| Code | Description | States | Median rate |
|---|---|---|---|
| 86000 | Febrile agglutinin test, each antigen | 46 | $6.73 |
| 86001 | Allergen-specific IgG test, each allergen | 44 | $6.72 |
| 86003 | Allergen-specific IgE test, each allergen | 46 | $5.11 |
| 86005 | Allergen IgE screen, multiple allergens | 40 | $7.62 |
| 86008 | Allergen component IgE test, each | 40 | $16.14 |
| 86015 | Smooth muscle antibody test, each | 41 | $10.42 |
| 86021 | White cell antibody identification | 46 | $13.79 |
| 86022 | Platelet antibody identification | 46 | $17.71 |
| 86023 | Platelet-associated antibody test | 45 | $12.15 |
| 86036 | ANCA antibody screen, each | 41 | $10.60 |
| 86037 | ANCA antibody titer, each | 41 | $10.42 |
| 86038 | Antinuclear antibody (ANA) test | 46 | $11.95 |
| 86039 | Antinuclear antibody (ANA) titer | 46 | $11.02 |
| 86051 | Aquaporin-4 antibody test (NMO), ELISA | 40 | $10.06 |
| 86052 | Aquaporin-4 antibody test (NMO), cell-based | 39 | $10.42 |
| 86053 | Aquaporin-4 antibody test (NMO), flow cytometry | 39 | $30.18 |
| 86060 | Antistreptolysin O titer | 46 | $7.14 |
| 86063 | Antistreptolysin O screen | 46 | $5.76 |
| 86077 | Difficult crossmatch review by blood bank physician | 41 | $41.47 |
| 86078 | Transfusion reaction investigation by blood bank physician | 42 | $43.31 |
| 86079 | Blood bank physician authorization for non-standard blood | 40 | $42.35 |
| 86140 | C-reactive protein | 46 | $5.07 |
| 86141 | High-sensitivity C-reactive protein (hsCRP) | 46 | $12.62 |
| 86146 | Beta-2 glycoprotein I antibody, each | 46 | $22.91 |
| 86147 | Cardiolipin antibody, each class | 46 | $22.91 |
| 86148 | Anti-phosphatidylserine antibody test | 44 | $14.46 |
| 86152 | Circulating tumor cell count, blood | 23 | $225.70 |
| 86153 | Circulating tumor cell count, physician interpretation | 22 | $27.17 |
| 86155 | White cell chemotaxis test | 44 | $15.01 |
| 86156 | Cold agglutinin screen | 46 | $7.26 |
| 86157 | Cold agglutinin titer | 46 | $7.91 |
| 86160 | Complement component test, each | 46 | $11.59 |
| 86161 | Complement function test, each component | 46 | $11.59 |
| 86162 | Total complement (CH50) test | 46 | $19.61 |
| 86171 | Complement fixation test, each antigen | 45 | $9.01 |
| 86200 | Anti-CCP antibody test (rheumatoid arthritis) | 46 | $12.68 |
| 86215 | Anti-DNase B antibody test | 46 | $12.79 |
| 86225 | Anti-double-stranded DNA antibody test | 46 | $13.58 |
| 86226 | Anti-single-stranded DNA antibody test | 46 | $12.08 |
| 86231 | Endomysial antibody (celiac), each class | 40 | $10.45 |
| 86235 | Extractable nuclear antigen antibody, each | 46 | $17.30 |
| 86255 | Fluorescent antibody screen, each antibody | 47 | $12.05 |
| 86256 | Fluorescent antibody titer, each antibody | 47 | $12.05 |
| 86258 | Deamidated gliadin antibody (celiac), each class | 41 | $10.42 |
| 86277 | Growth hormone antibody test | 46 | $15.39 |
| 86280 | Hemagglutination inhibition antibody test | 44 | $7.90 |
| 86294 | Tumor antigen immunoassay, qualitative (bladder) | 44 | $22.34 |
