|
Iron dextran 50 mg/ml injection solution
|
$33.54 |
$33.54 |
$33.54 |
$79.47
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$88.96 |
$88.96 |
$88.96 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$29.20 |
$29.20 |
$29.20 |
$117.60
|
|
Ivc venogram s&i
|
$1,514.00 |
$1,514.00 |
$1,514.00 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$29.20 |
$29.20 |
$29.20 |
$192.40
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$17.20 |
$17.20 |
$17.20 |
$160.05
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$20.40 |
$20.40 |
$20.40 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$61.00 |
$61.00 |
$61.00 |
$444.49
|
|
IV inj ra drug dx study
|
$106.20 |
$106.20 |
$106.20 |
$549.70
|
|
IV njx tst vasc flo flap/grf
|
$102.60 |
$102.60 |
$102.60 |
$476.00
|
|
Ivp w/nephrotomography
|
$866.20 |
$866.20 |
$866.20 |
$769.86
|
|
Ivp w/wo kub w/wo tomography
|
$138.40 |
$138.40 |
$138.40 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$10.96 |
$10.96 |
$10.96 |
$404.82
|
|
John cunningham antibody
|
$6.00 |
$6.00 |
$6.00 |
$66.31
|
|
Ketamine and metabolite screen - quest
|
$21.20 |
$21.20 |
$21.20 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$41.20 |
$41.20 |
$41.20 |
$60.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$6.86 |
$6.86 |
$6.86 |
$23.66
|
|
Kidney function study
|
$186.40 |
$186.40 |
$186.40 |
$968.50
|
|
Kidney imaging morphology
|
$186.40 |
$186.40 |
$186.40 |
$817.60
|
|
Kidney imag w/bld flow multi
|
$309.80 |
$309.80 |
$309.80 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$251.80 |
$251.80 |
$251.80 |
$1,442.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$809.00 |
$809.00 |
$809.00 |
$668.25
|
|
Kit gene analys d816 variant
|
$56.00 |
$56.00 |
$56.00 |
$374.61
|
|
Kit hfx iq ipg bundle
|
$23,500.00 |
$23,500.00 |
$23,500.00 |
$31,178.99
|
|
Kit lead specify 5-6-5
|
$26,500.00 |
$26,500.00 |
$26,500.00 |
$16,053.15
|
|
Knee MRI (with and without contrast)
|
$2,036.20 |
$2,036.20 |
$2,036.20 |
$3,021.20
|
|
Knee MRI (with contrast)
|
$1,924.80 |
$1,924.80 |
$1,924.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,800.60 |
$1,800.60 |
$1,800.60 |
$2,159.09
|
|
Knee X-ray
|
$528.00 |
$528.00 |
$528.00 |
$433.50
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$30.20 |
$30.20 |
$30.20 |
$109.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$5.64 |
$5.64 |
$5.64 |
$33.14
|
|
Lactate dehydrogenase (ldh)
|
$117.00 |
$117.00 |
$117.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$13.80 |
$13.80 |
$13.80 |
$45.56
|
|
Lactation class
|
$23.60 |
$23.60 |
$23.60 |
$98.50
|
|
Lactic acid
|
$117.60 |
$117.60 |
$117.60 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$43.40 |
$43.40 |
$43.40 |
$81.25
|
|
Lap enterolysis
|
$616.00 |
$616.00 |
$616.00 |
$6,161.68
|
|
Lead capillary
|
$17.40 |
$17.40 |
$17.40 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$630.00 |
$630.00 |
$630.00 |
$3,263.95
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$763.40 |
$763.40 |
$763.40 |
$1,092.58
|
|
Leishmania antibody
|
$2.18 |
$2.18 |
$2.18 |
$58.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$26.23 |
$26.23 |
$26.23 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$25.40 |
$25.40 |
$25.40 |
$84.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$9.36 |
$9.36 |
$9.36 |
$55.60
|
|
Liberta rc ipg
|
$10,497.00 |
$10,497.00 |
$10,497.00 |
$38,207.25
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$8.98 |
$8.98 |
$8.98 |
$46.02
|
|
Lidocaine therapeutic drug level
|
$19.80 |
$19.80 |
$19.80 |
$90.47
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$17.38 |
$17.38 |
$17.38 |
$125.66
|
|
Lipase
|
$156.00 |
$156.00 |
$156.00 |
$93.58
|
|
Lipoprotein blood quant
|
$5.61 |
$5.61 |
$5.61 |
$101.14
|
|
