|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,342.00 |
$3,342.00 |
$3,342.00 |
$2,457.24
|
|
Insulin total
|
$119.40 |
$119.40 |
$119.40 |
$72.15
|
|
Intro long gi tube
|
$678.60 |
$678.60 |
$678.60 |
$880.75
|
|
Intubation endotracheal emergency procedure
|
$502.20 |
$502.20 |
$502.20 |
$565.00
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.18 |
$0.18 |
$0.18 |
$145.52
|
|
Iron
|
$81.00 |
$81.00 |
$81.00 |
$67.50
|
|
Iron binding capacity
|
$46.80 |
$46.80 |
$46.80 |
$55.00
|
|
Irrigation implantable venous access device for drug delivery systems
|
$165.00 |
$165.00 |
$165.00 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$214.80 |
$214.80 |
$214.80 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$220.80 |
$220.80 |
$220.80 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$147.00 |
$147.00 |
$147.00 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$525.00 |
$525.00 |
$525.00 |
$476.50
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$94.20 |
$94.20 |
$94.20 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$39.01 |
$39.01 |
$39.01 |
$17.11
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$523.80 |
$523.80 |
$523.80 |
$618.54
|
|
Knee MRI (with and without contrast)
|
$4,352.40 |
$4,352.40 |
$4,352.40 |
$2,703.85
|
|
Knee MRI (without contrast)
|
$2,358.00 |
$2,358.00 |
$2,358.00 |
$2,120.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$44.90 |
$44.90 |
$44.90 |
$13.00
|
|
Lactate dehydrogenase (ldh)
|
$60.00 |
$60.00 |
$60.00 |
$50.55
|
|
Lactated ringers intravenous solution
|
$78.66 |
$78.66 |
$78.66 |
$46.35
|
|
Lactic acid
|
$109.80 |
$109.80 |
$109.80 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$59.40 |
$59.40 |
$59.40 |
$88.40
|
|
Lactoferrin fecal quant
|
$522.60 |
$522.60 |
$522.60 |
$106.10
|
|
Lead capillary
|
$102.00 |
$102.00 |
$102.00 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,381.20 |
$1,381.20 |
$1,381.20 |
$1,053.00
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$547.80 |
$547.80 |
$547.80 |
$609.00
|
|
Lens iol ant bicnvx 24.0 multi
|
$857.40 |
$857.40 |
$857.40 |
$1,136.25
|
|
Levalbuterol non-comp unit
|
$20.15 |
$20.15 |
$20.15 |
$20.15
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$81.00 |
$81.00 |
$81.00 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$88.80 |
$88.80 |
$88.80 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$64.88 |
$64.88 |
$64.88 |
$43.61
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$130.49 |
$130.49 |
$130.49 |
$84.28
|
|
Lipase
|
$94.20 |
$94.20 |
$94.20 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$87.00 |
$87.00 |
$87.00 |
$90.60
|
|
Lipoprotein blood quant
|
$130.80 |
$130.80 |
$130.80 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$47.40 |
$47.40 |
$47.40 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$55.20 |
$55.20 |
$55.20 |
$61.60
|
|
Lithium therapeutic drug level
|
$99.00 |
$99.00 |
$99.00 |
$62.40
|
|
Liver Function Test
|
$37.80 |
$37.80 |
$37.80 |
$92.85
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$38.73 |
$38.73 |
$38.73 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$885.00 |
$885.00 |
$885.00 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,287.00 |
$1,287.00 |
$1,287.00 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$281.40 |
$281.40 |
$281.40 |
$328.23
|
|
Lung Function Test (Spirometry)
|
$330.60 |
$330.60 |
$330.60 |
$290.89
|
|
Macroscopic exam arthropod
|
$17.40 |
$17.40 |
$17.40 |
$38.50
|
|
Magnesium
|
$82.20 |
$82.20 |
$82.20 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$64.61 |
$64.61 |
$64.61 |
$39.81
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$123.60 |
$123.60 |
