IGeneX, Inc.

Reference Laboratory
795 San Antonio Road Palo Alto CA 94303
Tel: (800) 832-3200

PRICE LIST EFFECTIVE FEBRUARY 11, 2016

LYME PANELS

RELAPSING FEVER PANELS

4090 - BASIC LYME PANEL**

$275.00
Lyme Western Blot IgG and IgM, Lyme IgG/IgM/IgA Screen (IFA)

8015 - BASIC RELAPSING FEVER PANEL**

$410.00
RF Western Blot IgG and IgM, Lyme IgG/IgM/IgA Screen (IFA)

5010 - INITIAL LYME PANEL

Lyme Western Blot IgG and IgM, Lyme PCR - Serum,
Lyme PCR W Blood

8025 - INITIAL RELAPSING FEVER PANEL**

$630.00
RF Western Blot IgG and IgM, RF PCR- Serum, RF PCR- W Blood

$430.00

6050 - COMPLETE LYME PANEL**

$499.00
Lyme Western Blot IgG and IgM, Lyme IgG/IgM/IgA Screen (IFA),
Lyme PCR - Serum, Lyme PCR W Blood
875 - URINE LYME PANEL**
Lyme DOT BLOT and PCR Panel for B. burgdorferi

$420.00

Includes LDA 3 samples (Test#805) and PCR on pooled samples (#465)

477 - NEWBORN PANEL (Cord Blood)

Lyme PCR- Serum and Lyme PCR- W Blood

8045 - COMPLETE RELAPSING FEVER PANEL

$870.00
WITH URINE**
RF Western Blot IgG and IgM, Lyme IgG/IgM/IgA Screen (IFA),
RF PCR- Serum, RF PCR- W Blood, RF PCR-Urine

$245.00

NEURODEGENERATIVE/NEUROINFLAMMATORY PANELS
8055 - NN SPECIAL BORRELIA PANEL**
$1100.00
Lyme Western Blot IgG and IgM, Lyme IgG/IgM/IgA Screen (IFA)
Lyme PCR - Serum, Lyme PCR - W Blood, RF Western Blot IgG and IgM,
RF PCR - Serum, RF PCR - W Blood
8075 - NN URINE PANEL**
$575.00
Lyme DOT BLOT Assay (LDA) 3-Sample, Lyme PCR on pooled samples,
RF PCR on pooled samples
8085 - CSF PANEL**
Lyme DOT BLOT Assay, Lyme PCR, RF PCR

8035 - COMPLETE RELAPSING FEVER PANEL**

$695.00
RF Western Blot IgG and IgM, Lyme IgG/IgM/IgA Screen (IFA),
RF PCR- Serum, RF PCR- W Blood

$475.00

CENTRAL NERVOUS SYSTEM (Cerebral Spinal Fluid)

810

Lyme DOT BLOT Assay - CSF **

87449

$ 85.00

459

Multiplex PCR - CSF

87800,87801

$245.00

565

Relapsing Fever PCR CSF**

87800,87801

$245.00

281

Bartonella henselae PCR - CSF

87471

$270.00

986

Rickettsia rickettsii and felis/typhi PCR Panel CSF

(Only R. rickettsii will be reported for NY residents**)

8095 - NN COINFECTION PANEL**

$745.00
Babesia FISH, B. microti IgG & IgM, B. duncani IgG & IgM,
Bartonella FISH, B. henselae IgG & IgM

87797,87798 x 2

$218.00

CO-INFECTION PANELS
5080

WESTERN REGIONAL CO-INFECTION PANEL**

B. duncani IgG & IgM, Babesia FISH, HME IgG & IgM, HGA IgG & IgM, Bartonella IgG & IgM

$695.00

5085

NEW WESTERN REGIONAL CO-INFECTION PANEL**(includes Bartonella FISH)

B. duncani IgG & IgM, Babesia FISH, HME IgG & IgM, HGA IgG & IgM, Bartonella IgG & IgM, Bartonella FISH

$820.00

5090

COMPLETE CO-INFECTION PANEL________________

B. microti IgG & IgM, Babesia FISH, HME IgG & IgM, HGA IgG & IgM, Bartonella IgG & IgM

$695.00

5095

NEW COMPLETE CO-INFECTION PANEL**(includes Bartonella FISH)

B. microti IgG & IgM, Babesia FISH, HME IgG & IgM, HGA IgG & IgM, Bartonella IgG & IgM, Bartonella FISH

5020

MID-WEST/EASTERN REGIONAL PANEL

$565.00
B. microti IgG & IgM, Babesia FISH, HGA IgG & IgM, Bartonella IgG & IgM
Add Bartonella FISH** to Panel 5020..................................................................................................... ........................$695.00

5025
5030
5035
5040
5045
5050
5055

__

$820.00

MIDWEST/EASTERN SUPPLEMENTAL PANEL

$565.00
HME IgG & IgM, HME PCR, HGA PCR
Add Bartonella FISH** to Panel 5030. $695.00
WESTERN REGIONAL PANEL**
$565.00
B. duncani IgG & IgM, Babesia FISH, HGA IgG & IgM, Bartonella IgG & IgM
Add Bartonella FISH** to Panel 5040 .... $695.00
SOUTHERN REGIONAL PANEL
$565.00
B. microti IgG & IgM, Babesia FISH, HME IgG & IgM, Bartonella IgG & IgM
Add Bartonella FISH** to Panel 5050 . $695.00

