|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$6,414.96 |
$6,414.96 |
$6,414.96 |
$6,655.71
|
|
Iron
|
$196.37 |
$196.37 |
$196.37 |
$70.72
|
|
Iron binding capacity
|
$185.97 |
$185.97 |
$185.97 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$159.70 |
$159.70 |
$159.70 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$409.37 |
$409.37 |
$409.37 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$120.07 |
$120.07 |
$120.07 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$169.14 |
$169.14 |
$169.14 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$26,321.37 |
$26,321.37 |
$26,321.37 |
$13,419.80
|
|
Ivc venogram s&i
|
$5,194.59 |
$5,194.59 |
$5,194.59 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$390.48 |
$390.48 |
$390.48 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$390.48 |
$390.48 |
$390.48 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$390.94 |
$390.94 |
$390.94 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,283.89 |
$1,283.89 |
$1,283.89 |
$460.85
|
|
IV inj ra drug dx study
|
$815.61 |
$815.61 |
$815.61 |
$560.00
|
|
Jak2 targeted sequence analysis
|
$500.00 |
$500.00 |
$500.00 |
$378.30
|
|
John cunningham antibody
|
$58.65 |
$58.65 |
$58.65 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$164.99 |
$164.99 |
$164.99 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$108.64 |
$108.64 |
$108.64 |
$30.08
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,515.41 |
$1,515.41 |
$1,515.41 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$6,082.35 |
$6,082.35 |
$6,082.35 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$6,861.30 |
$6,861.30 |
$6,861.30 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$5,713.98 |
$5,713.98 |
$5,713.98 |
$2,181.10
|
|
Knee X-ray
|
$1,403.41 |
$1,403.41 |
$1,403.41 |
$443.90
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$225.34 |
$225.34 |
$225.34 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$191.25 |
$191.25 |
$191.25 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$175.20 |
$175.20 |
$175.20 |
$53.30
|
|
Lactated ringers intravenous solution
|
$232.16 |
$232.16 |
$232.16 |
$54.11
|
|
Lactic acid
|
$132.64 |
$132.64 |
$132.64 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$67.00 |
$67.00 |
$67.00 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$43,082.86 |
$43,082.86 |
$43,082.86 |
$22,903.90
|
|
Laryngeal function studies
|
$312.22 |
$312.22 |
$312.22 |
$335.40
|
|
Lead capillary
|
$16.03 |
$16.03 |
$16.03 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,086.52 |
$2,086.52 |
$2,086.52 |
$1,100.74
|
|
Leishmania antibody
|
$43.56 |
$43.56 |
$43.56 |
$58.50
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$1,067.75 |
$1,067.75 |
$1,067.75 |
$146.32
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$341.95 |
$341.95 |
$341.95 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$66.82 |
$66.82 |
$66.82 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$201.36 |
$201.36 |
$201.36 |
$66.59
|
|
Lidocaine therapeutic drug level
|
$35.92 |
$35.92 |
$35.92 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$311.25 |
$311.25 |
$311.25 |
$177.90
|
|
Lipase
|
$270.36 |
$270.36 |
$270.36 |
$83.20
|
|
Lipoprotein blood quant
|
$59.58 |
$59.58 |
$59.58 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$147.96 |
$147.96 |
$147.96 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$133.64 |
$133.64 |
$133.64 |
$60.00
|
|
Lithium therapeutic drug level
|
$324.14 |
$324.14 |
$324.14 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$13,897.98 |
$13,897.98 |
$13,897.98 |
$4,371.12
|
|
Liver Function Test
|
$512.74 |
$512.74 |
$512.74 |
$110.50
|
|
Locm 100-199mg/ml iodine,1ml
|
$16.54 |
$16.54 |
$16.54 |
$16.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$48.22 |
$48.22 |
$48.22 |
$45.56
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$4,908.94 |
$4,908.94 |
$4,908.94 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$4,713.30 |
$4,713.30 |