$123.60 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$136.80 |
$136.80 |
$136.80 |
$147.72
|
|
Manual diff wbc count b-coat
|
$55.20 |
$55.20 |
$55.20 |
$22.75
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$64.20 |
$64.20 |
$64.20 |
$76.70
|
|
Mayo aathr protein s free
|
$250.80 |
$250.80 |
$250.80 |
$139.23
|
|
Mayo alkaline phosphatase isoenzyme
|
$61.20 |
$61.20 |
$61.20 |
$83.85
|
|
Mayo alpha 1 antitrypsin
|
$87.60 |
$87.60 |
$87.60 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$82.80 |
$82.80 |
$82.80 |
$112.89
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$385.20 |
$385.20 |
$385.20 |
$343.20
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,573.20 |
$1,573.20 |
$1,573.20 |
$1,922.13
|
|
Mayo androstenedione
|
$121.80 |
$121.80 |
$121.80 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$186.00 |
$186.00 |
$186.00 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$37.80 |
$37.80 |
$37.80 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$46.20 |
$46.20 |
$46.20 |
$72.60
|
|
Mayo bart bartonella henselae antibody igg
|
$97.20 |
$97.20 |
$97.20 |
$52.00
|
|
Mayo blastomyces antibody immunodiffusion
|
$46.80 |
$46.80 |
$46.80 |
$67.60
|
|
Mayo bordetella pertussis antibody igg
|
$45.00 |
$45.00 |
$45.00 |
$59.15
|
|
Mayo c1 esterase inhibitor
|
$64.80 |
$64.80 |
$64.80 |
$124.80
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$247.20 |
$247.20 |
$247.20 |
$104.55
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$195.00 |
$195.00 |
$195.00 |
$274.40
|
|
Mayo ceruloplasmin
|
$109.80 |
$109.80 |
$109.80 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$144.00 |
$144.00 |
$144.00 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$179.40 |
$179.40 |
$179.40 |
$122.00
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$289.80 |
$289.80 |
$289.80 |
$380.40
|
|
Mayo chromium
|
$66.00 |
$66.00 |
$66.00 |
$89.25
|
|
Mayo coccidioides antibody
|
$58.80 |
$58.80 |
$58.80 |
$61.10
|
|
Mayo cocou cortisone urine
|
$108.60 |
$108.60 |
$108.60 |
$222.62
|
|
Mayo cortisol free
|
$108.00 |
$108.00 |
$108.00 |
$109.85
|
|
Mayo covid-19 antibody nucleocapsid total
|
$63.60 |
$63.60 |
$63.60 |
$77.63
|
|
Mayo deoxyribonuclease antibody titer
|
$63.60 |
$63.60 |
$63.60 |
$74.40
|
|
Mayo dhea (dehydroepiandrosterone)
|
$179.40 |
$179.40 |
$179.40 |
$113.10
|
|
Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid
|
$18.60 |
$18.60 |
$18.60 |
$130.01
|
|
Mayo estriol
|
$109.20 |
$109.20 |
$109.20 |
$102.50
|
|
Mayo estrone
|
$105.00 |
$105.00 |
$105.00 |
$105.00
|
|
Mayo ethosuximide therapeutic drug level
|
$75.60 |
$75.60 |
$75.60 |
$81.60
|
|
Mayo everolimus therapeutic drug level
|
$183.00 |
$183.00 |
$183.00 |
$107.00
|
|
Mayo factor ii
|
$127.80 |
$127.80 |
$127.80 |
$96.76
|
|
Mayo factor v
|
$127.80 |
$127.80 |
$127.80 |
$119.60
|
|
Mayo factor vii
|
$105.00 |
$105.00 |
$105.00 |
$124.80
|
|
Mayo factor viii vw factor antigen
|
$109.20 |
$109.20 |
$109.20 |
$116.40
|
|
Mayo factor viii vw factor multimetric analysis
|
$159.00 |
$159.00 |
$159.00 |
$147.63
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$113.40 |
$113.40 |
$113.40 |
$133.25
|
|
Mayo factor x
|
$127.80 |
$127.80 |
$127.80 |
$130.65
|
|
Mayo factor xi
|
$105.00 |
$105.00 |
$105.00 |
$120.96
|
|
Mayo fbl culture fungi blood
|
$147.60 |
$147.60 |
$147.60 |
$91.65
|
|
Mayo ffspg allergen clam igg
|
$25.20 |
$25.20 |
$25.20 |
$37.05
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$169.20 |
$169.20 |
$169.20 |
$80.00
|
|
Mayo gamma-globin full gene sequencing
|
$906.60 |
$906.60 |
$906.60 |
$1,634.10
|
|
Mayo hemosiderin qualitative urine
|
$48.00 |
$48.00 |
$48.00 |
$38.35
|