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------IGeneX, Inc. accepts personal checks, money orders, Visa Card, MasterCard, Discover, and American Express.
BS-F-030 REV. 006 02-11-16
For Canadian/ International Residents: Visa Card, MasterCard, Discover, American Express or Money Order in US Dollars. NO Personal Checks.
** Not yet available for NY Residents

IGeneX, Inc. Reference Laboratory

795 San Antonio Road Palo Alto CA 94303
Tel: (800) 832-3200

PRICE LIST EFFECTIVE FEBRUARY 11, 2016

PANELS CONTINUED

670

COMPREHENSIVE BABESIA PANEL

_________
B. microti IgG & IgM, Babesia PCR Panel, Babesia FISH

$499.00

690

WEST COAST BABESIA PANEL**

B. duncani IgG & IgM, Babesia PCR Panel, Babesia FISH

695

COMPLETE BABESIA PANEL**

______________________
B. microti IgG & IgM, B. duncani IgG & IgM, Babesia PCR Panel, Babesia FISH

995

COMPLETE RICKETTSIA PANEL

Rickettsia ricketsii/typhi IgG Antibody, Rickettsia PCR Panel (Only R. rickettsii will be reported for NY residents**)

Test #

Description (Name)

__________

$499.00
$575.00
$305.00

INDIVIDUAL TESTS
IMMUNOLOGY
275
CD57**
295
Chlamydophila pneumoniae IgG ELISA**
296
Chlamydophila pneumoniae IgA ELISA**
BORRELIA TESTS
Lyme (B. burgdorferi)
230
Lyme G/M/A IFA Screen**
183
Lyme Serology IgG/IgM
195
Lyme Serology IgM
170
C6 Peptide B. burgdorferi
188
Lyme Western Blot IgM
189
Lyme Western Blot IgG
488 31 kDa Epitope Test IgM**
489 31 kDa Epitope Test IgG**
800
802
805

CPT Code

Prepay Price

86356
86631
86631

$145.00
$ 75.00
$ 75.00

86618
86618
86618
86618
86617
86617
86617
86617

$ 75.00
$ 75.00
$ 75.00
$110.00
$105.00
$105.00
$105.00
$105.00

Lyme DOT BLOT Assay (LDA) for antigen **

Lyme DOT BLOT Assay (LDA) 2-Sample **
Lyme DOT BLOT Assay (LDA) 3-Sample **

87449
87449 x 2
87449 x 3

$ 75.00
$150.00
$225.00

Multiplex PCR (B. burgdorferi)

453 Serum
456 Whole blood
450 Urine
465 Urine (pooled 3 samples)

87800, 87801

$245.00 (per sample type)

462 Miscellaneous (Tissue, Breast Milk, etc.)**

87800, 87801

$280.00

86619
86619

$175.00
$175.00

Relapsing Fever PCR**

573 Serum** 556 Whole blood**
559 Urine**
562 Urine (pooled 3 samples)**

87800, 87801

$245.00 (per sample type)

568 Miscellaneous (Tissue, Breast Milk, etc.)**

87800, 87801

$280.00

86611 x 2
88365
87471

$140.00
$208.00
$218.00

86317 x 2
87797, 87798 x 2
88365
86317 x 2

$140.00
$218.00
$208.00
$140.00

86666 x 2
87797, 87798
86666 x 2
87797, 87798

$140.00
$218.00
$140.00
$218.00

86757 x 2
87797, 87798 x 2

$140.00
$218.00

Relapsing Fever (Borrelia) **

585
RF Western Blot IgM**
595
RF Western Blot IgG**

BARTONELLOSIS TESTS
285
Bartonella henselae IgG & IgM Antibody
289
Bartonella FISH**
280
Bartonella henselae PCR Whole Blood
BABESIOSIS TESTS
200
B. microti IgG & IgM Antibody
663
Babesia PCR Panel for B. microti and B. duncani
640
Babesia FISH (RNA)
720
B. duncani IgG & IgM Antibody **
EHRLICHIOSIS TESTS
203
HME (Monocytic) IgG & IgM Antibody
770
HME (Monocytic) PCR Whole Blood
206
HGA (Anaplasma phagocytophilum) IgG & IgM Antibody
775
HGA (Anaplasma phagocytophilum) PCR Whole Blood
RICKETTSIOSIS TESTS (Rocky Mountain Spotted Fever)
965
Rickettsia rickettsii/typhi IgG Antibody
998
Rickettsia rickettsii and felis/typhi PCR Panel Whole Blood
(Only R. rickettsii will be reported for NY residents**)

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------IGeneX, Inc. accepts personal checks, money orders, Visa Card, MasterCard, Discover, and American Express.
BS-F-030 REV. 006 02-11-16
For Canadian/ International Residents: Visa Card, MasterCard, Discover, American Express or Money Order in US Dollars. NO Personal Checks.
** Not yet available for NY Residents