|
Insertion catheter bladder temporary simple
|
$278.78 |
$278.78 |
$278.78 |
$260.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,658.48 |
$4,658.48 |
$4,658.48 |
$2,487.99
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$8,683.53 |
$8,683.53 |
$8,683.53 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,978.45 |
$5,978.45 |
$5,978.45 |
$2,419.65
|
|
In situ hybridization per specimen each additional single probe stain
|
$2,543.28 |
$2,543.28 |
$2,543.28 |
$264.00
|
|
In situ hybridization per specimen initial single probe stain
|
$306.87 |
$306.87 |
$306.87 |
$350.35
|
|
Ins picad w subq port 5yr>
|
$8,891.66 |
$8,891.66 |
$8,891.66 |
$4,278.16
|
|
Instill, bupivac and meloxic
|
$905.55 |
$905.55 |
$905.55 |
$864.54
|
|
Insulin total
|
$306.97 |
$306.97 |
$306.97 |
$67.60
|
|
Intrinsic factor antibody
|
$397.35 |
$397.35 |
$397.35 |
$61.10
|
|
Intubation endotracheal emergency procedure
|
$2,579.16 |
$2,579.16 |
$2,579.16 |
$594.10
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$492.98 |
$492.98 |
$492.98 |
$184.87
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$768.29 |
$768.29 |
$768.29 |
$222.75
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$91,584.24 |
$91,584.24 |
$91,584.24 |
$51,292.53
|
|
Ipratropium bromide non-comp
|
$6.01 |
$6.01 |
$6.01 |
$11.59
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$490.93 |
$490.93 |
$490.93 |
$236.99
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$7,631.90 |
$7,631.90 |
$7,631.90 |
$5,138.18
|
|
Iron
|
$292.36 |
$292.36 |
$292.36 |
$72.80
|
|
Iron binding capacity
|
$166.64 |
$166.64 |
$166.64 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$118.65 |
$118.65 |
$118.65 |
$62.12
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$271.04 |
$271.04 |
$271.04 |
$255.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$260.79 |
$260.79 |
$260.79 |
$153.75
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$27,738.44 |
$27,738.44 |
$27,738.44 |
$11,912.16
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$427.37 |
$427.37 |
$427.37 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$427.37 |
$427.37 |
$427.37 |
$181.26
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$427.37 |
$427.37 |
$427.37 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$594.31 |
$594.31 |
$594.31 |
$460.85
|
|
IV inj ra drug dx study
|
$1,315.55 |
$1,315.55 |
$1,315.55 |
$549.70
|
|
Jak2 targeted sequence analysis
|
$1,339.96 |
$1,339.96 |
$1,339.96 |
$379.87
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$280.68 |
$280.68 |
$280.68 |
$53.78
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$82.13 |
$82.13 |
$82.13 |
$23.63
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,366.43 |
$1,366.43 |
$1,366.43 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$593.02 |
$593.02 |
$593.02 |
$100.00
|
|
Knee MRI (with and without contrast)
|
$5,540.18 |
$5,540.18 |
$5,540.18 |
$2,918.65
|
|
Knee MRI (without contrast)
|
$4,578.42 |
$4,578.42 |
$4,578.42 |
$2,209.22
|
|
Knee X-ray
|
$734.24 |
$734.24 |
$734.24 |
$442.85
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$151.64 |
$151.64 |
$151.64 |
$29.35
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$129.53 |
$129.53 |
$129.53 |
$207.29
|
|
Lactate dehydrogenase (ldh)
|
$165.27 |
$165.27 |
$165.27 |
$53.00
|
|
Lactated ringers intravenous solution
|
$57.56 |
$57.56 |
$57.56 |
$47.66
|
|
Lactic acid
|
$304.46 |
$304.46 |
$304.46 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$301.42 |
$301.42 |
$301.42 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$35,203.37 |
$35,203.37 |
$35,203.37 |
$22,875.00
|
|
Lead capillary
|
$435.65 |
$435.65 |
$435.65 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,975.02 |
$2,975.02 |
$2,975.02 |
$1,090.23
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$1,264.50 |
$1,264.50 |
$1,264.50 |
$120.34
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$117.73 |
$117.73 |
$117.73 |
$89.50
|
|
Levetiracetam therapeutic drug level
|
$349.64 |
$349.64 |
$349.64 |
$75.00
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$78.66 |
$78.66 |
$78.66 |
$64.88
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$108.12 |
