|
I131 iodide sol, rx
|
$1,756.36 |
$1,756.36 |
$1,756.36 |
$42.01
|
|
Iaadi respiratory synctial virus
|
$322.60 |
$322.60 |
$322.60 |
$42.35
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$3,847.57 |
$3,847.57 |
$3,847.57 |
$938.19
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$573.77 |
$573.77 |
$573.77 |
$340.00
|
|
Immune complex assay
|
$116.04 |
$116.04 |
$116.04 |
$89.25
|
|
Immunoassay tumor antigen quantitative ca 125
|
$208.37 |
$208.37 |
$208.37 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$208.37 |
$208.37 |
$208.37 |
$116.40
|
|
Immunodiffusion nes
|
$7.60 |
$7.60 |
$7.60 |
$58.07
|
|
Immunoglobulin assay
|
$90.48 |
$90.48 |
$90.48 |
$74.15
|
|
Implant ureth bulk agent
|
$4,359.65 |
$4,359.65 |
$4,359.65 |
$1,706.25
|
|
In-111 autol wbc diag per dose
|
$5,606.99 |
$5,606.99 |
$5,606.99 |
$3,704.00
|
|
In-111 capromab pendet
|
$6,266.45 |
$6,266.45 |
$6,266.45 |
$3,941.34
|
|
In-111 pentetate dtpa / 0.5 mci
|
$15,788.08 |
$15,788.08 |
$15,788.08 |
$2,106.00
|
|
In-111 pentetreotide
|
$26,138.83 |
$26,138.83 |
$26,138.83 |
$6,610.16
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$276.00 |
$276.00 |
$276.00 |
$576.35
|
|
Infect ag if hep delta agent
|
$45.00 |
$45.00 |
$45.00 |
$123.00
|
|
Infect ag if legionella pneumophila
|
$131.65 |
$131.65 |
$131.65 |
$75.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$2,011.33 |
$2,011.33 |
$2,011.33 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$77.00 |
$77.00 |
$77.00 |
$101.00
|
|
Infect ag na resp virus 12-25 targets
|
$6,443.81 |
$6,443.81 |
$6,443.81 |
$870.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$386.21 |
$386.21 |
$386.21 |
$79.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$116.53 |
$116.53 |
$116.53 |
$79.33
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$225.00 |
$225.00 |
$225.00 |
$138.05
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$94.84 |
$94.84 |
$94.84 |
$60.00
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$294.06 |
$294.06 |
$294.06 |
$143.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$57.00 |
$57.00 |
$57.00 |
$172.15
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$175.00 |
$175.00 |
$175.00 |
$173.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$271.00 |
$271.00 |
$271.00 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$294.06 |
$294.06 |
$294.06 |
$135.85
|
|
Infectious agent nucleic acid quantification bk virus
|
$240.00 |
$240.00 |
$240.00 |
$297.50
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$90.00 |
$90.00 |
$90.00 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$66.79 |
$66.79 |
$66.79 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$92.00 |
$92.00 |
$92.00 |
$381.55
|
|
Infliximab 100 mg intravenous solution
|
$4,693.76 |
$4,693.76 |
$4,693.76 |
$2,180.74
|
|
Influenza dna amp prob addl
|
$285.75 |
$285.75 |
$285.75 |
$69.60
|
|
Initiation & management bipap/cpap initial day
|
$4,985.63 |
$4,985.63 |
$4,985.63 |
$627.00
|
|
Inj cefazolin sodium, hikma
|
$32.59 |
$32.59 |
$32.59 |
$54.91
|
|
Inj ceftolozane tazobactam
|
$533.14 |
$533.14 |
$533.14 |
$381.60
|
|
Inj crotalidae im f(ab')2 eq
|
$2,735.85 |
$2,735.85 |
$2,735.85 |
$2,836.95
|
|
Injection, cangrelor
|
$3,342.53 |
$3,342.53 |
$3,342.53 |
$2,457.89
|
|
Injection, renflexis
|
$1,429.43 |
$1,429.43 |
$1,429.43 |
$1,407.33
|
|
Inj ivig privigen 500 mg
|
$2,637.00 |
$2,637.00 |
$2,637.00 |
$7,298.71
|
|
Inj levocarnitine per 1 gm
|
$206.75 |
$206.75 |
$206.75 |
$132.69
|
|
Inj mepivacaine hcl/10 ml
|
$122.85 |
$122.85 |
$122.85 |
$23.93
|
|
Inj secretin synthetic human
|
$2,658.32 |
$2,658.32 |
$2,658.32 |
$610.89
|
|
In situ hybridization per specimen initial single probe stain
|
$109.00 |
$109.00 |
$109.00 |
$340.00
|
|
Insti hexaminolevulinate hcl
|
$5,062.50 |
$5,062.50 |
$5,062.50 |
$2,359.80
|
|
Insulin total
|
$126.58 |
$126.58 |
$126.58 |
$67.50
|
|
Intrinsic factor antibody
|
$10.69 |
$10.69 |
$10.69 |
$59.95
|
|
Intro long gi tube w/mult fluo
|
$2,162.41 |
$2,162.41 |
$2,162.41 |
$477.85
