|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$3,065.16 |
$3,065.16 |
$3,065.16 |
$1,683.63
|
|
In-111 autol wbc diag per dose
|
$2,464.79 |
$2,464.79 |
$2,464.79 |
$3,704.00
|
|
In-111 oxyquinolin per 0.5 mci
|
$18,581.39 |
$18,581.39 |
$18,581.39 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$16,797.34 |
$16,797.34 |
$16,797.34 |
$2,135.29
|
|
In-111 pentetreotide
|
$23,738.40 |
$23,738.40 |
$23,738.40 |
$6,617.05
|
|
In-111 satumomab pend
|
$15,158.54 |
$15,158.54 |
$15,158.54 |
$3,524.25
|
|
Infect ag drug suscept pheno predict
|
$45.10 |
$45.10 |
$45.10 |
$325.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$89.10 |
$89.10 |
$89.10 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$6.00 |
$6.00 |
$6.00 |
$66.72
|
|
Infect ag if influenza a
|
$125.13 |
$125.13 |
$125.13 |
$40.61
|
|
Infect ag if influenza b
|
$125.13 |
$125.13 |
$125.13 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$125.13 |
$125.13 |
$125.13 |
$75.79
|
|
Infect ag if varicella zoster
|
$24.20 |
$24.20 |
$24.20 |
$66.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$53.00 |
$53.00 |
$53.00 |
$227.96
|
|
Infect ag na influenza revr/amp ea type
|
$247.50 |
$247.50 |
$247.50 |
$124.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$77.00 |
$77.00 |
$77.00 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$738.57 |
$738.57 |
$738.57 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$469.70 |
$469.70 |
$469.70 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$33.00 |
$33.00 |
$33.00 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$152.93 |
$152.93 |
$152.93 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$1,345.05 |
$1,345.05 |
$1,345.05 |
$60.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$138.00 |
$138.00 |
$138.00 |
$178.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$89.10 |
$89.10 |
$89.10 |
$210.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$70.91 |
$70.91 |
$70.91 |
$103.20
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$73.00 |
$73.00 |
$73.00 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$82.50 |
$82.50 |
$82.50 |
$278.78
|
|
Influenza dna amp prob addl
|
$73.00 |
$73.00 |
$73.00 |
$69.60
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$208.29 |
$208.29 |
$208.29 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$1,691.99 |
$1,691.99 |
$1,691.99 |
$645.79
|
|
Inj, bupivacaine liposome
|
$2,464.83 |
$2,464.83 |
$2,464.83 |
$816.31
|
|
Inj calcitriol per 0.1 mcg
|
$105.00 |
$105.00 |
$105.00 |
$33.36
|
|
Inj, cefiderocol, 10 mg
|
$1,694.00 |
$1,694.00 |
$1,694.00 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$550.20 |
$550.20 |
$550.20 |
$447.36
|
|
Inj crotalidae im f(ab')2 eq
|
$2,735.85 |
$2,735.85 |
$2,735.85 |
$2,836.95
|
|
Injection, cangrelor
|
$83.05 |
$83.05 |
$83.05 |
$2,546.20
|
|
Injection,onabotulinumtoxina
|
$31.50 |
$31.50 |
$31.50 |
$2,154.07
|
|
Inj levocarnitine per 1 gm
|
$309.75 |
$309.75 |
$309.75 |
$138.96
|
|
Inj., meropenem, vaborbactam
|
$633.75 |
$633.75 |
$633.75 |
$618.43
|
|
Inj. mycophenolate mofetil
|
$422.15 |
$422.15 |
$422.15 |
$344.84
|
|
Inj, nithiodote, 3mg / 125mg
|
$715.50 |
$715.50 |
$715.50 |
$389.50
|
|
Inj, pedmark, 100 mg
|
$401.25 |
$401.25 |
$401.25 |
$96.08
|
|
Insitu hybridization auto
|
$245.39 |
$245.39 |
$245.39 |
$398.16
|
|
Insitu hybridization manual
|
$143.00 |
$143.00 |
$143.00 |
$407.11
|
|
In situ hybridization per specimen initial single probe stain
|
$382.90 |
$382.90 |
$382.90 |
$338.40
|
|
Interrogate subq defib
|
$11,137.41 |
$11,137.41 |
$11,137.41 |
$139.10
|
|
Interrog device eval heart
|
$11,137.41 |
$11,137.41 |
$11,137.41 |
$150.00
|
|
Interrog evl pm/ldls pm ip
|
$11,137.41 |
$11,137.41 |
$11,137.41 |
$127.20
|
|
Intra-atrial pacing
|
$35,403.51 |
$35,403.51 |
$35,403.51 |
$5,155.51
|
|
Intra-atrial recording
|
$35,403.51 |
$35,403.51 |
$35,403.51 |
$5,707.00
|
|
Intracranial complete study
|
$1,423.10 |
$1,423.10 |
$1,423.10 |
$883.30
|
|
Intracranial limited study
|
$3,633.95 |
$3,633.95 |
$3,633.95 |
