|
Inj levocarnitine per 1 gm
|
$394.00 |
$394.00 |
$394.00 |
$139.67
|
|
Inj melpha hydroch nos 50 mg
|
$21,359.00 |
$21,359.00 |
$21,359.00 |
$1,627.50
|
|
Inj mepivacaine hcl/10 ml
|
$12.25 |
$12.25 |
$12.25 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$2,118.00 |
$2,118.00 |
$2,118.00 |
$618.43
|
|
Inj, moxifloxacin 100 mg
|
$129.00 |
$129.00 |
$129.00 |
$190.81
|
|
Inj progesterone per 50 mg
|
$297.00 |
$297.00 |
$297.00 |
$48.51
|
|
Inj secretin synthetic human
|
$3,959.25 |
$3,959.25 |
$3,959.25 |
$610.89
|
|
Insitu hybridization auto
|
$1,652.75 |
$1,652.75 |
$1,652.75 |
$393.13
|
|
Insitu hybridization (fish)
|
$944.25 |
$944.25 |
$944.25 |
$481.60
|
|
In situ hybridization per specimen initial single probe stain
|
$889.50 |
$889.50 |
$889.50 |
$341.60
|
|
Insulin total
|
$624.75 |
$624.75 |
$624.75 |
$67.50
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$30,213.00 |
$30,213.00 |
$30,213.00 |
$9,970.16
|
|
Intracranial limited study
|
$2,044.75 |
$2,044.75 |
$2,044.75 |
$423.52
|
|
Intrinsic factor antibody
|
$664.00 |
$664.00 |
$664.00 |
$59.95
|
|
Iodine i-125 sodium iodide
|
$197.00 |
$197.00 |
$197.00 |
$246.83
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$1,743.00 |
$1,743.00 |
$1,743.00 |
$227.39
|
|
Iron
|
$632.75 |
$632.75 |
$632.75 |
$71.50
|
|
Iron binding capacity
|
$869.75 |
$869.75 |
$869.75 |
$61.92
|
|
Irradiation of blood product each unit reference
|
$174.00 |
$174.00 |
$174.00 |
$124.24
|
|
Ivc venogram s&i
|
$9,437.00 |
$9,437.00 |
$9,437.00 |
$3,316.95
|
|
Ivp w/nephrotomography
|
$9,449.50 |
$9,449.50 |
$9,449.50 |
$769.86
|
|
Ivp w/wo kub w/wo tomography
|
$5,071.50 |
$5,071.50 |
$5,071.50 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$1,581.00 |
$1,581.00 |
$1,581.00 |
$54.16
|
|
Kidney img w/bldflw sgl without rx
|
$8,734.50 |
$8,734.50 |
$8,734.50 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$3,164.00 |
$3,164.00 |
$3,164.00 |
$668.25
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$6.75 |
$6.75 |
$6.75 |
$42.38
|
|
Lactated ringers intravenous solution
|
$341.00 |
$341.00 |
$341.00 |
$51.80
|
|
Lactoferrin fecal qualitative
|
$8.25 |
$8.25 |
$8.25 |
$85.83
|
|
Lactoferrin fecal quant
|
$159.75 |
$159.75 |
$159.75 |
$106.10
|
|
Lead capillary
|
$186.25 |
$186.25 |
$186.25 |
$61.75
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$4,406.50 |
$4,406.50 |
$4,406.50 |
$1,092.58
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$6,972.00 |
$6,972.00 |
$6,972.00 |
$4,876.80
|
|
Levalbuterol non-comp unit
|
$10.60 |
$10.60 |
$10.60 |
$13.29
|
|
Levetiracetam therapeutic drug level
|
$211.50 |
$211.50 |
$211.50 |
$72.00
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$232.50 |
$232.50 |
$232.50 |
$316.69
|
|
Lidocaine therapeutic drug level
|
$245.75 |
$245.75 |
$245.75 |
$85.15
|
|
Lipase
|
$1,796.50 |
$1,796.50 |
$1,796.50 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$374.00 |
$374.00 |
$374.00 |
$89.52
|
|
Lipoprotein direct measurement hdl
|
$655.50 |
$655.50 |
$655.50 |
$55.00
|
|
Lithium therapeutic drug level
|
$1,069.75 |
$1,069.75 |
$1,069.75 |
$67.60
|
|
Liver Function Test
|
$3,543.25 |
$3,543.25 |
$3,543.25 |
$111.13
|
|
Liver imaging
|
$8,623.00 |
$8,623.00 |
$8,623.00 |
$1,234.59
|
|
Liver/spleen imag static only
|
$4,203.50 |
$4,203.50 |
$4,203.50 |
$1,140.78
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$21,362.25 |
$21,362.25 |
$21,362.25 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$16,292.50 |
$16,292.50 |
$16,292.50 |
$1,848.60
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$19,707.75 |
$19,707.75 |
$19,707.75 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$20,130.50 |
$20,130.50 |
$20,130.50 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$18,069.25 |
$18,069.25 |
$18,069.25 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$18,069.25 |
$18,069.25 |
