|
In situ hybridization per specimen initial single probe stain
|
$851.20 |
$851.20 |
$851.20 |
$326.04
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$3,330.40 |
$3,330.40 |
$3,330.40 |
$1,609.25
|
|
Instillation anticarcinogenic agent bladder
|
$572.00 |
$572.00 |
$572.00 |
$621.40
|
|
Insulin total
|
$378.40 |
$378.40 |
$378.40 |
$66.64
|
|
Intrinsic factor antibody
|
$211.20 |
$211.20 |
$211.20 |
$66.60
|
|
Intro long gi tube
|
$2,113.60 |
$2,113.60 |
$2,113.60 |
$990.00
|
|
Intro long gi tube w/mult fluo
|
$54.40 |
$54.40 |
$54.40 |
$449.40
|
|
Intubation endotracheal emergency procedure
|
$1,063.20 |
$1,063.20 |
$1,063.20 |
$589.60
|
|
Ionm in operatng room 15 min
|
$433.60 |
$433.60 |
$433.60 |
$191.40
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$7.20 |
$7.20 |
$7.20 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$7.20 |
$7.20 |
$7.20 |
$279.10
|
|
Iron
|
$207.20 |
$207.20 |
$207.20 |
$74.40
|
|
Iron binding capacity
|
$207.20 |
$207.20 |
$207.20 |
$63.79
|
|
Irrigation implantable venous access device for drug delivery systems
|
$252.00 |
$252.00 |
$252.00 |
$142.20
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$336.80 |
$336.80 |
$336.80 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$312.80 |
$312.80 |
$312.80 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$308.80 |
$308.80 |
$308.80 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$737.60 |
$737.60 |
$737.60 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$161.60 |
$161.60 |
$161.60 |
$60.20
|
|
Kidney img w/bldflw sgl without rx
|
$924.80 |
$924.80 |
$924.80 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,172.00 |
$1,172.00 |
$1,172.00 |
$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
|
$2,060.80 |
$2,060.80 |
$2,060.80 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$5,486.40 |
$5,486.40 |
$5,486.40 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$5,348.80 |
$5,348.80 |
$5,348.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$5,379.20 |
$5,379.20 |
$5,379.20 |
$2,169.60
|
|
Knee orth pos locking joint
|
$780.80 |
$780.80 |
$780.80 |
$585.60
|
|
Knee X-ray
|
$974.40 |
$974.40 |
$974.40 |
$425.55
|
|
Kras gene addl variants
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$384.80
|
|
Kras gene variants exon 2
|
$1,594.40 |
$1,594.40 |
$1,594.40 |
$486.45
|
|
Lactate dehydrogenase (ldh)
|
$252.80 |
$252.80 |
$252.80 |
$55.50
|
|
Lactic acid
|
$389.60 |
$389.60 |
$389.60 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$178.40 |
$178.40 |
$178.40 |
$80.40
|
|
Lead capillary
|
$234.40 |
$234.40 |
$234.40 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,709.60 |
$1,709.60 |
$1,709.60 |
$1,088.26
|
|
Levetiracetam therapeutic drug level
|
$252.80 |
$252.80 |
$252.80 |
$88.92
|
|
Lidocaine therapeutic drug level
|
$180.80 |
$180.80 |
$180.80 |
$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
|
$312.00 |
$312.00 |
$312.00 |
$93.58
|
|
Lipoprotein blood quant
|
$332.00 |
$332.00 |
$332.00 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$278.40 |
$278.40 |
$278.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$122.40 |
$122.40 |
$122.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$190.40 |
$190.40 |
$190.40 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$816.00 |
$816.00 |
$816.00 |
$340.00
|
|
Liver Function Test
|
$358.40 |
$358.40 |
$358.40 |
$115.44
|
|
Liver/spleen imag static only
|
$1,532.80 |
$1,532.80 |
$1,532.80 |
$1,123.50
|
|
Locm 100-199mg/ml iodine,1ml
|
$8.00 |
$8.00 |
$8.00 |
$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)
|
$3,544.80 |
$3,544.80 |
$3,544.80 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,021.60 |
$3,021.60 |
