|
MRA w/cont, abd
|
$820.99 |
$2,079.00 |
$2,079.00 |
|
|
MRA w/cont, lwr ext
|
$912.00 |
$2,310.06 |
$2,310.06 |
|
|
Mra, w/dye, spinal canal
|
$1,645.15 |
$1,645.15 |
$1,645.15 |
|
|
Mra, w/dye, upper extremity
|
$1,645.15 |
$1,645.15 |
$1,645.15 |
|
|
MRA without cont, abd
|
$547.30 |
$1,648.42 |
$1,648.42 |
|
|
MRA without cont, lwr ext
|
$822.72 |
$1,648.42 |
$1,648.42 |
|
|
MRA without fol w/cont, abd
|
$1,276.99 |
$3,234.06 |
$3,234.06 |
|
|
MRA without fol w/cont, lwr ext
|
$1,641.79 |
$4,158.28 |
$4,158.28 |
|
|
MRA without fol w/cont, pelvis
|
$1,641.79 |
$2,206.29 |
$3,633.28 |
|
|
Mra, w/o&w/dye, spinal canal
|
$1,641.79 |
$1,641.79 |
$1,641.79 |
|
|
Mra, w/o&w/dye, upper extr
|
$1,641.79 |
$2,481.08 |
$3,633.28 |
|
|
Mr elastography
|
$969.07 |
$2,450.39 |
$2,450.39 |
|
|
Mrgfus strtctc ablt trgt icr
|
$20,950.13 |
$20,950.13 |
$20,950.13 |
|
|
MRI brain w/dye
|
$4,387.20 |
$4,387.20 |
$4,387.20 |
|
|
MRI brain without dye
|
$4,378.18 |
$4,378.18 |
$4,378.18 |
|
|
MRI brain without & w/dye
|
$4,378.18 |
$4,378.18 |
$4,378.18 |
|
|
MRI breast c- unilateral
|
$364.85 |
$924.39 |
$924.39 |
|
|
MRI breast c-+ w/cad uni
|
$548.35 |
$1,318.07 |
$1,318.07 |
|
|
MRI breast without cont bi
|
$456.05 |
$1,155.11 |
$3,612.00 |
|
|
MRI breast w IV cont bi
|
$594.10 |
$1,439.03 |
$3,747.20 |
|
|
MRI cardiac morph & func wo IV cont
|
$1,094.50 |
$1,386.00 |
$1,386.00 |
|
|
MRI cardiac morph & func wwo IV cont
|
$1,276.99 |
$2,310.06 |
$2,310.06 |
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$1,553.76 |
$1,553.76 |
$1,553.76 |
|
|
MRI chest without contrast
|
$820.99 |
$2,652.80 |
$3,237.60 |
|
|
MRI chest without & w/contrast
|
$1,185.79 |
$3,003.22 |
$3,921.60 |
|
|
MRI chest w IV cont
|
$1,003.30 |
$2,541.06 |
$3,609.60 |
|
|
MRI compatible system
|
$1,802.53 |
$2,394.34 |
$2,394.34 |
|
|
MRI fetal ea addl gestation
|
$649.30 |
$649.30 |
$649.30 |
|
|
MRI fetal sngl/1st gestation
|
$1,094.50 |
$1,094.50 |
$1,094.50 |
|
|
MRI guid ndl plc s&i
|
$1,096.80 |
$2,773.29 |
$2,773.29 |
|
|
MRI loex nonjt w IV cont
|
$751.39 |
$1,934.97 |
$3,582.40 |
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$1,094.50 |
$2,772.11 |
$3,237.60 |
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$1,368.19 |
$3,541.60 |
$4,112.80 |
|
|
MRI orbit fac&nck w IV cont
|
$912.00 |
$2,310.06 |
$3,553.60 |
|
|
MRI tmj
|
$820.99 |
$2,672.00 |
$3,237.60 |
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$1,094.50 |
$2,772.11 |
$3,222.40 |
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$1,459.39 |
$3,696.17 |
$4,062.40 |
|
|
MRI upper extremity w/dye
|
$3,265.60 |
$3,265.60 |
$3,493.60 |
|
|
MRI w/cont, breast, bi
|
$791.11 |
$791.11 |
$1,096.80 |
|
|
MRI w/cont, breast, uni
|
$791.11 |
$791.11 |
$877.44 |
|
|
MRI without fol w/cont, breast
|
$547.30 |
$1,386.00 |
$1,386.00 |
|
|
MRI without fol w/cont, brst, un
|
$501.70 |
$1,265.54 |
$1,265.54 |
|
|
Mr spectroscopy
|
$952.00 |
$952.00 |
$1,096.80 |
|
|
Msh6 gene known variants
|
$710.40 |
$710.40 |
$710.40 |
|
|
Mthfr gene analy common variants
|
$104.93 |
$109.37 |
$538.40 |
|
|
Multi-axial knee/shin system
|
$5,976.94 |
$7,743.74 |
$7,743.74 |
|
|
Multi-axial rotation unit
|
$1,229.76 |
$1,633.52 |
$1,633.52 |
|
|
Multi den insert direct form
|
$47.54 |
$65.02 |
$65.02 |
|
|
Multi-durometer below knee
|
$918.06 |
$1,219.46 |
$1,219.46 |
|
|
Multi-durometer symes
|
$1,032.58 |
$1,371.61 |
$1,371.61 |
|
|
Multi family grp psychotherapy