$108.12 |
$108.12 |
$130.49
|
|
Lipase
|
$131.57 |
$131.57 |
$131.57 |
$82.20
|
|
Lipoprotein blood quant
|
$409.33 |
$409.33 |
$409.33 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$204.67 |
$204.67 |
$204.67 |
$54.81
|
|
Lipoprotein direct measurement ldl
|
$99.39 |
$99.39 |
$99.39 |
$60.00
|
|
Lithium therapeutic drug level
|
$76.90 |
$76.90 |
$76.90 |
$67.08
|
|
Liver Function Test
|
$384.46 |
$384.46 |
$384.46 |
$111.59
|
|
Locm 100-199mg/ml iodine,1ml
|
$44.10 |
$44.10 |
$44.10 |
$12.00
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$39.88 |
$39.88 |
$39.88 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$5,900.98 |
$5,900.98 |
$5,900.98 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$4,843.52 |
$4,843.52 |
$4,843.52 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$4,361.58 |
$4,361.58 |
$4,361.58 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$6,008.53 |
$6,008.53 |
$6,008.53 |
$2,926.43
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$4,902.71 |
$4,902.71 |
$4,902.71 |
$2,025.14
|
|
Lower Back (Lumbar Spine) X-ray
|
$685.29 |
$685.29 |
$685.29 |
$341.64
|
|
Lung Function Test (Spirometry)
|
$406.97 |
$406.97 |
$406.97 |
$296.91
|
|
Lung perfusion imaging
|
$1,972.46 |
$1,972.46 |
$1,972.46 |
$1,082.75
|
|
Macroscopic exam parasite
|
$46.42 |
$46.42 |
$46.42 |
$36.55
|
|
Magnesium
|
$192.86 |
$192.86 |
$192.86 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$75.16 |
$75.16 |
$75.16 |
$57.51
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$214.10 |
$214.10 |
$214.10 |
$135.85
|
|
Manipulation chest wall initial demonstration/evaluation
|
$221.73 |
$221.73 |
$221.73 |
$163.15
|
|
Mannitol 12.5 gm/50 ml inj
|
$88.18 |
$88.18 |
$88.18 |
$40.12
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$89,329.77 |
$89,329.77 |
$89,329.77 |
$38,252.87
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$435.65 |
$435.65 |
$435.65 |
$71.78
|
|
Mayo aathr protein s free
|
$234.97 |
$234.97 |
$234.97 |
$135.60
|
|
Mayo activated protein c resistance assay
|
$216.52 |
$216.52 |
$216.52 |
$100.10
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$787.97 |
$787.97 |
$787.97 |
$180.00
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$174.72 |
$174.72 |
$174.72 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$128.03 |
$128.03 |
$128.03 |
$105.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$251.43 |
$251.43 |
$251.43 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$375.30 |
$375.30 |
$375.30 |
$137.80
|
|
Mayo alpha 1 antitrypsin
|
$194.48 |
$194.48 |
$194.48 |
$86.40
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$186.82 |
$186.82 |
$186.82 |
$87.00
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$301.82 |
$301.82 |
$301.82 |
$73.32
|
|
Mayo analysis gene calr common variants exon 9
|
$738.62 |
$738.62 |
$738.62 |
$509.00
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$746.42 |
$746.42 |
$746.42 |
$343.20
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$8,929.85 |
$8,929.85 |
$8,929.85 |
$1,927.61
|
|
Mayo androstenedione
|
$239.75 |
$239.75 |
$239.75 |
$111.15
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$116.94 |
$116.94 |
$116.94 |
$74.24
|
|
Mayo antithrombin iii antigen
|
$91.28 |
$91.28 |
$91.28 |
$67.13
|
|
Mayo aspergillus fumigatus antibody
|
$113.25 |
$113.25 |
$113.25 |
$67.60
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$108.32 |
$108.32 |
$108.32 |
$105.00
|
|
Mayo barbiturates definitive assay confirmation urine
|
$245.01 |
$245.01 |
$245.01 |
$94.25
|
|
Mayo bart bartonella henselae antibody igg
|
$121.25 |
$121.25 |
$121.25 |
$46.80
|
|
Mayo blastomyces antibody immunodiffusion
|
$154.76 |
$154.76 |
$154.76 |
$57.85
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$113.81 |
$113.81 |
$113.81 |
$66.00
|
|
Mayo bordetella pertussis antibody igg
|
$138.38 |
$138.38 |
$138.38 |
$59.15
|
|
Mayo c1 esterase inhibitor
|
$233.90 |
$233.90 |
$233.90 |
$90.30
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$260.40 |
$260.40 |
$260.40 |
$96.85
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$152.65 |
$152.65 |
$152.65 |
$85.80
|