|
Intrauterine transfusion ftl
|
$2,129.28 |
$2,129.28 |
$2,129.28 |
$1,063.50
|
|
Intraventricular pacing
|
$19,152.12 |
$19,152.12 |
$19,152.12 |
$5,456.17
|
|
Ionm in operatng room 15 min
|
$1,941.62 |
$1,941.62 |
$1,941.62 |
$200.16
|
|
Iron stain peripheral blood
|
$282.13 |
$282.13 |
$282.13 |
$30.55
|
|
Irradiation of blood product each unit reference
|
$220.07 |
$220.07 |
$220.07 |
$114.40
|
|
Irrigation implantable venous access device for drug delivery systems
|
$452.08 |
$452.08 |
$452.08 |
$144.62
|
|
IV inj ra drug dx study
|
$1,554.70 |
$1,554.70 |
$1,554.70 |
$552.60
|
|
Kafo fem fx cast molded to p
|
$9,953.00 |
$9,953.00 |
$9,953.00 |
$3,130.66
|
|
Kidney imag w/bld flow multi
|
$7,751.84 |
$7,751.84 |
$7,751.84 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$12,197.58 |
$12,197.58 |
$12,197.58 |
$1,425.00
|
|
Knee control full kneecap
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$192.00
|
|
Kras gene addl variants
|
$3,669.31 |
$3,669.31 |
$3,669.31 |
$386.75
|
|
Kras gene variants exon 2
|
$1,324.72 |
$1,324.72 |
$1,324.72 |
$509.00
|
|
Lev 1 hosp type b ed visit
|
$2,792.19 |
$2,792.19 |
$2,792.19 |
$186.98
|
|
Lev 2 hosp type b ed visit
|
$3,478.24 |
$3,478.24 |
$3,478.24 |
$359.65
|
|
Lev 4 hosp type b ed visit
|
$4,616.70 |
$4,616.70 |
$4,616.70 |
$915.40
|
|
Lev 5 hosp type b ed visit
|
$4,844.37 |
$4,844.37 |
$4,844.37 |
$1,542.68
|
|
Lift heel adj small gl60404sm
|
$17.00 |
$17.00 |
$17.00 |
$133.50
|
|
Lipoprotein blood high res frac & quant
|
$938.91 |
$938.91 |
$938.91 |
$86.42
|
|
Liver/spleen imag static only
|
$9,076.82 |
$9,076.82 |
$9,076.82 |
$1,123.50
|
|
Lmtd oph exam general anes
|
$10,029.43 |
$10,029.43 |
$10,029.43 |
$2,590.36
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$15,464.93 |
$15,464.93 |
$15,464.93 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$12,992.44 |
$12,992.44 |
$12,992.44 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$12,992.44 |
$12,992.44 |
$12,992.44 |
$2,065.69
|
|
Lso flex no ri stays pre ots
|
$912.00 |
$912.00 |
$912.00 |
$164.80
|
|
L/s ratio fetal lung
|
$2,977.27 |
$2,977.27 |
$2,977.27 |
$178.36
|
|
Lumbar diskogram s&i
|
$5,727.70 |
$5,727.70 |
$5,727.70 |
$2,358.23
|
|
Lung perfusion imaging
|
$9,439.76 |
$9,439.76 |
$9,439.76 |
$1,059.97
|
|
Lurbinectedin 4 mg intravenous solution
|
$603.60 |
$603.60 |
$603.60 |
$19,182.33
|
|
Lymphatics/lymph node imaging
|
$6,688.29 |
$6,688.29 |
$6,688.29 |
$1,463.22
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$689.07 |
$689.07 |
$689.07 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$859.83 |
$859.83 |
$859.83 |
$160.80
|
|
Mapping functional cort/subcort ea add'l hr
|
$1,989.27 |
$1,989.27 |
$1,989.27 |
$636.50
|
|
Map tachycard site(s)
|
$16,231.27 |