$18,069.25 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$2,176.75 |
$2,176.75 |
$2,176.75 |
$342.00
|
|
Lung Function Test (Spirometry)
|
$380.25 |
$380.25 |
$380.25 |
$298.50
|
|
Lung perfusion imaging
|
$6,324.00 |
$6,324.00 |
$6,324.00 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$3,766.00 |
$3,766.00 |
$3,766.00 |
$1,526.38
|
|
Lymph vessel x-ray arm/leg
|
$6,867.00 |
$6,867.00 |
$6,867.00 |
$862.57
|
|
Macroscopic exam parasite
|
$33.00 |
$33.00 |
$33.00 |
$38.50
|
|
Magnetic image bone marrow
|
$14,502.50 |
$14,502.50 |
$14,502.50 |
$970.85
|
|
Malaria antibody
|
$600.75 |
$600.75 |
$600.75 |
$38.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$343.25 |
$343.25 |
$343.25 |
$142.80
|
|
Manipulation chest wall initial demonstration/evaluation
|
$614.50 |
$614.50 |
$614.50 |
$178.75
|
|
Mannitol 12.5 gm/50 ml inj
|
$46.00 |
$46.00 |
$46.00 |
$40.12
|
|
Mastoids complete
|
$2,585.75 |
$2,585.75 |
$2,585.75 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$740.00 |
$740.00 |
$740.00 |
$66.50
|
|
Mayo activated protein c resistance assay
|
$1,123.00 |
$1,123.00 |
$1,123.00 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$364.25 |
$364.25 |
$364.25 |
$176.00
|
|
Mayo alpha 1 antitrypsin
|
$358.25 |
$358.25 |
$358.25 |
$85.80
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$703.50 |
$703.50 |
$703.50 |
$318.72
|
|
Mayo androstenedione
|
$764.25 |
$764.25 |
$764.25 |
$103.88
|
|
Mayo aspergillus fumigatus antibody
|
$288.00 |
$288.00 |
$288.00 |
$66.75
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$277.00 |
$277.00 |
$277.00 |
$353.60
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$640.00 |
$640.00 |
$640.00 |
$83.97
|
|
Mayo ceruloplasmin
|
$288.00 |
$288.00 |
$288.00 |
$64.07
|
|
Mayo chemiluminescent parathyroid related peptide
|
$571.00 |
$571.00 |
$571.00 |
$124.00
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$97.75 |
$97.75 |
$97.75 |
$50.88
|
|
Mayo chromium
|
$186.25 |
$186.25 |
$186.25 |
$70.85
|
|
Mayo coccidioides antibody
|
$288.00 |
$288.00 |
$288.00 |
$58.37
|
|
Mayo covid-19 antibody nucleocapsid total
|
$46.00 |
$46.00 |
$46.00 |
$72.52
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$632.75 |
$632.75 |
$632.75 |
$61.02
|
|
Mayo cyanide
|
$916.00 |
$916.00 |
$916.00 |
$87.10
|
|
Mayo dhea (dehydroepiandrosterone)
|
$514.50 |
$514.50 |
$514.50 |
$88.45
|
|
Mayo efpo chloride stool
|
$198.00 |
$198.00 |
$198.00 |
$42.90
|
|
Mayo estrone
|
$492.25 |
$492.25 |
$492.25 |
$81.62
|
|
Mayo ethosuximide therapeutic drug level
|
$683.50 |
$683.50 |
$683.50 |
$69.55
|
|
Mayo factor ii
|
$558.25 |
$558.25 |
$558.25 |
$94.90
|
|
Mayo factor v
|
$418.75 |
$418.75 |
$418.75 |
$127.80
|
|
Mayo factor vii
|
$471.00 |
$471.00 |
$471.00 |
$141.70
|
|
Mayo factor viii vw factor antigen
|
$558.25 |
$558.25 |
$558.25 |
$110.40
|
|
Mayo factor x
|
$567.00 |
$567.00 |
$567.00 |
$139.50
|
|
Mayo factor xi
|
$558.25 |
$558.25 |
$558.25 |
$117.50
|
|
Mayo fbl culture fungi blood
|
$1,161.25 |
$1,161.25 |
$1,161.25 |
$99.81
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$772.50 |
$772.50 |
$772.50 |
$70.39
|
|
Mayo gamma-globin full gene sequencing
|
$399.00 |
$399.00 |
$399.00 |
$1,460.30
|
|
Mayo hemosiderin qualitative urine
|
$285.25 |
$285.25 |
$285.25 |
$33.57
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$803.75 |
$803.75 |
$803.75 |
$165.00
|
|
Mayo hla typing a/b/c single antigen
|
$541.50 |
$541.50 |
$541.50 |
$118.33
|
|
Mayo hvdip HIV 1 antibody
|
$1,404.75 |
$1,404.75 |
$1,404.75 |
$67.60
|
|
Mayo hydroxyprogesterone 17-d
|
$495.25 |
$495.25 |
$495.25 |
$91.65
|
|
Mayo infectious agent nucleic acid amplified probe enterovirus
|
$3,768.25 |
$3,768.25 |
$3,768.25 |
$170.95
|
|
Mayo insulin antibodies
|
$1,177.75 |
$1,177.75 |
$1,177.75 |
$90.35
|
|
Mayo iodine
|
$159.75 |
$159.75 |
$159.75 |
$115.05
|
|
Mayo lamotrigine therapeutic drug level
|
$2,300.50 |
$2,300.50 |
$2,300.50 |
$69.75
|