| 86300 | CA 15-3 tumor marker | 46 | $20.34 |
| 86301 | CA 19-9 tumor marker | 45 | $20.60 |
| 86304 | CA 125 tumor marker | 46 | $20.60 |
| 86305 | HE4 tumor marker level (ovarian cancer) | 36 | $20.29 |
| 86308 | Mononucleosis screen | 46 | $5.07 |
| 86309 | Heterophile antibody (mono) titer | 46 | $6.33 |
| 86310 | Heterophile antibody titer after absorption | 46 | $7.21 |
| 86316 | Tumor marker immunoassay, other, each | 45 | $20.44 |
| 86317 | Infection antibody immunoassay, quantitative, other | 45 | $14.62 |
| 86318 | Infection antibody test, single-step (rapid) | 44 | $15.97 |
| 86320 | Immunoelectrophoresis, blood | 47 | $26.77 |
| 86325 | Immunoelectrophoresis, urine or spinal fluid | 47 | $22.11 |
| 86328 | COVID-19 rapid antibody test | 42 | $40.75 |
| 86329 | Immunodiffusion test | 46 | $13.66 |
| 86331 | Gel diffusion test (Ouchterlony), each | 45 | $11.74 |
| 86332 | Immune complex test | 45 | $23.88 |
| 86334 | Immunofixation electrophoresis, blood | 46 | $21.89 |
| 86335 | Immunofixation electrophoresis, urine or spinal fluid | 45 | $27.88 |
| 86336 | Inhibin A test | 44 | $15.28 |
| 86337 | Insulin antibody test | 46 | $19.27 |
| 86340 | Intrinsic factor antibody test | 46 | $14.74 |
| 86341 | Islet cell antibody test | 44 | $20.59 |
| 86343 | White cell histamine release test | 43 | $12.15 |
| 86344 | White cell phagocytosis test | 44 | $9.35 |
| 86352 | Immune cell function assay (ATP release) | 39 | $115.48 |
| 86353 | Lymphocyte transformation test | 46 | $47.31 |
| 86355 | B cell count | 46 | $33.96 |
| 86356 | Mononuclear cell antigen by flow cytometry, each | 44 | $24.10 |
| 86357 | Natural killer cell count | 45 | $33.96 |
| 86359 | T cell count, total | 46 | $33.96 |
| 86360 | CD4 and CD8 T cell count with ratio | 46 | $42.28 |
| 86361 | CD4 T cell count | 45 | $25.29 |
| 86362 | MOG antibody test, cell-based | 40 | $10.62 |
| 86363 | MOG antibody test, flow cytometry | 39 | $30.18 |
| 86364 | Tissue transglutaminase antibody (celiac), each class | 41 | $10.17 |
| 86367 | CD34 stem cell count | 45 | $62.22 |
| 86376 | Microsomal antibody test, each | 46 | $14.23 |
| 86381 | Mitochondrial antibody test, each | 40 | $22.21 |
| 86382 | Viral neutralization test | 45 | $16.15 |
| 86384 | Nitroblue tetrazolium test | 45 | $12.25 |
| 86403 | Particle agglutination antibody screen, each | 46 | $10.41 |
| 86406 | Particle agglutination antibody titer, each | 46 | $10.40 |
| 86408 | SARS-CoV-2 neutralizing antibody screen | 34 | $37.92 |
| 86409 | SARS-CoV-2 neutralizing antibody titer | 34 | $77.62 |
| 86413 | SARS-CoV-2 antibody, quantitative | 33 | $45.51 |
| 86430 | Rheumatoid factor test, qualitative | 46 | $5.98 |
| 86431 | Rheumatoid factor test, quantitative | 46 | $5.61 |
| 86480 | TB blood test (interferon gamma release) | 45 | $55.78 |
| 86481 | TB blood test (T-SPOT) | 44 | $85.70 |
| 86485 | Candida skin test | 38 | $10.07 |
| 86510 | Histoplasmosis skin test | 48 | $6.68 |
| 86580 | Tuberculosis skin test | 48 | $8.26 |
| 86590 | Streptokinase antibody test | 45 | $11.39 |
