|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$754.71 |
$754.71 |
$754.71 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$743.33 |
$743.33 |
$743.33 |
$713.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$17.85 |
$17.85 |
$17.85 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$48.29 |
$48.29 |
$48.29 |
$30.08
|
|
Kidney img w/bldflw sgl without rx
|
$1,550.95 |
$1,550.95 |
$1,550.95 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$565.36 |
$565.36 |
$565.36 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$934.81 |
$934.81 |
$934.81 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$888.93 |
$888.93 |
$888.93 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$843.05 |
$843.05 |
$843.05 |
$2,181.10
|
|
Knee X-ray
|
$344.66 |
$344.66 |
$344.66 |
$443.90
|
|
Kras gene variants exon 2
|
$144.30 |
$144.30 |
$144.30 |
$495.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$0.97 |
$0.97 |
$0.97 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$61.88 |
$61.88 |
$61.88 |
$53.30
|
|
Lactated ringers intravenous solution
|
$136.90 |
$136.90 |
$136.90 |
$54.11
|
|
Lactic acid
|
$56.33 |
$56.33 |
$56.33 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$57.81 |
$57.81 |
$57.81 |
$88.40
|
|
Lead capillary
|
$4.44 |
$4.44 |
$4.44 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,088.26 |
$1,088.26 |
$1,088.26 |
$1,100.74
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$41.80 |
$41.80 |
$41.80 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$19.61 |
$19.61 |
$19.61 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$39.96 |
$39.96 |
$39.96 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$21.57 |
$21.57 |
$21.57 |
$319.12
|
|
Lidocaine therapeutic drug level
|
$9.62 |
$9.62 |
$9.62 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$48.64 |
$48.64 |
$48.64 |
$177.90
|
|
Lipase
|
$66.79 |
$66.79 |
$66.79 |
$83.20
|
|
Lipoprotein blood quant
|
$29.69 |
$29.69 |
$29.69 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$45.88 |
$45.88 |
$45.88 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$21.37 |
$21.37 |
$21.37 |
$60.00
|
|
Lithium therapeutic drug level
|
$80.38 |
$80.38 |
$80.38 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$2,496.21 |
$2,496.21 |
$2,496.21 |
$4,371.12
|
|
Liver Function Test
|
$50.14 |
$50.14 |
$50.14 |
$110.50
|
|
Liver/spleen imag static only
|
$1,550.95 |
$1,550.95 |
$1,550.95 |
$1,140.78
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$36.99 |
$36.99 |
$36.99 |
$45.56
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$693.10 |
$693.10 |
$693.10 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$647.32 |
$647.32 |
$647.32 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$601.44 |
$601.44 |
$601.44 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$934.81 |
$934.81 |
$934.81 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$888.93 |
$888.93 |
$888.93 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,136.27 |
$1,136.27 |
$1,136.27 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$327.27 |
$327.27 |
$327.27 |
$344.00
|
|
Lumbar diskogram s&i
|
$2,805.80 |
$2,805.80 |
$2,805.80 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$233.56 |
$233.56 |
$233.56 |
$298.50
|
|
Lung perfusion imaging
|
$1,550.95 |
$1,550.95 |
$1,550.95 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$1,550.95 |
$1,550.95 |
$1,550.95 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$25.25 |
$25.25 |
$25.25 |
$38.58
|
|
Magnesium
|
$40.05 |
$40.05 |
$40.05 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$24.14 |
$24.14 |
$24.14 |
$65.49
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$97.59 |
$97.59 |
$97.59 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$95.83 |
$95.83 |
$95.83 |
$178.75
|
|