|
$47.38 |
$61.94 |
$61.94 |
|
|
Multiple sleep latency test
|
$1,443.70 |
$2,538.40 |
$3,290.40 |
|
|
Multipo locking shoulder jnt
|
$4,834.03 |
$6,262.98 |
$6,262.98 |
|
|
Mumps antibody igg
|
$42.62 |
$46.70 |
$158.40 |
|
|
Muscle test cran nerv unilat
|
$117.55 |
$117.55 |
$526.40 |
|
|
Muscle test hemidiaphragm
|
$54.14 |
$54.14 |
$386.40 |
|
|
Muscle test larynx
|
$54.14 |
$54.14 |
$1,288.00 |
|
|
Muscle test one fiber
|
$117.26 |
$117.26 |
$117.26 |
|
|
Mycobacteria dna amp probe
|
$721.56 |
$721.56 |
$721.56 |
|
|
Mycophenolate mofetil 250 mg capsule
|
$1.20 |
$3.39 |
$5.46 |
|
|
Mycophenolic acid
|
$7.94 |
$8.66 |
$25.83 |
|
|
Mycoplasma antibody igm
|
$29.38 |
$34.27 |
$137.60 |
|
|
Myd88 gene p.leu265pro vrnt
|
$607.20 |
$1,049.61 |
$1,079.57 |
|
|
Myelogphy 2/> spine regions
|
$2,435.20 |
$2,435.20 |
$2,435.20 |
|
|
Myelography l-s spine
|
$265.72 |
$282.67 |
$1,912.00 |
|
|
Myelography neck spine
|
$203.17 |
$203.17 |
$343.56 |
|
|
Myelography thoracic spine
|
$277.34 |
$463.51 |
$463.51 |
|
|
Myelography via inj w/s&i 2+ regions
|
$1,193.92 |
$1,193.92 |
$1,705.39 |
|
|
Myelography via inj w/s&i cervical
|
$939.79 |
$939.79 |
$1,590.40 |
|
|
Myelography via inj w/s&i lumbosacral
|
$923.27 |
$923.27 |
$1,457.60 |
|
|
Myelography via inj w/s&i thoracic
|
$1,318.80 |
$1,625.96 |
$1,625.96 |
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$104.00 |
$301.15 |
$370.10 |
|
|
Myocrd img pet 1 std w/ct
|
$4,399.30 |
$4,399.30 |
$4,399.30 |
|
|
Myocrd img pet 2rtracer
|
$7,229.90 |
$7,229.90 |
$7,229.90 |
|
|
Myocrd img pet 2rtracer CT
|
$8,201.42 |
$8,201.42 |
$8,201.42 |
|
|
Myocrd img pet rst&strs CT
|
$5,256.72 |
$5,256.72 |
$5,256.72 |
|
|
Myocrd img pet rst/strs w/ct
|
$2,830.51 |
$2,830.51 |
$2,830.51 |
|
|
Nafcillin 2 gram solution for injection
|
$30.08 |
$68.14 |
$95.64 |
|
|
Nalbuphine 10 mg/ml injection solution
|
$28.17 |
$31.71 |
$62.64 |
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$25.73 |
$38.73 |
$65.56 |
|
|
Naltrexone, depot form
|
$1,473.40 |
$2,897.88 |
$2,988.40 |
|
|
Nasal endoscopy dx uni/bi separate proc
|
$192.72 |
$192.72 |
$504.00 |
|
|
Nasopharyngoscopy w/endoscope
|
$169.68 |
$169.68 |
$374.40 |
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$11,758.96 |
$14,517.85 |
$14,517.85 |
|
|
Natriuretic peptide
|
$87.98 |
$179.48 |
$229.60 |
|
|
Natural killer cells total count
|
$92.06 |
$105.60 |
$140.00 |
|
|
N block inj hypogas plxs
|
$1,387.15 |
$1,387.15 |
$2,188.80 |
|
|
Ndl emg musc 1 xtr/non-limb
|
$65.04 |
$358.40 |
$358.40 |
|
|
Ndl insj without njx 1 or 2 musc
|
$28.80 |
$30.80 |
$41.60 |
|
|
Ndl insj without njx 3+ musc
|
$40.32 |
$43.12 |
$71.20 |
|
|
Ndl oculoelectromyography 1+
|
$71.23 |
$84.95 |
$84.95 |
|
|
Ndl round specialty proguide
|
$129.41 |
$150.98 |
$150.98 |
|
|
Nebulizer Breathing Treatment
|
$96.82 |
$161.09 |
$276.80 |
|
|
Neck Airway (Soft Tissue) X-ray
|
$192.80 |
$220.00 |
$393.60 |
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$863.71 |
$1,083.26 |
$2,843.20 |
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$647.76 |
$1,368.81 |
$2,521.60 |
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$431.81 |
$1,886.40 |
$2,522.40 |
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$912.00 |
$3,840.00 |
$4,720.80 |
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$729.74 |
$1,922.31 |
$3,990.40 |
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$547.30 |
$2,757.60 |
$3,444.00 |
|