|
Infectious agent nucleic acid quantification hepatitis c
|
$411.00 |
$411.00 |
$411.00 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$375.00 |
$375.00 |
$375.00 |
$381.55
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$129.00 |
$129.00 |
$129.00 |
$76.00
|
|
Influenza virus vaccine, live trivalent intranasal
|
$44.25 |
$44.25 |
$44.25 |
$40.89
|
|
Initial nursing facility care/day 35 minutes
|
$84.75 |
$84.75 |
$84.75 |
$244.00
|
|
Initial nursing facility care/day 45 minutes
|
$106.50 |
$106.50 |
$106.50 |
$333.60
|
|
Initial nursing facility care/day low severity 99304
|
$52.50 |
$52.50 |
$52.50 |
$162.40
|
|
Injection carpal tunnel therapeutic (both sides)
|
$86.25 |
$86.25 |
$86.25 |
$441.60
|
|
Injection,onabotulinumtoxina
|
$1,136.18 |
$1,136.18 |
$1,136.18 |
$12.88
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$243.00 |
$243.00 |
$243.00 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$294.75 |
$294.75 |
$294.75 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$66.75 |
$66.75 |
$66.75 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$133.50 |
$133.50 |
$133.50 |
$1,961.05
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$88.50 |
$88.50 |
$88.50 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$66.00 |
$66.00 |
$66.00 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$74.25 |
$74.25 |
$74.25 |
$654.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$18.75 |
$18.75 |
$18.75 |
$130.19
|
|
Inject sacroiliac joint
|
$249.00 |
$249.00 |
$249.00 |
$1,028.95
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$867.75 |
$867.75 |
$867.75 |
$1,673.66
|
|
Inj intralesional <= 7 lsn(s)
|
$66.00 |
$66.00 |
$66.00 |
$238.77
|
|
Inj testosterone cypionate
|
$13.13 |
$13.13 |
$13.13 |
$78.79
|
|
Insert drug delivery implant
|
$368.25 |
$368.25 |
$368.25 |
$257.40
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$351.00 |
$351.00 |
$351.00 |
$4,923.19
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$159.75 |
$159.75 |
$159.75 |
$2,457.24
|
|
Insulin total
|
$38.25 |
$38.25 |
$38.25 |
$72.15
|
|
Intrinsic factor antibody
|
$143.25 |
$143.25 |
$143.25 |
$76.77
|
|
Intubation endotracheal emergency procedure
|
$239.25 |
$239.25 |
$239.25 |
$565.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$4.50 |
$4.50 |
$4.50 |
$4.59
|
|
Iron
|
$21.75 |
$21.75 |
$21.75 |
$67.50
|
|
Iron binding capacity
|
$34.50 |
$34.50 |
$34.50 |
$55.00
|
|
Iron dextran 50 mg/ml injection solution
|
$36.75 |
$36.75 |
$36.75 |
$38.16
|
|
Irrigation implantable venous access device for drug delivery systems
|
$174.00 |
$174.00 |
$174.00 |
$149.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$23.25 |
$23.25 |
$23.25 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$12.00 |
$12.00 |
$12.00 |
$17.11
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$43.50 |
$43.50 |
$43.50 |
$618.54
|
|
Knee Arthroscopy (Cartilage Repair)
|
$598.50 |
$598.50 |
$598.50 |
$3,594.44
|
|
Knee arthroscopy dx
|
$408.75 |
$408.75 |
$408.75 |
$3,591.33
|
|
Knee arthroscopy/surgery
|
$504.00 |
$504.00 |
$504.00 |
$3,591.33
|
|
Knee arthroscopy/surgery
|
$486.75 |
$486.75 |
$486.75 |
$3,594.44
|
|
Knee arthroscopy/surgery
|
$1,432.50 |
$1,432.50 |
$1,432.50 |
$3,594.44
|
|
Knee arthroscopy/surgery
|
$660.00 |
$660.00 |
$660.00 |
$3,594.44
|
|
Knee MRI (without contrast)
|
$80.25 |
$80.25 |
$80.25 |
$2,120.00
|
|
Knee X-ray
|
$128.25 |
$128.25 |
$128.25 |
$387.20
|
|
Lactate dehydrogenase (ldh)
|
$21.75 |
$21.75 |
$21.75 |
$50.55
|
|
Lactated ringers intravenous solution
|
$6.82 |
$6.82 |
$6.82 |
$46.35
|
|
Lactic acid
|
$36.75 |
$36.75 |
$36.75 |
$85.20
|
|
Laparoscopy excise lesions
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
$5,747.73
|
|
Laparoscopy lysis
|
$969.00 |
$969.00 |
$969.00 |