Mannitol 12.5 gm/50 ml inj
|
$48.29 |
$48.29 |
$48.29 |
$40.12
|
|
Mastoids complete
|
$217.19 |
$217.19 |
$217.19 |
$271.95
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$4,371.37 |
$4,371.37 |
$4,371.37 |
$7,478.44
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$15.54 |
$15.54 |
$15.54 |
$66.50
|
|
Mayo aathr protein s free
|
$43.48 |
$43.48 |
$43.48 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$35.71 |
$35.71 |
$35.71 |
$98.70
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$57.08 |
$57.08 |
$57.08 |
$172.90
|
|
Mayo alcohol definitive assay volatile screen
|
$62.16 |
$62.16 |
$62.16 |
$118.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$5.55 |
$5.55 |
$5.55 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$25.90 |
$25.90 |
$25.90 |
$115.92
|
|
Mayo alpha 1 antitrypsin
|
$15.73 |
$15.73 |
$15.73 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$80.38 |
$80.38 |
$80.38 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$172.05 |
$172.05 |
$172.05 |
$472.31
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$96.57 |
$96.57 |
$96.57 |
$326.48
|
|
Mayo analysis gene smn1 dosage/deletion
|
$202.76 |
$202.76 |
$202.76 |
$328.80
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$4.81 |
$4.81 |
$4.81 |
$72.46
|
|
Mayo antithrombin iii antigen
|
$18.50 |
$18.50 |
$18.50 |
$68.90
|
|
Mayo aspergillus fumigatus antibody
|
$22.27 |
$22.27 |
$22.27 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$74.00 |
$74.00 |
$74.00 |
$157.95
|
|
Mayo barbiturates definitive assay confirmation urine
|
$38.11 |
$38.11 |
$38.11 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$4.44 |
$4.44 |
$4.44 |
$45.75
|
|
Mayo blastomyces antibody immunodiffusion
|
$4.63 |
$4.63 |
$4.63 |
$57.85
|
|
Mayo bordetella pertussis antibody igg
|
$6.94 |
$6.94 |
$6.94 |
$59.15
|
|
Mayo c1 esterase inhibitor
|
$45.88 |
$45.88 |
$45.88 |
$88.35
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$9.44 |
$9.44 |
$9.44 |
$83.97
|
|
Mayo chemiluminescent parathyroid related peptide
|
$24.24 |
$24.24 |
$24.24 |
$123.73
|
|
Mayo chikv chikungunya antibodies igg
|
$37.00 |
$37.00 |
$37.00 |
$102.40
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$71.04 |
$71.04 |
$71.04 |
$353.99
|
|
Mayo chromium
|
$36.63 |
$36.63 |
$36.63 |
$70.85
|
|
Mayo coccidioides antibody
|
$5.18 |
$5.18 |
$5.18 |
$58.37
|
|
Mayo cocou cortisone urine
|
$35.65 |
$35.65 |
$35.65 |
$207.26
|
|
Mayo cortisol free
|
$28.21 |
$28.21 |
$28.21 |
$100.00
|
|
Mayo covid-19 antibody nucleocapsid total
|
$32.19 |
$32.19 |
$32.19 |
$72.60
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$26.64 |
$26.64 |
$26.64 |
$61.02
|
|
Mayo cyanide
|
$12.58 |
$12.58 |
$12.58 |
$87.10
|
|
Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual
|
$166.50 |
$166.50 |
$166.50 |
$611.60
|
|
Mayo deoxyribonuclease antibody titer
|
$4.81 |
$4.81 |
$4.81 |
$56.80
|
|
Mayo dihydrotestosterone
|
$43.33 |
$43.33 |
$43.33 |
$81.90
|
|
Mayo efpo chloride stool
|
$22.57 |
$22.57 |
$22.57 |
$44.20
|
|
Mayo estriol
|
$35.79 |
$35.79 |
$35.79 |
$98.70
|
|
Mayo estrone
|
$36.93 |
$36.93 |
$36.93 |
$84.70
|
|
Mayo everolimus therapeutic drug level
|
$35.52 |
$35.52 |
$35.52 |
$80.50
|
|
Mayo factor ii
|
$70.30 |
$70.30 |
$70.30 |
$93.00
|
|
Mayo factor v
|
$42.37 |
$42.37 |
$42.37 |
$125.48
|
|
Mayo factor vii
|
$38.11 |
$38.11 |
$38.11 |
$141.00
|
|
Mayo factor viii vw factor antigen
|
$60.59 |
$60.59 |
$60.59 |
$110.50
|
|
Mayo factor viii vw factor multimetric analysis
|
$20.35 |
$20.35 |
$20.35 |
$125.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$56.33 |
$56.33 |
$56.33 |
$129.60
|
|
Mayo factor x
|
$44.31 |
$44.31 |
$44.31 |
$139.50
|
|
Mayo factor xi
|
$52.08 |
$52.08 |
$52.08 |
$117.50
|
|
Mayo fat/lipids feces quantitative
|
$11.10 |
$11.10 |
$11.10 |
$71.71
|
