|
Instillation anticarcinogenic agent bladder
|
$562.40 |
$562.40 |
$562.40 |
$638.40
|
|
Insulin total
|
$170.40 |
$170.40 |
$170.40 |
$66.64
|
|
Intra-atrial pacing
|
$6,374.40 |
$6,374.40 |
$6,374.40 |
$4,850.82
|
|
Intra-atrial recording
|
$6,374.40 |
$6,374.40 |
$6,374.40 |
$5,252.30
|
|
Intracranial complete study
|
$1,699.20 |
$1,699.20 |
$1,699.20 |
$881.50
|
|
Intracranial limited study
|
$1,106.40 |
$1,106.40 |
$1,106.40 |
$467.50
|
|
Intrapul surf admin endo tube
|
$118.40 |
$118.40 |
$118.40 |
$220.80
|
|
Intraventricular pacing
|
$6,374.40 |
$6,374.40 |
$6,374.40 |
$5,456.17
|
|
Intrinsic factor antibody
|
$194.40 |
$194.40 |
$194.40 |
$65.00
|
|
Intro catheter aorta
|
$4,917.60 |
$4,917.60 |
$4,917.60 |
$1,678.05
|
|
Intro long gi tube
|
$1,493.60 |
$1,493.60 |
$1,493.60 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$664.00 |
$664.00 |
$664.00 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,355.20 |
$4,355.20 |
$4,355.20 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$4,355.20 |
$4,355.20 |
$4,355.20 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$5.60 |
$5.60 |
$5.60 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$5.60 |
$5.60 |
$5.60 |
$279.10
|
|
Iron
|
$102.40 |
$102.40 |
$102.40 |
$75.00
|
|
Iron binding capacity
|
$135.20 |
$135.20 |
$135.20 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$384.00 |
$384.00 |
$384.00 |
$146.11
|
|
Ivc venogram s&i
|
$7,889.60 |
$7,889.60 |
$7,889.60 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$247.20 |
$247.20 |
$247.20 |
$133.90
|
|
IV Fluids (first hour)
|
$522.40 |
$522.40 |
$522.40 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$258.40 |
$258.40 |
$258.40 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$276.80 |
$276.80 |
$276.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$256.00 |
$256.00 |
$256.00 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$608.00 |
$608.00 |
$608.00 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$267.20 |
$267.20 |
$267.20 |
$167.50
|
|
IV Push Injection (first drug)
|
$300.80 |
$300.80 |
$300.80 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$1,300.80 |
$1,300.80 |
$1,300.80 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$623.20 |
$623.20 |
$623.20 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$503.20 |
$503.20 |
$503.20 |
$362.05
|
|
Jejunstmy tube plcmt
|
$848.80 |
$848.80 |
$848.80 |
$2,174.40
|
|
J-tube placement
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$593.08
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$144.00 |
$144.00 |
$144.00 |
$58.56
|
|
Kidney imaging morphology
|
$1,471.20 |
$1,471.20 |
$1,471.20 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$2,311.20 |
$2,311.20 |
$2,311.20 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$2,169.60 |
$2,169.60 |
$2,169.60 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,365.60 |
$1,365.60 |
$1,365.60 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$985.60 |
$985.60 |
$985.60 |
$490.75
|
|
Kit gene analys d816 variant
|
$2,396.80 |
$2,396.80 |
$2,396.80 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$7,672.00 |
$7,672.00 |
$7,672.00 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$6,208.80 |
$6,208.80 |
$6,208.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$5,300.00 |
$5,300.00 |
$5,300.00 |
$2,130.88
|
|
Knee X-ray
|
$953.60 |
$953.60 |
$953.60 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$883.20 |
$883.20 |
$883.20 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$883.20 |
$883.20 |
$883.20 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$402.40 |
$402.40 |
$402.40 |
$251.20
|
|
Kras gene addl variants
|
$1,106.40 |
$1,106.40 |
$1,106.40 |
$387.20
|
|
Kras gene variants exon 2
|
$1,540.00 |
$1,540.00 |
$1,540.00 |
$536.20
|
|
Lactate dehydrogenase (ldh)
|
$126.40 |
$126.40 |
$126.40 |
