|
Mra, without dye, spinal canal
|
$3,288.84 |
$3,288.84 |
$3,288.84 |
$1,033.39
|
|
Mra, without dye, upper extr
|
$3,288.84 |
$3,288.84 |
$3,288.84 |
$858.24
|
|
MRA without fol w/cont, abd
|
$4,477.34 |
$4,477.34 |
$4,477.34 |
$2,511.00
|
|
MRA without fol w/cont, lwr ext
|
$5,855.32 |
$5,855.32 |
$5,855.32 |
$2,192.59
|
|
MRA without fol w/cont, pelvis
|
$733.60 |
$733.60 |
$733.60 |
$2,206.29
|
|
Mra, w/o&w/dye, upper extr
|
$4,552.23 |
$4,552.23 |
$4,552.23 |
$1,260.80
|
|
Mr elastography
|
$488.80 |
$488.80 |
$488.80 |
$840.00
|
|
Mrgfus strtctc ablt trgt icr
|
$2,038.40 |
$2,038.40 |
$2,038.40 |
$22,209.60
|
|
MRI brain w/dye
|
$3,514.40 |
$3,514.40 |
$3,514.40 |
$2,145.00
|
|
MRI brain without dye
|
$3,324.00 |
$3,324.00 |
$3,324.00 |
$2,005.45
|
|
MRI brain without & w/dye
|
$3,313.60 |
$3,313.60 |
$3,313.60 |
$2,813.09
|
|
MRI breast c- unilateral
|
$1,684.53 |
$1,684.53 |
$1,684.53 |
$1,170.40
|
|
MRI breast c-+ w/cad uni
|
$710.40 |
$710.40 |
$710.40 |
$1,880.00
|
|
MRI breast without cont bi
|
$1,917.33 |
$1,917.33 |
$1,917.33 |
$1,871.10
|
|
MRI breast w IV cont bi
|
$1,920.03 |
$1,920.03 |
$1,920.03 |
$1,876.12
|
|
MRI cardiac morph & func wo IV cont
|
$769.60 |
$769.60 |
$769.60 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$1,021.60 |
$1,021.60 |
$1,021.60 |
$1,946.48
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$2,499.60
|
|
MRI chest without contrast
|
$2,782.26 |
$2,782.26 |
$2,782.26 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$4,184.76 |
$4,184.76 |
$4,184.76 |
$2,670.33
|
|
MRI chest w IV cont
|
$3,521.31 |
$3,521.31 |
$3,521.31 |
$2,278.18
|
|
MRI fetal ea addl gestation
|
$420.00 |
$420.00 |
$420.00 |
$577.07
|
|
MRI fetal sngl/1st gestation
|
$864.00 |
$864.00 |
$864.00 |
$1,136.26
|
|
MRI guid ndl plc s&i
|
$931.20 |
$931.20 |
$931.20 |
$1,334.45
|
|
MRI guid parenchymal tiss ablation
|
$2,527.20 |
$2,527.20 |
$2,527.20 |
$1,924.00
|
|
MRI loex nonjt w IV cont
|
$3,521.31 |
$3,521.31 |
$3,521.31 |
$2,116.20
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$2,921.37 |
$2,921.37 |
$2,921.37 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$4,477.34 |
$4,477.34 |
$4,477.34 |
$2,777.40
|
|
MRI orbit fac&nck w IV cont
|
$3,201.19 |
$3,201.19 |
$3,201.19 |
$2,204.98
|
|
MRI tmj
|
$2,921.27 |
$2,921.27 |
$2,921.27 |
$1,774.30
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$2,921.37 |
$2,921.37 |
$2,921.37 |
$1,967.40
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$4,477.34 |
$4,477.34 |
$4,477.34 |
