|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$49.78 |
$49.78 |
$49.78 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$52.63 |
$52.63 |
$52.63 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$152.00 |
$152.00 |
$152.00 |
$437.45
|
|
IV inj ra drug dx study
|
$95.19 |
$95.19 |
$95.19 |
$552.60
|
|
Ivp w/wo kub w/wo tomography
|
$271.32 |
$271.32 |
$271.32 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$123.31 |
$123.31 |
$123.31 |
$393.43
|
|
John cunningham antibody
|
$11.02 |
$11.02 |
$11.02 |
$66.31
|
|
Ketamine and metabolite screen - quest
|
$70.49 |
$70.49 |
$70.49 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$19.38 |
$19.38 |
$19.38 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$24.08 |
$24.08 |
$24.08 |
$23.77
|
|
Kidney imaging morphology
|
$264.86 |
$264.86 |
$264.86 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$606.67 |
$606.67 |
$606.67 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$361.00 |
$361.00 |
$361.00 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$220.97 |
$220.97 |
$220.97 |
$673.36
|
|
Kit gene analys d816 variant
|
$43.51 |
$43.51 |
$43.51 |
$366.03
|
|
Kit hfx iq ipg bundle
|
$7,182.00 |
$7,182.00 |
$7,182.00 |
$34,160.00
|
|
Kit lead specify 5-6-5
|
$0.19 |
$0.19 |
$0.19 |
$16,965.41
|
|
Knee MRI (with and without contrast)
|
$1,730.52 |
$1,730.52 |
$1,730.52 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,018.21 |
$1,018.21 |
$1,018.21 |
$2,110.76
|
|
Knee X-ray
|
$153.90 |
$153.90 |
$153.90 |
$425.55
|
|
Kras gene variants exon 2
|
$196.27 |
$196.27 |
$196.27 |
$509.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$58.03 |
$58.03 |
$58.03 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$1,450.08 |
$1,450.08 |
$1,450.08 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$7.22 |
$7.22 |
$7.22 |
$55.50
|
|
Lactated ringers intravenous solution
|
$604.58 |
$604.58 |
$604.58 |
$44.91
|
|
Lactic acid
|
$179.17 |
$179.17 |
$179.17 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$15.96 |
$15.96 |
$15.96 |
$81.00
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$5,882.46 |
$5,882.46 |
$5,882.46 |
$19,124.00
|
|
Laparscpy ablat 1>lvr tum cryo
|
$4,357.46 |
$4,357.46 |
$4,357.46 |
$11,221.60
|
|
Laryngeal function studies
|
$52.44 |
$52.44 |
$52.44 |
$335.40
|
|
Lead capillary
|
$41.42 |
$41.42 |
$41.42 |
$55.25
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$360.43 |
$360.43 |
$360.43 |
$1,092.58
|
|
Leishmania antibody
|
$7.60 |
$7.60 |
$7.60 |
$58.50
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$75.74 |
$75.74 |
$75.74 |
$164.09
|
|
Leuprolide acetate injeciton
|
$1,881.13 |
$1,881.13 |
$1,881.13 |
$1,322.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$62.98 |
$62.98 |
$62.98 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$21.28 |
$21.28 |
$21.28 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$56.17 |
$56.17 |
$56.17 |
$55.60
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$25.65 |
$25.65 |
$25.65 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$70.11 |
$70.11 |
$70.11 |
$87.45
|
|
Lincomycin injection
|
$250.51 |
$250.51 |
$250.51 |
$64.31
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$65.83 |
$65.83 |
$65.83 |
$121.00
|
|
Lipase
|
$58.52 |
$58.52 |
$58.52 |
$91.65
|
|
Lipoprotein blood quant
|
$33.25 |
$33.25 |
$33.25 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$10.83 |
$10.83 |
$10.83 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$28.69 |
$28.69 |
$28.69 |
$61.60
|
|
Lip surgery procedure
|
$57.95 |
$57.95 |
$57.95 |
$335.50
|
|
Lithium therapeutic drug level
|
$31.35 |
$31.35 |
$31.35 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$298.30 |
$298.30 |
$298.30 |
