|
Ipratropium bromide non-comp
|
$3.75 |
$3.75 |
$3.75 |
$9.93
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$7,340.45 |
$7,340.45 |
$7,340.45 |
$230.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$340.20 |
$340.20 |
$340.20 |
$210.49
|
|
Irradiation of blood product each unit reference
|
$1,258.99 |
$1,258.99 |
$1,258.99 |
$124.24
|
|
Ivp w/wo kub w/wo tomography
|
$6,242.39 |
$6,242.39 |
$6,242.39 |
$692.18
|
|
Ketogenic steroids fract
|
$18.40 |
$18.40 |
$18.40 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$21.80 |
$21.80 |
$21.80 |
$54.16
|
|
Kidney function study
|
$55.66 |
$55.66 |
$55.66 |
$549.70
|
|
Kidney imag w/bld flow multi
|
$17,593.40 |
$17,593.40 |
$17,593.40 |
$1,574.40
|
|
Kidney img w/bldflw sgl without rx
|
$18,128.22 |
$18,128.22 |
$18,128.22 |
$1,468.04
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$9,896.14 |
$9,896.14 |
$9,896.14 |
$270.00
|
|
Kras gene variants exon 2
|
$214.17 |
$214.17 |
$214.17 |
$495.00
|
|
Lactated ringers intravenous solution
|
$35.44 |
$35.44 |
$35.44 |
$51.80
|
|
Lactoferrin fecal quant
|
$44.50 |
$44.50 |
$44.50 |
$106.10
|
|
Laryngeal function studies
|
$1,375.77 |
$1,375.77 |
$1,375.77 |
$335.40
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$7,113.20 |
$7,113.20 |
$7,113.20 |
$3,844.90
|
|
Levetiracetam therapeutic drug level
|
$10.59 |
$10.59 |
$10.59 |
$72.00
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$26.32 |
$26.32 |
$26.32 |
$48.48
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$580.47 |
$580.47 |
$580.47 |
$159.12
|
|
Lipase
|
$748.79 |
$748.79 |
$748.79 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$35.00 |
$35.00 |
$35.00 |
$89.52
|
|
Lipoprotein direct measurement hdl
|
$190.81 |
$190.81 |
$190.81 |
$55.25
|
|
Lithium therapeutic drug level
|
$841.04 |
$841.04 |
$841.04 |
$67.20
|
|
Liver imaging
|
$8,511.14 |
$8,511.14 |
$8,511.14 |
$1,172.25
|
|
Liver imag w/vasclr flow
|
$9,192.37 |
$9,192.37 |
$9,192.37 |
$1,255.15
|
|
Liver/spleen imag w/vasclr flow
|
$13,915.00 |
$13,915.00 |
$13,915.00 |
$928.20
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$22,125.84 |
$22,125.84 |
$22,125.84 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$22,125.84 |
$22,125.84 |
$22,125.84 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$17,221.65 |
$17,221.65 |
$17,221.65 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$14,186.00 |
$14,186.00 |
$14,186.00 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$13,135.00 |
$13,135.00 |
$13,135.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$12,087.00 |
$12,087.00 |
$12,087.00 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$3,280.31 |
$3,280.31 |
$3,280.31 |
$341.64
|
|
Low frequency non-thermal Ultrasound
|
$1,162.81 |
$1,162.81 |
$1,162.81 |
$272.22
|
|
L/s ratio fetal lung
|
$8.00 |
$8.00 |
$8.00 |
$168.00
|
|
Lumbar diskogram s&i
|
$6,125.02 |
$6,125.02 |
$6,125.02 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$356.95 |
$356.95 |
$356.95 |
$180.16
|
|
Lung perfusion imaging
|
$10,471.34 |
$10,471.34 |
$10,471.34 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$21,671.10 |
$21,671.10 |
$21,671.10 |
$1,543.75
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$784.08 |
$784.08 |
$784.08 |
$142.67
|
|
Manipulation chest wall initial demonstration/evaluation
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$176.52
|
|
Mannitol 12.5 gm/50 ml inj
|
$41.25 |
$41.25 |
$41.25 |
$40.12
|
|
Mastoids complete
|
$3,237.96 |
$3,237.96 |
$3,237.96 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$14.51 |
$14.51 |
$14.51 |
$66.50
|
|
Mayo alcohol definitive assay volatile screen
|
$11.54 |
$11.54 |
$11.54 |
$117.00
|
|
Mayo alkaline phosphatase isoenzyme
|
$6.52 |
$6.52 |
$6.52 |
$65.49
|
|
Mayo androstenedione
|
$10.00 |
$10.00 |
$10.00 |
$102.60
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$3.67 |
$3.67 |
$3.67 |
$71.55
|
|
Mayo antithrombin iii antigen
|
$14.00 |
$14.00 |