$16,231.27 |
$16,231.27 |
$4,082.82
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$42.68 |
$42.68 |
$42.68 |
$6,321.66
|
|
Mayo alcohol definitive assay volatile screen
|
$107.81 |
$107.81 |
$107.81 |
$122.45
|
|
Mayo c1 esterase inhibitor
|
$252.03 |
$252.03 |
$252.03 |
$86.73
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$946.70 |
$946.70 |
$946.70 |
$107.10
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$951.16 |
$951.16 |
$951.16 |
$80.16
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$3,556.43 |
$3,556.43 |
$3,556.43 |
$360.33
|
|
Mayo cocaine definitive assay confirmation urine
|
$191.79 |
$191.79 |
$191.79 |
$100.00
|
|
Mayo cyanide
|
$166.13 |
$166.13 |
$166.13 |
$87.50
|
|
Mayo deoxyribonuclease antibody titer
|
$642.29 |
$642.29 |
$642.29 |
$56.80
|
|
Mayo efpo chloride stool
|
$195.15 |
$195.15 |
$195.15 |
$43.41
|
|
Mayo estriol
|
$959.65 |
$959.65 |
$959.65 |
$90.34
|
|
Mayo ethosuximide therapeutic drug level
|
$787.24 |
$787.24 |
$787.24 |
$69.55
|
|
Mayo everolimus therapeutic drug level
|
$84.70 |
$84.70 |
$84.70 |
$97.50
|
|
Mayo fat/lipids feces quantitative
|
$1,445.15 |
$1,445.15 |
$1,445.15 |
$76.05
|
|
Mayo fbl culture fungi blood
|
$467.23 |
$467.23 |
$467.23 |
$105.60
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$45.35 |
$45.35 |
$45.35 |
$66.43
|
|
Mayo gamma-globin full gene sequencing
|
$3,955.73 |
$3,955.73 |
$3,955.73 |
$1,460.30
|
|
Mayo hla typing a/b/c single antigen
|
$886.49 |
$886.49 |
$886.49 |
$122.80
|
|
Mayo infliximab therapeutic drug level
|
$2,003.16 |
$2,003.16 |
$2,003.16 |
$150.40
|
|
Mayo inhab inhibin a
|
$573.16 |
$573.16 |
$573.16 |
$79.95
|
|
Mayo lacosamide therapeutic drug level
|
$250.23 |
$250.23 |
$250.23 |
$104.00
|
|
Mayo methadone definitive assay confirmation urine
|
$264.25 |
$264.25 |
$264.25 |
$97.20
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$449.37 |
$449.37 |
$449.37 |
$70.56
|
|
Mayo muramidase
|
$592.10 |
$592.10 |
$592.10 |
$59.50
|
|
Mayo mycophenolic acid therapeutic drug level
|
$171.71 |
$171.71 |
$171.71 |
$78.47
|
|
Mayo nickel
|
$80.29 |
$80.29 |
$80.29 |
$69.56
|
|
Mayo opatu opioid/analogs definitive assay 1 or 2
|
$219.69 |
$219.69 |
$219.69 |
$72.14
|
|
Mayo pancreatic elastase fecal qualitative or semi quantitative
|
$1,066.01 |
$1,066.01 |
$1,066.01 |
$156.00
|
|
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme)
|
$1,961.41 |
$1,961.41 |
$1,961.41 |
$177.60
|
|
Mayo proinsulin
|
$1,803.09 |
$1,803.09 |
$1,803.09 |
$97.50
|
|
Mayo sirolimus therapeutic drug level
|
$2,051.75 |
$2,051.75 |
$2,051.75 |
$99.81
|
|
Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification
|
$2,102.72 |
$2,102.72 |
$2,102.72 |
$507.60
|
|
Mayo thiopurine s-methyltransferase
|
$868.66 |
$868.66 |
