|
MRA pelvis
|
$5,630.30 |
$5,630.30 |
$5,630.30 |
$2,304.70
|
|
MRA spinal canal
|
$2,960.75 |
$2,960.75 |
$2,960.75 |
$1,988.00
|
|
MRA upper extremity post contrast-bil
|
$3,933.80 |
$3,933.80 |
$3,933.80 |
$2,482.20
|
|
MRA without fol w/cont, pelvis
|
$5,630.30 |
$5,630.30 |
$5,630.30 |
$2,206.29
|
|
Mr elastography
|
$314.60 |
$314.60 |
$314.60 |
$891.60
|
|
Mrgfus strtctc ablt trgt icr
|
$5,720.65 |
$5,720.65 |
$5,720.65 |
$22,209.60
|
|
MRI breast c- unilateral
|
$414.70 |
$414.70 |
$414.70 |
$1,170.40
|
|
MRI breast c-+ w/cad uni
|
$4,038.45 |
$4,038.45 |
$4,038.45 |
$1,880.00
|
|
MRI breast without cont bi
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,825.38
|
|
MRI breast w IV cont bi
|
$5,460.00 |
$5,460.00 |
$5,460.00 |
$1,876.12
|
|
MRI cardiac morph & func wo IV cont
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$1,946.48
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$2,499.60
|
|
MRI chest without contrast
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,652.73
|
|
MRI chest w IV cont
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$2,252.39
|
|
MRI fetal ea addl gestation
|
$481.00 |
$481.00 |
$481.00 |
$577.07
|
|
MRI fetal sngl/1st gestation
|
$780.00 |
$780.00 |
$780.00 |
$1,108.00
|
|
MRI guid ndl plc s&i
|
$1,667.90 |
$1,667.90 |
$1,667.90 |
$1,334.45
|
|
MRI guid parenchymal tiss ablation
|
$1,327.95 |
$1,327.95 |
$1,327.95 |
$1,924.00
|
|
MRI loex nonjt w IV cont
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,116.20
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,770.95
|
|
MRI orbit fac&nck w IV cont
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,204.98
|
|
MRI tmj
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,741.07
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$1,355.25 |
$1,355.25 |
$1,355.25 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,669.70
|
|
MRI upper extremity w/dye
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,076.72
|
|
Mr safety determination physician/other qhp
|
$665.60 |
$665.60 |
$665.60 |
$161.40
|
|
Mr safety implant elec prepj
|
$728.65 |
$728.65 |
$728.65 |
$173.40
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$744.25 |
$744.25 |
$744.25 |
$55.00
|
|
Mr safety implt pos&/immoblj
|
$505.05 |
$505.05 |
$505.05 |
$125.00
|
|
Mr sfty implt&/fb asmt stf 1
|
$236.60 |
$236.60 |
$236.60 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$1,572.35 |
$1,572.35 |
$1,572.35 |
$444.00
|
|
Mr spectroscopy
|
$304.20 |
$304.20 |
$304.20 |
$1,340.00
|
|
Mthfr gene analy common variants
|
$88.40 |
$88.40 |
$88.40 |
$184.00
|
|
Mucopolysaccharides
|
$55.90 |
$55.90 |
$55.90 |
$178.36
|
|
Multi family grp psychotherapy
|
$391.95 |
$391.95 |
$391.95 |
$250.25
|
|
Multiple sleep latency test
|
$2,974.40 |
$2,974.40 |
$2,974.40 |
$2,466.00
|
|
Mumps antibody igg
|
$49.40 |
$49.40 |
$49.40 |
$78.00
|
|
Muscle-skin graft arm
|
$4,430.40 |
$4,430.40 |
$4,430.40 |
$3,014.40
|
|
Muscle-skin graft leg
|
$5,445.70 |
$5,445.70 |
$5,445.70 |
$4,633.78
|
|
Muscle-skin graft trunk
|
$5,980.00 |
$5,980.00 |
$5,980.00 |
$4,332.25
|
|
Muscle test cran nerv unilat
|
$1,745.90 |
$1,745.90 |
$1,745.90 |
$385.07
|
|
Muscle test hemidiaphragm
|
$325.00 |
$325.00 |
$325.00 |
$296.40
|
|
Muscle test larynx
|
$722.15 |
$722.15 |
$722.15 |
$296.80
|
|
Muscle test one fiber
|
$748.80 |
$748.80 |
$748.80 |
$432.00
|
|
Musc myoq/fscq flp h&n pedcl
|
$4,076.80 |
$4,076.80 |
$4,076.80 |
$4,331.73
|
|
Mycophenolate mofetil 250 mg capsule
|
$28.07 |
$28.07 |
$28.07 |
$10.79
|
|
Mycophenolic acid
|
$23.27 |
$23.27 |
$23.27 |
$12.84
|
|
Mycoplasma antibody igm
|
$75.40 |
$75.40 |
$75.40 |
$77.35
|
|
Myd88 gene p.leu265pro vrnt
|
$654.55 |
$654.55 |
$654.55 |
$416.00
|
|
Myelogphy 2/> spine regions
|
$4,774.90 |
$4,774.90 |
$4,774.90 |
$1,494.22
|
|