$3,021.60 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,638.40 |
$2,638.40 |
$2,638.40 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$5,204.00 |
$5,204.00 |
$5,204.00 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,444.00 |
$4,444.00 |
$4,444.00 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,682.40 |
$3,682.40 |
$3,682.40 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$554.40 |
$554.40 |
$554.40 |
$352.32
|
|
Low frequency non-thermal Ultrasound
|
$371.20 |
$371.20 |
$371.20 |
$364.00
|
|
Lumbar diskogram s&i
|
$4,468.00 |
$4,468.00 |
$4,468.00 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$344.80 |
$344.80 |
$344.80 |
$295.35
|
|
Lung perfusion imaging
|
$1,556.80 |
$1,556.80 |
$1,556.80 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$2,411.20 |
$2,411.20 |
$2,411.20 |
$1,448.00
|
|
Macroscopic exam arthropod
|
$114.40 |
$114.40 |
$114.40 |
$38.50
|
|
Macroscopic exam parasite
|
$198.40 |
$198.40 |
$198.40 |
$36.40
|
|
Magnesium
|
$336.00 |
$336.00 |
$336.00 |
$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
|
$800.00 |
$800.00 |
$800.00 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$291.20 |
$291.20 |
$291.20 |
$66.36
|
|
Mayo aathr protein s free
|
$362.40 |
$362.40 |
$362.40 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$311.20 |
$311.20 |
$311.20 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$928.00 |
$928.00 |
$928.00 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$264.00 |
$264.00 |
$264.00 |
$102.96
|
|
Mayo alcohol definitive assay volatile screen
|
$388.00 |
$388.00 |
$388.00 |
$112.85
|
|
Mayo alkaline phosphatase isoenzyme
|
$168.00 |
$168.00 |
$168.00 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$179.20 |
$179.20 |
$179.20 |
$105.11
|
|
Mayo alpha 1 antitrypsin
|
$245.60 |
$245.60 |
$245.60 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$216.80 |
$216.80 |
$216.80 |
$82.80
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$61.60 |
$61.60 |
$61.60 |
$82.50
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$236.00 |
$236.00 |
$236.00 |
$80.08
|
|
Mayo analysis gene calr common variants exon 9
|
$1,933.60 |
$1,933.60 |
$1,933.60 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$1,768.00 |
$1,768.00 |
$1,768.00 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$2,334.40 |
$2,334.40 |
$2,334.40 |
$361.50
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$7,006.40 |
$7,006.40 |
$7,006.40 |
$1,860.00
|
|
Mayo androstenedione
|
$299.20 |
$299.20 |
$299.20 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$375.20 |
$375.20 |
$375.20 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$264.00 |
$264.00 |
$264.00 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$260.80 |
$260.80 |
$260.80 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$664.00 |
$664.00 |
$664.00 |
$165.78
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$46.40 |
$46.40 |
$46.40 |
$95.45
|
|
Mayo barbiturates definitive assay confirmation urine
|
$838.40 |
$838.40 |
$838.40 |
$91.50
|
|
Mayo bart bartonella henselae antibody igg
|
$151.20 |
$151.20 |
$151.20 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$472.00 |
$472.00 |
$472.00 |
$325.60
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$565.60 |
$565.60 |
$565.60 |
$347.00
|
|
Mayo blastomyces antibody immunodiffusion
|
$152.80 |
$152.80 |
$152.80 |
$57.85
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$37.60 |
$37.60 |
$37.60 |
$60.15
|
|
Mayo bordetella pertussis antibody igg
|
$336.80 |
$336.80 |
$336.80 |
$69.00
|
|
Mayo brcmg brucella antibody igm
|
$576.00 |
$576.00 |
$576.00 |
$44.14
|
|
Mayo c1 esterase inhibitor
|
$456.00 |
$456.00 |
$456.00 |
$85.00
|