|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,594.88 |
$2,594.88 |
$2,594.88 |
$2,414.10
|
|
Insitu hybridization auto
|
$453.60 |
$453.60 |
$453.60 |
$371.00
|
|
In situ hybridization per specimen each additional single probe stain
|
$332.64 |
$332.64 |
$332.64 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$634.32 |
$634.32 |
$634.32 |
$326.04
|
|
Insulin total
|
$76.32 |
$76.32 |
$76.32 |
$66.64
|
|
Intens cardiac rehab no exer
|
$260.64 |
$260.64 |
$260.64 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$260.64 |
$260.64 |
$260.64 |
$238.40
|
|
Intrinsic factor antibody
|
$84.96 |
$84.96 |
$84.96 |
$66.60
|
|
Intubation endotracheal emergency procedure
|
$619.92 |
$619.92 |
$619.92 |
$589.60
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1.97 |
$1.97 |
$1.97 |
$279.10
|
|
Iron
|
$92.16 |
$92.16 |
$92.16 |
$74.40
|
|
Iron binding capacity
|
$110.88 |
$110.88 |
$110.88 |
$63.79
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$2.25 |
$2.25 |
$2.25 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$86.40 |
$86.40 |
$86.40 |
$119.83
|
|
Irrigation implantable venous access device for drug delivery systems
|
$110.16 |
$110.16 |
$110.16 |
$142.20
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$137.52 |
$137.52 |
$137.52 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$119.52 |
$119.52 |
$119.52 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$100.08 |
$100.08 |
$100.08 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$596.88 |
$596.88 |
$596.88 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$1,164.24 |
$1,164.24 |
$1,164.24 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$475.20 |
$475.20 |
$475.20 |
$379.87
|
|
John cunningham antibody
|
$2,387.52 |
$2,387.52 |
$2,387.52 |
$72.60
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$84.24 |
$84.24 |
$84.24 |
$60.20
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$12.96 |
$12.96 |
$12.96 |
$23.50
|
|
Kidney imag w/bld flow multi
|
$1,290.24 |
$1,290.24 |
$1,290.24 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,015.92 |
$1,015.92 |
$1,015.92 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$978.48 |
$978.48 |
$978.48 |
$666.00
|
|
Knee MRI (with and without contrast)
|
$4,085.28 |
$4,085.28 |
$4,085.28 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$3,488.40 |
$3,488.40 |
$3,488.40 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,375.36 |
$3,375.36 |
$3,375.36 |
$2,169.60
|
|
Knee X-ray
|
$567.36 |
$567.36 |
$567.36 |
$425.55
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$3.24 |
$3.24 |
$3.24 |
$32.34
|
|
Lactate dehydrogenase (ldh)
|
$89.28 |
$89.28 |
$89.28 |
$55.50
|
|
Lactated ringers intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$45.56
|
|
Lactic acid
|
$146.16 |
$146.16 |
$146.16 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$100.08 |
$100.08 |
$100.08 |
$80.40
|
|
Lactoferrin fecal quant
|
$211.68 |
$211.68 |
$211.68 |
$106.10
|
|
Largsc w/rmvl foreign bdy(s)
|
$776.88 |
$776.88 |
$776.88 |
$765.97
|
|
Lead capillary
|
$59.04 |
$59.04 |
$59.04 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,143.44 |
$2,143.44 |
$2,143.44 |
$1,088.26
|
|
Lens, intraocular (new tech)
|
$324.00 |
$324.00 |
$324.00 |
$589.05
|
|
Lens iol ant bicnvx 24.0 multi
|
$324.00 |
$324.00 |
$324.00 |
$1,065.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$0.27 |
$0.27 |
$0.27 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$123.84 |
$123.84 |
$123.84 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$65.52 |
$65.52 |
$65.52 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$36.49 |
$36.49 |
$36.49 |
$385.62
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$2.16 |
$2.16 |
$2.16 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$0.13 |
$0.13 |
$0.13 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$79.20 |
$79.20 |
$79.20 |
$89.70
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$52.42 |
