|
Mayo immunoassay infectious agent antibody quantitative diptheria igg
|
$47.60 |
$47.60 |
$47.60 |
$86.84
|
|
Mayo lamotrigine therapeutic drug level
|
$47.20 |
$47.20 |
$47.20 |
$66.43
|
|
Mayo lywb borrelia burgdorferi (lyme disease) antibody igg confirmatory
|
$92.40 |
$92.40 |
$92.40 |
$69.55
|
|
Mayo methadone definitive assay confirmation urine
|
$33.20 |
$33.20 |
$33.20 |
$97.20
|
|
Mayo syphilis test non-treponemal antibody qualitative vdrl
|
$37.60 |
$37.60 |
$37.60 |
$49.28
|
|
Mayo tgrp testosterone free
|
$44.00 |
$44.00 |
$44.00 |
$102.05
|
|
Mayo tgrp testosterone total
|
$126.00 |
$126.00 |
$126.00 |
$127.20
|
|
Mayo ticks babesia microti antibody igg
|
$42.00 |
$42.00 |
$42.00 |
$64.84
|
|
Metabolic Blood Panel (Basic)
|
$74.80 |
$74.80 |
$74.80 |
$117.50
|
|
Metabolic Blood Panel (Comprehensive)
|
$136.40 |
$136.40 |
$136.40 |
$157.50
|
|
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr
|
$2.06 |
$2.06 |
$2.06 |
$15.75
|
|
Midazolam 1 mg/ml injection solution
|
$1.26 |
$1.26 |
$1.26 |
$63.30
|
|
Natriuretic peptide
|
$115.20 |
$115.20 |
$115.20 |
$176.15
|
|
Natural killer cells total count
|
$109.20 |
$109.20 |
$109.20 |
$135.00
|
|
Neck Airway (Soft Tissue) X-ray
|
$174.00 |
$174.00 |
$174.00 |
$237.43
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$343.20 |
$343.20 |
$343.20 |
$508.50
|
|
New Patient Office Visit (level 3)
|
$209.20 |
$209.20 |
$209.20 |
$211.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$0.86 |
$0.86 |
$0.86 |
$22.62
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$82.40 |
$82.40 |
$82.40 |
$97.80
|
|
Pelvis X-ray (1 to 2 views)
|
$192.40 |
$192.40 |
$192.40 |
$281.82
|
|
Phenobarbital therapeutic drug level
|
$66.00 |
$66.00 |
$66.00 |
$105.00
|
|
Phosphorus
|
$32.00 |
$32.00 |
$32.00 |
$49.20
|
|
Physical Therapy Evaluation (high complexity)
|
$244.40 |
$244.40 |
$244.40 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$158.40 |
$158.40 |
$158.40 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$181.20 |
$181.20 |
$181.20 |
$256.20
|
|
Pr discharge day management hospital ip/obs <=30 min on ecounter date
|
$48.40 |
$48.40 |
$48.40 |
$131.34
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$334.40 |
$334.40 |
$334.40 |
$313.30
|
|
Pr hospital ip/obs care initial straightforward or low level per day
|
$65.60 |
$65.60 |
$65.60 |
$180.05
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$53.20 |
$53.20 |
$53.20 |
$119.60
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$41.20 |
$41.20 |
$41.20 |
$74.75
|
|
Prolactin
|
$120.00 |
$120.00 |
$120.00 |
$123.50
|
|
Propofol infusion 10 mg/ml
|
$4.32 |
$4.32 |
$4.32 |
$73.36
|
|
PSA (Prostate) Test
|
$131.20 |
$131.20 |
$131.20 |
$107.50
|
|
Psychotherapy group therapy
|
$165.20 |
$165.20 |
$165.20 |
$225.39
|
|
Psychotherapy patient individual therapy 30 minutes
|
$180.80 |
$180.80 |
$180.80 |
$190.13
|
|
Psychotherapy patient individual therapy 45 minutes
|
$215.60 |
$215.60 |
$215.60 |
$250.95
|
|
Psychotherapy patient individual therapy 60 minutes
|
$242.00 |
$242.00 |
$242.00 |
$287.95
|
|
Pt application of modality >=1 area hot/cold packs
|
$26.40 |
$26.40 |
$26.40 |
$35.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$58.80 |
$58.80 |
$58.80 |
$83.00
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$79.20 |
$79.20 |
$79.20 |
$80.30
|
|
Quest t3 uptake
|
$49.20 |
$49.20 |
$49.20 |
