| Code | Description | States | Median rate |
|---|---|---|---|
| 80047 | Basic metabolic panel (ionized calcium) | 45 | $12.11 |
| 80048 | Basic metabolic panel (total calcium) | 46 | $8.38 |
| 80050 | General health panel | 35 | $39.17 |
| 80051 | Electrolyte panel | 46 | $6.77 |
| 80053 | Comprehensive metabolic panel | 46 | $10.33 |
| 80055 | Obstetric blood test panel | 46 | $40.96 |
| 80061 | Lipid (cholesterol) panel | 46 | $12.93 |
| 80069 | Kidney function panel | 46 | $8.49 |
| 80074 | Acute hepatitis blood test panel | 46 | $46.21 |
| 80076 | Liver function panel | 46 | $8.09 |
| 80081 | Obstetric blood test panel with HIV | 45 | $71.12 |
| 80143 | Acetaminophen drug level | 41 | $16.12 |
| 80145 | Adalimumab drug level | 39 | $33.94 |
| 80150 | Amikacin drug level | 46 | $14.22 |
| 80151 | Amiodarone drug level | 41 | $16.31 |
| 80155 | Caffeine drug level | 44 | $31.40 |
| 80156 | Carbamazepine drug level, total | 46 | $14.25 |
| 80157 | Carbamazepine drug level, free | 46 | $11.93 |
| 80158 | Cyclosporine drug level | 46 | $17.17 |
| 80159 | Clozapine drug level | 46 | $18.14 |
| 80161 | Carbamazepine epoxide drug level | 40 | $16.22 |
| 80162 | Digoxin drug level, total | 46 | $12.98 |
| 80163 | Digoxin drug level, free | 41 | $13.27 |
| 80164 | Valproic acid drug level, total | 46 | $13.38 |
| 80165 | Valproic acid drug level, total | 42 | $13.06 |
| 80167 | Felbamate drug level | 41 | $16.31 |
| 80168 | Ethosuximide drug level | 46 | $15.82 |
| 80169 | Everolimus drug level | 45 | $13.11 |
| 80170 | Gentamicin drug level | 46 | $15.81 |
| 80171 | Gabapentin drug level | 46 | $18.09 |
| 80173 | Haloperidol drug level | 46 | $15.43 |
| 80175 | Lamotrigine drug level | 46 | $12.91 |
| 80176 | Lidocaine drug level | 46 | $14.18 |
| 80177 | Levetiracetam drug level | 46 | $12.79 |
| 80178 | Lithium drug level | 46 | $6.46 |
| 80179 | Salicylate (aspirin) drug level | 42 | $16.22 |
| 80180 | Mycophenolate drug level | 45 | $17.24 |
| 80181 | Flecainide drug level | 41 | $16.31 |
| 80183 | Oxcarbazepine drug level | 45 | $12.66 |
| 80184 | Phenobarbital drug level | 45 | $13.77 |
| 80185 | Phenytoin drug level, total | 45 | $12.99 |
| 80186 | Phenytoin drug level, free | 45 | $13.48 |
| 80187 | Posaconazole drug level | 38 | $23.65 |
| 80188 | Primidone drug level | 45 | $16.51 |
| 80189 | Itraconazole drug level | 38 | $23.59 |
| 80190 | Procainamide drug level | 45 | $48.00 |
| 80192 | Procainamide and metabolite drug level | 45 | $16.67 |
| 80193 | Leflunomide drug level | 37 | $33.75 |
| 80194 | Quinidine drug level | 45 | $14.31 |
| 80195 | Sirolimus drug level | 45 | $12.36 |
| 80197 | Tacrolimus drug level | 45 | $13.11 |
| 80198 | Theophylline drug level | 45 | $13.79 |
| 80199 | Tiagabine drug level | 44 | $23.04 |
| 80200 | Tobramycin drug level | 45 | $15.81 |
| 80201 | Topiramate drug level | 45 | $11.62 |
| 80202 | Vancomycin drug level | 45 | $13.20 |
| 80203 | Zonisamide drug level | 45 | $12.92 |
| 80210 | Rufinamide drug level | 38 | $23.79 |
| 80220 | Hydroxychloroquine drug level | 38 | $16.42 |
| 80230 | Infliximab drug level | 38 | $33.65 |
| 80235 | Lacosamide drug level | 40 | $23.44 |
| 80280 | Vedolizumab drug level | 38 | $33.65 |
| 80285 | Voriconazole drug level | 39 | $23.45 |
| 80299 | Drug level test, other drug | 43 | $16.78 |
| 80305 | Drug screen by direct-read test (e.g. dipstick cup) | 44 | $11.34 |
| 80306 | Drug screen by instrument-read test | 44 | $15.43 |
| 80307 | Drug screen by chemistry analyzer | 45 | $55.93 |
| 80400 | ACTH stimulation test panel, adrenal insufficiency | 44 | $32.53 |
| 80402 | ACTH stimulation test panel, 21-hydroxylase | 44 | $85.87 |
| 80406 | ACTH stimulation test panel, 3-beta-HSD | 43 | $76.30 |
| 80408 | Aldosterone suppression test panel | 44 | $122.87 |
| 80410 | Calcitonin stimulation test panel | 43 | $72.33 |
| 80412 | CRH stimulation test panel | 44 | $647.50 |
| 80414 | hCG stimulation test panel, testosterone response | 42 | $50.96 |
| 80415 | hCG stimulation test panel, estradiol response | 42 | $54.96 |
| 80416 | Kidney vein renin stimulation test panel | 42 | $180.22 |
| 80417 | Peripheral vein renin stimulation test panel | 42 | $43.44 |
| 80418 | Combined pituitary stimulation test panel | 44 | $572.32 |
| 80420 | Dexamethasone suppression test panel, 48 hour | 44 | $129.50 |
| 80422 | Glucagon tolerance test panel, insulinoma | 44 | $45.51 |
| 80424 | Glucagon tolerance test panel, pheochromocytoma | 43 | $49.54 |
| 80426 | GnRH stimulation test panel | 43 | $145.44 |
| 80428 | Growth hormone stimulation test panel | 44 | $65.20 |
| 80430 | Growth hormone suppression test panel | 43 | $109.93 |
| 80432 | C-peptide suppression test panel | 45 | $145.11 |
| 80434 | Insulin tolerance test panel for ACTH deficiency | 45 | $228.02 |
| 80435 | Insulin tolerance test panel for growth hormone | 45 | $102.46 |
| 80436 | Metyrapone test panel | 45 | $90.71 |
| 80438 | TRH stimulation test panel, 1 hour | 45 | $50.41 |
| 80439 | TRH stimulation test panel, 2 hour | 45 | $67.21 |
| 80503 | Pathology clinical consultation, limited | 37 | $21.65 |
| 80504 | Pathology clinical consultation, moderate | 37 | $43.22 |
| 80505 | Pathology clinical consultation, high complexity | 37 | $79.80 |
| 80506 | Pathology clinical consultation, each added 30 minutes | 37 | $35.40 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.