|
Monovisc inj per dose
|
$4,730.97 |
$4,730.97 |
$5,258.02 |
$1,741.47
|
|
Mopath procedure level 1
|
$102.02 |
$102.02 |
$987.22 |
$234.65
|
|
Mopath procedure level 3
|
$2,320.34 |
$2,320.34 |
$2,320.34 |
$341.30
|
|
Mopath procedure level 5
|
$961.91 |
$975.00 |
$4,242.00 |
$886.05
|
|
Mopath procedure level 6
|
$1,054.73 |
$1,363.59 |
$4,651.34 |
$976.30
|
|
Mopath procedure level 7
|
$975.00 |
$990.08 |
$4,366.26 |
$1,268.80
|
|
Mopath procedure level 8
|
$2,961.95 |
$2,961.95 |
$13,062.18 |
$1,345.48
|
|
Mopath procedure level 9
|
$2,290.00 |
$7,000.00 |
$30,870.00 |
$2,200.00
|
|
Morphine 4 mg/ml injection (wrapper)
|
$727.79 |
$727.79 |
$842.29 |
$72.78
|
|
Morphine 4 mg/ml injection (wrapper)|discarded drug not administered
|
$20.58 |
$88.09 |
$94.90 |
$38.54
|
|
Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain
|
$1,666.44 |
$1,666.44 |
$1,666.44 |
$402.00
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted
|
$1,517.98 |
$3,289.10 |
$3,289.10 |
$328.79
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual
|
$122.08 |
$134.00 |
$1,666.44 |
$309.50
|
|
Motion analysis video/3d
|
$5,546.51 |
$5,546.51 |
$5,546.51 |
$587.81
|
|
M/phmtrc alys ishquant/semiq
|
$377.64 |
$377.64 |
$377.64 |
$232.26
|
|
M/phmtrc alys ishquant/semiq
|
$820.69 |
$1,666.44 |
$1,676.10 |
$574.00
|
|
M/phmtrc alysishquant/semiq
|
$820.69 |
$1,692.16 |
$1,776.73 |
$331.55
|
|
M/phmtrc alys skeletal musc
|
$185.30 |
$185.30 |
$882.61 |
$274.49
|
|
Mpl gene analysis common variants
|
$552.47 |
$552.47 |
$552.47 |
$444.00
|
|
MRA abdomen post contrast
|
$1,280.88 |
$1,280.88 |
$3,442.01 |
$2,144.35
|
|
MRA aorta thoracic w/wo contrast
|
$2,028.39 |
$2,028.39 |
$2,028.39 |
$2,295.00
|
|
MRA chest w IV cont
|
$17,251.49 |
$17,251.49 |
$17,251.49 |
$1,421.28
|
|
MRA chest wo IV cont
|
$9,948.57 |
$9,948.57 |
$9,948.57 |
$1,337.22
|
|
MRA chest wwo IV cont
|
$4,876.45 |
$4,876.45 |
$6,507.93 |
$2,288.40
|
|
MRA ext low(run-off)pst cntrst
|
$2,564.48 |
$2,564.48 |
$2,564.48 |
$2,539.68
|
|
MRA pelvis
|
$1,652.13 |
$1,652.13 |
$3,639.57 |
$2,229.00
|
|
MRA pelvis w IV cont
|
$7,957.87 |
$7,957.87 |
$9,948.57 |
$1,211.35
|
|
MRA pelvis wo IV cont
|
$7,957.87 |
$7,957.87 |
$9,948.57 |
$1,056.43
|
|
MRA spinal canal
|
$3,317.61 |
$3,317.61 |
$3,471.61 |
$1,803.94
|
|
MRA upper extremity post contrast-bil
|
$2,564.48 |
$2,564.48 |
$3,528.12 |
$1,943.87
|
|
MRA w/cont, abd
|
$7,577.33 |
$7,577.33 |
$9,474.19 |
$1,670.76
|
|
MRA without cont, abd
|
$7,074.27 |
$7,074.27 |
$12,018.93 |
$1,651.00
|
|
MRA without cont, lwr ext
|
$7,597.90 |
$7,597.90 |
$7,597.90 |
$1,406.72
|
|
MRA without fol w/cont, abd
|
$5,858.59 |
