|
MRI lower extremity other than joint without contrast (both sides)
|
$1,322.53 |
$1,716.39 |
$11,676.27 |
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$1,739.89 |
$2,122.00 |
$9,954.94 |
|
|
MRI orbit fac&nck w IV cont
|
$403.75 |
$2,132.13 |
$3,358.00 |
|
|
MRI tmj
|
$1,215.38 |
$1,276.08 |
$3,339.08 |
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$1,210.35 |
$1,741.74 |
$11,676.27 |
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$1,597.52 |
$2,122.00 |
$14,926.78 |
|
|
MRI upper extremity w/dye
|
$1,905.15 |
$1,905.15 |
$2,742.00 |
|
|
MRI w/cont, breast, bi
|
$1,967.55 |
$1,967.55 |
$4,266.00 |
|
|
MRI w/cont, breast, uni
|
$1,423.11 |
$1,423.11 |
$4,022.00 |
|
|
MRI without fol w/cont, breast
|
$1,793.76 |
$2,034.63 |
$5,676.00 |
|
|
MRI without fol w/cont, brst, un
|
$1,508.13 |
$1,508.13 |
$4,711.00 |
|
|
Mr safety determination physician/other qhp
|
$211.00 |
$211.00 |
$237.57 |
|
|
Mr safety implant elec prepj
|
$220.00 |
$220.00 |
$249.03 |
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$118.00 |
$118.00 |
$132.67 |
|
|
Mr safety implt pos&/immoblj
|
$143.00 |
$143.00 |
$158.21 |
|
|
Mr sfty implt&/fb asmt stf 1
|
$59.00 |
$59.00 |
$66.34 |
|
|
Mr sfty med physics xm cstmz
|
$580.00 |
$580.00 |
$654.62 |
|
|
Mr spectroscopy
|
$1,539.72 |
$1,539.72 |
$13,683.81 |
|
|
Msh2 gene dup/delete variant
|
$981.00 |
$981.00 |
$981.00 |
|
|
Msh2 gene full seq
|
$1,756.00 |
$1,756.00 |
$1,756.00 |
|
|
Msh6 gene dup/delete variant
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
|
|
Msh6 gene full seq
|
$2,953.00 |
$2,953.00 |
$2,953.00 |
|
|
Mthfr gene analy common variants
|
$72.23 |
$296.79 |
$816.75 |
|
|
Mucin synovial fluid
|
$65.52 |
$65.52 |
$65.52 |
|
|
Mucopolysaccharides
|
$299.13 |
$299.13 |
$299.13 |
|
|
Multifocal erg w/i&r
|
$401.00 |
$401.00 |
$401.00 |
|
|
Multiple sleep latency test
|
$1,531.14 |
$3,634.29 |
$9,686.00 |
|
|
Mumps antibody igg
|
$32.86 |
$106.86 |
$812.79 |
|
|
Muscle-skin graft arm
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
|
|
Muscle-skin graft leg
|
$1,096.09 |
$7,906.00 |
$7,906.00 |
|
|
Muscle-skin graft trunk
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
|
|
Muscle test cran nerv unilat
|
$377.52 |
$377.52 |
$3,786.43 |
|
|
Muscle test hemidiaphragm
|
$121.68 |
$121.68 |
$461.00 |
|
|
Muscle test larynx
|
$317.07 |
$317.07 |
$369.00 |
|
|
Muscle test one fiber
|
$273.00 |
$273.00 |
$432.00 |
|
|
Muscle transfers
|
$15,440.00 |
$15,440.00 |
$15,440.00 |
|
|
Muscle transfer shoulder/arm
|
$11,148.00 |
$11,148.00 |
$11,148.00 |
|
|
Musc myoq/fscq flp h&n pedcl
|
$4,331.73 |
$4,331.73 |
$9,435.00 |
|
|
Musc/tdn transfer upr a/e 1
|
$9,372.00 |
$9,372.00 |
$9,372.00 |
|
|
Mycobacteria dna amp probe
|
$67.86 |
$67.86 |
$145.00 |
|
|
Mycophenolate mofetil 250 mg capsule
|
$29.86 |
$46.69 |
$5,799.92 |
|
|
Mycophenolic acid
|
$18.03 |
$18.03 |
$822.50 |
|
|
Mycoplasma antibody igm
|
$27.24 |
$87.36 |
$709.61 |
|
|
Myd88 gene p.leu265pro vrnt
|
$289.77 |
$289.77 |
$3,057.00 |
|
|
Myelogphy 2/> spine regions
|
$672.52 |
$883.35 |
$8,613.34 |
|
|
Myelography l-s spine
|
$1,103.70 |
$1,103.70 |
$8,613.34 |
|
|
Myelography neck spine
|
$1,103.70 |
$1,103.70 |
$8,613.34 |
|
|
Myelography thoracic spine
|
$1,103.70 |
$1,103.70 |
$8,613.34 |
|
|
Myelography via inj w/s&i 2+ regions
|
$796.24 |
$3,997.89 |
$8,613.34 |
|
|
Myelography via inj w/s&i cervical
|
$796.24 |
$3,112.59 |
$3,112.59 |
|
|
Myelography via inj w/s&i lumbosacral
|
$842.12 |
$3,112.59 |
$10,032.17 |
|
|
Myelography via inj w/s&i thoracic
|
$796.24 |
$3,112.59 |
$10,032.17 |