$423.52
|
|
Intraventricular pacing
|
$35,403.51 |
$35,403.51 |
$35,403.51 |
$5,775.22
|
|
Intrinsic factor antibody
|
$74.13 |
$74.13 |
$74.13 |
$59.95
|
|
Ionm in operatng room 15 min
|
$491.62 |
$491.62 |
$491.62 |
$200.78
|
|
Ionm remote/>1 pt or per hr
|
$2,328.72 |
$2,328.72 |
$2,328.72 |
$622.70
|
|
Ipratropium bromide non-comp
|
$19.01 |
$19.01 |
$19.01 |
$7.57
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$2.10 |
$2.10 |
$2.10 |
$198.01
|
|
Irrigation implantable venous access device for drug delivery systems
|
$1,484.15 |
$1,484.15 |
$1,484.15 |
$154.50
|
|
Ivp w/nephrotomography
|
$8,410.56 |
$8,410.56 |
$8,410.56 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$3,336.91 |
$3,336.91 |
$3,336.91 |
$713.05
|
|
Kidney imag w/bld flow multi
|
$14,925.26 |
$14,925.26 |
$14,925.26 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$10,476.88 |
$10,476.88 |
$10,476.88 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$4,230.17 |
$4,230.17 |
$4,230.17 |
$668.25
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$5.06 |
$5.06 |
$5.06 |
$42.38
|
|
Lactated ringers intravenous solution
|
$60.00 |
$60.00 |
$60.00 |
$54.11
|
|
Lactoferrin fecal quant
|
$46.20 |
$46.20 |
$46.20 |
$106.10
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,423.10 |
$1,423.10 |
$1,423.10 |
$1,100.74
|
|
Leishmania antibody
|
$18.15 |
$18.15 |
$18.15 |
$58.50
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$391.65 |
$391.65 |
$391.65 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,155.94 |
$1,155.94 |
$1,155.94 |
$3,271.64
|
|
Levetiracetam therapeutic drug level
|
$12.10 |
$12.10 |
$12.10 |
$71.40
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$574.56 |
$574.56 |
$574.56 |
$49.11
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$265.65 |
$265.65 |
$265.65 |
$177.90
|
|
Lipoprotein blood high res frac & quant
|
$57.20 |
$57.20 |
$57.20 |
$89.52
|
|
Lipoprotein direct measurement hdl
|
$983.58 |
$983.58 |
$983.58 |
$55.90
|
|
Liver imaging
|
$1,172.25 |
$1,172.25 |
$1,172.25 |
$1,241.25
|
|
Liver/spleen imag static only
|
$5,586.89 |
$5,586.89 |
$5,586.89 |
$1,140.78
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$39,307.42 |
$39,307.42 |
$39,307.42 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$25,236.87 |
$25,236.87 |
$25,236.87 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$20,248.25 |
$20,248.25 |
$20,248.25 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$32,181.51 |
$32,181.51 |
$32,181.51 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$24,168.58 |
$24,168.58 |
$24,168.58 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$8,012.91 |
$8,012.91 |
$8,012.91 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$5,681.62 |
$5,681.62 |
$5,681.62 |
$344.00
|
|
Lung function test (mbc/mvv)
|
$314.24 |
$314.24 |
$314.24 |
$182.91
|
|
Lung perfusion imaging
|
$8,358.32 |
$8,358.32 |
$8,358.32 |
$1,100.39
|
|
Lvad shower bag heartmate
|
$1,104.25 |
$1,104.25 |
$1,104.25 |
$1,090.58
|
|
Lymphatics/lymph node imaging
|
$7,096.57 |
$7,096.57 |
$7,096.57 |
$1,543.75
|
|
Macroscopic exam parasite
|
$14.25 |
$14.25 |
$14.25 |
$38.50
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$190.18 |
$190.18 |
$190.18 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$190.18 |
$190.18 |
$190.18 |
$178.75
|
|
Mannitol 12.5 gm/50 ml inj
|
$6.30 |
$6.30 |
$6.30 |
$40.12
|
|
Mapping functional cort/subcort ea add'l hr
|
$1,536.95 |
$1,536.95 |
$1,536.95 |
$705.82
|
|
Map tachycard site(s)
|
$33,021.70 |
$33,021.70 |
$33,021.70 |
$3,960.00
|
|
M.avium-intra dna dir prob
|
$57.20 |
$57.20 |
$57.20 |
$58.25
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$16.50 |
$16.50 |
$16.50 |
$66.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$465.00 |
$465.00 |
$465.00 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$100.00 |
$100.00 |
$100.00 |
$101.44
|
|
Mayo alkaline phosphatase isoenzyme
|
$7.00 |
$7.00 |
$7.00 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$22.00 |
$22.00 |
$22.00 |
$115.92
|