| 86592 | Syphilis screening test, non-treponemal | 46 | $4.18 |
| 86593 | Syphilis test, quantitative | 45 | $4.31 |
| 86596 | Voltage-gated calcium channel antibody test, each | 39 | $11.75 |
| 86602 | Actinomyces antibody test | 45 | $9.17 |
| 86603 | Adenovirus antibody test | 46 | $11.58 |
| 86606 | Aspergillus antibody test | 46 | $13.97 |
| 86609 | Bacterial antibody test, other | 45 | $11.59 |
| 86611 | Bartonella antibody test | 46 | $9.59 |
| 86612 | Blastomyces antibody test | 46 | $11.61 |
| 86615 | Bordetella (whooping cough) antibody test | 46 | $12.73 |
| 86617 | Lyme disease antibody confirmation test | 46 | $15.09 |
| 86618 | Lyme disease antibody test | 46 | $16.42 |
| 86619 | Relapsing fever (Borrelia) antibody test | 45 | $12.78 |
| 86622 | Brucella antibody test | 46 | $8.70 |
| 86625 | Campylobacter antibody test | 46 | $11.81 |
| 86628 | Candida antibody test | 45 | $10.81 |
| 86631 | Chlamydia antibody test | 45 | $11.29 |
| 86632 | Chlamydia IgM antibody test | 46 | $12.35 |
| 86635 | Coccidioides (valley fever) antibody test | 46 | $10.32 |
| 86638 | Q fever antibody test | 46 | $10.91 |
| 86641 | Cryptococcus antibody test | 46 | $12.97 |
| 86644 | Cytomegalovirus (CMV) antibody test | 46 | $13.89 |
| 86645 | Cytomegalovirus (CMV) IgM antibody test | 46 | $15.63 |
| 86648 | Diphtheria antibody test | 46 | $14.66 |
| 86651 | California encephalitis antibody test | 46 | $12.72 |
| 86652 | Eastern equine encephalitis antibody test | 46 | $12.72 |
| 86653 | St. Louis encephalitis antibody test | 46 | $12.72 |
| 86654 | Western equine encephalitis antibody test | 46 | $12.72 |
| 86658 | Enterovirus antibody test | 45 | $11.73 |
| 86663 | Epstein-Barr virus early antigen antibody | 46 | $12.83 |
| 86664 | Epstein-Barr virus nuclear antigen antibody | 46 | $14.75 |
| 86665 | Epstein-Barr virus capsid antibody | 46 | $17.49 |
| 86666 | Ehrlichia antibody test | 46 | $9.31 |
| 86668 | Tularemia antibody test | 46 | $12.55 |
| 86671 | Fungal antibody test, other | 44 | $11.03 |
| 86674 | Giardia antibody test | 45 | $14.06 |
| 86677 | H. pylori antibody test | 45 | $15.17 |
| 86682 | Worm (helminth) antibody test | 44 | $11.71 |
| 86684 | Haemophilus influenzae antibody test | 46 | $15.27 |
| 86687 | HTLV-I antibody test | 44 | $8.85 |
| 86688 | HTLV-II antibody test | 44 | $12.60 |
| 86689 | HIV or HTLV antibody confirmation test | 46 | $19.12 |
| 86692 | Hepatitis D antibody test | 46 | $16.56 |
| 86694 | Herpes simplex antibody test, non-type-specific | 46 | $14.07 |
| 86695 | Herpes simplex type 1 antibody test | 46 | $12.90 |
| 86696 | Herpes simplex type 2 antibody test | 46 | $18.92 |
| 86698 | Histoplasma antibody test | 46 | $12.42 |
| 86701 | HIV-1 antibody test | 47 | $8.65 |
| 86702 | HIV-2 antibody test | 45 | $12.17 |
| 86703 | HIV-1 and HIV-2 antibody test | 47 | $12.34 |
| 86704 | Hepatitis B core antibody, total | 46 | $11.81 |
| 86705 | Hepatitis B core antibody, IgM | 46 | $11.48 |
| 86706 | Hepatitis B surface antibody | 46 | $10.47 |