$53.20
|
|
Rapid Strep Test
|
$33.20 |
$33.20 |
$33.20 |
$76.00
|
|
Rib and Chest X-ray (3 views, left side)
|
$289.60 |
$289.60 |
$289.60 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$321.20 |
$321.20 |
$321.20 |
$491.70
|
|
Sarscov coronavirus ag ia
|
$49.60 |
$49.60 |
$49.60 |
$60.40
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$39.60 |
$39.60 |
$39.60 |
$57.60
|
|
Sedimentation rate erythrocyte automated
|
$32.40 |
$32.40 |
$32.40 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$78.40 |
$78.40 |
$78.40 |
$96.00
|
|
Shoulder X-ray
|
$275.20 |
$275.20 |
$275.20 |
$340.10
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$12.67 |
$12.67 |
$12.67 |
$54.80
|
|
Susceptibility mic per plate
|
$68.40 |
$68.40 |
$68.40 |
$106.00
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$40.00 |
$40.00 |
$40.00 |
$42.24
|
|
T3 (triiodothyronine) free
|
$103.60 |
$103.60 |
$103.60 |
$100.32
|
|
T3 (triiodothyronine) total
|
$91.20 |
$91.20 |
$91.20 |
$93.52
|
|
T4 (thyroxine) free
|
$64.80 |
$64.80 |
$64.80 |
$89.60
|
|
T4 (thyroxine) total
|
$51.20 |
$51.20 |
$51.20 |
$70.20
|
|
Tailbone (Sacrum and Coccyx) X-ray
|
$224.00 |
$224.00 |
$224.00 |
$289.20
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$154.00 |
$154.00 |
$154.00 |
$179.95
|
|
T cells absolute cd4/cd8 including ratio
|
$139.20 |
$139.20 |
$139.20 |
$184.00
|
|
T cells total count
|
$124.80 |
$124.80 |
$124.80 |
$130.20
|
|
Therapy Activity Training (each 15 minutes)
|
$75.20 |
$75.20 |
$75.20 |
$101.38
|
|
Therapy Exercise Session (each 15 minutes)
|
$92.40 |
$92.40 |
$92.40 |
$98.58
|
|
Thigh Bone (Femur) X-ray (both sides)
|
$190.80 |
$190.80 |
$190.80 |
$313.60
|
|
Thyroid (TSH) Test
|
$106.40 |
$106.40 |
$106.40 |
$112.70
|
|
Toe X-ray (both feet)
|
$198.00 |
$198.00 |
$198.00 |
$258.65
|
|
Treponema pallidum antibody
|
$36.80 |
$36.80 |
$36.80 |
$72.05
|
|
Upper Back (Thoracic Spine) X-ray (2 views)
|
$258.80 |
$258.80 |
$258.80 |
$321.95
|
|
Upper Back (Thoracic Spine) X-ray (3 views)
|
$269.60 |
$269.60 |
$269.60 |
$381.60
|
|
Urinalysis (with microscopy)
|
$42.80 |
$42.80 |
$42.80 |
$55.20
|
|
Urinalysis (without microscopy)
|
$32.00 |
$32.00 |
$32.00 |
$36.00
|
|
Urine Culture Test
|
$57.20 |
$57.20 |
$57.20 |
$83.00
|
|
Valproic acid total therapeutic drug level
|
$84.80 |
$84.80 |
$84.80 |
$115.00
|
|
Vitamin b-12
|
$64.00 |
$64.00 |
$64.00 |
$100.28
|
|
Vitamin D Test
|
$180.00 |
$180.00 |
$180.00 |
$132.00
|
|
Walking (Gait) Training (each 15 minutes)
|
$77.20 |
$77.20 |
$77.20 |
$87.50
|
|
Warde 3400652 ova & parasites direct smear concentration and id
|
$94.00 |
$94.00 |
$94.00 |
$62.50
|
|
Warde 3400652 smear complex special stain ova/parasites
|
$50.80 |
$50.80 |
$50.80 |
$73.60
|
|
Warde clozapine therapeutic drug level
|
$22.80 |
$22.80 |
$22.80 |
$66.43
|
|
Warde hepatitis a antibody
|
$64.40 |
$64.40 |
$64.40 |
$85.15
|
|
Warde infectious agent antigen immunoassay ql/sq multi step hepatitis be agn
|
$33.20 |
$33.20 |
$33.20 |
$57.50
|
|
Warde oxcarbazepine therapeutic drug level
|
$64.40 |
$64.40 |
$64.40 |
$65.80
|
|
Warde topiramate therapeutic drug level
|
$33.20 |
$33.20 |
$33.20 |
$71.20
|
|
Wrist X-ray
|
$240.00 |
$240.00 |
$240.00 |
$349.70
|
|
Wrist X-ray (2 views, both wrists)
|
$190.80 |
$190.80 |
$190.80 |
$291.20
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$312.40 |
$312.40 |
$312.40 |
$512.80
|
