Panel & Test Price List
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- David Robbins
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1 Effective October 16, 2017 we are offering our new tests for Lyme IGXSpot, Lyme Borreliosis, and Tick-borne Relapsing Fever Borreliosis The new ImmunoBlot tests have replaced the original Western Blot tests in most panels. The original Western Blot IgG and IgM will still be offered as individual tests. Prior to selecting your tests/panels, please review the components listed within each panel. Updated Prices for all tests and panels (effective October 16, 2017) are also listed on the new Test Requisition Form. *Tests/Panels are not yet available for New York Residents LYME PANELS (BORRELIA BURGDORFERI) LPA LYME PANEL A $ Lyme Western Blot IgM Lyme Western Blot IgG *IB1 LYME IMMUNOBLOT PANEL 1 $ *IB2 LYME IMMUNOBLOT PANEL 2 $ *IB3 LYME IMMUNOBLOT PANEL 3 $ LPCR1 LYME PCR PANEL 1 $ *LU1 LYME URINE PANEL 1 $ Lyme Dot Blot - 3 urine samples x3 Lyme PCR - 3 urine samples-pooled 87800, BS-WS-001 REV *Tests/Panels are not yet available for New York Residents 795 San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 1 of 8
2 LYME INDIVIDUAL TESTS (BORRELIA BURGDORFERI) *300 Lyme IgXSpot $ * $ * $ *230 Lyme G/M/A IFA Screen $ Lyme Serology IgG/IgM $ C6 Peptide B. burgdorferi $ Lyme Western Blot IgM $ Lyme Western Blot IgG $ * kda Epitope IgM $ * kda Epitope IgG $ Lyme Serology IgM $ *800 Lyme Dot Blot Assay (LDA) 1 sample $ *802 Lyme Dot Blot Assay (LDA) 2 samples x 2 $ *805 Lyme Dot Blot Assay (LDA) 3 samples x 3 $ Lyme Multiplex PCR Whole Blood 87800, $ Lyme Multiplex PCR Urine 87800, $ Lyme Multiplex PCR Urine, Pooled 87800, $ Lyme Multiplex PCR Serum 87800, $ *462 Lyme Multiplex PCR Miscellaneous (Tissue, Breast Milk, etc.) 87800, $ TICK-BORNE RELAPSING FEVER - BORRELIA (TBRF) *TBRF1 TBRF PANEL 1 $ TBRF PCR - Serum 87800, TBRF PCR - Whole Blood 87800, *TBRF2 TBRF PANEL 2 $ TBRF PCR - Serum 87800, TBRF PCR - Whole Blood 87800, TICK-BORNE RELAPSING FEVER INDIVIDUAL TESTS (TBRF) *585 TBRF Western Blot IgM $ *595 TBRF Western Blot IgG $ *345 $ *355 $ Relapsing Fever Borrelia and B. burgdorferi sensu lato real-time PCR *556 Relapsing Fever PCR - Whole Blood 87800, $ *562 Relapsing Fever PCR - Urine (pooled 3 samples) 87800, $ *573 Relapsing Fever PCR - Serum 87800, $ *568 Relapsing Fever PCR - Miscellaneous (Tissue, Breast Milk, etc.) 87800, $ *559 Relapsing Fever PCR - Urine 87800, $ San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 2 of 8
3 BORRELIOSIS PANELS - COMBINES LYME AND TBRF TESTING *LTP1 LYME/TBRF PANEL 1 $ *LTP2 LYME/TBRF PANEL 2 $ *LTP3 LYME/TBRF PANEL 3 $ TBRF PCR - Serum 87800, TBRF PCR - Whole Blood 87800, CENTRAL NERVOUS SYSTEM PANEL *CSF1 CSF PANEL 1 $ Lyme Dot Blot Assay CSF Lyme PCR CSF 87800, TBRF PCR - CSF 87800, CENTRAL NERVOUS SYSTEM INDIVIDUAL TESTS (CEREBRAL SPINAL FLUID) *810 Lyme Dot Blot Assay CSF $ Bartonella henselae PCR CSF $ Lyme (B. burgdorferi ) PCR CSF 87800, $ *565 TBRF PCR - CSF 87800, $ Rickettsia PCR Panel CSF (Only R. rickettsii will be reported for NY Resident*) 87797, x 2 $ San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 3 of 8