$868.66 |
$93.93
|
|
Mayo tramadol definitive assay w metabolite quantitative urine
|
$18.95 |
$18.95 |
$18.95 |
$74.75
|
|
Mayo valpg valproic acid free therapeutic drug level
|
$379.73 |
$379.73 |
$379.73 |
$62.00
|
|
Mayo vasoactive intestinal peptide
|
$740.41 |
$740.41 |
$740.41 |
$136.50
|
|
Mayo zonisamide therapeutic drug level
|
$545.27 |
$545.27 |
$545.27 |
$87.88
|
|
Medroxyprogesterone 150 mg/ml im injection (wrapper)
|
$278.80 |
$278.80 |
$278.80 |
$190.81
|
|
Mepolizumab 100 mg/ml subcutaneous auto-injector
|
$10,265.43 |
$10,265.43 |
$10,265.43 |
$8,780.20
|
|
Mesna 100 mg/ml intravenous solution
|
$45.00 |
$45.00 |
$45.00 |
$107.41
|
|
Metabolic panel ionized ca
|
$1,010.23 |
$1,010.23 |
$1,010.23 |
$141.60
|
|
Methacholine chloride 0.0625 mg/ml nebulization soln
|
$174.00 |
$174.00 |
$174.00 |
$263.00
|
|
Methocarbamol ivpb 250 mg in 50 ml ns - cnr (headpain)
|
$149.79 |
$149.79 |
$149.79 |
$73.19
|
|
Methotrexate sodium 2.5 mg tablet
|
$6.45 |
$6.45 |
$6.45 |
$8.73
|
|
Methotrexate therapeutic drug level
|
$559.77 |
$559.77 |
$559.77 |
$105.30
|
|
Methyldopate hcl injection
|
$182.50 |
$182.50 |
$182.50 |
$100.80
|
|
Methylergonovine 0.2 mg/ml (1 ml) injection solution
|
$160.88 |
$160.88 |
$160.88 |
$76.20
|
|
Metoprolol tartrate 5 mg/5 ml intravenous (wrapper)
|
$164.95 |
$164.95 |
$164.95 |
$8.55
|
|
Microdissection manual
|
$366.50 |
$366.50 |
$366.50 |
$289.50
|
|
Middle cerebral artery echo
|
$701.74 |
$701.74 |
$701.74 |
$319.15
|
|
Minocycline hydrochloride
|
$429.31 |
$429.31 |
$429.31 |
$623.04
|
|
Mitoxantrone 2 mg/ml concentrate,intravenous
|
$356.70 |
$356.70 |
$356.70 |
$560.27
|
|
Mopath procedure level 3
|
$1,430.68 |
$1,430.68 |
$1,430.68 |
$347.20
|
|
M/phmtrc alys ishquant/semiq
|
$289.72 |
$289.72 |
$289.72 |
$487.50
|
|
MRA chest wwo IV cont
|
$15,572.90 |
$15,572.90 |
$15,572.90 |
$2,492.05
|
|
MRA pelvis w IV cont
|
$3,271.07 |
$3,271.07 |
$3,271.07 |
$1,565.72
|
|
MRA pelvis wo IV cont
|
$3,271.07 |
$3,271.07 |
$3,271.07 |
$1,434.21
|
|
MRA w/cont, abd
|
$6,592.14 |
$6,592.14 |
$6,592.14 |
$1,907.28
|
|
MRA without cont, abd
|
$8,528.39 |
$8,528.39 |
$8,528.39 |
$1,749.65
|
|
MRA without cont, lwr ext
|
$6,592.14 |
$6,592.14 |
$6,592.14 |
$1,648.42
|
|
MRA without fol w/cont, abd
|
$8,528.39 |
$8,528.39 |
$8,528.39 |
$2,416.27
|
|
MRA without fol w/cont, pelvis
|
$4,664.82 |
$4,664.82 |
$4,664.82 |
$2,206.29
|
|
MRI breast without cont bi
|
$10,962.51 |
$10,962.51 |
$10,962.51 |
$1,778.00
|
|
MRI cardiac morph & func wo IV cont
|
$9,928.36 |
$9,928.36 |
$9,928.36 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$11,189.13 |
$11,189.13 |
$11,189.13 |
$1,928.40
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$12,481.15 |
$12,481.15 |
$12,481.15 |
$2,444.00
|
