|
Liver Function Test
|
$8.99 |
$8.99 |
$8.99 |
$110.50
|
|
Liver imaging
|
$396.80 |
$396.80 |
$396.80 |
$1,241.25
|
|
Liver/spleen imag static only
|
$352.64 |
$352.64 |
$352.64 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$559.30 |
$559.30 |
$559.30 |
$949.00
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,839.54
|
|
Low back disk surgery
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$7,907.11
|
|
Low cost skin substitute app
|
$1,295.23 |
$1,295.23 |
$1,295.23 |
$862.55
|
|
Low cost skin substitute app
|
$1,084.80 |
$1,084.80 |
$1,084.80 |
$2,164.64
|
|
Low cost skin substitute app
|
$1,253.86 |
$1,253.86 |
$1,253.86 |
$933.40
|
|
Low cost skin substitute app
|
$585.36 |
$585.36 |
$585.36 |
$868.70
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$807.13 |
$807.13 |
$807.13 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$768.74 |
$768.74 |
$768.74 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$732.15 |
$732.15 |
$732.15 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$966.45 |
$966.45 |
$966.45 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$667.50 |
$667.50 |
$667.50 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$567.66 |
$567.66 |
$567.66 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$106.01 |
$106.01 |
$106.01 |
$344.00
|
|
Lower jaw bone graft
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,839.00
|
|
Low frequency non-thermal Ultrasound
|
$107.20 |
$107.20 |
$107.20 |
$275.88
|
|
Lsh uterus 250 g or less
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,839.00
|
|
Lsh uterus above 250 g
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,839.00
|
|
Lsh w/t/o ut 250 g or less
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$7,961.97
|
|
Lsh w/t/o uterus above 250 g
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,839.00
|
|
L/s ratio fetal lung
|
$24.19 |
$24.19 |
$24.19 |
$168.00
|
|
Lumbar diskogram s&i
|
$702.11 |
$702.11 |
$702.11 |
$2,358.23
|
|
Lumbar Spinal Fusion (single level)
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,311.00
|
|
Lung function test (mbc/mvv)
|
$51.91 |
$51.91 |
$51.91 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$164.68 |
$164.68 |
$164.68 |
$298.50
|
|
Lung perfusion imaging
|
$334.74 |
$334.74 |
$334.74 |
$1,100.39
|
|
Lvad shower bag heartmate
|
$119.34 |
$119.34 |
$119.34 |
$1,090.58
|
|
Lw ntsty Ultrasound stimj bone healg
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$39.77
|
|
Lymphatics/lymph node imaging
|
$511.96 |
$511.96 |
$511.96 |
$1,543.75
|
|
Lymphocyte culture mixed
|
$40.22 |
$40.22 |
$40.22 |
$50.45
|
|
Lymphocyte transformation mitogen
|
$53.93 |
$53.93 |
$53.93 |
$266.20
|
|
Lymphocytotoxicity assay
|
$208.46 |
$208.46 |
$208.46 |
$370.20
|
|
Lysis intranasal synechia 30560
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$714.40
|
|
Lysis of labial adhesions
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$3,762.53
|
|
Lysis penil circumic lesion
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$4,173.43
|
|
Macro exam dissect molec study ea
|
$30.63 |
$30.63 |
$30.63 |
$75.00
|
|
Macroscopic exam arthropod
|
$4.70 |
$4.70 |
$4.70 |
$38.58
|
|
Macroscopic exam parasite
|
$4.74 |
$4.74 |
$4.74 |
$38.50
|
|
Magnesium
|
$7.37 |
$7.37 |
$7.37 |
$71.50
|
|
Malaria antibody
|
$14.51 |
$14.51 |
$14.51 |
$38.80
|
|
Male sling procedure
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$8,465.18
|
|
Manipulate finger w/anesth
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,893.86
|
|
Manipulate wrist w/anesthes
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$2,084.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$40.97 |
$40.97 |
$40.97 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$39.58 |
$39.58 |
$39.58 |
$178.75
|
|
Manipulation of hip joint
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,893.86
|
|
Manipulation of spine
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$1,893.86
|
|
Manipulat palm cord post inj