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$86.77 |
$86.77 |
$86.77 |
$184.87
|
|
Iron
|
$81.38 |
$81.38 |
$81.38 |
$74.40
|
|
Iron binding capacity
|
$102.05 |
$102.05 |
$102.05 |
$63.05
|
|
Iron dextran 50 mg/ml injection solution
|
$464.61 |
$464.61 |
$464.61 |
$62.12
|
|
Irradiation of blood product each unit reference
|
$57.79 |
$57.79 |
$57.79 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$332.09 |
$332.09 |
$332.09 |
$153.75
|
|
Ivc venogram s&i
|
$4,304.07 |
$4,304.07 |
$4,304.07 |
$3,258.00
|
|
Ivp w/nephrotomography
|
$7,888.25 |
$7,888.25 |
$7,888.25 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$7,846.82 |
$7,846.82 |
$7,846.82 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$36.00 |
$36.00 |
$36.00 |
$53.78
|
|
Kidney imaging morphology
|
$10,186.41 |
$10,186.41 |
$10,186.41 |
$769.51
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$21.80 |
$21.80 |
$21.80 |
$33.78
|
|
Lactated ringers intravenous solution
|
$12.62 |
$12.62 |
$12.62 |
$48.59
|
|
Lactic acid
|
$1,022.10 |
$1,022.10 |
$1,022.10 |
$102.90
|
|
Lead capillary
|
$4.00 |
$4.00 |
$4.00 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$4,748.59 |
$4,748.59 |
$4,748.59 |
$1,092.58
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$458.31 |
$458.31 |
$458.31 |
$89.50
|
|
Levetiracetam therapeutic drug level
|
$13.00 |
$13.00 |
$13.00 |
$74.00
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$19.50 |
$19.50 |
$19.50 |
$40.79
|
|
Lidocaine therapeutic drug level
|
$128.52 |
$128.52 |
$128.52 |
$85.15
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$864.64 |
$864.64 |
$864.64 |
$141.75
|
|
Lipoprotein direct measurement hdl
|
$1,647.89 |
$1,647.89 |
$1,647.89 |
$55.80
|
|
Lithium therapeutic drug level
|
$1,183.03 |
$1,183.03 |
$1,183.03 |
$67.60
|
|
Liver Function Test
|
$1,731.33 |
$1,731.33 |
$1,731.33 |
$112.80
|
|
Liver imaging
|
$4,584.71 |
$4,584.71 |
$4,584.71 |
$1,241.25
|
|
Liver imag w/vasclr flow
|
$4,281.83 |
$4,281.83 |
$4,281.83 |
$1,255.15
|
|
Liver/spleen imag static only
|
$12,835.79 |
$12,835.79 |
$12,835.79 |
$1,140.78
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$24,088.70 |
$24,088.70 |
$24,088.70 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$20,306.18 |
$20,306.18 |
$20,306.18 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$19,797.45 |
$19,797.45 |
$19,797.45 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$13,853.33 |
$13,853.33 |
$13,853.33 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$5,723.87 |
$5,723.87 |
$5,723.87 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$11,566.04 |
$11,566.04 |
$11,566.04 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$3,685.15 |
$3,685.15 |
$3,685.15 |
$344.00
|
|
Lumbar diskogram s&i
|
$8,430.42 |
$8,430.42 |
$8,430.42 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$2,559.62 |
$2,559.62 |
$2,559.62 |
$180.73
|
|
Lung Function Test (Spirometry)
|
$2,556.50 |
$2,556.50 |
$2,556.50 |
$295.35
|
|
Lung perfusion imaging
|
$7,229.29 |
$7,229.29 |
$7,229.29 |
$1,082.75
|
|
Lymphatics/lymph node imaging
|
$5,479.11 |
$5,479.11 |
$5,479.11 |
$1,526.38
|
|
Lymph vessel x-ray arms/legs
|
$4,939.53 |
$4,939.53 |
$4,939.53 |
$2,229.24
|
|
Lymph vessel x-ray trunk
|
$35,611.13 |
$35,611.13 |
$35,611.13 |
$3,332.55
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$300.06 |
$300.06 |
$300.06 |
$140.87
|
|
Manipulation chest wall initial demonstration/evaluation
|
$336.97 |
$336.97 |
$336.97 |
$170.00
|
|
Mannitol 12.5 gm/50 ml inj
|
$48.81 |
$48.81 |
$48.81 |
$40.12
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$11.81 |
$11.81 |
$11.81 |
$67.00
|
|
Mayo activated protein c resistance assay
|
$162.11 |
$162.11 |
$162.11 |
$97.50
|
|
Mayo alkaline phosphatase isoenzyme
|
$5.61 |
$5.61 |
$5.61 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$22.81 |
$22.81 |
$22.81 |
$134.55
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$162.90 |
$162.90 |
$162.90 |
$338.00
|
|
Mayo androstenedione
|
$14.10 |
$14.10 |
$14.10 |
$103.89
|