|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$2,814.00 |
$2,814.00 |
$2,814.00 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$26.88 |
$26.88 |
$26.88 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$115.82 |
$115.82 |
$115.82 |
$85.15
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$2.70 |
$2.70 |
$2.70 |
$57.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$869.67 |
$869.67 |
$869.67 |
$99.04
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$10.80 |
$10.80 |
$10.80 |
$93.60
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$64.83 |
$64.83 |
$64.83 |
$143.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$717.57 |
$717.57 |
$717.57 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$32.58 |
$32.58 |
$32.58 |
$175.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$64.83 |
$64.83 |
$64.83 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$93.91 |
$93.91 |
$93.91 |
$100.13
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,323.38 |
$1,323.38 |
$1,323.38 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$9,350.70 |
$9,350.70 |
$9,350.70 |
$627.00
|
|
Inj, bupivacaine liposome
|
$1,410.44 |
$1,410.44 |
$1,410.44 |
$1,040.36
|
|
Inj calcitriol per 0.1 mcg
|
$78.58 |
$78.58 |
$78.58 |
$30.19
|
|
Inj ceftolozane tazobactam
|
$493.92 |
$493.92 |
$493.92 |
$333.00
|
|
Inj crotalidae im f(ab')2 eq
|
$2,735.85 |
$2,735.85 |
$2,735.85 |
$2,735.85
|
|
Inj, levothyroxine, freskabi
|
$443.07 |
$443.07 |
$443.07 |
$244.63
|
|
Inj., omadacycline, 1 mg
|
$1,379.82 |
$1,379.82 |
$1,379.82 |
$3.80
|
|
Inj progesterone per 50 mg
|
$48.51 |
$48.51 |
$48.51 |
$49.00
|
|
Insitu hybridization auto
|
$118.20 |
$118.20 |
$118.20 |
$398.51
|
|
Insitu hybridization (fish)
|
$255.81 |
$255.81 |
$255.81 |
$481.60
|
|
Insitu hybridization manual
|
$140.40 |
$140.40 |
$140.40 |
$411.33
|
|
In situ hybridization per specimen initial single probe stain
|
$179.19 |
$179.19 |
$179.19 |
$341.90
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$14,223.57 |
$14,223.57 |
$14,223.57 |
$9,736.00
|
|
Interferon alfa-2b inj
|
$2,353.84 |
$2,353.84 |
$2,353.84 |
$473.03
|
|
Intra-atrial pacing
|
$8,383.17 |
$8,383.17 |
$8,383.17 |
$5,155.51
|
|
Intracranial complete study
|
$2,076.25 |
$2,076.25 |
$2,076.25 |
$873.82
|
|
Intracranial limited study
|
$1,397.32 |
$1,397.32 |
$1,397.32 |
$418.44
|
|
Intraventricular pacing
|
$8,383.17 |
$8,383.17 |
$8,383.17 |
$5,644.35
|
|
Intrinsic factor antibody
|
$5.40 |
$5.40 |
$5.40 |
$59.95
|
|
Intro long gi tube w/mult fluo
|
$2,557.16 |
$2,557.16 |
$2,557.16 |
$477.85
|
|
Ipratropium bromide non-comp
|
$3.75 |
$3.75 |
$3.75 |
$11.91
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$286.65 |
$286.65 |
$286.65 |
$236.99
|
|
Iron dextran 50 mg/ml injection solution
|
$109.15 |
$109.15 |
$109.15 |
$62.12
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$340.20 |
$340.20 |
$340.20 |
$255.60
|
|
Irradiation of blood product each unit reference
|
$773.95 |
$773.95 |
$773.95 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$324.45 |
$324.45 |
$324.45 |
$153.75
|
|
Ivc venogram s&i
|
$11,028.92 |
$11,028.92 |
$11,028.92 |
$3,258.00
|
|
Ivp w/nephrotomography
|
$6,167.70 |
$6,167.70 |
$6,167.70 |
$712.53
|
|
Ivp w/wo kub w/wo tomography
|
$7,189.45 |
$7,189.45 |
$7,189.45 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$23.54 |
$23.54 |
$23.54 |
$52.80
|
|
Kidney imag w/bld flow multi
|
$5,058.22 |
$5,058.22 |
$5,058.22 |
$1,574.40
|
|
Kidney img w/bldflw sgl without rx
|
$5,058.22 |
$5,058.22 |
$5,058.22 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,676.99 |
$2,676.99 |
$2,676.99 |
$668.25
|
|
Lactated ringers intravenous solution
|
$40.22 |
$40.22 |
$40.22 |
$47.66
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$47.41 |
$47.41 |
$47.41 |
$120.34
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$26.33 |
$26.33 |
$26.33 |
$38.02
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$48.47 |
$48.47 |
$48.47 |
$130.49
|
|
Lipase
|
$905.43 |
$905.43 |
$905.43 |
$82.20
|
|
Lipoprotein direct measurement hdl
