|
Initiation & management bipap/cpap initial day
|
$2,531.72 |
$2,531.72 |
$2,531.72 |
$641.55
|
|
Inj, cefiderocol, 10 mg
|
$1,694.00 |
$1,694.00 |
$1,694.00 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$1,724.00 |
$1,724.00 |
$1,724.00 |
$436.64
|
|
Inj crotalidae im f(ab')2 eq
|
$2,706.67 |
$2,706.67 |
$2,706.67 |
$2,836.95
|
|
Injection, cangrelor
|
$2,457.89 |
$2,457.89 |
$2,457.89 |
$2,457.89
|
|
Injection, fulvestrant
|
$8,049.00 |
$8,049.00 |
$8,049.00 |
$2,744.26
|
|
Injection,onabotulinumtoxina
|
$3,497.00 |
$3,497.00 |
$3,497.00 |
$2,154.07
|
|
Injection, peramivir
|
$2,198.00 |
$2,198.00 |
$2,198.00 |
$1,257.68
|
|
Inj levocarnitine per 1 gm
|
$299.83 |
$299.83 |
$299.83 |
$139.67
|
|
Inj, levothyroxine, freskabi
|
$598.66 |
$598.66 |
$598.66 |
$287.45
|
|
Inj., meropenem, vaborbactam
|
$2,047.96 |
$2,047.96 |
$2,047.96 |
$618.43
|
|
Inj. mycophenolate mofetil
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$348.34
|
|
Inj, nithiodote, 3mg / 125mg
|
$1,425.00 |
$1,425.00 |
$1,425.00 |
$519.39
|
|
Inj, pedmark, 100 mg
|
$668.75 |
$668.75 |
$668.75 |
$96.08
|
|
Inj progesterone per 50 mg
|
$231.00 |
$231.00 |
$231.00 |
$48.51
|
|
Inj testosterone cypionate
|
$2.00 |
$2.00 |
$2.00 |
$77.70
|
|
Insitu hybridization (fish)
|
$911.83 |
$911.83 |
$911.83 |
$481.60
|
|
In situ hybridization per specimen each additional single probe stain
|
$206.01 |
$206.01 |
$206.01 |
$259.01
|
|
Intra-atrial pacing
|
$27,069.70 |
$27,069.70 |
$27,069.70 |
$5,041.63
|
|
Intracard echo interv w/s&i
|
$35,167.69 |
$35,167.69 |
$35,167.69 |
$4,013.16
|
|
Intracranial complete study
|
$1,408.17 |
$1,408.17 |
$1,408.17 |
$882.00
|
|
Intracranial limited study
|
$1,428.28 |
$1,428.28 |
$1,428.28 |
$423.52
|
|
Intrapul surf admin endo tube
|
$1,011.41 |
$1,011.41 |
$1,011.41 |
$239.52
|
|
Intraventricular pacing
|
$5,775.22 |
$5,775.22 |
$5,775.22 |
$5,644.35
|
|
Intro long gi tube w/mult fluo
|
$1,183.04 |
$1,183.04 |
$1,183.04 |
$477.85
|
|
Ionm in operatng room 15 min
|
$688.77 |
$688.77 |
$688.77 |
$213.59
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$140,341.00 |
$140,341.00 |
$140,341.00 |
$52,277.70
|
|
Ipratropium bromide non-comp
|
$59.09 |
$59.09 |
$59.09 |
$9.07
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$1,301.00 |
$1,301.00 |
$1,301.00 |
$227.39
|
|
Iron dextran 50 mg/ml injection solution
|
$240.00 |
$240.00 |
$240.00 |
$65.63
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1,628.00 |
$1,628.00 |
$1,628.00 |
$200.51
|
|
Irradiation of blood product each unit reference
|
$1,851.51 |
$1,851.51 |
$1,851.51 |
$124.24
|
|
Ivp w/nephrotomography
|
$10,895.95 |
$10,895.95 |
$10,895.95 |
$769.86
|
|
Ivp w/wo kub w/wo tomography
|
$5,795.92 |
$5,795.92 |
$5,795.92 |
$692.18
|
|
Ketogenic steroids fract
|
$39.86 |
$39.86 |
$39.86 |
$79.54
|
|
Kidney imag w/bld flow multi
|
$12,925.97 |
$12,925.97 |
$12,925.97 |
$1,574.40
|
|
Kidney img w/bldflw sgl without rx
|
$12,925.97 |
$12,925.97 |
$12,925.97 |
$1,468.04
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$17,257.39 |
$17,257.39 |
$17,257.39 |
$740.00
|
|
Kras gene variants exon 2
|
$23.98 |
$23.98 |
$23.98 |
$495.00
|
|
Kyleena, 19.5 mg
|
$3,976.76 |
$3,976.76 |
$3,976.76 |
$2,992.45
|
|
Lactated ringers intravenous solution
|
$280.00 |
$280.00 |
$280.00 |
$51.80
|
|
Lactoferrin fecal qualitative
|
$409.27 |
$409.27 |
$409.27 |
$85.83
|
|
Lactoferrin fecal quant
|
$64.31 |
$64.31 |
$64.31 |
$106.10
|
|
Laryngeal function studies
|
$686.04 |
$686.04 |
$686.04 |
$335.40
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$199.00 |
$199.00 |
$199.00 |
$144.40
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$12,762.00 |
$12,762.00 |
$12,762.00 |
$4,876.80
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$506.80 |
$506.80 |
$506.80 |
$48.74
|
|
Liletta, 52 mg
|
$3,203.77 |
$3,203.77 |
$3,203.77 |
$2,360.29
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$1,894.00 |
$1,894.00 |
$1,894.00 |
$167.08
|
|
Lipoprotein blood high res frac & quant
|
$89.52 |
