|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$1,425.48 |
$4,060.00 |
$10,285.00 |
|
|
MRI orbit fac&nck w IV cont
|
$945.60 |
$1,946.28 |
$4,121.61 |
|
|
MRI tmj
|
$570.70 |
$1,342.56 |
$3,007.68 |
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$1,101.36 |
$2,645.60 |
$8,573.00 |
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$1,435.56 |
$3,798.68 |
$11,134.00 |
|
|
MRI upper extremity w/dye
|
$945.60 |
$945.60 |
$2,563.04 |
|
|
MRI w/cont, breast, bi
|
$625.60 |
$625.60 |
$2,891.22 |
|
|
MRI w/cont, breast, uni
|
$508.00 |
$508.00 |
$2,238.93 |
|
|
MRI without fol w/cont, breast
|
$625.60 |
$1,779.08 |
$3,854.56 |
|
|
MRI without fol w/cont, brst, un
|
$508.00 |
$1,779.08 |
$2,985.25 |
|
|
Mr safety determination physician/other qhp
|
$63.00 |
$132.80 |
$185.00 |
|
|
Mr safety implant elec prepj
|
$65.52 |
$207.20 |
$207.20 |
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$18.06 |
$92.80 |
$103.00 |
|
|
Mr safety implt pos&/immoblj
|
$42.42 |
$268.00 |
$268.00 |
|
|
Mr sfty implt&/fb asmt stf 1
|
$18.06 |
$19.20 |
$51.00 |
|
|
Mr sfty med physics xm cstmz
|
$172.62 |
$402.40 |
$507.00 |
|
|
Mr spectroscopy
|
$578.76 |
$1,023.00 |
$2,450.28 |
|
|
Msh2 gene dup/delete variant
|
$427.20 |
$427.20 |
$427.20 |
|
|
Msh2 gene full seq
|
$764.00 |
$764.00 |
$764.00 |
|
|
Msh2 gene known variants
|
$676.00 |
$676.00 |
$676.00 |
|
|
Msh6 gene dup/delete variant
|
$476.00 |
$476.00 |
$476.00 |
|
|
Msh6 gene full seq
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
|
|
Msh6 gene known variants
|
$616.00 |
$616.00 |
$616.00 |
|
|
Mthfr gene analy common variants
|
$103.35 |
$131.20 |
$589.47 |
|
|
M.tuberculo dna dir probe
|
$58.40 |
$58.40 |
$58.40 |
|
|
M.tuberculo dna quant
|
$108.00 |
$108.00 |
$108.00 |
|
|
Mucin synovial fluid
|
$30.00 |
$33.57 |
$68.11 |
|
|
Mucopolysaccharides
|
$86.42 |
$86.42 |
$320.00 |
|
|
Mucormycosis antibody
|
$38.40 |
$38.40 |
$38.40 |
|
|
Multi den insert custom mold
|
$108.80 |
$108.80 |
$108.80 |
|
|
Multi family grp psychotherapy
|
$80.80 |
$80.80 |
$121.20 |
|
|
Multifocal erg w/i&r
|
$181.60 |
$181.60 |
$181.60 |
|
|
Multiple sleep latency test
|
$264.60 |
$1,636.05 |
$4,963.40 |
|
|
Mumps antibody igg
|
$3.78 |
$78.00 |
$372.45 |
|
|
Muscle-skin graft arm
|
$1,829.76 |
$3,014.40 |
$3,014.40 |
|
|
Muscle-skin graft leg
|
$2,587.20 |
$3,197.60 |
$46,870.38 |
|
|
Muscle-skin graft trunk
|
$1,829.76 |
$3,704.80 |
$26,704.12 |
|
|
Muscle test cran nerv unilat
|
$130.62 |
$233.60 |
$538.69 |
|
|
Muscle test hemidiaphragm
|
$295.20 |
$295.20 |
$295.20 |
|
|
Muscle test larynx
|
$82.74 |
$335.20 |
$335.20 |
|
|
Muscle test one fiber
|
$130.62 |
$442.40 |
$442.40 |
|
|
Muscle transfers
|
$2,810.40 |
$2,810.40 |
$2,810.40 |
|
|
Muscle transfer shoulder/arm
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
|
|
Musc myoq/fscq flp h&n pedcl
|
$1,867.20 |
$2,586.40 |
$3,386.00 |
|
|
Musc/tdn transfer upr a/e 1
|
$1,844.80 |
$1,844.80 |
$1,844.80 |
|
|
Mycobacteria dna amp probe
|
$101.60 |
$101.60 |
$381.00 |
|
|
Mycobacteria dna dir probe
|
$50.40 |
$50.40 |
$50.40 |
|
|
Mycobacteria dna quant
|
$108.00 |
$108.00 |
$108.00 |
|
|
Mycophenolate mofetil 250 mg capsule
|
$0.59 |
$1.24 |
$1,351.62 |
|
|
Mycophenolic acid
|
$0.39 |
$5.05 |
$1,253.15 |
|
|
Mycoplasma antibody igm
|
$48.57 |
$73.45 |
$300.00 |
|
|
Myd88 gene p.leu265pro vrnt
|
$168.39 |
$168.39 |
$655.20 |
|
|
