|
MRA pelvis
|
$603.70 |
$797.64 |
$1,111.62 |
$2,277.26
|
|
MRA pelvis w IV cont
|
$908.22 |
$908.22 |
$908.22 |
$1,648.98
|
|
MRA pelvis wo IV cont
|
$679.22 |
$679.22 |
$679.22 |
$1,509.69
|
|
MRA spinal canal
|
$732.63 |
$732.63 |
$943.54 |
$1,988.00
|
|
MRA upper extremity post contrast-bil
|
$697.15 |
$697.15 |
$740.54 |
$2,452.45
|
|
MRA w/cont, abd
|
$864.71 |
$864.71 |
$864.71 |
$1,907.28
|
|
MRA w/cont, lwr ext
|
$846.62 |
$846.62 |
$846.62 |
$1,691.95
|
|
Mra, w/dye, upper extremity
|
$639.14 |
$639.14 |
$639.14 |
$943.83
|
|
MRA without cont, abd
|
$635.71 |
$635.71 |
$635.71 |
$1,749.65
|
|
MRA without cont, lwr ext
|
$846.62 |
$846.62 |
$846.62 |
$1,656.00
|
|
Mra, without dye, upper extr
|
$410.14 |
$410.14 |
$410.14 |
$858.24
|
|
MRA without fol w/cont, lwr ext
|
$1,075.62 |
$1,075.62 |
$1,075.62 |
$2,192.59
|
|
MRA without fol w/cont, pelvis
|
$1,137.22 |
$1,137.22 |
$1,137.22 |
$2,206.29
|
|
Mra, w/o&w/dye, upper extr
|
$868.14 |
$868.14 |
$868.14 |
$1,260.80
|
|
Mr elastography
|
$213.12 |
$213.12 |
$359.08 |
$891.60
|
|
Mrgfus strtctc ablt trgt icr
|
$15,469.86 |
$15,469.86 |
$15,469.86 |
$22,209.60
|
|
MRI brain w/dye
|
$676.54 |
$676.54 |
$757.39 |
$2,174.90
|
|
MRI brain without dye
|
$541.24 |
$541.24 |
$605.91 |
$2,005.45
|
|
MRI brain without & w/dye
|
$811.85 |
$811.85 |
$908.87 |
$2,813.09
|
|
MRI breast c- unilateral
|
$367.42 |
$367.42 |
$373.25 |
$1,114.75
|
|
MRI breast c-+ w/cad uni
|
$551.12 |
$559.87 |
$1,133.02 |
$1,880.00
|
|
MRI breast without cont bi
|
$551.12 |
$559.87 |
$1,949.35 |
$1,825.38
|
|
MRI breast w IV cont bi
|
$826.69 |
$839.81 |
$1,691.12 |
$1,876.12
|
|
MRI cardiac morph & func wo IV cont
|
$326.97 |
$332.16 |
$1,121.94 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$490.46 |
$498.24 |
$1,289.64 |
$1,946.48
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$687.20 |
$687.20 |
$698.11 |
$2,499.60
|
|
MRI chest without contrast
|
$322.81 |
$327.94 |
$769.35 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$484.22 |
$491.90 |
$1,282.38 |
$2,652.73
|
|
MRI chest w IV cont
|
$403.52 |
$409.92 |
$808.37 |
$2,249.10
|
|
MRI compatible system
|
$3,173.28 |
$3,173.28 |
$3,173.28 |
$2,672.33
|
|
MRI fetal sngl/1st gestation
|
$158.02 |
$158.02 |
$350.68 |
$1,136.26
|
|
MRI guid ndl plc s&i
|
$429.98 |
$429.98 |
$436.80 |
$1,326.91
|
|
MRI guid parenchymal tiss ablation
|
$451.90 |
$451.90 |
$459.07 |
$1,924.00
|
|
MRI loex nonjt w IV cont
|
$493.10 |
$500.93 |
$1,630.38 |
$2,116.20
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$394.44 |
$400.70 |
$2,198.41 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$591.76 |
$601.15 |
$3,663.77 |
$2,753.50
|
|
MRI orbit fac&nck w IV cont
|
$404.34 |
$452.65 |
$1,740.78 |
$2,203.50
|
|
MRI tmj
|
$406.71 |
$469.29 |
$691.04 |
$1,741.07
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$312.61 |
$317.57 |
$803.73 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$468.91 |
$476.35 |
$2,820.69 |
$2,655.25
|
|
MRI upper extremity w/dye
|
$390.85 |
$397.06 |
$1,001.23 |
$2,061.15
|
|
Mr safety determination physician/other qhp
|
$35.24 |
$35.24 |
$38.07 |
$160.20
|
|
Mr safety implant elec prepj
|
$54.03 |
$54.03 |
$58.37 |
$170.13
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$50.37 |
$50.37 |
$54.43 |
$55.00
|
|
Mr safety implt pos&/immoblj
|
$75.69 |
$75.69 |
$81.78 |
$122.85
|
|
Mr sfty implt&/fb asmt stf 1
|
$10.44 |
$10.44 |
$11.28 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$141.98 |
$141.98 |
$153.41 |
$439.80
|
|
Mr spectroscopy
|
$371.31 |
$371.31 |
$399.74 |
$1,352.40
|
|
Msh2 gene dup/delete variant
|
$305.22 |
$305.22 |
$305.22 |
$403.20
|
|
Msh2 gene full seq
|
$305.22 |
$305.22 |
$305.22 |
$764.00
|
|
Msh6 gene dup/delete variant
|
$305.22 |
$305.22 |
$305.22 |
$476.00
|
|
Msh6 gene full seq
|