$5,057.88
|
|
Lap enterolysis
|
$2,127.00 |
$2,127.00 |
$2,127.00 |
$5,868.27
|
|
Lavh >250 gms 58553
|
$1,590.75 |
$1,590.75 |
$1,590.75 |
$8,917.26
|
|
Lead capillary
|
$25.50 |
$25.50 |
$25.50 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$41.25 |
$41.25 |
$41.25 |
$1,053.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$4,308.91
|
|
Ligate/transect fallopian tubes 58600
|
$504.75 |
$504.75 |
$504.75 |
$3,474.84
|
|
Limited visual field xm
|
$116.25 |
$116.25 |
$116.25 |
$79.20
|
|
Lincomycin injection
|
$16.50 |
$16.50 |
$16.50 |
$13.25
|
|
Lipase
|
$19.50 |
$19.50 |
$19.50 |
$67.68
|
|
Lipoprotein blood quant
|
$83.25 |
$83.25 |
$83.25 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$29.25 |
$29.25 |
$29.25 |
$54.60
|
|
Lithium therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
$62.40
|
|
Liver Function Test
|
$46.50 |
$46.50 |
$46.50 |
$92.85
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$60.75 |
$60.75 |
$60.75 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$257.25 |
$257.25 |
$257.25 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$87.75 |
$87.75 |
$87.75 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$123.75 |
$123.75 |
$123.75 |
$328.23
|
|
Lung Function Test (Spirometry)
|
$33.00 |
$33.00 |
$33.00 |
$290.89
|
|
Macroscopic exam parasite
|
$46.50 |
$46.50 |
$46.50 |
$35.98
|
|
Magnesium
|
$21.75 |
$21.75 |
$21.75 |
$64.80
|
|
Mayo aathr protein s free
|
$47.25 |
$47.25 |
$47.25 |
$139.23
|
|
Mayo alcohol definitive assay volatile screen
|
$25.50 |
$25.50 |
$25.50 |
$118.40
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$67.50 |
$67.50 |
$67.50 |
$96.10
|
|
Mayo alpha 1 antitrypsin
|
$46.50 |
$46.50 |
$46.50 |
$91.80
|
|
Mayo androstenedione
|
$90.00 |
$90.00 |
$90.00 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$88.50 |
$88.50 |
$88.50 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$82.50 |
$82.50 |
$82.50 |
$75.00
|
|
Mayo bart bartonella henselae antibody igg
|
$31.50 |
$31.50 |
$31.50 |
$52.00
|
|
Mayo c1 esterase inhibitor
|
$257.25 |
$257.25 |
$257.25 |
$124.80
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$149.25 |
$149.25 |
$149.25 |
$104.55
|
|
Mayo ceruloplasmin
|
$65.25 |
$65.25 |
$65.25 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$145.50 |
$145.50 |
$145.50 |
$125.50
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$216.00 |
$216.00 |
$216.00 |
$380.40
|
|
Mayo coccidioides antibody
|
$48.00 |
$48.00 |
$48.00 |
$61.10
|
|
Mayo cocou cortisone urine
|
$173.25 |
$173.25 |
$173.25 |
$222.62
|
|
Mayo cortisol free
|
$135.75 |
$135.75 |
$135.75 |
$109.85
|
|
Mayo dhea (dehydroepiandrosterone)
|
$137.25 |
$137.25 |
$137.25 |
$113.10
|
|
Mayo estriol
|
$75.75 |
$75.75 |
$75.75 |
$102.50
|
|
Mayo estrone
|
$156.75 |
$156.75 |
$156.75 |
$105.00
|
|
Mayo factor ii
|
$120.75 |
$120.75 |
$120.75 |
$96.76
|
|
Mayo factor v
|
$120.75 |
$120.75 |
$120.75 |
$119.60
|
|
Mayo factor vii
|
$120.75 |
$120.75 |
$120.75 |
$124.80
|
|
Mayo factor viii vw factor antigen
|
$55.50 |
$55.50 |
$55.50 |
$116.40
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$119.25 |
$119.25 |
$119.25 |
$133.25
|
|
Mayo factor x
|
$120.75 |
$120.75 |
$120.75 |
$130.65
|
|
Mayo factor xi
|
$123.75 |
$123.75 |
$123.75 |
$120.96
|
|
Mayo hla typing a/b/c single antigen
|
$126.75 |
$126.75 |
$126.75 |
$142.00
|
|
Mayo hvdip HIV 1 antibody
|
$25.50 |
$25.50 |
$25.50 |
$69.60
|
|
Mayo hydroxyprogesterone 17-d
|
$132.75 |
$132.75 |
$132.75 |
$120.75
|
|
Mayo immunoassay c1 esterase inhibitor antibody quantitative
|
$76.50 |
$76.50 |
$76.50 |
$202.63
|
|
Mayo immunoassay infectious agent antibody quantitative diptheria igg
|
$16.50 |
$16.50 |
$16.50 |
$83.40
|
|
Mayo immunoassay tumor antigen quantitative ca 27.29
|
$84.75 |
$84.75 |
$84.75 |
$117.20
|