Myelogphy 2/> spine regions
|
$340.80 |
$1,721.15 |
$2,084.02 |
|
|
Myelography l-s spine
|
$236.00 |
$1,069.41 |
$1,636.15 |
|
|
Myelography neck spine
|
$252.80 |
$1,468.86 |
$1,739.83 |
|
|
Myelography thoracic spine
|
$252.00 |
$727.86 |
$1,669.96 |
|
|
Myelography via inj w/s&i 2+ regions
|
$273.00 |
$1,501.28 |
$3,155.10 |
|
|
Myelography via inj w/s&i cervical
|
$640.00 |
$1,697.28 |
$2,707.90 |
|
|
Myelography via inj w/s&i lumbosacral
|
$261.00 |
$1,519.21 |
$2,919.15 |
|
|
Myelography via inj w/s&i thoracic
|
$268.20 |
$1,519.21 |
$2,231.76 |
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$64.28 |
$115.05 |
$2,867.00 |
|
|
Myocardial resection 33542
|
$4,863.60 |
$6,414.40 |
$6,414.40 |
|
|
Myocrd img pet 1std rst/strs
|
$2,679.18 |
$2,753.60 |
$3,891.55 |
|
|
Myocrd img pet 1 std w/ct
|
$1,049.76 |
$1,167.18 |
$3,150.18 |
|
|
Myocrd img pet 2rtracer
|
$3,840.76 |
$3,840.76 |
$3,840.76 |
|
|
Myocrd img pet 2rtracer CT
|
$1,358.28 |
$3,656.90 |
$7,533.50 |
|
|
Myocrd img pet mlt rst&strs
|
$2,677.08 |
$2,770.40 |
$2,770.40 |
|
|
Myocrd img pet rst&strs CT
|
$4,564.92 |
$4,670.96 |
$5,811.00 |
|
|
Myocrd img pet rst/strs w/ct
|
$2,958.61 |
$3,093.78 |
$3,218.80 |
|
|
Myomectomy abdom complex
|
$2,145.00 |
$2,896.00 |
$2,896.00 |
|
|
Myomectomy abdom method
|
$1,700.40 |
$2,315.20 |
$2,802.00 |
|
|
Myomectomy vag method
|
$1,131.60 |
$1,399.20 |
$1,399.20 |
|
|
Myringoplasty
|
$1,297.20 |
$3,449.60 |
$14,140.30 |
|
|
Nafcillin 2 gram solution for injection
|
$0.48 |
$27.30 |
$95.59 |
|
|
Nalbuphine 10 mg/ml injection solution
|
$4.80 |
$73.60 |
$115.61 |
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$0.60 |
$75.00 |
$546.10 |
|
|
Naltrexone, depot form
|
$4.80 |
$4.80 |
$8,240.35 |
|
|
Narcosynthesis
|
$378.40 |
$378.40 |
$378.40 |
|
|
Nasal endoscopy dx uni/bi separate proc
|
$126.75 |
$471.20 |
$17,030.45 |
|
|
Nasal endoscopy with removal of nasal foreign body
|
$158.34 |
$158.34 |
$158.34 |
|
|
Nasal function studies
|
$129.60 |
$129.60 |
$129.60 |
|
|
Nasal/sinus endoscopy surg
|
$632.40 |
$1,003.20 |
$1,003.20 |
|
|
Nasal/sinus endoscopy surg
|
$5,662.40 |
$5,662.40 |
$5,662.40 |
|
|
Nasal/sinus endoscopy surg w/bx 31237
|
$511.00 |
$1,243.20 |
$32,405.09 |
|
|
Nasal/sinus endo spendt remove tiss 31288
|
$741.00 |
$1,166.40 |
$26,741.15 |
|
|
Nasal/sinus endo surg w/concha bullosa resct 31240
|
$417.60 |
$785.60 |
$54,774.79 |
|
|
Nasal/sinus endo w/ethmoidectomy part 31254
|
$744.60 |
$2,067.20 |
$31,943.36 |
|
|
Nasal/sinus endo w/ethmoidectomy tot 31255
|
$1,123.20 |
$1,617.60 |
$27,321.23 |
|
|
Nasal/sinus endo w/front sinus expl 31276
|
$1,075.20 |
$1,888.00 |
$60,862.53 |
|
|
Nasal/sinus maxillary endoscopy dx 31233
|
$493.20 |
$1,281.60 |
$1,281.60 |
|
|
Nasal/sinus sphenoid endoscopy dx 31235
|
$557.40 |
$1,465.60 |
$1,465.60 |
|
|
Nasal sinus therapy
|
$364.80 |
$364.80 |
$364.80 |
|
|
Nasopharyngoscopy w/endoscope
|
$114.00 |
$272.80 |
$454.33 |
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$28.00 |
$17,929.21 |
$26,637.70 |
|
|
Natriuretic peptide
|
$72.96 |
$155.35 |
$964.00 |
|
|
Natural killer cells total count
|
$68.64 |
$110.00 |
$197.60 |
|
|
Navigational bronchoscopy 31627
|
$663.36 |
$3,104.80 |
$32,752.80 |
|
|
Nav srv peer sup 60 min pr m
|
$151.20 |
$151.20 |
$151.20 |
|
|
N block inj common digit
|
$295.75 |
$440.00 |
$574.48 |
|
|
N block inj hypogas plxs
|
$477.60 |
$585.90 |
$3,259.14 |
|
