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Pediatrics - Cardiology

Houston, Texas

BCM faculty, staff and trainees are the heart of the organization.
Pediatrics - Cardiology
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Payment

Payment Options for Clients within the United States

  • Direct Billing: Referring institutions and physicians may establish institutional accounts with monthly invoicing. In order to retain your institutional billing status, payment in full is expected upon receipt of each monthly statement. To establish an institutional account, complete the Institutional Account Application or contact Dr. Fan at 832-824-4155 or Hope at 832-824-4152.

    Institutional Account Application (PDF)
  • Prepayment: We accept checks (payable to John Welsh Cardiovascular Diagnostic Laboratory), money orders and credit card payments (AMEX, MasterCard, Visa, or Discover). If paying by credit card, please complete the Credit Card Authorization form. Testing will not begin until payment-in-full is received.

    Credit Card Authorization Form (PDF)

Payment Options for International Clients

  • Money Orders: Please make money orders payable to the John Welsh Cardiovascular Diagnostic Laboratory. Testing will not begin until payment-in-full is received.
  • Credit Card: Payment will be accepted on an approved credit card account (AMEX, MasterCard, Visa, or Discover). If paying by credit card, please complete the Credit Card Authorization form.

    Credit Card Authorization Form (PDF)

Tax Form

Service Fees

Copy Number Variation (CNV) Analysis by aCGH

Direct and Institutional Billing

CPT Codes

Single Gene

$1,200 per sample

81228, G0452

Panel

$1,500 per sample

81228, G0452

ABCA1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ABCG5 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$900 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ABCG8 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ACTA2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

AKAP9 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,650 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403,G0452

ACVRL1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$700 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ANGPTL3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ANGPTL4 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ANK2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,650 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

APOA1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

APOA2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

APOA5 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

APOB Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,300 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

APOC2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

APOE Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

BMPR2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

CACNA1B Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

CACNA1C Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

CACNB2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

CASQ2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

CAV1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

CAV3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$450 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

COL3A1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81408, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

DES Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

DSC2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,200 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

DSG2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,200 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

DSP Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

EMD Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$450 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ENG Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

EPHX2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

FBN1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case (Full Gene)

$1,650 per sample

81408, G0452

Index Case - Neonatal MFS (Exons 24-33)

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familialmutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

FBN2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,650 per sample

81408, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

GATA4 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

GDF2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

GPD1L Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

HCN4 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

JUP Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,100 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNA5 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81403, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCND3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNE1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81403, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNE2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81403, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNE3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81403, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNH2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNJ2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$450 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNJ5 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNJ8 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNK3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

KCNQ1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LAMP2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LACT Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LDLR Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LIPC Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LIPI Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LMF1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LMNA Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LPIN1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,200 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

LPL Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

MTTP Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,100 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

MYH11 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

MYLK Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,200 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

NKX2.5 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$450 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

NOTCH1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,500 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

NPC1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,200 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PCSK9 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$900 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PKP2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,100 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PKP4 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,200 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PNPLA3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PPARA Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PPARG Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PPP1R17 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

PRKG1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,300 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

RYR2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$3,000 per sample

81408, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SCN1B Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SCN2B Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$700 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SCN3B Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SCN4B Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SCN5A Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,100 per sample

81407, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SCO2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$300 per sample

81403, G0452

Additional Family Members

$300 per sample; known familial mutations only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SLC2A10 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SMAD3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SMAD4 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SMAD8 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$500 per sample

81404, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SNTA1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

SURF1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutations only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TAZ(G4.5) Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TBX5 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TBX20 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TGFB2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$750 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TGFB3 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TGFBR1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TGFBR2 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$600 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

TMEM43 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$1,000 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

USF1 Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81405, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

ZASP (LDB3) Mutation Analysis

Direct and Institutional Billing

CPT Codes

Index Case

$800 per sample

81406, G0452

Additional Family Members

$300 per sample; known familial mutation only

81403, G0452

Prenatal

$600 per fetus

81265, 81403, G0452

Genetic Testing Panels

Direct and Institutional Billing

CPT Codes

PANEL A

Please call 832-824-4152 to inquire

81404, 81405x5, 81406x2, 81407x3, 81408x3, G0452

PANEL B

Please call 832-824-4152 to inquire

81404, 81405x3, 81406, 81408, G0452

PANEL C

Please call 832-824-4152 to inquire

81405x2, 81406x5, 81407, G0452

PANEL D

Please call 832-824-4152 to inquire

81406x4, G0452

PANEL E

Please call 832-824-4152 to inquire

81404, 81405x2, 81406x3, G0452

PANEL F

Please call 832-824-4152 to inquire

81403, 81404, 81405x2, 81406, 81408, G0452

PANEL G

Please call 832-824-4152 to inquire

81403x2, 81404x4, 81405, 81406x2, 81407x4, G0452

PANEL H

Please call 832-824-4152 to inquire

81403, 81404, 81405, 81406x2, 81407x2, 81408, G0452

PANEL I

Please call 832-824-4152 to inquire

81403x2, 81404x3, 81405x2, 81406x3, 81407x3, G0452

PANEL J

Please call 832-824-4152 to inquire

81404x2, 81405x2, 81406, 81407, G0452

PANEL K

Please call 832-824-4152 to inquire

81404, 81406x2, 81407x2, G0452

PANEL L

Please call 832-824-4152 to inquire

81403x2, 81404x2, 81406, 81407, G0452

PANEL M

Please call 832-824-4152 to inquire

81403, 81404x4, 81405, 81406x3, G0452

PANEL N

Please call 832-824-4152 to inquire

81403, 81404x5, 81405x2, 81406, 81407x2, G0452

PANEL O

Please call 832-824-4152 to inquire

81405x2, 81406x7, 81408, G0452

PANEL P

Please call 832-824-4152 to inquire

81404, 81405, 81406x2, G0452

PANEL Q

Please call 832-824-4152 to inquire

81404x6, 81405x8, 81406x11, 81407x2 G0452

Viral PCR Analysis

Direct and Institutional Billing

CPT Codes

Adenovirus

$400 per sample

87798

Cytomegalovirus

$400 per sample

87496

Epstein-Barr virus

$400 per sample

87798

Enterovirus

$400 per sample

87498

Influenza A virus

$400 per sample

87502

Mumps virus

$400 per sample

87798

Parvovirus

$400 per sample

87798

Rubella virus

$400 per sample

86762

Respiratory syncytial virus

$400 per sample

87798

Viral panel

$800 per sample

87496, 87498, 87798x3

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