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$58.00 |
$175.50 |
$617.96 |
|
|
Myocrd img pet 1std rst/strs
|
$1,276.36 |
$2,383.68 |
$5,791.00 |
|
|
Myocrd img pet 1 std w/ct
|
$2,135.64 |
$2,135.64 |
$6,427.00 |
|
|
Myocrd img pet 2rtracer
|
$2,967.40 |
$9,210.00 |
$9,210.00 |
|
|
Myocrd img pet 2rtracer CT
|
$2,543.19 |
$2,543.19 |
$8,425.00 |
|
|
Myocrd img pet mlt rst&strs
|
$1,276.36 |
$2,712.06 |
$8,441.00 |
|
|
Myocrd img pet rst&strs CT
|
$2,670.81 |
$9,367.00 |
$9,367.00 |
|
|
Myocrd img pet rst/strs w/ct
|
$1,721.24 |
$6,427.00 |
$6,427.00 |
|
|
Myringoplasty
|
$8,568.00 |
$8,568.00 |
$8,568.00 |
|
|
Nalbuphine 10 mg/ml injection solution
|
$22.99 |
$25.17 |
$167.21 |
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$54.67 |
$440.28 |
$440.28 |
|
|
Naltrexone, depot form
|
$10.70 |
$10.70 |
$4,056.82 |
|
|
Nasal endoscopy dx uni/bi separate proc
|
$228.15 |
$228.15 |
$4,894.00 |
|
|
Nasal endoscopy with removal of nasal foreign body
|
$1,580.49 |
$8,576.00 |
$8,576.00 |
|
|
Nasal/sinus endoscopy surg
|
$6,698.00 |
$6,698.00 |
$6,698.00 |
|
|
Nasal/sinus endoscopy surg
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
|
|
Nasal/sinus endoscopy surg
|
$8,718.00 |
$8,718.00 |
$8,718.00 |
|
|
Nasal/sinus endoscopy surg w/bx 31237
|
$2,340.78 |
$2,340.78 |
$5,849.00 |
|
|
Nasal/sinus endo spendt remove tiss 31288
|
$6,698.00 |
$6,698.00 |
$6,698.00 |
|
|
Nasal/sinus endo surg w/concha bullosa resct 31240
|
$5,849.00 |
$5,849.00 |
$5,849.00 |
|
|
Nasal/sinus endo w/ethmoidectomy part 31254
|
$6,698.00 |
$6,698.00 |
$6,698.00 |
|
|
Nasal/sinus endo w/ethmoidectomy tot 31255
|
$9,445.00 |
$9,445.00 |
$9,445.00 |
|
|
Nasal/sinus endo w/front sinus expl 31276
|
$6,698.00 |
$6,698.00 |
$6,698.00 |
|
|
Nasal/sinus maxillary endoscopy dx 31233
|
$1,118.00 |
$1,118.00 |
$1,118.00 |
|
|
Nasopharyngoscopy w/endoscope
|
$434.00 |
$595.14 |
$595.14 |
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$53.70 |
$53.70 |
$131,287.91 |
|
|
Natriuretic peptide
|
$102.72 |
$207.48 |
$975.68 |
|
|
Natural killer cells total count
|
$48.25 |
$111.54 |
$582.94 |
|
|
Navigational bronchoscopy 31627
|
$283.53 |
$283.53 |
$1,780.44 |
|
|
N block inj common digit
|
$660.66 |
$660.66 |
$8,600.00 |
|
|
N block inj hypogas plxs
|
$2,420.73 |
$2,420.73 |
$8,224.69 |
|
|
Ndl emg musc 1 xtr/non-limb
|
$90.88 |
$163.41 |
$524.00 |
|
|
Ndl insj without njx 1 or 2 musc
|
$60.84 |
$60.84 |
$359.02 |
|
|
Ndl insj without njx 3+ musc
|
$83.00 |
$87.36 |
$359.02 |
|
|
Ndl oculoelectromyography 1+
|
$159.00 |
$159.00 |
$159.00 |
|
|
Ndl round specialty proguide
|
$6.22 |
$89.21 |
$374.00 |
|
|
Nebulizer Breathing Treatment
|
$142.68 |
$379.08 |
$976.18 |
|
|
Neck Airway (Soft Tissue) X-ray
|
$165.17 |
$309.60 |
$1,410.49 |
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$1,658.49 |
$1,728.48 |
$10,186.70 |
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$1,530.03 |
$1,685.58 |
$9,658.20 |
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,157.00 |
$1,598.22 |
$9,596.96 |
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$2,122.00 |
$2,382.51 |
$6,844.57 |
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$1,724.20 |
$1,833.39 |
$6,115.70 |
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$1,500.00 |
$1,760.46 |
$11,676.27 |
|
|
Neck (Cervical Spine) X-ray (2 to 3 views)
|
$101.53 |
$440.00 |
$1,791.99 |
|
|
Neck (Cervical Spine) X-ray (4 to 5 views)
|
$338.33 |
$566.00 |
$2,988.99 |
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$429.80 |
$566.00 |
$2,988.99 |
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$1,554.89 |
$2,122.00 |
$11,676.27 |
|