$305.22 |
$305.22 |
$305.22 |
$1,130.35
|
|
Mthfr gene analy common variants
|
$58.91 |
$80.84 |
$133.70 |
$184.00
|
|
Mucopolysaccharides
|
$24.97 |
$24.97 |
$41.26 |
$178.36
|
|
Multiple sleep latency test
|
$3,893.48 |
$3,893.48 |
$3,893.48 |
$2,466.00
|
|
Mumps antibody igg
|
$11.78 |
$15.19 |
$50.84 |
$78.00
|
|
Muscle test cran nerv unilat
|
$89.18 |
$98.05 |
$319.74 |
$385.07
|
|
Muscle test larynx
|
$134.90 |
$134.90 |
$134.90 |
$296.80
|
|
Mycobacteria dna amp probe
|
$99.45 |
$121.95 |
$457.64 |
$234.00
|
|
Mycophenolate mofetil 250 mg capsule
|
$21.07 |
$21.07 |
$21.40 |
$10.79
|
|
Mycophenolic acid
|
$6.50 |
$6.50 |
$8.71 |
$12.84
|
|
Mycoplasma antibody igm
|
$10.45 |
$13.47 |
$34.63 |
$77.35
|
|
Myd88 gene p.leu265pro vrnt
|
$158.20 |
$236.03 |
$377.80 |
$416.00
|
|
Myelogphy 2/> spine regions
|
$705.48 |
$762.25 |
$2,444.04 |
$1,494.22
|
|
Myelography l-s spine
|
$558.28 |
$603.20 |
$1,629.23 |
$1,334.09
|
|
Myelography neck spine
|
$558.28 |
$603.20 |
$1,629.23 |
$1,241.50
|
|
Myelography thoracic spine
|
$558.80 |
$603.76 |
$1,629.23 |
$1,255.00
|
|
Myelography via inj w/s&i 2+ regions
|
$1,143.81 |
$1,236.47 |
$1,288.87 |
$2,267.34
|
|
Myelography via inj w/s&i cervical
|
$815.88 |
$881.97 |
$1,134.54 |
$1,760.85
|
|
Myelography via inj w/s&i lumbosacral
|
$761.47 |
$823.15 |
$1,134.54 |
$1,850.00
|
|
Myelography via inj w/s&i thoracic
|
$907.17 |
$980.66 |
$1,134.54 |
$1,742.95
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$29.53 |
$53.92 |
$764.00 |
$130.80
|
|
Myocrd img pet 1 std w/ct
|
$1,522.78 |
$1,522.78 |
$1,522.78 |
$3,314.15
|
|
Myocrd img pet 2rtracer
|
$1,318.78 |
$1,318.78 |
$1,318.78 |
$4,240.58
|
|
Myocrd img pet 2rtracer CT
|
$1,446.19 |
$1,446.19 |
$1,446.19 |
$5,083.90
|
|
Myocrd img pet rst&strs CT
|
$1,339.83 |
$1,339.83 |
$1,339.83 |
$4,846.40
|
|
Myocrd img pet rst/strs w/ct
|
$1,063.59 |
$1,063.59 |
$1,063.59 |
$3,311.85
|
|
Nafcillin 2 gram solution for injection
|
$58.45 |
$58.45 |
$58.45 |
$84.00
|
|
Nalbuphine 10 mg/ml injection solution
|
$9.94 |
$9.94 |
$9.94 |
$38.00
|
|
Nasal endoscopy dx uni/bi separate proc
|
$274.66 |
$274.66 |
$274.66 |
$353.62
|
|
Nasopharyngoscopy w/endoscope
|
$179.77 |
$179.77 |
$276.19 |
$293.58
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$8,093.82 |
$8,093.82 |
$8,093.82 |
$16,254.52
|
|
Natriuretic peptide
|
$60.20 |
$60.96 |
$189.86 |
$176.15
|
|
Natural killer cells total count
|
$21.66 |
$27.93 |
$83.28 |
$135.00
|
|
Nav srv peer sup 60 min pr m
|
$134.85 |
$134.85 |
$134.85 |
$109.46
|
|
N block inj hypogas plxs
|
$431.03 |
$431.03 |
$1,250.67 |
$1,912.00
|
|
Ndl emg musc 1 xtr/non-limb
|
$73.91 |
$81.27 |
$199.03 |
$228.50
|
|
Ndl round specialty proguide
|
$106.43 |
$126.42 |
$2,293.15 |
$329.50
|
|
Nebulizer Breathing Treatment
|
$84.96 |
$84.96 |
$330.05 |
$203.49
|
|
Neck Airway (Soft Tissue) X-ray
|
$80.65 |
$87.14 |
$269.31 |
$237.43
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$657.86 |
$788.64 |
$2,706.47 |
$2,032.54
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$548.30 |
$657.30 |
$2,139.59 |
$1,717.80
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$438.57 |
$525.76 |
$1,828.64 |
$1,470.00
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$462.72 |
$520.56 |
$2,550.15 |
$2,869.75
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$385.66 |
$433.87 |
$1,795.02 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$308.48 |
$347.04 |
$1,464.97 |
$2,042.95
|
|
Neck (Cervical Spine) X-ray (2 to 3 views)
|
$96.57 |
$104.34 |
$333.11 |
$333.83
|
|
Neck (Cervical Spine) X-ray (4 to 5 views)
|
$104.92 |
$113.36 |
$436.63 |
$463.80
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$139.90 |
$151.15 |
$526.40 |
$508.50
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$540.09 |
$540.09 |
$1,625.41 |
$2,659.98
|
