|
Ligation internal/common carotid artery 37605
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,724.63
|
|
Ligation internal jugular vein 37565
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,564.80
|
|
Ligation major artery neck
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,724.63
|
|
Ligation nasal sinus artery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,724.63
|
|
Ligation of femoral vein
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,724.63
|
|
Ligation of inf vena cava
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,872.94
|
|
Ligation of neck artery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,724.63
|
|
Ligation of salivary duct
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,837.72
|
|
Ligation upper jaw artery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,486.86
|
|
Ligation vericose vein cluster(s) 1 leg
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,486.86
|
|
Lig/band angioaccess av fistula
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,240.23
|
|
Lig&div&compl strpg saph vn
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,724.63
|
|
Lipase
|
$7.58 |
$7.58 |
$7.58 |
$83.20
|
|
Lip exc/transverse wedge/w closure 40510
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,780.73
|
|
Lipoprotein blood high res frac & quant
|
$37.25 |
$37.25 |
$37.25 |
$89.52
|
|
Lipoprotein blood quant
|
$37.61 |
$37.61 |
$37.61 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$9.01 |
$9.01 |
$9.01 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$11.55 |
$11.55 |
$11.55 |
$60.00
|
|
Lipoprtn dir meas sd ldl chl
|
$37.61 |
$37.61 |
$37.61 |
$37.61
|
|
Lip surgery procedure
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$325.68
|
|
Listeria monocytogenes
|
$14.51 |
$14.51 |
$14.51 |
$95.40
|
|
Lithium therapeutic drug level
|
$7.27 |
$7.27 |
$7.27 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$77.40 |
$77.40 |
$77.40 |
$4,371.12
|
|
Liver ds alys 3 bmrk srm alg
|
$193.81 |
$193.81 |
$193.81 |
$365.28
|
|
Liver Function Test
|
$8.99 |
$8.99 |
$8.99 |
$110.50
|
|
Liver imaging
|
$257.35 |
$257.35 |
$257.35 |
$1,241.25
|
|
Liver imag w/vasclr flow
|
$356.42 |
$356.42 |
$356.42 |
$1,255.15
|
|
Liver/spleen imag static only
|
$228.71 |
$228.71 |
$228.71 |
$1,140.78
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Low back disk surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$7,907.11
|
|
Low cost skin substitute app
|
$840.04 |
$840.04 |
$840.04 |
$1,030.00
|
|
Low cost skin substitute app
|
$703.56 |
$703.56 |
$703.56 |
$2,164.64
|
|
Low cost skin substitute app
|
$813.21 |
$813.21 |
$813.21 |
$1,132.56
|
|
Low cost skin substitute app
|
$379.64 |
$379.64 |
$379.64 |
$1,030.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$523.48 |
$523.48 |
$523.48 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$498.58 |
$498.58 |
$498.58 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$474.84 |
$474.84 |
$474.84 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$626.81 |
$626.81 |
$626.81 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$432.92 |
$432.92 |
$432.92 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$368.16 |
$368.16 |
$368.16 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$68.75 |
$68.75 |
$68.75 |
$344.00
|
|
Lower jaw bone graft
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,839.00
|
|
Low frequency non-thermal Ultrasound
|
$69.53 |
$69.53 |
$69.53 |
$275.88
|
|
Lsh uterus 250 g or less
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,839.00
|
|
Lsh uterus above 250 g
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,839.00
|
|
Lsh w/t/o ut 250 g or less
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$7,961.97
|
|
Lsh w/t/o uterus above 250 g
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,839.00
|
|
L/s ratio fetal lung
|
$24.19 |
$24.19 |
$24.19 |
$168.00
|
|
Lumbar diskogram s&i
|
$455.37 |
$455.37 |
$455.37 |
$2,358.23
|
|
Lumbar Spinal Fusion (single level)
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,311.00
|
|
Lung function test (mbc/mvv)
|
$33.66 |
$33.66 |
$33.66 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$106.81 |
$106.81 |
$106.81 |
$298.50
|
|
Lung perfusion imaging
|
$217.10 |
$217.10 |
$217.10 |
$1,100.39
|
|
Lvad shower bag heartmate
|
$108.36 |
$108.36 |
$108.36 |
$972.60
|
|
Lw ntsty Ultrasound stimj bone healg
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$39.77
|
|
Lymphatics/lymph node imaging
|
$332.04 |
$332.04 |
$332.04 |
$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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$714.40
|
|
Lysis of labial adhesions
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,762.53
|
|
Lysis penil circumic lesion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,173.43
|
|
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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$8,465.18
|
|
Manipulate finger w/anesth
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,893.86
|
|
Manipulate wrist w/anesthes
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,084.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$26.57 |
$26.57 |
$26.57 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$25.67 |
$25.67 |
$25.67 |
$178.75
|
|
Manipulation of hip joint
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,893.86
|
|
Manipulation of spine
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,893.86
|
|
Manipulat palm cord post inj
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$521.60
|
|
Manual diff wbc count b-coat
|
$5.58 |
$5.58 |
$5.58 |
$22.75
|
|
Mastectomy partial
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,509.59
|
|
Mast mod rad
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,886.40
|
|
Mastoidectomy
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,260.10
|
|
Mastoidectomy complete 69502
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,465.11
|
|
Mastoids complete
|
$71.46 |
$71.46 |
$71.46 |
$271.95
|
|
Mastoid surgery revision
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,553.49
|
|
Mastopexy
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,774.26
|
|
Mast simple complete
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,419.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$363.50 |
$363.50 |
$363.50 |
$6,321.00
|
|
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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$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
|
$37.02 |
$37.02 |
$37.02 |
$101.44
|
|
Mayo alcohol definitive assay volatile screen
|
$32.25 |
$32.25 |
$32.25 |
$118.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$16.26 |
$16.26 |
$16.26 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$38.18 |
$38.18 |
$38.18 |
$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
|
$37.02 |
$37.02 |
$37.02 |
$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
|