|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$5,841.62 |
$5,841.62 |
$5,841.62 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$4,902.08 |
$4,902.08 |
$4,902.08 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$6,205.11 |
$6,205.11 |
$6,205.11 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$5,872.30 |
$5,872.30 |
$5,872.30 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$6,892.74 |
$6,892.74 |
$6,892.74 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$912.18 |
$912.18 |
$912.18 |
$356.16
|
|
L/s ratio fetal lung
|
$1,322.52 |
$1,322.52 |
$1,322.52 |
$178.36
|
|
Lung Function Test (Spirometry)
|
$1,043.75 |
$1,043.75 |
$1,043.75 |
$295.35
|
|
Lung perfusion imaging
|
$3,747.66 |
$3,747.66 |
$3,747.66 |
$1,059.97
|
|
Lymphatics/lymph node imaging
|
$5,123.29 |
$5,123.29 |
$5,123.29 |
$1,463.22
|
|
Mayo activated protein c resistance assay
|
$465.05 |
$465.05 |
$465.05 |
$97.50
|
|
Mayo alkaline phosphatase isoenzyme
|
$373.89 |
$373.89 |
$373.89 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$466.60 |
$466.60 |
$466.60 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$191.57 |
$191.57 |
$191.57 |
$81.81
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$336.71 |
$336.71 |
$336.71 |
$369.00
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$528.39 |
$528.39 |
$528.39 |
$1,860.00
|
|
Mayo androstenedione
|
$184.59 |
$184.59 |
$184.59 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$435.70 |
$435.70 |
$435.70 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$786.41 |
$786.41 |
$786.41 |
$73.50
|
|
Mayo avwpr vw factor activity
|
$1,021.26 |
$1,021.26 |
$1,021.26 |
$171.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$1,227.12 |
$1,227.12 |
$1,227.12 |
$328.20
|
|
Mayo c1 esterase inhibitor
|
$129.78 |
$129.78 |
$129.78 |
$86.73
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$647.35 |
$647.35 |
$647.35 |
$107.10
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$475.86 |
$475.86 |
$475.86 |
$80.16
|
|
Mayo ceruloplasmin
|
$296.64 |
$296.64 |
$296.64 |
$68.40
|
|
Mayo chromium
|
$520.68 |
$520.68 |
$520.68 |
$74.94
|
|
Mayo cocaine definitive assay confirmation urine
|
$186.93 |
$186.93 |
$186.93 |
$100.00
|
|
Mayo cortisol free
|
$465.05 |
$465.05 |
$465.05 |
$94.95
|
|
Mayo cyanide
|
$444.96 |
$444.96 |
$444.96 |
$87.50
|
|
Mayo deoxyribonuclease antibody titer
|
$324.46 |
$324.46 |
$324.46 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$724.60 |
$724.60 |
$724.60 |
$105.60
|
|
Mayo efpo chloride stool
|
$123.59 |
$123.59 |
$123.59 |
$43.41
|
|
Mayo estriol
|
$435.70 |
$435.70 |
$435.70 |
$90.34
|
|
Mayo estrone
|
$461.96 |
$461.96 |
$461.96 |
$85.00
|
|
Mayo ethosuximide therapeutic drug level
|
$546.94 |
$546.94 |
$546.94 |
$69.55
|
|
Mayo everolimus therapeutic drug level
|
$944.00 |
$944.00 |
$944.00 |
$97.50
|
|
Mayo factor ii
|
$417.15 |
$417.15 |
$417.15 |
$99.06
|
|
Mayo factor v
|
$392.43 |
$392.43 |
$392.43 |
$127.80
|
|
Mayo factor vii
|
$392.43 |
$392.43 |
$392.43 |
$155.00
|
|
Mayo factor viii vw factor antigen
|
$282.73 |
$282.73 |
$282.73 |
$122.62
|
|
Mayo factor viii vw factor multimetric analysis
|
$383.16 |
$383.16 |
$383.16 |
$130.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$406.35 |
$406.35 |
$406.35 |
$141.00
|
|
Mayo factor x
|
$446.50 |
$446.50 |
$446.50 |
$155.00
|
|
Mayo factor xi
|
$452.67 |
$452.67 |
$452.67 |
$122.20
|
|
Mayo fat/lipids feces quantitative
|
$679.81 |
$679.81 |
$679.81 |
$76.05
|
|
Mayo fbl culture fungi blood
|
$525.29 |
$525.29 |
$525.29 |
$105.60
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$152.94 |
$152.94 |
$152.94 |
$66.43
|
|
Mayo hemosiderin qualitative urine
|
$134.43 |
$134.43 |
$134.43 |
$33.57
|
|
Mayo hla typing a/b/c single antigen
|
$834.29 |
$834.29 |
$834.29 |
$122.80
|
|
Mayo hvdip HIV 1 antibody
|
$330.63 |
$330.63 |
$330.63 |
$74.25
|
|
Mayo hvdip HIV 2 antibody
|
$212.10 |
$212.10 |
$212.10 |
$77.77
|
|
Mayo infectious agent antigen immunoassay direct optical observation cryptococcus
