Forms
*Please open the forms in Adobe Acrobat before printing.
Billing Information and Turnaround Time
*Reflex testing options: Maximum cost is listed, although our lab only bills for the services performed. Final charge may be less than listed price, but cannot be determined until the testing has been completed.
Lymphedema Test Billing Information and Turnaround Time
| Name of Test |
Turnaround Time |
Cost |
CPT Codes |
| Lymphedema Panel (v1) |
4-6 Weeks |
$3400 |
81479 |
| Lymphedema Panel (v1) (Prenatal) |
2-4 Weeks |
$4220 |
81479, 81265, 99199 |
| FFPE Sample Isolation Surcharge |
N/A |
$160 |
88381 |
Sample Requirements
- Please refer to the sample requirements form at the top of this page.
Shipping Instructions
Shipping Sample
Please refer to the sample requirements form at the top of this page for shipping requirements based on sample type.
Shipping Address
Genetic Diagnostic Laboratory
University of Pennsylvania
Room 560 Clinical Research Building
415 Curie Boulevard
Philadelphia, PA 19104
