|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,832.00 |
$1,832.00 |
$1,832.00 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$29,456.00 |
$29,456.00 |
$29,456.00 |
$29,146.96
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$14,073.60 |
$14,073.60 |
$14,073.60 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,312.80 |
$7,312.80 |
$7,312.80 |
$7,342.20
|
|
Insert pm/icd lead dual
|
$7,312.80 |
$7,312.80 |
$7,312.80 |
$7,388.80
|
|
Ins icd gen exist sgl lead
|
$20,569.60 |
$20,569.60 |
$20,569.60 |
$23,742.75
|
|
Insitu hybridization (fish)
|
$809.60 |
$809.60 |
$809.60 |
$481.60
|
|
Insitu hybridization manual
|
$770.40 |
$770.40 |
$770.40 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$672.00 |
$672.00 |
$672.00 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$600.80 |
$600.80 |
$600.80 |
$326.04
|
|
Instillation anticarcinogenic agent bladder
|
$571.20 |
$571.20 |
$571.20 |
$621.40
|
|
Insulin total
|
$167.20 |
$167.20 |
$167.20 |
$66.64
|
|
Interdental fixation
|
$2,156.00 |
$2,156.00 |
$2,156.00 |
$2,162.05
|
|
Intrinsic factor antibody
|
$204.00 |
$204.00 |
$204.00 |
$66.60
|
|
Intro long gi tube w/mult fluo
|
$592.80 |
$592.80 |
$592.80 |
$449.40
|
|
Intubation endotracheal emergency procedure
|
$2,747.20 |
$2,747.20 |
$2,747.20 |
$589.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$5.60 |
$5.60 |
$5.60 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$5.60 |
$5.60 |
$5.60 |
$279.10
|
|
Iron
|
$134.40 |
$134.40 |
$134.40 |
$74.40
|
|
Iron binding capacity
|
$162.40 |
$162.40 |
$162.40 |
$63.79
|
|
Irrigation implantable venous access device for drug delivery systems
|
$224.80 |
$224.80 |
$224.80 |
$142.20
|
|
Ivc venogram s&i
|
$2,644.00 |
$2,644.00 |
$2,644.00 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$305.60 |
$305.60 |
$305.60 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$283.20 |
$283.20 |
$283.20 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$279.20 |
$279.20 |
$279.20 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$667.20 |
$667.20 |
$667.20 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$1,712.80 |
$1,712.80 |
$1,712.80 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$140.80 |
$140.80 |
$140.80 |
$60.20
|
|
Kidney imaging morphology
|
$1,771.20 |
$1,771.20 |
$1,771.20 |
$785.00
|
|
Kidney img w/bldflw sgl without rx
|
$3,512.00 |
$3,512.00 |
$3,512.00 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,312.00 |
$1,312.00 |
$1,312.00 |
$666.00
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$780.80 |
$780.80 |
$780.80 |
$104.52
|
|
Kit gene analys d816 variant
|
$2,249.60 |
$2,249.60 |
$2,249.60 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$7,845.60 |
$7,845.60 |
$7,845.60 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$6,336.80 |
$6,336.80 |
$6,336.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$5,815.20 |
$5,815.20 |
$5,815.20 |
$2,169.60
|
|
Knee orth pos locking joint
|
$780.80 |
$780.80 |
$780.80 |
$585.60
|
|
Knee X-ray
|
$934.40 |
$934.40 |
$934.40 |
$425.55
|
|
Kras gene addl variants
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
$384.80
|
|
Kras gene variants exon 2
|
$1,445.60 |
$1,445.60 |
$1,445.60 |
$486.45
|
|
Lactate dehydrogenase (ldh)
|
$140.80 |
$140.80 |
$140.80 |
$55.50
|
|
Lactic acid
|
$399.20 |
$399.20 |
$399.20 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$178.40 |
$178.40 |
$178.40 |
$80.40
|
|
Lead capillary
|
$240.00 |
$240.00 |
$240.00 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$1,088.26
|
|
Levetiracetam therapeutic drug level
|
$247.20 |
$247.20 |
$247.20 |
$88.92
|
|
Lidocaine therapeutic drug level
|
$136.00 |
$136.00 |
$136.00 |
$89.70
|
|
Lift heel adj small gl60404sm
|
$113.60 |
$113.60 |
$113.60 |
$148.39
|
|
Limited ankle motion ea jnt
|
$780.80 |
$780.80 |
$780.80 |
$123.05
|
|
Lipase
|
$316.80 |
$316.80 |
$316.80 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$119.20 |