$4,713.30 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$4,525.15 |
$4,525.15 |
$4,525.15 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$7,489.37 |
$7,489.37 |
$7,489.37 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$6,997.71 |
$6,997.71 |
$6,997.71 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$6,360.92 |
$6,360.92 |
$6,360.92 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$1,481.16 |
$1,481.16 |
$1,481.16 |
$344.00
|
|
Lung function test (mbc/mvv)
|
$353.20 |
$353.20 |
$353.20 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$451.64 |
$451.64 |
$451.64 |
$298.50
|
|
Lung perfusion imaging
|
$2,652.43 |
$2,652.43 |
$2,652.43 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$3,593.94 |
$3,593.94 |
$3,593.94 |
$1,543.75
|
|
Lymphocyte transformation mitogen
|
$81.52 |
$81.52 |
$81.52 |
$266.20
|
|
Macroscopic exam parasite
|
$114.37 |
$114.37 |
$114.37 |
$38.50
|
|
Magnesium
|
$167.84 |
$167.84 |
$167.84 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$201.36 |
$201.36 |
$201.36 |
$65.49
|
|
Mammosite ced
|
$180.87 |
$180.87 |
$180.87 |
$5,100.00
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$377.08 |
$377.08 |
$377.08 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$415.51 |
$415.51 |
$415.51 |
$178.75
|
|
Mannitol 12.5 gm/50 ml inj
|
$117.10 |
$117.10 |
$117.10 |
$40.12
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$84,762.68 |
$84,762.68 |
$84,762.68 |
$34,164.07
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$126.30 |
$126.30 |
$126.30 |
$7,478.44
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$34.48 |
$34.48 |
$34.48 |
$66.50
|
|
Mayo aathr protein s free
|
$70.93 |
$70.93 |
$70.93 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$70.93 |
$70.93 |
$70.93 |
$98.70
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$368.75 |
$368.75 |
$368.75 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$132.49 |
$132.49 |
$132.49 |
$101.44
|
|
Mayo alcohol definitive assay volatile screen
|
$111.33 |
$111.33 |
$111.33 |
$118.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$29.77 |
$29.77 |
$29.77 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$221.42 |
$221.42 |
$221.42 |
$115.92
|
|
Mayo alpha 1 antitrypsin
|
$63.08 |
$63.08 |
$63.08 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$12.54 |
$12.54 |
$12.54 |
$81.81
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$54.30 |
$54.30 |
$54.30 |
$92.30
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$347.73 |
$347.73 |
$347.73 |
$73.60
|
|
Mayo analysis gene calr common variants exon 9
|
$661.86 |
$661.86 |
$661.86 |
$472.31
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$746.42 |
$746.42 |
$746.42 |
$326.48
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,814.50 |
$2,814.50 |
$2,814.50 |
$1,909.44
|
|
Mayo androstenedione
|
$59.70 |
$59.70 |
$59.70 |
$105.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$27.79 |
$27.79 |
$27.79 |
$72.46
|
|
Mayo antithrombin iii antigen
|
$81.05 |
$81.05 |
$81.05 |
$68.90
|
|
Mayo aspergillus fumigatus antibody
|
$52.27 |
$52.27 |
$52.27 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$180.90 |
$180.90 |
$180.90 |
$157.95
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$96.73 |
$96.73 |
$96.73 |
$105.00
|
|
Mayo barbiturates definitive assay confirmation urine
|
$54.30 |
$54.30 |
$54.30 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$35.35 |
$35.35 |
$35.35 |
$45.75
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$503.01 |
$503.01 |
$503.01 |
$353.60
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$601.03 |
$601.03 |
$601.03 |
$373.75
|
|
Mayo blastomyces antibody immunodiffusion
|
$22.31 |
$22.31 |
$22.31 |
$57.85
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$917.71 |
$917.71 |
$917.71 |
$66.00
|
|
Mayo brcmg brucella antibody igm
|
$14.23 |
$14.23 |
$14.23 |
$48.57
|
|
Mayo c1 esterase inhibitor
|
$54.12 |
$54.12 |
$54.12 |
$88.35
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$148.25 |
$148.25 |
$148.25 |
$96.85
|