$89.52 |
$89.52 |
$89.52
|
|
Lipoprotein blood quant
|
$32.61 |
$32.61 |
$32.61 |
$98.95
|
|
Lipoprotein direct measurement hdl
|
$2,293.67 |
$2,293.67 |
$2,293.67 |
$55.00
|
|
Liver imaging
|
$3,730.50 |
$3,730.50 |
$3,730.50 |
$1,234.59
|
|
Liver imag w/vasclr flow
|
$9,754.32 |
$9,754.32 |
$9,754.32 |
$1,255.15
|
|
Liver/spleen imag static only
|
$13,238.09 |
$13,238.09 |
$13,238.09 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$9,754.32 |
$9,754.32 |
$9,754.32 |
$928.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$1.16 |
$1.16 |
$1.16 |
$16.54
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$16,258.85 |
$16,258.85 |
$16,258.85 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$18,693.41 |
$18,693.41 |
$18,693.41 |
$1,848.60
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$18,693.41 |
$18,693.41 |
$18,693.41 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$19,297.31 |
$19,297.31 |
$19,297.31 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$19,347.91 |
$19,347.91 |
$19,347.91 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$18,414.99 |
$18,414.99 |
$18,414.99 |
$2,065.69
|
|
L/s ratio fetal lung
|
$8.00 |
$8.00 |
$8.00 |
$168.00
|
|
Lung function test (mbc/mvv)
|
$1,417.50 |
$1,417.50 |
$1,417.50 |
$180.73
|
|
Lung perfusion imaging
|
$11,227.59 |
$11,227.59 |
$11,227.59 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$10,589.48 |
$10,589.48 |
$10,589.48 |
$1,526.38
|
|
Lymphocytotoxicity assay
|
$177.67 |
$177.67 |
$177.67 |
$370.20
|
|
Mannitol 12.5 gm/50 ml inj
|
$219.00 |
$219.00 |
$219.00 |
$40.12
|
|
M.avium-intra dna dir prob
|
$247.51 |
$247.51 |
$247.51 |
$58.25
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$22.81 |
$22.81 |
$22.81 |
$115.92
|
|
Mayo analysis gene calr common variants exon 9
|
$467.61 |
$467.61 |
$467.61 |
$494.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$135.00 |
$135.00 |
$135.00 |
$322.30
|
|
Mayo antithrombin iii antigen
|
$9.04 |
$9.04 |
$9.04 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$135.00 |
$135.00 |
$135.00 |
$157.95
|
|
Mayo barbiturates definitive assay confirmation urine
|
$8.26 |
$8.26 |
$8.26 |
$91.50
|
|
Mayo blastomyces antibody immunodiffusion
|
$27.62 |
$27.62 |
$27.62 |
$57.85
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$43.01 |
$43.01 |
$43.01 |
$110.00
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$106.45 |
$106.45 |
$106.45 |
$349.47
|
|
Mayo chromium
|
$242.72 |
$242.72 |
$242.72 |
$70.85
|
|
Mayo coccidioides antibody
|
$82.00 |
$82.00 |
$82.00 |
$58.37
|
|
Mayo covid-19 antibody nucleocapsid total
|
$42.00 |
$42.00 |
$42.00 |
$72.52
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$16.75 |
$16.75 |
$16.75 |
$61.02
|
|
Mayo efpo chloride stool
|
$1,302.37 |
$1,302.37 |
$1,302.37 |
$42.90
|
|
Mayo ethosuximide therapeutic drug level
|
$97.45 |
$97.45 |
$97.45 |
$69.55
|
|
Mayo factor vii
|
$137.25 |
$137.25 |
$137.25 |
$141.70
|
|
Mayo factor viii vw factor multimetric analysis
|
$23.78 |
$23.78 |
$23.78 |
$125.00
|
|
Mayo factor x
|
$620.94 |
$620.94 |
$620.94 |
$139.50
|
|
Mayo fbl culture fungi blood
|
$2,319.81 |
$2,319.81 |
$2,319.81 |
$99.81
|
|
Mayo ffspg allergen clam igg
|
$39.24 |
$39.24 |
$39.24 |
$37.05
|
|
Mayo gamma-globin full gene sequencing
|
$2,919.60 |
$2,919.60 |
$2,919.60 |
$1,460.30
|
|
Mayo hemosiderin qualitative urine
|
$23.50 |
$23.50 |
$23.50 |
$33.57
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$84.71 |
$84.71 |
$84.71 |
$165.00
|
|
Mayo hvdip HIV 2 antibody
|
$18.63 |
$18.63 |
$18.63 |
$66.82
|
|
Mayo hydroxyprogesterone 17-d
|
$16.00 |
$16.00 |
$16.00 |
$91.65
|
|
Mayo infectious agent nucleic acid quantification cytomegalovirus
|
$301.00 |
$301.00 |
$301.00 |
$231.40
|
|
Mayo infectious disease hepatitis c chronic six biochemical assays
|
$101.81 |
$101.81 |
$101.81 |
$226.20
|
|
Mayo inhab inhibin a
|
$24.44 |
$24.44 |
$24.44 |
$81.60
|
|
Mayo insft insulin free
|
$11.99 |
$11.99 |
$11.99 |
$58.50
|
|
Mayo insulin antibodies
|
$18.24 |
$18.24 |
$18.24 |
$90.35
|