Lipoprotein direct measurement hdl
|
$111.80 |
$111.80 |
$111.80 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$116.40 |
$116.40 |
$116.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$141.40 |
$141.40 |
$141.40 |
$69.42
|
|
Liver Function Test
|
$148.20 |
$148.20 |
$148.20 |
$115.44
|
|
Liver imaging
|
$281.00 |
$281.00 |
$281.00 |
$1,093.50
|
|
Liver imag w/vasclr flow
|
$281.00 |
$281.00 |
$281.00 |
$1,255.15
|
|
Liver/spleen imag static only
|
$249.80 |
$249.80 |
$249.80 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$252.80 |
$252.80 |
$252.80 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$46.40 |
$46.40 |
$46.40 |
$44.91
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$5.40 |
$5.40 |
$5.40 |
$37.44
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,021.20 |
$3,021.20 |
$3,021.20 |
$1,937.91
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,568.20 |
$2,568.20 |
$2,568.20 |
$1,828.00
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,034.80 |
$2,034.80 |
$2,034.80 |
$1,495.45
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,445.00 |
$2,445.00 |
$2,445.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,413.60 |
$2,413.60 |
$2,413.60 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$433.40 |
$433.40 |
$433.40 |
$355.85
|
|
Lumbar diskogram s&i
|
$497.00 |
$497.00 |
$497.00 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$36.20 |
$36.20 |
$36.20 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$73.20 |
$73.20 |
$73.20 |
$296.91
|
|
Lung perfusion imaging
|
$231.80 |
$231.80 |
$231.80 |
$1,077.05
|
|
Lymphatics/lymph node imaging
|
$171.00 |
$171.00 |
$171.00 |
$1,487.90
|
|
Lymphocyte transformation mitogen
|
$33.56 |
$33.56 |
$33.56 |
$267.30
|
|
Macroscopic exam arthropod
|
$89.60 |
$89.60 |
$89.60 |
$38.58
|
|
Macroscopic exam parasite
|
$116.40 |
$116.40 |
$116.40 |
$38.50
|
|
Magnesium
|
$174.40 |
$174.40 |
$174.40 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$13.10 |
$13.10 |
$13.10 |
$59.88
|
|
Magnetic image bone marrow
|
$499.80 |
$499.80 |
$499.80 |
$1,342.55
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$32.80 |
$32.80 |
$32.80 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$32.80 |
$32.80 |
$32.80 |
$158.60
|
|
Marker biop eviva buckle ss
|
$222.60 |
$222.60 |
$222.60 |
$1,382.40
|
|
Mast mod rad
|
$1,694.46 |
$1,694.46 |
$1,694.46 |
$7,127.17
|
|
Mastoids complete
|
$347.40 |
$347.40 |
$347.40 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$5.76 |
$5.76 |
$5.76 |
$65.28
|
|
Mayo aathr protein s free
|
$5.00 |
$5.00 |
$5.00 |
$131.40
|
|
Mayo activated protein c resistance assay
|
$2.72 |
$2.72 |
$2.72 |
$96.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$42.10 |
$42.10 |
$42.10 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$19.32 |
$19.32 |
$19.32 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$110.60 |
$110.60 |
$110.60 |
$115.05
|
|
Mayo alkaline phosphatase isoenzyme
|
$3.56 |
$3.56 |
$3.56 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$27.20 |
$27.20 |
$27.20 |
$102.82
|
|
Mayo alpha 1 antitrypsin
|
$7.27 |
$7.27 |
$7.27 |
$90.50
|
|
Mayo amikacin trough therapeutic drug level
|
$3.20 |
$3.20 |
$3.20 |
$83.04
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$1.72 |
$1.72 |
$1.72 |
$81.25
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$1.72 |
$1.72 |
$1.72 |
$78.10
|
|
Mayo analysis gene calr common variants exon 9
|
$21.62 |
$21.62 |
$21.62 |
$492.00
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$19.86 |
$19.86 |
$19.86 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$27.40 |
$27.40 |
$27.40 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$289.50 |
$289.50 |
$289.50 |
$1,860.00
|
|
Mayo androstenedione
|
$7.60 |
$7.60 |
$7.60 |
$110.00
|