$2,669.70
|
|
MRI upper extremity w/dye
|
$945.60 |
$945.60 |
$945.60 |
$2,061.15
|
|
MRI w/cont, breast, bi
|
$1,732.08 |
$1,732.08 |
$1,732.08 |
$2,119.87
|
|
MRI w/cont, breast, uni
|
$1,777.16 |
$1,777.16 |
$1,777.16 |
$1,567.09
|
|
MRI without fol w/cont, breast
|
$1,824.70 |
$1,824.70 |
$1,824.70 |
$2,550.00
|
|
MRI without fol w/cont, brst, un
|
$1,869.76 |
$1,869.76 |
$1,869.76 |
$1,779.08
|
|
Mr safety determination physician/other qhp
|
$178.60 |
$178.60 |
$178.60 |
$161.40
|
|
Mr safety implant elec prepj
|
$207.20 |
$207.20 |
$207.20 |
$173.40
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$92.80 |
$92.80 |
$92.80 |
$55.00
|
|
Mr safety implt pos&/immoblj
|
$268.00 |
$268.00 |
$268.00 |
$125.00
|
|
Mr sfty implt&/fb asmt stf 1
|
$49.68 |
$49.68 |
$49.68 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$490.31 |
$490.31 |
$490.31 |
$444.00
|
|
Mr spectroscopy
|
$1,018.40 |
$1,018.40 |
$1,018.40 |
$1,375.50
|
|
Msh2 gene dup/delete variant
|
$427.20 |
$427.20 |
$427.20 |
$422.64
|
|
Msh2 gene full seq
|
$764.00 |
$764.00 |
$764.00 |
$764.00
|
|
Msh2 gene known variants
|
$676.00 |
$676.00 |
$676.00 |
$466.07
|
|
Msh6 gene dup/delete variant
|
$476.00 |
$476.00 |
$476.00 |
$476.00
|
|
Msh6 gene full seq
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$1,160.50
|
|
Msh6 gene known variants
|
$616.00 |
$616.00 |
$616.00 |
$369.60
|
|
Mthfr gene analy common variants
|
$131.20 |
$131.20 |
$131.20 |
$184.00
|
|
M.tuberculo dna dir probe
|
$58.40 |
$58.40 |
$58.40 |
$58.40
|
|
M.tuberculo dna quant
|
$108.00 |
$108.00 |
$108.00 |
$59.12
|
|
Mucin synovial fluid
|
$33.57 |
$33.57 |
$33.57 |
$33.57
|
|
Mucopolysaccharides
|
$86.42 |
$86.42 |
$86.42 |
$178.36
|
|
Mucormycosis antibody
|
$38.40 |
$38.40 |
$38.40 |
$38.40
|
|
Multi den insert custom mold
|
$108.80 |
$108.80 |
$108.80 |
$56.00
|
|
Multi family grp psychotherapy
|
$80.80 |
$80.80 |
$80.80 |
$250.25
|
|
Multifocal erg w/i&r
|
$181.60 |
$181.60 |
$181.60 |
$386.40
|
|
Multiple sleep latency test
|
$1,442.48 |
$1,442.48 |
$1,442.48 |
$2,481.00
|
|
Mumps antibody igg
|
$48.57 |
$48.57 |
$48.57 |
$78.00
|
|
Muscle-skin graft arm
|
$3,014.40 |
$3,014.40 |
$3,014.40 |
$3,014.40
|
|
Muscle-skin graft leg
|
$3,197.60 |
$3,197.60 |
$3,197.60 |
$4,633.78
|
|
Muscle-skin graft trunk
|
$3,704.80 |
$3,704.80 |
$3,704.80 |
$4,332.25
|
|
Muscle test cran nerv unilat
|
$233.60 |
$233.60 |
$233.60 |
$385.07
|
|
Muscle test hemidiaphragm
|
$295.20 |
$295.20 |
$295.20 |
$296.40
|
|
Muscle test larynx
