|
Liver/spleen imag static only
|
$1,214.85 |
$1,214.85 |
$1,214.85 |
$1,135.20
|
|
Liver/spleen imag w/vasclr flow
|
$934.05 |
$934.05 |
$934.05 |
$727.35
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$55.64 |
$55.64 |
$55.64 |
$37.37
|
|
Low back disk surgery
|
$31,367.87 |
$31,367.87 |
$31,367.87 |
$7,907.11
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,093.00 |
$2,093.00 |
$2,093.00 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,963.00 |
$1,963.00 |
$1,963.00 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,834.30 |
$1,834.30 |
$1,834.30 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,075.80 |
$3,075.80 |
$3,075.80 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,332.20 |
$2,332.20 |
$2,332.20 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,332.20 |
$2,332.20 |
$2,332.20 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$328.25 |
$328.25 |
$328.25 |
$328.23
|
|
Lumbar diskogram s&i
|
$1,786.85 |
$1,786.85 |
$1,786.85 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$466.70 |
$466.70 |
$466.70 |
$290.89
|
|
Lung perfusion imaging
|
$1,030.25 |
$1,030.25 |
$1,030.25 |
$919.75
|
|
Lurbinectedin 4 mg intravenous solution
|
$13,674.05 |
$13,674.05 |
$13,674.05 |
$298.13
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$6,825.32 |
$6,825.32 |
$6,825.32 |
$68.76
|
|
Lutetium lu 177 vipivotide
|
$542.10 |
$542.10 |
$542.10 |
$332.80
|
|
Lymphatics/lymph node imaging
|
$28,053.83 |
$28,053.83 |
$28,053.83 |
$1,330.00
|
|
Lysis penil circumic lesion
|
$9,947.25 |
$9,947.25 |
$9,947.25 |
$2,874.36
|
|
Macroscopic exam arthropod
|
$18.20 |
$18.20 |
$18.20 |
$38.50
|
|
Macroscopic exam parasite
|
$18.20 |
$18.20 |
$18.20 |
$35.98
|
|
Magnesium
|
$192.40 |
$192.40 |
$192.40 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$50.37 |
$50.37 |
$50.37 |
$39.81
|
|
Male sling procedure
|
$37,985.92 |
$37,985.92 |
$37,985.92 |
$9,674.50
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$137.80 |
$137.80 |
$137.80 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$228.80 |
$228.80 |
$228.80 |
$147.72
|
|
Mapping io sentinel lymph node
|
$28,796.99 |
$28,796.99 |
$28,796.99 |
$505.67
|
|
Mastectomy partial
|
$529.10 |
$529.10 |
$529.10 |
$4,306.52
|
|
Mastoids complete
|
$542.75 |
$542.75 |
$542.75 |
$271.95
|
|
Mast simple complete
|
$767.65 |
$767.65 |
$767.65 |
$5,582.40
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$40.95 |
$40.95 |
$40.95 |
$76.70
|
|
Mayo aathr protein s free
|
$239.20 |
$239.20 |
$239.20 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$102.70 |
$102.70 |
$102.70 |
$100.26
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$117.00 |
$117.00 |
$117.00 |
$172.80
|
|
Mayo alkaline phosphatase isoenzyme
|
$42.25 |
$42.25 |
$42.25 |
$83.85
|
|
Mayo alpha 1 antitrypsin
|
$174.20 |
$174.20 |
$174.20 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$50.05 |
$50.05 |
$50.05 |
$112.89
|
|
Mayo analysis gene calr common variants exon 9
|
$269.75 |
$269.75 |
$269.75 |
$517.60
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$343.20 |
$343.20 |
$343.20 |
$343.20
|
|
Mayo analysis gene smn1 dosage/deletion
|
$314.60 |
$314.60 |
$314.60 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,065.05 |
$2,065.05 |
$2,065.05 |
$1,922.13
|
|
Mayo androstenedione
|
$200.85 |
$200.85 |
$200.85 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$151.45 |
$151.45 |
$151.45 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$58.50 |
$58.50 |
$58.50 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$78.00 |
$78.00 |
$78.00 |
$72.60
|
|
Mayo avwpr vw factor activity
|
$234.65 |
$234.65 |
$234.65 |
$159.66
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$44.85 |
$44.85 |
$44.85 |
$147.20
|
|
Mayo bart bartonella henselae antibody igg
|
$89.70 |
$89.70 |
$89.70 |
$52.00
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$300.30 |
$300.30 |
$300.30 |
$364.90