$5,858.59 |
$10,929.51 |
$2,547.05
|
|
MRA without fol w/cont, lwr ext
|
$3,301.19 |
$3,301.19 |
$5,139.33 |
$1,965.82
|
|
MRA without fol w/cont, pelvis
|
$2,948.22 |
$2,948.22 |
$9,948.57 |
$1,795.30
|
|
Mra, w/o&w/dye, upper extr
|
$3,582.22 |
$3,582.22 |
$3,582.22 |
$1,087.71
|
|
Mr elastography
|
$785.61 |
$785.61 |
$812.98 |
$684.06
|
|
Mrgfus strtctc ablt trgt icr
|
$67,815.16 |
$67,815.16 |
$67,815.16 |
$14,756.87
|
|
MRI breast c- unilateral
|
$1,928.17 |
$1,928.17 |
$2,833.35 |
$1,097.50
|
|
MRI breast c-+ w/cad uni
|
$3,289.93 |
$3,289.93 |
$3,289.93 |
$1,829.72
|
|
MRI breast without cont bi
|
$5,222.75 |
$5,222.75 |
$10,544.45 |
$1,778.00
|
|
MRI breast w IV cont bi
|
$6,805.05 |
$6,805.05 |
$6,805.05 |
$1,876.12
|
|
MRI cardiac morph & func wo IV cont
|
$3,602.24 |
$4,452.58 |
$13,400.90 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$3,602.24 |
$3,707.24 |
$16,580.63 |
$1,946.48
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$7,308.76 |
$7,308.76 |
$13,400.90 |
$2,249.80
|
|
MRI chest without contrast
|
$2,833.35 |
$2,833.35 |
$10,642.54 |
$1,810.38
|
|
MRI chest without & w/contrast
|
$7,513.52 |
$7,513.52 |
$10,929.51 |
$2,564.10
|
|
MRI chest w IV cont
|
$3,171.89 |
$7,308.76 |
$10,134.50 |
$2,105.25
|
|
MRI fetal ea addl gestation
|
$1,003.09 |
$1,003.09 |
$1,003.09 |
$576.10
|
|
MRI fetal sngl/1st gestation
|
$1,662.85 |
$1,662.85 |
$2,833.35 |
$1,136.26
|
|
MRI guid ndl plc s&i
|
$743.77 |
$2,550.52 |
$4,381.89 |
$1,133.22
|
|
MRI loex nonjt w IV cont
|
$6,164.45 |
$6,164.45 |
$6,164.45 |
$2,035.00
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$5,685.15 |
$5,685.15 |
$5,849.33 |
$2,096.84
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$6,387.80 |
$6,387.80 |
$6,387.80 |
$2,713.80
|
|
MRI orbit/face/neck without contrast
|
$4,946.43 |
$4,946.43 |
$10,134.50 |
$1,813.00
|
|
MRI orbit/face/neck without & w/contrast
|
$7,877.64 |
$7,877.64 |
$10,929.51 |
$2,674.83
|
|
MRI orbit fac&nck w IV cont
|
$5,940.95 |
$5,940.95 |
$10,642.54 |
$2,120.25
|
|
MRI tmj
|
$2,232.73 |
$2,586.58 |
$10,642.54 |
$1,818.25
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$4,753.13 |
$4,753.13 |
$4,753.13 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$7,515.42 |
$7,515.42 |
$7,515.42 |
$2,655.25
|
|
MRI upper extremity w/dye
|
$5,673.90 |
$5,673.90 |
$5,673.90 |
$1,968.59
|
|
MRI w/cont, breast, bi
|
$6,579.47 |
$6,579.47 |
$14,461.92 |
$1,967.55
|
|
MRI w/cont, breast, uni
|
$5,303.53 |
$5,303.53 |
$5,303.53 |
$1,294.80
|
|
MRI without fol w/cont, breast
|
$21,141.60 |
$21,141.60 |
$21,141.60 |
$2,056.69
|
|
Mr safety determination physician/other qhp
|