| 86707 | Hepatitis B e antibody | 45 | $11.34 |
| 86708 | Hepatitis A antibody, total | 46 | $12.08 |
| 86709 | Hepatitis A antibody, IgM | 46 | $10.98 |
| 86710 | Influenza antibody test | 45 | $13.18 |
| 86711 | JC virus antibody test | 44 | $15.11 |
| 86713 | Legionella antibody test | 46 | $15.12 |
| 86717 | Leptospira antibody test | 45 | $10.90 |
| 86720 | Leishmania antibody test | 46 | $14.50 |
| 86723 | Listeria antibody test | 45 | $11.87 |
| 86727 | Lymphocytic choriomeningitis antibody test | 46 | $11.58 |
| 86732 | Mucormycosis antibody test | 45 | $13.34 |
| 86735 | Mumps antibody test | 45 | $12.72 |
| 86738 | Mycoplasma antibody test | 46 | $12.78 |
| 86741 | Meningococcus antibody test | 44 | $11.87 |
| 86744 | Nocardia antibody test | 46 | $14.31 |
| 86747 | Parvovirus antibody test | 46 | $14.49 |
| 86750 | Malaria antibody test | 45 | $11.87 |
| 86753 | Protozoa antibody test, other | 44 | $11.15 |
| 86756 | RSV antibody test | 46 | $14.30 |
| 86757 | Rickettsia antibody test | 46 | $18.92 |
| 86759 | Rotavirus antibody test | 46 | $16.24 |
| 86762 | Rubella antibody test | 46 | $13.89 |
| 86765 | Measles (rubeola) antibody test | 46 | $12.06 |
| 86768 | Salmonella antibody test | 45 | $11.87 |
| 86769 | COVID-19 antibody test | 44 | $37.92 |
| 86771 | Shigella antibody test | 45 | $19.58 |
| 86774 | Tetanus antibody test | 45 | $13.32 |
| 86777 | Toxoplasma antibody test | 46 | $13.89 |
| 86778 | Toxoplasma IgM antibody test | 46 | $14.04 |
| 86780 | Syphilis antibody test (treponemal) | 46 | $12.70 |
| 86784 | Trichinella antibody test | 46 | $11.30 |
| 86787 | Varicella (chickenpox) antibody test | 46 | $11.95 |
| 86788 | West Nile virus IgM antibody test | 46 | $16.26 |
| 86789 | West Nile virus antibody test | 46 | $14.39 |
| 86790 | Viral antibody test, other | 44 | $11.95 |
| 86793 | Yersinia antibody test | 46 | $11.80 |
| 86794 | Zika virus IgM antibody test | 39 | $15.60 |
| 86800 | Thyroglobulin antibody test | 46 | $14.69 |
| 86803 | Hepatitis C antibody test | 46 | $13.63 |
| 86804 | Hepatitis C antibody confirmation test | 46 | $15.18 |
| 86805 | Transplant crossmatch, lymphocyte, with titration | 46 | $151.61 |
| 86806 | Transplant crossmatch, lymphocyte, no titration | 46 | $46.52 |
| 86807 | Transplant antibody screen (PRA), standard | 46 | $64.03 |
| 86808 | Transplant antibody screen (PRA), quick method | 46 | $29.02 |
| 86812 | HLA typing, A, B or C, single antigen | 46 | $25.23 |
| 86813 | HLA typing, A, B or C, multiple antigens | 46 | $57.28 |
| 86816 | HLA typing, DR/DQ, single antigen | 45 | $29.57 |
| 86817 | HLA typing, DR/DQ, multiple antigens | 46 | $89.60 |
| 86821 | Mixed lymphocyte culture (transplant matching) | 46 | $36.56 |
| 86825 | HLA crossmatch by flow cytometry, first sample | 43 | $96.56 |
| 86826 | HLA crossmatch by flow cytometry, each added sample | 43 | $32.21 |
| 86828 | HLA antibody screen, class I and II | 43 | $54.56 |
| 86829 | HLA antibody screen, class I or II | 43 | $53.15 |