$365.28
|
|
Liver Function Test
|
$63.46 |
$63.46 |
$63.46 |
$115.44
|
|
Liver imag w/vasclr flow
|
$457.14 |
$457.14 |
$457.14 |
$1,227.60
|
|
Liver/spleen imag static only
|
$301.72 |
$301.72 |
$301.72 |
$1,123.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$57.24 |
$57.24 |
$57.24 |
$37.37
|
|
Low cost skin substitute app
|
$225.72 |
$225.72 |
$225.72 |
$933.60
|
|
Low cost skin substitute app
|
$755.25 |
$755.25 |
$755.25 |
$2,147.57
|
|
Low cost skin substitute app
|
$225.72 |
$225.72 |
$225.72 |
$1,012.00
|
|
Low cost skin substitute app
|
$584.82 |
$584.82 |
$584.82 |
$1,009.49
|
|
Low cost skin substitute app
|
$62.89 |
$62.89 |
$62.89 |
$428.35
|
|
Low cost skin substitute app
|
$170.24 |
$170.24 |
$170.24 |
$727.77
|
|
Low cost skin substitute app
|
$62.89 |
$62.89 |
$62.89 |
$408.04
|
|
Low cost skin substitute app
|
$170.24 |
$170.24 |
$170.24 |
$515.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$916.56 |
$916.56 |
$916.56 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$762.47 |
$762.47 |
$762.47 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$662.15 |
$662.15 |
$662.15 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,704.87 |
$1,704.87 |
$1,704.87 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,043.67 |
$1,043.67 |
$1,043.67 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$126.73 |
$126.73 |
$126.73 |
$356.16
|
|
Lumbar diskogram s&i
|
$790.02 |
$790.02 |
$790.02 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$82.65 |
$82.65 |
$82.65 |
$295.35
|
|
Lung perfusion imaging
|
$397.48 |
$397.48 |
$397.48 |
$1,059.97
|
|
Lymphatics/lymph node imaging
|
$182.97 |
$182.97 |
$182.97 |
$1,463.22
|
|
Lymph vessel x-ray arms/legs
|
$587.29 |
$587.29 |
$587.29 |
$2,072.40
|
|
Macroscopic exam parasite
|
$2.28 |
$2.28 |
$2.28 |
$36.55
|
|
Magnesium
|
$52.25 |
$52.25 |
$52.25 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$93.05 |
$93.05 |
$93.05 |
$59.88
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$39.90 |
$39.90 |
$39.90 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$32.30 |
$32.30 |
$32.30 |
$160.80
|
|
Mannitol 12.5 gm/50 ml inj
|
$19.00 |
$19.00 |
$19.00 |
$30.75
|
|
Map tachycard site(s)
|
$416.86 |
$416.86 |
$416.86 |
$4,082.82
|
|
Marker biop eviva buckle ss
|
$284.24 |
$284.24 |
$284.24 |
$1,451.30
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$51.68 |
$51.68 |
$51.68 |
$65.00
|
|
Mayo aathr protein s free
|
$42.75 |
$42.75 |
$42.75 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$12.73 |
$12.73 |
$12.73 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$22.99 |
$22.99 |
$22.99 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$41.42 |
$41.42 |
$41.42 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$90.82 |
$90.82 |
$90.82 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$9.12 |
$9.12 |
$9.12 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$102.03 |
$102.03 |
$102.03 |
$111.69
|
|
Mayo alpha 1 antitrypsin
|
$30.78 |
$30.78 |
$30.78 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$72.77 |
$72.77 |
$72.77 |
$81.81
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$60.99 |
$60.99 |
$60.99 |
$75.90
|
|
Mayo analysis gene calr common variants exon 9
|
$89.30 |
$89.30 |
$89.30 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$328.89 |
$328.89 |
$328.89 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$106.78 |
$106.78 |
$106.78 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$519.65 |
$519.65 |
$519.65 |
$1,860.00
|
|
Mayo androstenedione
|
$40.28 |
$40.28 |
$40.28 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$20.14 |
$20.14 |
$20.14 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$7.22 |
$7.22 |
$7.22 |
$73.50
|