella-Zoster V Ab, IgG $50.00
Blood Type $85.00 Viral Culture General $135.00
CBC $40.00 Vitamin B12 and Folate$50.00
Celiac Panel $150.00 Vitamin D Hydroxy $60.00
Chem Panel (CMP) $40.00    
CMP14+LP+CBC/D/Plt+TSH $90.00 Xray  
CMP14+LP+CBC/DPlt+TSH +PSA $90.00 AC Joint $50.00
Cortisol $30.00 Ankle $50.00
C-Reactive Protein Cardiac $50.00 Chest 1 View $50.00
CRP $25.00 Chest 2 View $70.00
Estradiol $50.00 Chest 3 View $80.00
Ferritin $30.00 Clavicle $55.00
FSH and LSH $65.00 Elbow 3 View $70.00
GGT $40.00 Eyes Foreign Body $50.00
Glucose Finger Stick $10.00 Facial Bones Complete $55.00
Gon/Chlamydia $110.00 Femur 2 Views $65.00
H. Pylori, IgG Abs $40.00 Femur 3 Views $70.00
HCG, Qual $35.00 Fingers 2 Views $50.00
Hemoglobin A1c $35.00 Fingers 3 Views $60.00
Hepatitis Panel $90.00 Foot 3 Views $65.00
Hep A Ab, IgM $125.00 Forearm 2 Views $65.00
Hep B Surface Ab $125.00 Hand 3 Views $55.00
HIV $70.00 Heel 2 Views $50.00
HIV 1/2 Ab $150.00 Humerus 2 Views $60.00
HSV Culture without Typing $150.00 Knee 3 Views $65.00
Iron and TIBC $30.00 Sacrum/Coccyx 2 Views $60.00
Lipase $40.00    
Lipid Panel $40.00 SI Joint 3 Views $50.00
Magnesium $25.00 Sinuses 3 Views $50.00
Monospot $50.00 Skull 4 Views $80.00
Pap Smear $225.00 Spine Cervical 4 Views $85.00
Pap Smear w HPV/GC $550.00 Spine Lumbar 4 Views $80.00
Pap Smear w HPV $385.00 Spine Thoracic 3 Views $70.00
Prothrombin Time (PT/INR) $30.00 Spine Scoliosis 3 Views $80.00
PSA (only) $55.00 Tib/Fib 2 Views $60.00
PSA (Serial Monitor) $75.00 Toes 2 Views $50.00
Rapid Strep Test $30.00 Wrist 3 Views $50.00
Strep Culture Group A $90.00 Radiologist Read*** $15.00
Renal Panel $50.00    
Rheumatoid Arthritis Factor (RAF) $50.00    
RPR $55.00    
Sedimentation Rate Westergren (ESR) $30.00    
Testosterone Free and Total $100.00    
Urine Microalbumin $50.00    
Thyroid Panel $45.00    
Thyroid Panel with TSH $45.00    
T3 Uptake $25.00    
Thyroxine (T4) $25.00    
Trichomonas $175.00    

***All x-rays require a radiologist to read therefore will incur an additional charge of $15.00 body site imaged
All Prices are subject to change depending on complexity and time required for patient care. All prices are also in addition to the patient visit/consult price