$55.50
|
|
Lactic acid
|
$410.40 |
$410.40 |
$410.40 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$124.00 |
$124.00 |
$124.00 |
$82.16
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$2,184.80 |
$2,184.80 |
$2,184.80 |
$740.40
|
|
Lead capillary
|
$246.40 |
$246.40 |
$246.40 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,973.60 |
$1,973.60 |
$1,973.60 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,617.60 |
$2,617.60 |
$2,617.60 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,539.20 |
$2,539.20 |
$2,539.20 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,188.00 |
$2,188.00 |
$2,188.00 |
$1,092.58
|
|
Levetiracetam therapeutic drug level
|
$244.80 |
$244.80 |
$244.80 |
$88.92
|
|
Lidocaine therapeutic drug level
|
$224.80 |
$224.80 |
$224.80 |
$87.45
|
|
Lipase
|
$336.80 |
$336.80 |
$336.80 |
$93.58
|
|
Lipoprotein blood quant
|
$288.00 |
$288.00 |
$288.00 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$123.20 |
$123.20 |
$123.20 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$90.40 |
$90.40 |
$90.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$143.20 |
$143.20 |
$143.20 |
$69.75
|
|
Liver abs/cyst dr opn 1-2 stge
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$1,714.14
|
|
Liver ds alys 3 bmrk srm alg
|
$816.00 |
$816.00 |
$816.00 |
$365.28
|
|
Liver Function Test
|
$168.00 |
$168.00 |
$168.00 |
$115.44
|
|
Liver/spleen imag static only
|
$1,422.40 |
$1,422.40 |
$1,422.40 |
$1,138.55
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$235.20 |
$235.20 |
$235.20 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,211.20 |
$2,211.20 |
$2,211.20 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,152.80 |
$2,152.80 |
$2,152.80 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,777.60 |
$1,777.60 |
$1,777.60 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$6,354.40 |
$6,354.40 |
$6,354.40 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,504.80 |
$4,504.80 |
$4,504.80 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$4,504.80 |
$4,504.80 |
$4,504.80 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$471.20 |
$471.20 |
$471.20 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$542.40 |
$542.40 |
$542.40 |
$505.83
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$612.80 |
$612.80 |
$612.80 |
$540.60
|
|
Lower Leg (Shin) X-ray (both sides)
|
$883.20 |
$883.20 |
$883.20 |
$338.40
|
|
Low frequency non-thermal Ultrasound
|
$371.20 |
$371.20 |
$371.20 |
$364.77
|
|
Lumbar diskogram s&i
|
$5,553.60 |
$5,553.60 |
$5,553.60 |
$2,358.23
|
|
Lung Function Test Before and After an Inhaler
|
$526.40 |
$526.40 |
$526.40 |
$549.83
|
|
Lung function test (mbc/mvv)
|
$113.60 |
$113.60 |
$113.60 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$289.60 |
$289.60 |
$289.60 |
$296.91
|
|
Lung perfusion imaging
|
$1,664.00 |
$1,664.00 |
$1,664.00 |
$1,069.25
|
|
Lymphatics/lymph node imaging
|
$1,792.80 |
$1,792.80 |
$1,792.80 |
$1,491.70
|
|
Macroscopic exam arthropod
|
$74.40 |
$74.40 |
$74.40 |
$38.58
|
|
Macroscopic exam parasite
|
$82.40 |
$82.40 |
$82.40 |
$37.05
|
|
Magnesium
|
$236.80 |
$236.80 |
$236.80 |
$73.00
|
|
Map tachycard site(s)
|
$20,445.60 |
$20,445.60 |
$20,445.60 |
$4,082.82
|
|
Mastoids complete
|
$1,146.40 |
$1,146.40 |
$1,146.40 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$221.60 |
$221.60 |
$221.60 |
$65.28
|
|
Mayo aathr protein s free
|
$339.20 |
$339.20 |
$339.20 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$268.00 |
$268.00 |
$268.00 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$986.40 |
$986.40 |
$986.40 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$281.60 |
$281.60 |
$281.60 |
$101.07
|
|
Mayo alcohol definitive assay volatile screen
|
$413.60 |
$413.60 |
$413.60 |
$126.36
|
|
Mayo alkaline phosphatase isoenzyme
|
$115.20 |
$115.20 |
$115.20 |
$66.60
|
