|
Inject sacroiliac joint
|
$1,454.46 |
$1,454.46 |
$1,454.46 |
$1,028.95
|
|
Inj for ext venography
|
$3,819.90 |
$3,819.90 |
$3,819.90 |
$946.64
|
|
Inj proc for lymphang
|
$1,970.64 |
$1,970.64 |
$1,970.64 |
$1,718.73
|
|
Inj proc sialogram
|
$656.04 |
$656.04 |
$656.04 |
$419.34
|
|
Inj retro urethrocysto
|
$579.18 |
$579.18 |
$579.18 |
$569.60
|
|
Inj secretin synthetic human
|
$35.54 |
$35.54 |
$35.54 |
$610.89
|
|
Insert cath pleura without image
|
$974.40 |
$974.40 |
$974.40 |
$2,157.58
|
|
Insulin total
|
$23.94 |
$23.94 |
$23.94 |
$72.15
|
|
Interrog evl pm/ldls pm ip
|
$97.44 |
$97.44 |
$97.44 |
$130.00
|
|
Intrinsic factor antibody
|
$8.72 |
$8.72 |
$8.72 |
$76.77
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.74 |
$0.74 |
$0.74 |
$4.59
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$17.52 |
$17.52 |
$17.52 |
$254.59
|
|
Iron binding capacity
|
$28.56 |
$28.56 |
$28.56 |
$55.00
|
|
Iron dextran 50 mg/ml injection solution
|
$26.62 |
$26.62 |
$26.62 |
$38.16
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1.23 |
$1.23 |
$1.23 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$27.30 |
$27.30 |
$27.30 |
$127.49
|
|
Ivc venogram s&i
|
$1,402.38 |
$1,402.38 |
$1,402.38 |
$2,975.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$69.72 |
$69.72 |
$69.72 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$50.40 |
$50.40 |
$50.40 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$97.02 |
$97.02 |
$97.02 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$222.18 |
$222.18 |
$222.18 |
$476.50
|
|
Ivp w/nephrotomography
|
$440.16 |
$440.16 |
$440.16 |
$673.90
|
|
Ivp w/wo kub w/wo tomography
|
$452.34 |
$452.34 |
$452.34 |
$687.80
|
|
Ketogenic steroids fract
|
$12.81 |
$12.81 |
$12.81 |
$81.12
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$7.98 |
$7.98 |
$7.98 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$1.69 |
$1.69 |
$1.69 |
$17.11
|
|
Kidney imag w/bld flow multi
|
$673.26 |
$673.26 |
$673.26 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$572.46 |
$572.46 |
$572.46 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$262.50 |
$262.50 |
$262.50 |
$618.54
|
|
Knee X-ray
|
$131.04 |
$131.04 |
$131.04 |
$387.20
|
|
Lactated ringers intravenous solution
|
$13.91 |
$13.91 |
$13.91 |
$46.35
|
|
Lactic acid
|
$12.60 |
$12.60 |
$12.60 |
$85.20
|
|
Lead capillary
|
$4.41 |
$4.41 |
$4.41 |
$66.32
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$8.39 |
$8.39 |
$8.39 |
$115.27
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,440.16 |
$1,440.16 |
$1,440.16 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$1,033.94 |
$1,033.94 |
$1,033.94 |
$4,308.91
|
|
Lidocaine therapeutic drug level
|
$10.68 |
$10.68 |
$10.68 |
$82.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$18.80 |
$18.80 |
$18.80 |
$84.28
|
|
Lipase
|
$14.28 |
$14.28 |
$14.28 |
$67.68
|
|
Lipoprotein direct measurement hdl
|
$18.06 |
$18.06 |
$18.06 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$21.00 |
$21.00 |
$21.00 |
$61.60
|
|
Listeria monocytogenes
|
$30.24 |
$30.24 |
$30.24 |
$60.84
|
|
Lithium therapeutic drug level
|
$14.28 |
$14.28 |
$14.28 |
$62.40
|
|
Liver imaging
|
$411.18 |
$411.18 |
$411.18 |
$827.28
|
|
Liver/spleen imag static only
|
$621.18 |
$621.18 |
$621.18 |
$1,135.20
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$1.13 |
$1.13 |
$1.13 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,043.70 |
$1,043.70 |
$1,043.70 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$891.24 |
$891.24 |
$891.24 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$736.68 |
$736.68 |
$736.68 |
$1,450.15
|
|
Lower Back (Lumbar Spine) X-ray
|
$146.16 |
$146.16 |