$14.00 |
$67.13
|
|
Mayo barbiturates definitive assay confirmation urine
|
$13.32 |
$13.32 |
$13.32 |
$91.65
|
|
Mayo blastomyces antibody immunodiffusion
|
$37.60 |
$37.60 |
$37.60 |
$57.85
|
|
Mayo c1 esterase inhibitor
|
$15.96 |
$15.96 |
$15.96 |
$86.73
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$20.00 |
$20.00 |
$20.00 |
$83.97
|
|
Mayo ceruloplasmin
|
$4.69 |
$4.69 |
$4.69 |
$59.80
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$797.00 |
$797.00 |
$797.00 |
$347.75
|
|
Mayo coccidioides antibody
|
$16.04 |
$16.04 |
$16.04 |
$58.37
|
|
Mayo cortisol free
|
$10.41 |
$10.41 |
$10.41 |
$100.00
|
|
Mayo covid-19 antibody nucleocapsid total
|
$42.13 |
$42.13 |
$42.13 |
$72.52
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$13.64 |
$13.64 |
$13.64 |
$61.02
|
|
Mayo cyanide
|
$70.00 |
$70.00 |
$70.00 |
$87.10
|
|
Mayo dhea (dehydroepiandrosterone)
|
$4.89 |
$4.89 |
$4.89 |
$88.00
|
|
Mayo estrone
|
$10.00 |
$10.00 |
$10.00 |
$81.62
|
|
Mayo ethosuximide therapeutic drug level
|
$9.77 |
$9.77 |
$9.77 |
$69.55
|
|
Mayo factor viii vw factor multimetric analysis
|
$60.27 |
$60.27 |
$60.27 |
$125.00
|
|
Mayo fat/lipids feces quantitative
|
$15.00 |
$15.00 |
$15.00 |
$70.67
|
|
Mayo fbl culture fungi blood
|
$86.30 |
$86.30 |
$86.30 |
$98.21
|
|
Mayo fibrinogen antigen
|
$9.30 |
$9.30 |
$9.30 |
$98.28
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$8.15 |
$8.15 |
$8.15 |
$70.39
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$79.71 |
$79.71 |
$79.71 |
$165.00
|
|
Mayo hvdip HIV 2 antibody
|
$384.79 |
$384.79 |
$384.79 |
$65.70
|
|
Mayo hydroxyprogesterone 17-d
|
$15.74 |
$15.74 |
$15.74 |
$91.65
|
|
Mayo infectious agent nucleic acid amplified probe enterovirus
|
$68.00 |
$68.00 |
$68.00 |
$170.95
|
|
Mayo infectious agent nucleic acid quantification cytomegalovirus
|
$225.00 |
$225.00 |
$225.00 |
$230.65
|
|
Mayo insft insulin free
|
$4.89 |
$4.89 |
$4.89 |
$58.50
|
|
Mayo insulin antibodies
|
$22.40 |
$22.40 |
$22.40 |
$89.40
|
|
Mayo lamotrigine therapeutic drug level
|
$8.96 |
$8.96 |
$8.96 |
$69.75
|
|
Mayo ld_i lactate dehydrogenase isoenzymes
|
$6.07 |
$6.07 |
$6.07 |
$53.39
|
|
Mayo leptospira antibody igm
|
$60.00 |
$60.00 |
$60.00 |
$76.05
|
|
Mayo lipoprotein electrophoresis
|
$11.75 |
$11.75 |
$11.75 |
$50.40
|
|
Mayo manganese
|
$33.72 |
$33.72 |
$33.72 |
$94.90
|
|
Mayo methadone definitive assay confirmation urine
|
$11.54 |
$11.54 |
$11.54 |
$97.20
|
|
Mayo mgle voltage-gated calcium channel antibody each
|
$122.18 |
$122.18 |
$122.18 |
$99.24
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$11.40 |
$11.40 |
$11.40 |
$65.00
|
|
Mayo muramidase
|
$12.22 |
$12.22 |
$12.22 |
$62.70
|
|
Mayo opatu opioid/analogs definitive assay 1 or 2
|
$11.99 |
$11.99 |
$11.99 |
$72.14
|
|
Mayo opatu oxycodone definitive assay
|
$40.00 |
$40.00 |
$40.00 |
$111.00
|
|
Mayo organic acid methylmalonic single quantitative
|
$10.00 |
$10.00 |
$10.00 |
$102.00
|
|
Mayo oxalate 24 hour urine
|
$9.48 |
$9.48 |
$9.48 |
$65.00
|
|
Mayo pancreatic elastase fecal qualitative or semi quantitative
|
$199.55 |
$199.55 |
$199.55 |
$156.00
|
|
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme)
|
$59.00 |
$59.00 |
$59.00 |
$184.17
|
|
Mayo pntft phenytoin free therapeutic drug level
|
$6.74 |
$6.74 |
$6.74 |
$70.95
|
|
Mayo pqnu porphobilinogen urine quantitative 24 hour urine
|
$6.37 |
$6.37 |
$6.37 |
$43.20
|
|
Mayo prmb primidone therapeutic drug level
|
$10.88 |
$10.88 |
$10.88 |
$71.20
|
|
Mayo proinsulin
|
$28.47 |
$28.47 |
$28.47 |
$97.50
|
|
Mayo receptor assay transferrin soluble
|
$24.44 |
$24.44 |
$24.44 |
$122.40
|
|
Mayo renin
|
$5.00 |
$5.00 |
$5.00 |
$93.60
|
|
Mayo serotonin
|
$18.73 |
$18.73 |
$18.73 |
$111.15
|
|
Mayo sirolimus therapeutic drug level
|
$16.86 |
$16.86 |
$16.86 |
$89.78
|
|
Mayo tau phosphorylated 217 each
|
$208.33 |
$208.33 |
$208.33 |
$297.70
|
|
Mayo tgrp testosterone free
|
$3.26 |
$3.26 |
$3.26 |
$89.15
|