|
$2,312.43 |
$2,312.43 |
$2,312.43 |
$54.60
|
|
Lithium therapeutic drug level
|
$2,767.03 |
$2,767.03 |
$2,767.03 |
$66.43
|
|
Liver/spleen imag static only
|
$5,173.12 |
$5,173.12 |
$5,173.12 |
$1,140.78
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$27.56 |
$27.56 |
$27.56 |
$37.64
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$36,900.29 |
$36,900.29 |
$36,900.29 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$23,098.37 |
$23,098.37 |
$23,098.37 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$17,778.00 |
$17,778.00 |
$17,778.00 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$11,268.40 |
$11,268.40 |
$11,268.40 |
$2,919.75
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$8,982.81 |
$8,982.81 |
$8,982.81 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$8,195.08 |
$8,195.08 |
$8,195.08 |
$2,013.08
|
|
Lower Back (Lumbar Spine) X-ray
|
$3,627.29 |
$3,627.29 |
$3,627.29 |
$341.64
|
|
Lumbar diskogram s&i
|
$6,686.94 |
$6,686.94 |
$6,686.94 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$356.82 |
$356.82 |
$356.82 |
$182.91
|
|
Lung perfusion imaging
|
$3,816.52 |
$3,816.52 |
$3,816.52 |
$1,082.75
|
|
Lymphatics/lymph node imaging
|
$12,187.16 |
$12,187.16 |
$12,187.16 |
$1,526.38
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$706.97 |
$706.97 |
$706.97 |
$137.25
|
|
Manipulation chest wall initial demonstration/evaluation
|
$750.49 |
$750.49 |
$750.49 |
$163.15
|
|
Mannitol 12.5 gm/50 ml inj
|
$28.67 |
$28.67 |
$28.67 |
$40.12
|
|
Map tachycard site(s)
|
$9,650.36 |
$9,650.36 |
$9,650.36 |
$3,960.00
|
|
Mayo alcohol definitive assay volatile screen
|
$10.80 |
$10.80 |
$10.80 |
$111.33
|
|
Mayo alkaline phosphatase isoenzyme
|
$5.40 |
$5.40 |
$5.40 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$21.60 |
$21.60 |
$21.60 |
$137.80
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$116.55 |
$116.55 |
$116.55 |
$343.20
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$4.86 |
$4.86 |
$4.86 |
$74.10
|
|
Mayo antithrombin iii antigen
|
$15.12 |
$15.12 |
$15.12 |
$67.13
|
|
Mayo avwpr vw factor activity
|
$135.00 |
$135.00 |
$135.00 |
$159.66
|
|
Mayo barbiturates definitive assay confirmation urine
|
$15.30 |
$15.30 |
$15.30 |
$95.55
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$796.62 |
$796.62 |
$796.62 |
$353.60
|
|
Mayo blastomyces antibody immunodiffusion
|
$16.20 |
$16.20 |
$16.20 |
$57.85
|
|
Mayo ceruloplasmin
|
$5.07 |
$5.07 |
$5.07 |
$64.80
|
|
Mayo chikv chikungunya antibodies igg
|
$7.56 |
$7.56 |
$7.56 |
$119.40
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$12.96 |
$12.96 |
$12.96 |
$51.75
|
|
Mayo coccidioides antibody
|
$17.32 |
$17.32 |
$17.32 |
$61.10
|
|
Mayo cocou cortisone urine
|
$270.00 |
$270.00 |
$270.00 |
$218.40
|
|
Mayo cortisol free
|
$13.80 |
$13.80 |
$13.80 |
$105.30
|
|
Mayo covid-19 antibody nucleocapsid total
|
$42.13 |
$42.13 |
$42.13 |
$72.52
|
|
Mayo dhea (dehydroepiandrosterone)
|
$22.68 |
$22.68 |
$22.68 |
$101.00
|
|
Mayo efpo chloride stool
|
$1,206.00 |
$1,206.00 |
$1,206.00 |
$42.60
|
|
Mayo factor viii vw factor antigen
|
$112.28 |
$112.28 |
$112.28 |
$110.50
|
|
Mayo factor viii vw factor multimetric analysis
|
$79.92 |
$79.92 |
$79.92 |
$125.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$152.58 |
$152.58 |
$152.58 |
$130.40
|
|
Mayo gamma-globin full gene sequencing
|
$5,394.60 |
$5,394.60 |
$5,394.60 |
$1,498.00
|
|
Mayo hemosiderin qualitative urine
|
$7.56 |
$7.56 |
$7.56 |
$33.57
|
|
Mayo hvdip HIV 2 antibody
|
$103.65 |
$103.65 |
$103.65 |
$67.60
|
|
Mayo hydroxyprogesterone 17-d
|
$20.87 |
$20.87 |
$20.87 |
$96.33
|
|
Mayo infectious agent nucleic acid amplified probe enterovirus
|
$97.20 |
$97.20 |
$97.20 |
$170.66
|
|
Mayo insft insulin free
|
$8.10 |
$8.10 |
$8.10 |
$58.50
|
|
Mayo insulin antibodies
|
$24.19 |
$24.19 |
$24.19 |
$92.07
|
|
Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory
|
$46.50 |
$46.50 |
$46.50 |
$70.40
|
|
Mayo mgle voltage-gated calcium channel antibody each
|
$162.00 |
$162.00 |
$162.00 |
$99.24
|