Myelography l-s spine
|
$4,644.90 |
$4,644.90 |
$4,644.90 |
$1,334.09
|
|
Myelography neck spine
|
$4,665.70 |
$4,665.70 |
$4,665.70 |
$1,241.50
|
|
Myelography thoracic spine
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,255.00
|
|
Myelography via inj w/s&i 2+ regions
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$2,267.34
|
|
Myelography via inj w/s&i cervical
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,775.40
|
|
Myelography via inj w/s&i lumbosacral
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,850.00
|
|
Myelography via inj w/s&i thoracic
|
$4,429.10 |
$4,429.10 |
$4,429.10 |
$1,745.94
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$605.80 |
$605.80 |
$605.80 |
$130.41
|
|
Myocrd img pet 1std rst/strs
|
$8,177.00 |
$8,177.00 |
$8,177.00 |
$3,627.73
|
|
Myocrd img pet 1 std w/ct
|
$457.60 |
$457.60 |
$457.60 |
$3,314.15
|
|
Myocrd img pet 2rtracer
|
$538.20 |
$538.20 |
$538.20 |
$4,835.00
|
|
Myocrd img pet 2rtracer CT
|
$10,799.75 |
$10,799.75 |
$10,799.75 |
$5,083.90
|
|
Myocrd img pet mlt rst&strs
|
$468.00 |
$468.00 |
$468.00 |
$4,060.00
|
|
Myocrd img pet rst&strs CT
|
$12,295.40 |
$12,295.40 |
$12,295.40 |
$4,846.40
|
|
Myocrd img pet rst/strs w/ct
|
$434.20 |
$434.20 |
$434.20 |
$3,311.85
|
|
Myomectomy abdom complex
|
$5,288.40 |
$5,288.40 |
$5,288.40 |
$1,893.60
|
|
Myomectomy abdom method
|
$4,105.40 |
$4,105.40 |
$4,105.40 |
$2,064.48
|
|
Nafcillin 2 gram solution for injection
|
$67.61 |
$67.61 |
$67.61 |
$84.00
|
|
Nalbuphine 10 mg/ml injection solution
|
$26.17 |
$26.17 |
$26.17 |
$37.81
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$156.78 |
$156.78 |
$156.78 |
$70.87
|
|
Naltrexone, depot form
|
$3,955.40 |
$3,955.40 |
$3,955.40 |
$3,249.40
|
|
Narcosynthesis
|
$812.50 |
$812.50 |
$812.50 |
$378.40
|
|
Nasal endoscopy dx uni/bi separate proc
|
$725.40 |
$725.40 |
$725.40 |
$351.52
|
|
Nasal endoscopy with removal of nasal foreign body
|
$2,651.35 |
$2,651.35 |
$2,651.35 |
$406.00
|
|
Nasal function studies
|
$143.00 |
$143.00 |
$143.00 |
$348.00
|
|
Nasal/sinus endoscopy surg
|
$1,001.00 |
$1,001.00 |
$1,001.00 |
$4,881.00
|
|
Nasal/sinus endoscopy surg
|
$4,838.60 |
$4,838.60 |
$4,838.60 |
$5,662.40
|
|
Nasal/sinus endoscopy surg w/bx 31237
|
$6,445.40 |
$6,445.40 |
$6,445.40 |
$2,831.51
|
|
Nasal/sinus endo surg w/concha bullosa resct 31240
|
$746.20 |
$746.20 |
$746.20 |
$2,040.67
|
|
Nasal/sinus endo w/front sinus expl 31276
|
$1,930.50 |
$1,930.50 |
$1,930.50 |
$6,698.00
|
|
Nasal/sinus maxillary endoscopy dx 31233
|
$1,451.45 |
$1,451.45 |
$1,451.45 |
$973.39
|
|
Nasal/sinus sphenoid endoscopy dx 31235
|
$755.30 |
$755.30 |
$755.30 |
$2,232.24
|
|
Nasopharyngoscopy w/endoscope
|
$631.15 |
$631.15 |
$631.15 |
$293.58
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$1,385.16 |
$1,385.16 |
$1,385.16 |
$16,254.52
|
|
Natriuretic peptide
|
$139.75 |
$139.75 |
$139.75 |
$176.15
|
|
Natural killer cells total count
|
$161.85 |
$161.85 |
$161.85 |
$135.00
|
|
Navigational bronchoscopy 31627
|
$1,319.50 |
$1,319.50 |
$1,319.50 |
$1,751.25
|
|
N block inj common digit
|
$351.65 |
$351.65 |
$351.65 |
$540.80
|
|
N block inj hypogas plxs
|
$4,991.35 |
$4,991.35 |
$4,991.35 |
$1,912.00
|
|
Ndl emg musc 1 xtr/non-limb
|
$722.15 |
$722.15 |
$722.15 |
$225.25
|
|
Ndl insj without njx 1 or 2 musc
|
$91.65 |
$91.65 |
$91.65 |
$39.77
|
|
Ndl insj without njx 3+ musc
|
$91.65 |
$91.65 |
$91.65 |
$45.00
|
|
Ndsc hrv uxtr art 1 sgm cab
|
$868.40 |
$868.40 |
$868.40 |
$426.40
|
|
Nebulizer Breathing Treatment
|
$2,357.55 |
$2,357.55 |
$2,357.55 |
$203.49
|
|
Neck Airway (Soft Tissue) X-ray
|
$494.00 |
$494.00 |
$494.00 |
$237.76
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$997.75 |
$997.75 |
$997.75 |
$2,032.54
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$1,719.75
|