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$521.60
|
|
Manual diff wbc count b-coat
|
$5.58 |
$5.58 |
$5.58 |
$22.75
|
|
Map tachycard site(s)
|
$1,178.68 |
$1,178.68 |
$1,178.68 |
$3,960.00
|
|
Mastectomy partial
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$4,509.59
|
|
Mast mod rad
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$5,886.40
|
|
Mastoidectomy
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,260.10
|
|
Mastoidectomy complete 69502
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,465.11
|
|
Mastoids complete
|
$110.19 |
$110.19 |
$110.19 |
$271.95
|
|
Mastoid surgery revision
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$6,553.49
|
|
Mastopexy
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$5,774.26
|
|
Mast simple complete
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$5,419.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$400.33 |
$400.33 |
$400.33 |
$7,478.44
|
|
M.avium-intra dna amp prob
|
$38.60 |
$38.60 |
$38.60 |
$113.31
|
|
M.avium-intra dna dir prob
|
$30.02 |
$30.02 |
$30.02 |
$58.25
|
|
Maxillofacial fixation
|
$3,986.00 |
$3,986.00 |
$3,986.00 |
$5,419.00
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$15.91 |
$15.91 |
$15.91 |
$66.50
|
|
Mayo aathr protein s free
|
$16.85 |
$16.85 |
$16.85 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$16.85 |
$16.85 |
$16.85 |
$98.70
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$42.43 |
$42.43 |
$42.43 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$57.08 |
$57.08 |
$57.08 |
$101.44
|
|
Mayo alcohol definitive assay volatile screen
|
$39.38 |
$39.38 |
$39.38 |
$118.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$16.26 |
$16.26 |
$16.26 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$58.87 |
$58.87 |
$58.87 |
$115.92
|
|
Mayo alpha 1 antitrypsin
|
$14.78 |
$14.78 |
$14.78 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$16.59 |
$16.59 |
$16.59 |
$81.81
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$57.08 |
$57.08 |
$57.08 |
$73.60
|
|
Mayo analysis gene calr common variants exon 9
|
$133.79 |
$133.79 |
$133.79 |
$472.31
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$100.83 |
$100.83 |
$100.83 |
$326.48
|
|
Mayo analysis gene smn1 dosage/deletion
|
$150.70 |
$150.70 |
$150.70 |
$328.80
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$1,909.44
|
|
Mayo androstenedione
|
$32.21 |
$32.21 |
$32.21 |
$105.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$16.06 |
$16.06 |
$16.06 |
$72.46
|
|
Mayo antithrombin iii antigen
|
$11.89 |
$11.89 |
$11.89 |
$68.90
|
|
Mayo aspergillus fumigatus antibody
|
$16.56 |
$16.56 |
$16.56 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$33.95 |
$33.95 |
$33.95 |
$157.95
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$38.60 |
$38.60 |
$38.60 |
$105.00
|
|
Mayo barbiturates definitive assay confirmation urine
|
$5.96 |
$5.96 |
$5.96 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$11.20 |
$11.20 |
$11.20 |
$45.75
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$159.32 |
$159.32 |
$159.32 |
$353.60
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$236.08 |
$236.08 |
$236.08 |
$373.75
|
|
Mayo blastomyces antibody immunodiffusion
|
$14.19 |
$14.19 |
$14.19 |
$57.85
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$57.08 |
$57.08 |
$57.08 |
$66.00
|
|
Mayo bordetella pertussis antibody igg
|
$14.51 |
$14.51 |
$14.51 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$9.82 |
$9.82 |
$9.82 |
$48.57
|
|
Mayo c1 esterase inhibitor
|
$14.96 |
$14.96 |
$14.96 |
$88.35
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$57.08 |
$57.08 |
$57.08 |
$96.85
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$18.56 |
$18.56 |
$18.56 |
$83.97
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$29.46 |
$29.46 |
$29.46 |
$110.00
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$134.44 |
$134.44 |
$134.44 |
$274.40
|
|
Mayo ceruloplasmin
|
$11.81 |
$11.81 |
$11.81 |
$65.08
|