|
$276.56 |
$276.56 |
$276.56 |
$89.40
|
|
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal
|
$1,079.95 |
$1,079.95 |
$1,079.95 |
$109.00
|
|
Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae
|
$634.99 |
$634.99 |
$634.99 |
$155.00
|
|
Mayo infliximab therapeutic drug level
|
$1,195.79 |
$1,195.79 |
$1,195.79 |
$150.40
|
|
Mayo inhab inhibin a
|
$596.39 |
$596.39 |
$596.39 |
$79.95
|
|
Mayo insft insulin free
|
$101.97 |
$101.97 |
$101.97 |
$55.00
|
|
Mayo insulin antibodies
|
$392.43 |
$392.43 |
$392.43 |
$97.80
|
|
Mayo iodine
|
$259.55 |
$259.55 |
$259.55 |
$114.60
|
|
Mayo lacosamide therapeutic drug level
|
$156.00 |
$156.00 |
$156.00 |
$104.00
|
|
Mayo lamotrigine therapeutic drug level
|
$27.96 |
$27.96 |
$27.96 |
$66.43
|
|
Mayo leptospira antibody igm
|
$423.33 |
$423.33 |
$423.33 |
$81.06
|
|
Mayo lipoprotein electrophoresis
|
$767.87 |
$767.87 |
$767.87 |
$50.70
|
|
Mayo metanephrines plasma
|
$644.28 |
$644.28 |
$644.28 |
$122.40
|
|
Mayo methadone definitive assay confirmation urine
|
$276.56 |
$276.56 |
$276.56 |
$97.20
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$35.57 |
$35.57 |
$35.57 |
$70.56
|
|
Mayo molecular pathology procedure level 2 apoe genotype
|
$2,232.53 |
$2,232.53 |
$2,232.53 |
$435.00
|
|
Mayo muramidase
|
$296.64 |
$296.64 |
$296.64 |
$59.50
|
|
Mayo muscle-specific kinase (musk) antibody
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$232.50
|
|
Mayo nickel
|
$338.36 |
$338.36 |
$338.36 |
$69.56
|
|
Mayo opatu opioid/analogs definitive assay 1 or 2
|
$465.05 |
$465.05 |
$465.05 |
$72.14
|
|
Mayo opatu oxycodone definitive assay
|
$276.56 |
$276.56 |
$276.56 |
$84.50
|
|
Mayo oxalate 24 hour urine
|
$373.89 |
$373.89 |
$373.89 |
$67.14
|
|
Mayo pancreatic elastase fecal qualitative or semi quantitative
|
$1,189.66 |
$1,189.66 |
$1,189.66 |
$156.00
|
|
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme)
|
$987.25 |
$987.25 |
$987.25 |
$177.60
|
|
Mayo pntft phenytoin free therapeutic drug level
|
$97.32 |
$97.32 |
$97.32 |
$69.00
|
|
Mayo pqnu porphobilinogen urine quantitative 24 hour urine
|
$156.05 |
$156.05 |
$156.05 |
$48.00
|
|
Mayo pregnenolone
|
$744.68 |
$744.68 |
$744.68 |
$78.40
|
|
Mayo prmb primidone therapeutic drug level
|
$548.46 |
$548.46 |
$548.46 |
$66.43
|
|
Mayo proinsulin
|
$103.63 |
$103.63 |
$103.63 |
$97.50
|
|
Mayo psaft prostate specific antigen free
|
$120.53 |
$120.53 |
$120.53 |
$90.00
|
|
Mayo renin
|
$651.99 |
$651.99 |
$651.99 |
$102.60
|
|
Mayo serotonin
|
$1,662.42 |
$1,662.42 |
$1,662.42 |
$113.10
|
|
Mayo sirolimus therapeutic drug level
|
$1,132.49 |
$1,132.49 |
$1,132.49 |
$99.81
|
|
Mayo syphilis test non-treponemal antibody qualitative vdrl
|
$245.67 |
$245.67 |
$245.67 |
$48.75
|
|
Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification
|
$1,631.52 |
$1,631.52 |
$1,631.52 |
$507.60
|
|
Mayo tgrp testosterone free
|
$1,235.99 |
$1,235.99 |
$1,235.99 |
$99.00
|
|
Mayo thiopurine s-methyltransferase
|
$601.01 |
$601.01 |
$601.01 |
$93.93
|
|
Mayo thyroglobulin
|
$546.94 |
$546.94 |
$546.94 |
$95.00
|
|
Mayo tramadol definitive assay w metabolite quantitative urine
|
$166.85 |
$166.85 |
$166.85 |
$74.75
|
|
Mayo ttfb testosterone bioavailable direct
|
$478.54 |
$478.54 |
$478.54 |
$89.60
|
|
Mayo valpg valproic acid free therapeutic drug level
|
$451.13 |
$451.13 |
$451.13 |
$62.00
|
|
Mayo vasoactive intestinal peptide
|
$1,081.51 |
$1,081.51 |
$1,081.51 |
$136.50
|
|
Mayo vitamin b-2 (riboflavin)
|
$101.97 |
$101.97 |
$101.97 |
$90.12
|
|
Mayo vitamin b3 (niacin)
|
$147.90 |
$147.90 |
$147.90 |
$110.00
|
|
Mayo vitamin k
|
$899.19 |
$899.19 |
$899.19 |
$94.60
|
|
Mayo zonisamide therapeutic drug level
|
$208.58 |
$208.58 |
$208.58 |
$87.88
|
|
Medroxyprogesterone 150 mg/ml im injection (wrapper)
|
$627.38 |
$627.38 |
$627.38 |
$190.81
|
|
Mepolizumab 100 mg/ml subcutaneous auto-injector
|
$9,739.14 |
$9,739.14 |
$9,739.14 |
$8,780.20
|
|
Metabolic Blood Panel (Basic)
|
$1,042.88 |
$1,042.88 |
$1,042.88 |
$117.15
|