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$68.90 |
$68.90 |
$68.90 |
$381.55
|
|
Mayo blastomyces antibody immunodiffusion
|
$51.35 |
$51.35 |
$51.35 |
$67.60
|
|
Mayo bordetella pertussis antibody igg
|
$44.20 |
$44.20 |
$44.20 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$109.20 |
$109.20 |
$109.20 |
$56.80
|
|
Mayo c1 esterase inhibitor
|
$51.35 |
$51.35 |
$51.35 |
$124.80
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$232.70 |
$232.70 |
$232.70 |
$104.55
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$55.90 |
$55.90 |
$55.90 |
$110.02
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$189.80 |
$189.80 |
$189.80 |
$274.40
|
|
Mayo ceruloplasmin
|
$131.95 |
$131.95 |
$131.95 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$166.40 |
$166.40 |
$166.40 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$163.80 |
$163.80 |
$163.80 |
$122.00
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$157.30 |
$157.30 |
$157.30 |
$59.11
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$173.55 |
$173.55 |
$173.55 |
$380.40
|
|
Mayo chromium
|
$50.70 |
$50.70 |
$50.70 |
$89.25
|
|
Mayo coccidioides antibody
|
$53.30 |
$53.30 |
$53.30 |
$61.10
|
|
Mayo cocou cortisone urine
|
$438.75 |
$438.75 |
$438.75 |
$222.62
|
|
Mayo cortisol free
|
$215.80 |
$215.80 |
$215.80 |
$109.85
|
|
Mayo covid-19 antibody nucleocapsid total
|
$62.40 |
$62.40 |
$62.40 |
$77.63
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$99.45 |
$99.45 |
$99.45 |
$67.80
|
|
Mayo deoxyribonuclease antibody titer
|
$187.85 |
$187.85 |
$187.85 |
$74.40
|
|
Mayo dhea (dehydroepiandrosterone)
|
$263.90 |
$263.90 |
$263.90 |
$113.10
|
|
Mayo dihydrotestosterone
|
$48.75 |
$48.75 |
$48.75 |
$94.90
|
|
Mayo efpo chloride stool
|
$78.00 |
$78.00 |
$78.00 |
$45.00
|
|
Mayo estriol
|
$66.30 |
$66.30 |
$66.30 |
$102.50
|
|
Mayo estrone
|
$244.40 |
$244.40 |
$244.40 |
$105.00
|
|
Mayo ethosuximide therapeutic drug level
|
$41.60 |
$41.60 |
$41.60 |
$81.60
|
|
Mayo everolimus therapeutic drug level
|
$81.25 |
$81.25 |
$81.25 |
$107.00
|
|
Mayo factor ii
|
$257.40 |
$257.40 |
$257.40 |
$96.76
|
|
Mayo factor v
|
$122.20 |
$122.20 |
$122.20 |
$119.60
|
|
Mayo factor vii
|
$210.60 |
$210.60 |
$210.60 |
$124.80
|
|
Mayo factor viii vw factor antigen
|
$110.50 |
$110.50 |
$110.50 |
$116.40
|
|
Mayo factor viii vw factor multimetric analysis
|
$68.90 |
$68.90 |
$68.90 |
$147.63
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$115.70 |
$115.70 |
$115.70 |
$133.25
|
|
Mayo factor x
|
$213.20 |
$213.20 |
$213.20 |
$130.65
|
|
Mayo factor xi
|
$210.60 |
$210.60 |
$210.60 |
$120.96
|
|
Mayo fat/lipids feces quantitative
|
$74.75 |
$74.75 |
$74.75 |
$76.05
|
|
Mayo fbl culture fungi blood
|
$136.50 |
$136.50 |
$136.50 |
$91.65
|
|
Mayo ffspg allergen clam igg
|
$101.40 |
$101.40 |
$101.40 |
$37.05
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$61.10 |
$61.10 |
$61.10 |
$80.00
|
|
Mayo gamma-globin full gene sequencing
|
$1,650.35 |
$1,650.35 |
$1,650.35 |
$1,634.10
|
|
Mayo hemosiderin qualitative urine
|
$35.10 |
$35.10 |
$35.10 |
$38.35
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$193.70 |
$193.70 |
$193.70 |
$170.57
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-2
|
$263.25 |
$263.25 |
$263.25 |
$121.20
|
|
Mayo hiser histoplasma antibodies immunodiffusion
|
$49.40 |
$49.40 |
$49.40 |
$61.75
|
|
Mayo hla typing a/b/c single antigen
|
$44.20 |
$44.20 |
$44.20 |
$142.00
|
|
Mayo hvdip HIV 1 antibody
|
$109.20 |
$109.20 |
$109.20 |
$69.60
|
|
Mayo hvdip HIV 2 antibody
|
$109.20 |
$109.20 |
$109.20 |
$80.00
|
|
Mayo hydroxyprogesterone 17-d
|
$165.10 |
$165.10 |
$165.10 |
$120.75
|
|
Mayo immunoassay c1 esterase inhibitor antibody quantitative
|
$307.45 |
$307.45 |
$307.45 |
$202.63
|
|
Mayo immunoassay infectious agent antibody quantitative diptheria igg
|
$39.00 |
$39.00 |
$39.00 |
$83.40
|
|
Mayo immunoassay tumor antigen quantitative ca 27.29
|
$240.50 |
$240.50 |
$240.50 |
$117.20
|