$146.16 |
$328.23
|
|
Lumbar diskogram s&i
|
$1,161.30 |
$1,161.30 |
$1,161.30 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$126.00 |
$126.00 |
$126.00 |
$290.89
|
|
Lung perfusion imaging
|
$618.66 |
$618.66 |
$618.66 |
$919.75
|
|
Lymphocyte transformation mitogen
|
$37.80 |
$37.80 |
$37.80 |
$235.56
|
|
Magnesium
|
$4.17 |
$4.17 |
$4.17 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$6.26 |
$6.26 |
$6.26 |
$39.81
|
|
Mannitol 12.5 gm/50 ml inj
|
$3.46 |
$3.46 |
$3.46 |
$33.24
|
|
Mastoids complete
|
$127.26 |
$127.26 |
$127.26 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$10.95 |
$10.95 |
$10.95 |
$76.70
|
|
Mayo aathr protein s free
|
$32.76 |
$32.76 |
$32.76 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$60.06 |
$60.06 |
$60.06 |
$100.26
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$96.12 |
$96.12 |
$96.12 |
$96.80
|
|
Mayo alkaline phosphatase isoenzyme
|
$12.37 |
$12.37 |
$12.37 |
$83.85
|
|
Mayo amikacin trough therapeutic drug level
|
$20.58 |
$20.58 |
$20.58 |
$112.89
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$25.20 |
$25.20 |
$25.20 |
$343.20
|
|
Mayo androstenedione
|
$7.04 |
$7.04 |
$7.04 |
$131.30
|
|
Mayo aspergillus fumigatus antibody
|
$17.64 |
$17.64 |
$17.64 |
$72.60
|
|
Mayo bart bartonella henselae antibody igg
|
$4.82 |
$4.82 |
$4.82 |
$52.00
|
|
Mayo blastomyces antibody immunodiffusion
|
$11.99 |
$11.99 |
$11.99 |
$67.60
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$42.84 |
$42.84 |
$42.84 |
$60.15
|
|
Mayo brcmg brucella antibody igm
|
$2.95 |
$2.95 |
$2.95 |
$56.80
|
|
Mayo c1 esterase inhibitor
|
$34.44 |
$34.44 |
$34.44 |
$124.80
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$16.85 |
$16.85 |
$16.85 |
$84.00
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$10.69 |
$10.69 |
$10.69 |
$104.55
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$116.34 |
$116.34 |
$116.34 |
$274.40
|
|
Mayo ceruloplasmin
|
$23.10 |
$23.10 |
$23.10 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$3.36 |
$3.36 |
$3.36 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$13.28 |
$13.28 |
$13.28 |
$122.00
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$40.64 |
$40.64 |
$40.64 |
$59.11
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$16.17 |
$16.17 |
$16.17 |
$54.40
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$264.60 |
$264.60 |
$264.60 |
$380.40
|
|
Mayo chromium
|
$6.51 |
$6.51 |
$6.51 |
$89.25
|
|
Mayo coccidioides antibody
|
$17.64 |
$17.64 |
$17.64 |
$61.10
|
|
Mayo cocou cortisone urine
|
$288.44 |
$288.44 |
$288.44 |
$222.62
|
|
Mayo cyanide
|
$14.32 |
$14.32 |
$14.32 |
$98.40
|
|
Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual
|
$263.34 |
$263.34 |
$263.34 |
$780.00
|
|
Mayo deoxyribonuclease antibody titer
|
$4.56 |
$4.56 |
$4.56 |
$74.40
|
|
Mayo efpo chloride stool
|
$5.04 |
$5.04 |
$5.04 |
$45.00
|
|
Mayo estriol
|
$12.60 |
$12.60 |
$12.60 |
$102.50
|
|
Mayo ethosuximide therapeutic drug level
|
$5.21 |
$5.21 |
$5.21 |
$81.60
|
|
Mayo factor ii
|
$14.76 |
$14.76 |
$14.76 |
$96.76
|
|
Mayo factor v
|
$8.43 |
$8.43 |
$8.43 |
$119.60
|
|
Mayo factor vii
|
$10.02 |
$10.02 |
$10.02 |
$124.80
|
|
Mayo factor viii vw factor antigen
|
$15.86 |
$15.86 |
$15.86 |
$116.40
|
|
Mayo factor viii vw factor multimetric analysis
|
$69.09 |
$69.09 |
$69.09 |
$147.63
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$7.66 |
$7.66 |
$7.66 |
$133.25
|
|
Mayo factor x
|
$9.11 |
$9.11 |
$9.11 |
$130.65
|
|
Mayo factor xi
|
$16.22 |
$16.22 |
$16.22 |
$120.96
|
|
Mayo fat/lipids feces quantitative
|
$12.60 |
$12.60 |
$12.60 |
$76.05
|
|
Mayo fdp/fsp paracoagulation
|
$101.22 |
$101.22 |
$101.22 |
$115.53
|