$52.42 |
$52.42 |
$125.66
|
|
Lipase
|
$104.40 |
$104.40 |
$104.40 |
$93.58
|
|
Lipoprotein blood quant
|
$149.76 |
$149.76 |
$149.76 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$77.04 |
$77.04 |
$77.04 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$108.72 |
$108.72 |
$108.72 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$43.20 |
$43.20 |
$43.20 |
$48.41
|
|
Lithium therapeutic drug level
|
$82.80 |
$82.80 |
$82.80 |
$69.42
|
|
Liver Function Test
|
$294.48 |
$294.48 |
$294.48 |
$115.44
|
|
Liver/spleen imag static only
|
$1,427.04 |
$1,427.04 |
$1,427.04 |
$1,123.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$12.96 |
$12.96 |
$12.96 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,150.72 |
$3,150.72 |
$3,150.72 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,029.76 |
$3,029.76 |
$3,029.76 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,685.60 |
$2,685.60 |
$2,685.60 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,242.24 |
$4,242.24 |
$4,242.24 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,517.92 |
$3,517.92 |
$3,517.92 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,121.92 |
$3,121.92 |
$3,121.92 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$688.32 |
$688.32 |
$688.32 |
$352.32
|
|
Lung Function Test (Spirometry)
|
$285.84 |
$285.84 |
$285.84 |
$295.35
|
|
Lung perfusion imaging
|
$2,243.52 |
$2,243.52 |
$2,243.52 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$3,181.68 |
$3,181.68 |
$3,181.68 |
$1,448.00
|
|
Macroscopic exam parasite
|
$39.60 |
$39.60 |
$39.60 |
$36.40
|
|
Magnesium
|
$79.92 |
$79.92 |
$79.92 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$16.38 |
$16.38 |
$16.38 |
$58.70
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$138.96 |
$138.96 |
$138.96 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$138.96 |
$138.96 |
$138.96 |
$152.54
|
|
Manual diff wbc count b-coat
|
$56.16 |
$56.16 |
$56.16 |
$30.68
|
|
Marker biop eviva buckle ss
|
$280.08 |
$280.08 |
$280.08 |
$1,152.48
|
|
Mastoids complete
|
$606.24 |
$606.24 |
$606.24 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$164.88 |
$164.88 |
$164.88 |
$66.36
|
|
Mayo aathr protein s free
|
$145.44 |
$145.44 |
$145.44 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$100.80 |
$100.80 |
$100.80 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$222.48 |
$222.48 |
$222.48 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$158.40 |
$158.40 |
$158.40 |
$102.96
|
|
Mayo alkaline phosphatase isoenzyme
|
$65.52 |
$65.52 |
$65.52 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$69.84 |
$69.84 |
$69.84 |
$105.11
|
|
Mayo alpha 1 antitrypsin
|
$81.36 |
$81.36 |
$81.36 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$48.24 |
$48.24 |
$48.24 |
$82.80
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$175.68 |
$175.68 |
$175.68 |
$80.08
|
|
Mayo analysis gene calr common variants exon 9
|
$1,087.92 |
$1,087.92 |
$1,087.92 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$417.60 |
$417.60 |
$417.60 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$489.60 |
$489.60 |
$489.60 |
$361.50
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,461.60 |
$1,461.60 |
$1,461.60 |
$1,860.00
|
|
Mayo androstenedione
|
$97.20 |
$97.20 |
$97.20 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$84.96 |
$84.96 |
$84.96 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$38.16 |
$38.16 |
$38.16 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$98.64 |
$98.64 |
$98.64 |
$67.60
|
|
Mayo barbiturates definitive assay confirmation urine
|
$36.00 |
$36.00 |
$36.00 |
$91.50
|
|
Mayo bart bartonella henselae antibody igg
|
$79.20 |
$79.20 |
$79.20 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$303.84 |
$303.84 |
$303.84 |
$325.60
|
|
Mayo blastomyces antibody immunodiffusion
|
$62.64 |
$62.64 |
$62.64 |
$57.85
|
|
Mayo bordetella pertussis antibody igg
|
$93.60 |
$93.60 |
$93.60 |
$69.00
|