|
$335.20 |
$335.20 |
$335.20 |
$296.80
|
|
Muscle test one fiber
|
$442.40 |
$442.40 |
$442.40 |
$442.40
|
|
Muscle transfers
|
$2,810.40 |
$2,810.40 |
$2,810.40 |
$8,453.60
|
|
Muscle transfer shoulder/arm
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$8,434.13
|
|
Musc myoq/fscq flp h&n pedcl
|
$2,586.40 |
$2,586.40 |
$2,586.40 |
$4,331.73
|
|
Musc/tdn transfer upr a/e 1
|
$1,844.80 |
$1,844.80 |
$1,844.80 |
$7,807.24
|
|
Mycobacteria dna amp probe
|
$101.60 |
$101.60 |
$101.60 |
$234.00
|
|
Mycobacteria dna dir probe
|
$50.40 |
$50.40 |
$50.40 |
$65.17
|
|
Mycobacteria dna quant
|
$108.00 |
$108.00 |
$108.00 |
$141.45
|
|
Mycophenolate mofetil 250 mg capsule
|
$0.64 |
$0.64 |
$0.64 |
$10.79
|
|
Mycophenolic acid
|
$3.27 |
$3.27 |
$3.27 |
$12.84
|
|
Mycoplasma antibody igm
|
$48.57 |
$48.57 |
$48.57 |
$78.40
|
|
Myd88 gene p.leu265pro vrnt
|
$168.39 |
$168.39 |
$168.39 |
$417.00
|
|
Myelogphy 2/> spine regions
|
$750.40 |
$750.40 |
$750.40 |
$1,494.22
|
|
Myelography l-s spine
|
$750.40 |
$750.40 |
$750.40 |
$1,334.09
|
|
Myelography neck spine
|
$750.40 |
$750.40 |
$750.40 |
$1,241.50
|
|
Myelography thoracic spine
|
$750.40 |
$750.40 |
$750.40 |
$1,255.00
|
|
Myelography via inj w/s&i 2+ regions
|
$802.10 |
$802.10 |
$802.10 |
$2,267.34
|
|
Myelography via inj w/s&i cervical
|
$801.47 |
$801.47 |
$801.47 |
$1,784.80
|
|
Myelography via inj w/s&i lumbosacral
|
$802.10 |
$802.10 |
$802.10 |
$1,850.00
|
|
Myelography via inj w/s&i thoracic
|
$877.12 |
$877.12 |
$877.12 |
$1,745.94
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$64.28 |
$64.28 |
$64.28 |
$129.69
|
|
Myocardial resection 33542
|
$6,414.40 |
$6,414.40 |
$6,414.40 |
$6,414.40
|
|
Myocrd img pet 1std rst/strs
|
$2,753.60 |
$2,753.60 |
$2,753.60 |
$3,627.73
|
|
Myocrd img pet mlt rst&strs
|
$2,770.40 |
$2,770.40 |
$2,770.40 |
$4,060.00
|
|
Myomectomy abdom complex
|
$2,896.00 |
$2,896.00 |
$2,896.00 |
$1,893.60
|
|
Myomectomy abdom method
|
$2,315.20 |
$2,315.20 |
$2,315.20 |
$2,064.48
|
|
Myomectomy vag method
|
$1,399.20 |
$1,399.20 |
$1,399.20 |
$3,762.53
|
|
Myringoplasty
|
$3,449.60 |
$3,449.60 |
$3,449.60 |
$3,837.72
|
|
Nafcillin 2 gram solution for injection
|
$0.84 |
$0.84 |
$0.84 |
$84.00
|
|
Nalbuphine 10 mg/ml injection solution
|
$77.16 |
$77.16 |
$77.16 |
$37.81
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$3.68 |
$3.68 |
$3.68 |
$70.87
|
|
Naltrexone, depot form
|
$4.80 |
$4.80 |
$4.80 |
$3,249.40
|
|
Narcosynthesis
|
$378.40 |
$378.40 |
$378.40 |
$378.40
|