$295.04 |
$295.04 |
$295.04 |
$160.20
|
|
Mr safety implant elec prepj
|
$309.28 |
$309.28 |
$309.28 |
$168.60
|
|
Mr safety implt pos&/immoblj
|
$196.49 |
$196.49 |
$196.49 |
$137.25
|
|
Mr sfty implt&/fb asmt stf 1
|
$82.38 |
$82.38 |
$82.38 |
$45.00
|
|
Mr sfty med physics xm cstmz
|
$812.98 |
$812.98 |
$812.98 |
$402.40
|
|
Mr spectroscopy
|
$6,477.52 |
$6,477.52 |
$6,477.52 |
$1,322.36
|
|
Msh2 gene dup/delete variant
|
$746.55 |
$746.55 |
$746.55 |
$388.30
|
|
Msh2 gene full seq
|
$1,335.95 |
$1,335.95 |
$1,335.95 |
$504.56
|
|
Msh6 gene dup/delete variant
|
$833.00 |
$833.00 |
$833.00 |
$476.00
|
|
Msh6 gene full seq
|
$2,246.48 |
$2,246.48 |
$2,246.48 |
$773.00
|
|
Mthfr gene analy common variants
|
$62.15 |
$67.00 |
$1,008.53 |
$211.70
|
|
Mucopolysaccharides
|
$439.90 |
$439.90 |
$439.90 |
$205.15
|
|
Multi family grp psychotherapy
|
$588.50 |
$588.50 |
$1,649.95 |
$213.27
|
|
Multiple sleep latency test
|
$5,546.51 |
$5,546.51 |
$5,546.51 |
$2,585.70
|
|
Mumps antibody igg
|
$219.70 |
$219.70 |
$219.70 |
$78.00
|
|
Muscle test cran nerv unilat
|
$990.86 |
$990.86 |
$1,036.17 |
$385.07
|
|
Muscle test larynx
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$305.00
|
|
Mycobacteria dna amp probe
|
$744.59 |
$744.59 |
$744.59 |
$240.24
|
|
Mycophenolate mofetil 250 mg capsule
|
$59.69 |
$236.55 |
$271.17 |
$12.06
|
|
Mycophenolic acid
|
$66.62 |
$66.62 |
$66.62 |
$12.84
|
|
Mycoplasma antibody igm
|
$65.70 |
$65.70 |
$204.36 |
$79.20
|
|
Myd88 gene p.leu265pro vrnt
|
$2,707.30 |
$2,707.30 |
$2,707.30 |
$397.50
|
|
Myelogphy 2/> spine regions
|
$3,442.91 |
$3,442.91 |
$23,694.99 |
$1,366.30
|
|
Myelography l-s spine
|
$4,974.35 |
$4,974.35 |
$18,134.35 |
$1,334.09
|
|
Myelography neck spine
|
$4,806.90 |
$4,806.90 |
$5,835.91 |
$1,103.70
|
|
Myelography thoracic spine
|
$3,261.15 |
$3,261.15 |
$7,862.22 |
$1,085.32
|
|
Myelography via inj w/s&i 2+ regions
|
$3,536.57 |
$3,536.57 |
$3,536.57 |
$2,352.78
|
|
Myelography via inj w/s&i cervical
|
$3,147.12 |
$3,147.12 |
$3,147.12 |
$1,910.79
|
|
Myelography via inj w/s&i lumbosacral
|
$3,072.54 |
$3,072.54 |
$3,072.54 |
$2,006.40
|
|
Myelography via inj w/s&i thoracic
|
$3,039.02 |
$3,039.02 |
$3,039.02 |
$1,931.60
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$177.96 |
$177.96 |
$186.00 |
$134.40
|
|
Myocrd img pet 1std rst/strs
|
$14,593.75 |
$14,593.75 |
$14,593.75 |
$3,267.37
|
|
Myocrd img pet mlt rst&strs
|
$14,593.75 |
$14,593.75 |
$14,593.75 |
$3,055.50
|
|
Nalbuphine 10 mg/ml injection solution
|
$80.50 |
$90.42 |
$97.45 |
$43.66
|
|
Nasal endoscopy dx uni/bi separate proc
|
$2,034.51 |
$2,034.51 |
$2,034.51 |
$372.00
|