| 86830 | HLA antibody identification panel, class I | 43 | $85.97 |
| 86831 | HLA antibody identification panel, class II | 43 | $73.69 |
| 86832 | HLA antibody specificity panel, class I | 43 | $268.07 |
| 86833 | HLA antibody specificity panel, class II | 43 | $269.76 |
| 86834 | HLA antibody titer panel, class I | 43 | $341.56 |
| 86835 | HLA antibody titer panel, class II | 43 | $308.50 |
| 86850 | Red blood cell antibody screen | 46 | $8.66 |
| 86860 | Red cell antibody elution, each | 35 | $19.42 |
| 86870 | Red cell antibody identification panel | 40 | $23.42 |
| 86880 | Direct Coombs test | 46 | $5.36 |
| 86885 | Indirect Coombs test, qualitative | 45 | $5.72 |
| 86886 | Indirect Coombs test, antibody titer | 46 | $5.18 |
| 86890 | Autologous blood collection for later transfusion | 24 | $44.32 |
| 86891 | Blood salvage during or after surgery for transfusion | 20 | $97.03 |
| 86900 | Blood typing, ABO | 46 | $2.98 |
| 86901 | Blood typing, Rh | 46 | $2.99 |
| 86902 | Donor blood antigen typing, each antigen | 44 | $5.39 |
| 86904 | Donor unit antigen screen with patient serum, per unit | 46 | $13.74 |
| 86905 | Red cell antigen typing, other than ABO or Rh, each | 46 | $3.81 |
| 86906 | Rh phenotyping, complete | 46 | $7.74 |
| 86910 | Paternity blood typing, per person, ABO, Rh and MN | 14 | $24.62 |
| 86911 | Paternity blood typing, each added antigen system | 13 | $7.40 |
| 86920 | Blood compatibility test, immediate spin | 34 | $21.30 |
| 86921 | Blood compatibility test, incubation technique | 34 | $21.30 |
| 86922 | Blood compatibility test, antiglobulin technique | 36 | $26.28 |
| 86923 | Blood compatibility test, electronic | 24 | $21.00 |
| 86927 | Fresh frozen plasma thawing, each unit | 25 | $15.64 |
| 86930 | Frozen blood preparation, freezing, each unit | 21 | $41.79 |
| 86931 | Frozen blood preparation, thawing, each unit | 20 | $43.48 |
| 86932 | Frozen blood preparation, freezing and thawing, each unit | 20 | $41.45 |
| 86940 | Autoantibody hemolysin and agglutinin screen | 45 | $8.16 |
| 86941 | Autoantibody hemolysin and agglutinin screen, incubated | 45 | $11.81 |
| 86945 | Blood product irradiation, each unit | 31 | $24.12 |
| 86950 | White cell (leukocyte) transfusion | 23 | $46.90 |
| 86960 | Blood volume reduction, each unit | 17 | $23.15 |
| 86965 | Platelet pooling | 27 | $14.43 |
| 86970 | Red cell pretreatment with chemical agents for antibody ID | 25 | $15.58 |
| 86971 | Red cell pretreatment with enzymes for antibody ID | 23 | $17.28 |
| 86972 | Red cell pretreatment by density gradient for antibody ID | 22 | $19.69 |
| 86975 | Serum pretreatment with drugs for antibody ID | 23 | $22.79 |
| 86976 | Serum pretreatment by dilution for antibody ID | 23 | $18.70 |
| 86977 | Serum pretreatment with inhibitors for antibody ID | 26 | $18.85 |
| 86978 | Serum pretreatment by red cell absorption, each | 26 | $19.30 |
| 86985 | Blood product splitting, each unit | 24 | $17.34 |
| 86999 | Unlisted immunology test | 13 | $21.96 |
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.