4 CO-INFECTION PANELS *TBD1 TICK-BORNE DISEASE PANEL $ *CP1 CO-INFECTION PANEL 1 $ Rickettsia rickettsii IgG IFA Rickettsia typhi IgG IFA San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 4 of 8
5 *CP2 CO-INFECTION PANEL 2 $ *CP3 CO-INFECTION PANEL 3 $ Bartonella FISH San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 5 of 8
6 CP4 CO-INFECTION PANEL 4 $ Rickettsia ricketsii IgG IFA Rickettsia typhi IgG IFA CP5 CO-INFECTION PANEL 5 $ Rickettsia ricketsii IgG IFA Rickettsia typhi IgG IFA San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 6 of 8
7 BABESIOSIS PANELS BAB1 BABESIA PANEL 1 $ Babesia PCR Panel 87797, x2 *BAB2 BABESIA PANEL 2 $ Babesia PCR Panel 87797, x2 BABESIOSIS INDIVIDUAL TESTS 200 B. microti IgG & IgM IFA x2 $ Babesia FISH (RNA) $ *720 B. duncani IgG & IgM IFA x2 $ Babesia PCR Panel Whole Blood 87797, x2 $ BARTONELLOSIS PANEL *BART1 BARTONELLA PANEL 1 $ Bartonella PCR Whole Blood *Bartonella FISH BARTONELLOSIS INDIVIDUAL TESTS 285 Bartonella henselae IgG & IgM IFA x2 $ *289 Bartonella FISH $ Bartonella henselae PCR Whole Blood $ San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 7 of 8
8 RICKETTSIOSIS PANEL RP1 RICKETTSIA PANEL 1 $ Rickettsia ricketsii IgG IFA Rickettsia typhi IgG IFA Rickettsia PCR Panel (Only R. rickettsii will be reported for NY Resident*) 87797, x2 RICKETTSIOSIS INDIVIDUAL TESTS (ROCKY MOUNTAINSPOTTED FEVER) 965 Rickettsia rickettsii/typhi IgG IFA x2 $ Rickettsia PCR Whole Blood (Only R. rickettsii will be reported for NYResident*) 87797, x2 $ EHRLICHIOSIS PANEL EP1 EHRLICHIA PANEL 1 $ Ehrlichia chaffeensis (HME) PCR Whole Blood 87797, Anaplasma phagocytophilum (HGA) PCR Whole Blood 87797, EHRLICHIOSIS INDIVIDUAL TESTS 203 Ehrlichia chaffeensis (HME) IgG & IgM IFA x2 $ Anaplasma phagocytophilum (HGA) IgG & IgM IFA x2 $ Ehrlichia chaffeensis (HME) PCR Whole Blood 87797, $ Anaplasma phagocytophilum (HGA) PCR Whole Blood 87797, $ IMMUNOLOGY *275 CD $ *296 Chlamydophila pneumoniae IgA ELISA $ *295 Chlamydophila pneumoniae IgG ELISA $ Test Panels are tailored to meet the needs of the referring healthcare practitioner. Test Panel discounts apply only to tests ordered at the same time. IGeneX, Inc. accepts Personal Checks, Money Orders, Visa, MasterCard, Discover, and American Express. Canadian/International Residents: NO Personal Checks accepted. Visa, MasterCard, Discover, American Express, Money Orders in US Dollars. *Tests/Panels are not yet available for New York Residents Please Note: Only tests that are medically reasonable and necessary for the diagnosis or treatment of a Medicare patient will be reimbursed. The Office of the Inspector General -OIG takes the position that a physician who orders medically unnecessary tests for which Medicare reimbursement is claimed may be subject to civil penalties under the False Claims Act. 795 San Antonio Road, Palo Alto, CA T: (800) F: (650) Page 8 of 8
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