$119.20 |
$119.20 |
$90.35
|
|
Lipoprotein blood quant
|
$228.00 |
$228.00 |
$228.00 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$131.20 |
$131.20 |
$131.20 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$94.40 |
$94.40 |
$94.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$253.60 |
$253.60 |
$253.60 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$816.00 |
$816.00 |
$816.00 |
$340.00
|
|
Liver Function Test
|
$217.60 |
$217.60 |
$217.60 |
$115.44
|
|
Liver/spleen imag static only
|
$2,201.60 |
$2,201.60 |
$2,201.60 |
$1,123.50
|
|
Locm 100-199mg/ml iodine,1ml
|
$5.60 |
$5.60 |
$5.60 |
$45.90
|
|
Lo sag rig pnl stays pre cst
|
$113.60 |
$113.60 |
$113.60 |
$167.74
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,472.00 |
$3,472.00 |
$3,472.00 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,303.20 |
$3,303.20 |
$3,303.20 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$3,336.00 |
$3,336.00 |
$3,336.00 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$5,146.40 |
$5,146.40 |
$5,146.40 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,436.00 |
$4,436.00 |
$4,436.00 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$4,057.60 |
$4,057.60 |
$4,057.60 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$471.20 |
$471.20 |
$471.20 |
$352.32
|
|
Low frequency non-thermal Ultrasound
|
$371.20 |
$371.20 |
$371.20 |
$364.00
|
|
Lung function test (mbc/mvv)
|
$129.60 |
$129.60 |
$129.60 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$541.60 |
$541.60 |
$541.60 |
$295.35
|
|
Lung perfusion imaging
|
$2,148.00 |
$2,148.00 |
$2,148.00 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$2,142.40 |
$2,142.40 |
$2,142.40 |
$1,448.00
|
|
Macroscopic exam parasite
|
$153.60 |
$153.60 |
$153.60 |
$36.40
|
|
Magnesium
|
$168.00 |
$168.00 |
$168.00 |
$73.00
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$136.00 |
$136.00 |
$136.00 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$136.00 |
$136.00 |
$136.00 |
$152.54
|
|
Marker biop eviva buckle ss
|
$4,476.80 |
$4,476.80 |
$4,476.80 |
$1,152.48
|
|
Mastoids complete
|
$1,455.20 |
$1,455.20 |
$1,455.20 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$215.20 |
$215.20 |
$215.20 |
$66.36
|
|
Mayo aathr protein s free
|
$305.60 |
$305.60 |
$305.60 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$338.40 |
$338.40 |
$338.40 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$964.80 |
$964.80 |
$964.80 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$273.60 |
$273.60 |
$273.60 |
$102.96
|
|
Mayo alcohol definitive assay volatile screen
|
$404.00 |
$404.00 |
$404.00 |
$112.85
|
|
Mayo alkaline phosphatase isoenzyme
|
$233.60 |
$233.60 |
$233.60 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$185.60 |
$185.60 |
$185.60 |
$105.11
|
|
Mayo alpha 1 antitrypsin
|
$219.20 |
$219.20 |
$219.20 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$226.40 |
$226.40 |
$226.40 |
$82.80
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$64.80 |
$64.80 |
$64.80 |
$82.50
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$246.40 |
$246.40 |
$246.40 |
$80.08
|
|
Mayo analysis gene calr common variants exon 9
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$1,072.00 |
$1,072.00 |
$1,072.00 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$2,549.60 |
$2,549.60 |
$2,549.60 |
$361.50
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$6,428.00 |
$6,428.00 |
$6,428.00 |
$1,860.00
|
|
Mayo androstenedione
|
$306.40 |
$306.40 |
$306.40 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$276.00 |
$276.00 |
$276.00 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$156.80 |
$156.80 |
$156.80 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$129.60 |
$129.60 |
$129.60 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$689.60 |
$689.60 |
$689.60 |
$165.78
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$48.80 |
$48.80 |
$48.80 |
$95.45
|
