|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$96.80 |
$96.80 |
$96.80 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$81.60 |
$81.60 |
$81.60 |
$109.18
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$59.60 |
$59.60 |
$59.60 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$68.40 |
$68.40 |
$68.40 |
$135.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$436.00 |
$436.00 |
$436.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$229.20 |
$229.20 |
$229.20 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$150.40 |
$150.40 |
$150.40 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$239.20 |
$239.20 |
$239.20 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$158.40 |
$158.40 |
$158.40 |
$381.55
|
|
Initiation & management bipap/cpap initial day
|
$216.40 |
$216.40 |
$216.40 |
$608.40
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$714.80 |
$714.80 |
$714.80 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$494.40 |
$494.40 |
$494.40 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$714.80 |
$714.80 |
$714.80 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$665.20 |
$665.20 |
$665.20 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$665.20 |
$665.20 |
$665.20 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,140.80 |
$1,140.80 |
$1,140.80 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,140.80 |
$1,140.80 |
$1,140.80 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$112.00 |
$112.00 |
$112.00 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$274.00 |
$274.00 |
$274.00 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$368.80 |
$368.80 |
$368.80 |
$654.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$62.40 |
$62.40 |
$62.40 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$62.40 |
$62.40 |
$62.40 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$143.20 |
$143.20 |
$143.20 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$59.20 |
$59.20 |
$59.20 |
$130.19
|
|
Inject sacroiliac joint
|
$688.00 |
$688.00 |
$688.00 |
$1,028.95
|
|
Insertion catheter bladder non indwelling
|
$166.40 |
$166.40 |
$166.40 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$193.60 |
$193.60 |
$193.60 |
$245.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,113.60 |
$1,113.60 |
$1,113.60 |
$2,079.43
|
|
Insulin total
|
$60.00 |
$60.00 |
$60.00 |
$72.15
|
|
Intrinsic factor antibody
|
$152.00 |
$152.00 |
$152.00 |
$76.77
|
|
Intubation endotracheal emergency procedure
|
$287.60 |
$287.60 |
$287.60 |
$565.00
|
|
Iron
|
$28.80 |
$28.80 |
$28.80 |
$67.50
|
|
Iron binding capacity
|
$30.80 |
$30.80 |
$30.80 |
$55.00
|
|
Irrigation implantable venous access device for drug delivery systems
|
$68.00 |
$68.00 |
$68.00 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$102.40 |
$102.40 |
$102.40 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$115.60 |
$115.60 |
$115.60 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$68.00 |
$68.00 |
$68.00 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$179.60 |
$179.60 |
$179.60 |
$476.50
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$30.80 |
$30.80 |
$30.80 |
$52.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$593.20 |
$593.20 |
$593.20 |
$618.54
|
|
Kit gene analys d816 variant
|
$320.00 |
$320.00 |
$320.00 |
$276.38
|
|
Knee MRI (with and without contrast)
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$1,382.00 |
$1,382.00 |
$1,382.00 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$1,610.80 |
$1,610.80 |
$1,610.80 |
$2,120.00
|
|
Knee X-ray
|
$183.20 |
$183.20 |
$183.20 |
$387.20
|
|
Lactate dehydrogenase (ldh)
|
$28.80 |
$28.80 |
$28.80 |
$50.55
|
|
Lactic acid
|
$42.40 |
$42.40 |
$42.40 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$76.00 |
$76.00 |
$76.00 |
$88.40
|
|
Lead capillary
|
$32.40 |
$32.40 |
$32.40 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$274.00 |
$274.00 |
$274.00 |
$1,053.00
|
|
Lipase
|
$75.20 |
$75.20 |
$75.20 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$48.80 |
$48.80 |
$48.80 |
$90.60
|
|
Lipoprotein blood quant
|
$32.40 |
$32.40 |
$32.40 |
$106.43
|
|
Lipoprotein direct measurement ldl
|
$44.00 |
$44.00 |
$44.00 |
$61.60
|
|
Lithium therapeutic drug level
|
$66.00 |
$66.00 |
$66.00 |
$62.40
|
|
Liver Function Test
|
$105.60 |
$105.60 |
$105.60 |
$92.85
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,321.20 |
$1,321.20 |
$1,321.20 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,204.40 |
$1,204.40 |
$1,204.40 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,849.20 |
$2,849.20 |
$2,849.20 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,117.60 |
$2,117.60 |
$2,117.60 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,694.40 |
$1,694.40 |
$1,694.40 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$271.20 |
$271.20 |
$271.20 |
$328.23
|
|
Macroscopic exam arthropod
|
$60.00 |
$60.00 |
$60.00 |
$38.50
|
|
Macroscopic exam parasite
|
$60.00 |
$60.00 |
$60.00 |
$35.98
|
|
Magnesium
|
$48.80 |
$48.80 |
$48.80 |
$64.80
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$77.60 |
$77.60 |
$77.60 |
$76.70
|
|
Mayo aathr protein s free
|
$95.20 |
$95.20 |
$95.20 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$228.80 |
$228.80 |
$228.80 |
$100.26
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$190.40 |
$190.40 |
$190.40 |
$172.80
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$71.20 |
$71.20 |
$71.20 |
$96.80
|
|
Mayo alcohol definitive assay volatile screen
|
$102.40 |
$102.40 |
$102.40 |
$118.40
|
|
Mayo alkaline phosphatase isoenzyme
|
$68.40 |
$68.40 |
$68.40 |
$83.85
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$42.40 |
$42.40 |
$42.40 |
$96.10
|
|
Mayo alpha 1 antitrypsin
|
$81.60 |
$81.60 |
$81.60 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$80.00 |
$80.00 |
$80.00 |
$112.89
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$269.60 |
$269.60 |
$269.60 |
$343.20
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$986.00 |
$986.00 |
$986.00 |
$1,922.13
|
|
Mayo androstenedione
|
$162.80 |
$162.80 |
$162.80 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$139.60 |
$139.60 |
$139.60 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$52.00 |
$52.00 |
$52.00 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$58.80 |
$58.80 |
$58.80 |
$72.60
|
|
Mayo avwpr vw factor activity
|
$101.60 |
$101.60 |
$101.60 |
$159.66
|
|
Mayo bart bartonella henselae antibody igg
|
$28.80 |
$28.80 |
$28.80 |
$52.00
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$276.40 |
$276.40 |
$276.40 |
$364.90
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$141.60 |
$141.60 |
$141.60 |
$381.55
|
|
Mayo c1 esterase inhibitor
|
$74.00 |
$74.00 |
$74.00 |
$124.80
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$43.20 |
$43.20 |
$43.20 |
$84.00
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$102.40 |
$102.40 |
$102.40 |
$104.55
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$56.40 |
$56.40 |
$56.40 |
$110.02
|
|
Mayo ceruloplasmin
|
$82.80 |
$82.80 |
$82.80 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$138.80 |
$138.80 |
$138.80 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$45.20 |
$45.20 |
$45.20 |
$122.00
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$337.60 |
$337.60 |
$337.60 |
$380.40
|
|
Mayo chromium
|
$50.00 |
$50.00 |
$50.00 |
$89.25
|
|
Mayo coccidioides antibody
|
$69.20 |
$69.20 |
$69.20 |
$61.10
|
|
Mayo cocou cortisone urine
|
$210.00 |
$210.00 |
$210.00 |
$222.62
|
|
Mayo cortisol free
|
$85.20 |
$85.20 |
$85.20 |
$109.85
|
|
Mayo covid-19 antibody nucleocapsid total
|
$56.00 |
$56.00 |
$56.00 |
$77.63
|