| Code | Description | States | Median rate |
|---|---|---|---|
| 85002 | Bleeding time test | 46 | $4.61 |
| 85004 | Automated white cell differential count | 46 | $6.40 |
| 85007 | Blood smear with manual differential count | 47 | $3.42 |
| 85008 | Blood smear exam without differential | 46 | $3.40 |
| 85009 | Manual white cell differential, buffy coat | 46 | $4.51 |
| 85013 | Spun hematocrit | 47 | $5.60 |
| 85014 | Hematocrit | 46 | $2.34 |
| 85018 | Hemoglobin level | 47 | $2.32 |
| 85025 | Complete blood count (CBC) with differential | 47 | $6.99 |
| 85027 | Complete blood count (CBC) without differential | 46 | $6.33 |
| 85032 | Manual blood cell count, each type | 46 | $4.31 |
| 85041 | Red blood cell count, automated | 47 | $2.94 |
| 85044 | Reticulocyte count, manual | 46 | $4.25 |
| 85045 | Reticulocyte count, automated | 46 | $3.99 |
| 85046 | Reticulocyte count, automated, with cell parameters | 46 | $5.51 |
| 85048 | White blood cell count, automated | 47 | $2.49 |
| 85049 | Platelet count, automated | 46 | $4.38 |
| 85055 | Reticulated platelet test | 46 | $31.66 |
| 85060 | Blood smear physician interpretation | 44 | $17.71 |
| 85097 | Bone marrow smear interpretation | 47 | $55.37 |
| 85130 | Chromogenic clotting substrate assay | 43 | $10.70 |
| 85170 | Clot retraction test | 45 | $13.04 |
| 85175 | Clot lysis time | 46 | $16.30 |
| 85210 | Clotting factor II test | 46 | $11.55 |
| 85220 | Clotting factor V test | 46 | $15.89 |
| 85230 | Clotting factor VII test | 46 | $16.11 |
| 85240 | Clotting factor VIII test | 46 | $16.11 |
| 85244 | Factor VIII related antigen test | 46 | $19.71 |
| 85245 | Von Willebrand factor activity (ristocetin cofactor) | 46 | $21.28 |
| 85246 | Von Willebrand factor antigen test | 46 | $21.28 |
| 85247 | Von Willebrand factor multimer analysis | 46 | $21.28 |
| 85250 | Clotting factor IX test | 46 | $17.14 |
| 85260 | Clotting factor X test | 46 | $16.11 |
| 85270 | Clotting factor XI test | 46 | $16.11 |
| 85280 | Clotting factor XII test | 46 | $17.42 |
| 85290 | Clotting factor XIII test | 46 | $14.71 |
| 85291 | Clotting factor XIII screen | 46 | $8.68 |
| 85292 | Prekallikrein (Fletcher factor) test | 46 | $18.28 |
| 85300 | Antithrombin III activity test | 46 | $11.07 |
| 85301 | Antithrombin III antigen test | 46 | $10.43 |
| 85302 | Protein C antigen test | 46 | $11.79 |
| 85303 | Protein C activity test | 46 | $13.35 |
| 85305 | Protein S test, total | 46 | $11.47 |
| 85306 | Protein S test, free | 46 | $14.98 |
| 85307 | Activated protein C resistance test | 46 | $14.98 |
| 85335 | Clotting factor inhibitor test | 46 | $11.94 |
| 85337 | Thrombomodulin test | 45 | $14.30 |
| 85345 | Clotting time, Lee and White | 46 | $4.25 |
| 85347 | Activated clotting time | 46 | $3.96 |
| 85348 | Clotting time, other method | 46 | $3.98 |
| 85360 | Euglobulin clot lysis test | 46 | $8.11 |
| 85362 | Fibrin degradation products, slide test | 46 | $6.65 |
| 85366 | Fibrin degradation products, paracoagulation | 45 | $64.37 |
| 85370 | Fibrin degradation products, quantitative | 46 | $11.05 |
| 85378 | D-dimer test, qualitative | 46 | $8.75 |
| 85379 | D-dimer, quantitative | 46 | $9.96 |
| 85380 | D-dimer test, ultrasensitive | 46 | $9.96 |
| 85384 | Fibrinogen activity test | 46 | $8.75 |
| 85385 | Fibrinogen antigen test | 46 | $12.05 |
| 85396 | Whole blood clotting assessment (TEG or ROTEM), per day | 42 | $15.32 |
| 85397 | Clotting factor activity test, other (ADAMTS-13) | 41 | $27.33 |
| 85400 | Plasmin test | 46 | $7.64 |
| 85410 | Alpha-2 antiplasmin test | 46 | $7.44 |
| 85415 | Plasminogen activator test | 46 | $15.54 |
| 85420 | Plasminogen activity test | 46 | $6.12 |
| 85421 | Plasminogen antigen test | 45 | $9.93 |
| 85441 | Heinz body test, direct | 46 | $4.06 |
| 85445 | Heinz body test, induced | 46 | $6.59 |
| 85460 | Fetal blood cells in mother's blood (Kleihauer-Betke) | 46 | $7.09 |
| 85461 | Fetal blood cells in mother's blood, rosette test | 46 | $8.29 |
| 85475 | Acid hemolysin test (Ham test) | 46 | $8.48 |
| 85520 | Heparin level test | 46 | $11.78 |
| 85525 | Heparin neutralization test | 46 | $11.43 |
| 85530 | Heparin-protamine tolerance test | 46 | $11.84 |
| 85536 | Iron stain, blood smear | 45 | $6.74 |
| 85540 | White cell alkaline phosphatase score | 46 | $8.31 |
| 85547 | Red cell mechanical fragility test | 46 | $7.71 |
| 85549 | Muramidase (lysozyme) test | 46 | $18.10 |
| 85555 | Red cell osmotic fragility, unincubated | 45 | $6.72 |
| 85557 | Red cell osmotic fragility, incubated | 46 | $12.39 |
| 85576 | Platelet aggregation test, each agent | 47 | $22.29 |
| 85597 | Platelet neutralization test (lupus anticoagulant) | 46 | $16.18 |
| 85598 | Hexagonal phospholipid neutralization test | 44 | $16.67 |
| 85610 | Prothrombin time (blood clotting) | 46 | $4.01 |
| 85611 | Prothrombin time with plasma substitution, each | 46 | $3.94 |
| 85612 | Russell viper venom time, undiluted | 46 | $13.99 |
| 85613 | Russell viper venom time, diluted | 46 | $8.62 |
| 85635 | Reptilase clotting test | 46 | $9.50 |
| 85651 | Sedimentation rate, non-automated | 47 | $3.84 |
| 85652 | Sedimentation rate, automated | 47 | $2.63 |
| 85660 | Sickle cell reduction test | 46 | $5.39 |
| 85670 | Thrombin time | 45 | $5.51 |
| 85675 | Thrombin time titer | 43 | $6.71 |
| 85705 | Tissue thromboplastin inhibition test | 46 | $8.62 |
| 85730 | Partial thromboplastin time (blood clotting) | 46 | $5.89 |
| 85732 | PTT with plasma substitution, each | 46 | $6.26 |
| 85810 | Blood viscosity test | 46 | $11.41 |
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.