for uninsured services - Saskatchewan Medical Association

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SECTION V:LABORATORY MEDICINESpecialist in Pathology161V IgM $32.60163V Immunofixation (serum/CSF/urine) $191.00630V Rheumatoid factor $32.60166V Transferrin $32.60167V Cryoglobulins $49.00Chemistry - Endocrinology and TherapeuticDrug Monitoring171V For any single analyte ordered on the same specimen $21.80from the following group172V For each additional analyte ordered from the following $7.00group add: alpha fetoprotein, carbazamepine, CEA,digoxin, ferritin, follicle stimulating hormone, gentamicinleutenizing hormone, phenobarbital, phenytoin, prolactin,serum beta HCG quantitative, theophylline, tobramycin,troponin 1, valproic acid, vancomycin173V Estradiol $59.80174V Free T3 $16.20175V Free T4 $16.20270V TSH $16.20271V TSH (Free T4 reflexed) $22.00181V TSH (Free T4 & Free T3 reflexed) $28.00182V Amikacin $27.20183V Cortisol $27.20185V Cyclosporine $38.00186V Methotrexate $27.20187V PSA $21.80188V Secobarbital, phenytoin, amobarbital, butalbarbital, $109.00pentobarbital, phenobarbital (unine/serum) (whendone as a panel of six)189V Tacrolimus $43.40190V Thiopental $81.40203V Toxicology screen (serum or urine) $189.00Chemistry - Miscellaneous204V B2 microglobulin $27.20205V Bili aminiotic - B12/RBC folate - see hematology section $75.00302V Calculus analysis $59.80142V Carotene $136.00206V Chylomicrons (refridge & visual) $43.40207V Chymex $81.40208V Cryofibrinogen $81.40168V Cryoglobulin $49.00209V Ethanol, isopropanol, methanol (when done as a $87.00panel of three)210V Ethylene glycol $87.00211V Fat globule (prep, stain, interp) $109.00412V Fecal fat assay $299.00212V FEP assay $103.00213V Gastric analysis $32.40214V Glucose by glucose meter $14.00215V Haptoglobin $32.60216V Hemoglobin A1C - iron/iron binding/%saturation - see $23.60hematology section249V Lithium $22.00217V LS/PG on amniotic fluid $271.00338V Melanin $54.20202V Methemalbumin $114.00425V Mucin $27.20218V pH - ph meter (fluid) $11.80219V Phenylalanine $81.40221V Plasma hemoglobin $81.40349V Porphobilinogen scrn $49.00222V Porphyrin screen (feces/urine/serum) $59.10SMA FEE GUIDE - V4 - April 1, 2012
SECTION V:LABORATORY MEDICINESpecialist in Pathology224V Prealbumin $32.60225V Pregnancy test/HCG in serum $46.00227V Sweat chloride analysis (does not include specimen $32.40collection418V Trypsin $59.80229V Xylose $43.40Chemistry - Allergy235V IgE $137.00236V Food mix screen $137.00237V Inhalant screen IgE $137.00238V For each additional specific allergen ordered with $19.00total IgE or a screen, add239V For each allergen, if ordered individually - some common $137.00allergens are: dog dander, dust, milk, yellow hornet,honney bee, peanutHaematology - Routine422V CBC 8 parameters + histograms, three or five part diff $25.00423V CBC 8 parameters or less (Hb, Hct, RBC, WCB, MCV, $15.00MCH, MCHC + platlets)Miscellaneous251V B12 $21.80253V Cell count and diff CSF $105.00434V Erythrocyte sedimentation rate $20.00464V Estimate - platelet/WBC $15.00254V RBC folate $54.20180V Iron, TIBC and % saturation $25.40255V Manual differential $55.20257V Manual hemoglobin $55.20476V Manual WBC $31.20259V Monotest $31.20260V Morphology $15.00470V Reticulocyte count $45.40494V Blood parasites (malarial & others) $110.00261V Bone marrow - assist, stain, differential, iron $462.00262V Bone marrow - <strong>for</strong> each additional 500 cells counted, add $99.60263V Bone marrow - <strong>for</strong> each additional slide stained $99.60265V Buffy coat preparation $80.20481V Cell count and diff $90.40266V Cytospin $35.20267V Eosinophil smear (sputum) $40.20268V Eosinophil smear (urines) $75.20550V Esterase, iron, peroxidase, sudan black, TRAP $101.00274V Fluid crystals $31.20497V Heinz bodies (direct) $75.20346V Hemoglobin pigments (qual) $60.20275V Hemolysate preparation $85.60276V Iron stain hematology $25.00277V Luik, Alk phos score $182.00278V Hemosiderin - urine $31.20Haematology - Coagulation279V PT/NR & aPTT $22.60280V Prothrombin time/INR $20.00281V aPTT $20.00282V DDIMER - automated $184.00283V Factor assays (each) $132.00506V Fibrinogen $20.00Haematology - Flow Cytometry284V CD4/CD8 $734.00285V CD34-Peripheral bld $541.00287V CD34-apheresis $720.00SMA FEE GUIDE - V5 - April 1, 2012
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SMA Fee Guide (for uninsured servic
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INTRODUCTION / PREAMBLEAn understan
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INTRODUCTION / PREAMBLE8. Classific
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INTRODUCTION / PREAMBLERequests fro
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INTRODUCTION / PREAMBLEa) Keep Pati
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SECTION A1:UNINSURED SERVICESIICHAR
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SECTION B:GENERAL PRACTICEGeneral P
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SECTION B:GENERAL PRACTICE35B- per
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SECTION B:GENERAL PRACTICE15 minute
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SECTION C:PAEDIATRICSVisitsFee3C Co
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SECTION D:INTERNAL MEDICINEFee350D
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SECTION K:NEUROSURGERY540K -- each
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