|
MRI lower extremity other than joint without contrast (both sides)
|
$264.17 |
$267.55 |
$284.66 |
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$390.30 |
$395.29 |
$420.58 |
|
|
MRI orbit fac&nck w IV cont
|
$390.30 |
$586.43 |
$1,382.50 |
|
|
MRI tmj
|
$264.17 |
$332.69 |
$741.62 |
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$264.17 |
$267.55 |
$284.66 |
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$390.30 |
$395.29 |
$420.58 |
|
|
MRI upper extremity w/dye
|
$390.30 |
$395.29 |
$420.58 |
|
|
MRI w/cont, breast, bi
|
$390.30 |
$420.58 |
$1,048.58 |
|
|
MRI w/cont, breast, uni
|
$194.55 |
$197.04 |
$209.65 |
|
|
MRI without fol w/cont, breast
|
$390.30 |
$420.58 |
$1,721.89 |
|
|
MRI without fol w/cont, brst, un
|
$390.30 |
$395.29 |
$420.58 |
|
|
Mr safety determination physician/other qhp
|
$27.21 |
$46.16 |
$103.69 |
|
|
Mr safety implant elec prepj
|
$28.89 |
$49.01 |
$108.10 |
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$13.54 |
$21.77 |
$24.95 |
|
|
Mr safety implt pos&/immoblj
|
$19.86 |
$33.69 |
$69.95 |
|
|
Mr sfty implt&/fb asmt stf 1
|
$9.03 |
$15.31 |
$28.84 |
|
|
Mr sfty med physics xm cstmz
|
$73.14 |
$124.05 |
$284.66 |
|
|
Mr spectroscopy
|
$96.23 |
$103.69 |
$685.71 |
|
|
Msh2 gene dup/delete variant
|
$213.30 |
$234.63 |
$234.63 |
|
|
Msh2 gene full seq
|
$381.70 |
$419.87 |
$419.87 |
|
|
Msh2 gene known variants
|
$337.73 |
$371.50 |
$371.50 |
|
|
Msh6 gene dup/delete variant
|
$238.00 |
$261.80 |
$261.80 |
|
|
Msh6 gene full seq
|
$641.85 |
$706.04 |
$706.04 |
|
|
Msh6 gene known variants
|
$308.00 |
$338.80 |
$338.80 |
|
|
Mthfr gene analy common variants
|
$65.34 |
$71.87 |
$71.87 |
|
|
M.tuberculo dna dir probe
|
$26.88 |
$29.57 |
$29.57 |
|
|
M.tuberculo dna quant
|
$42.84 |
$47.12 |
$47.12 |
|
|
Mucin synovial fluid
|
$5.86 |
$6.45 |
$6.45 |
|
|
Mucopolysaccharides
|
$28.50 |
$31.35 |
$129.50 |
|
|
Mucormycosis antibody
|
$15.00 |
$16.50 |
$16.50 |
|
|
Mult fam adapt bhv tx gdn
|
$32.56 |
$32.97 |
$100.00 |
|
|
Multi family grp psychotherapy
|
$53.11 |
$175.59 |
$189.21 |
|
|
Multifocal erg w/i&r
|
$170.99 |
$173.18 |
$184.26 |
|
|
Multiple sleep latency test
|
$493.65 |
$587.81 |
$1,648.37 |
|
|
Mumps antibody igg
|
$13.05 |
$14.36 |
$70.00 |
|
|
Muscle-skin graft arm
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
Muscle-skin graft leg
|
$3,786.00 |
$4,311.38 |
$6,839.00 |
|
|
Muscle-skin graft trunk
|
$3,786.00 |
$4,311.38 |
$6,839.00 |
|
|
Muscle test cran nerv unilat
|
$52.11 |
$344.68 |
$366.72 |
|
|
Muscle test hemidiaphragm
|
$72.30 |
$173.18 |
$184.26 |
|
|
Muscle test larynx
|
$140.87 |
$142.67 |
$151.80 |
|
|
Muscle test one fiber
|
$170.99 |
$173.18 |
$184.26 |
|
|
Muscle transfers
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Muscle transfer shoulder/arm
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Musc myoq/fscq flp h&n pedcl
|
$3,786.00 |
$4,311.38 |
$6,839.00 |
|
|
Musc/tdn transfer upr a/e 1
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Mycobacteria dna amp probe
|
$48.24 |
$53.06 |
$53.06 |
|
|
Mycobacteria dna dir probe
|
$20.05 |
$22.06 |
$22.06 |
|
|
Mycobacteria dna quant
|
$42.84 |
$47.12 |
$47.12 |
|
|
Mycoplasma antibody igm
|
$13.24 |
$14.56 |
$14.56 |
|
|
Myd88 gene p.leu265pro vrnt
|
$175.40 |
$192.94 |
$192.94 |
|
|
Myelogphy 2/> spine regions
|
$312.82 |
$659.14 |
$930.42 |
|
|
Myelography l-s spine
|
$218.91 |
$474.79 |
$930.42 |
|
|
Myelography neck spine
|
$227.16 |
$515.71 |
$930.42 |
|
|
Myelography thoracic spine
|
$231.42 |
$435.34 |
$930.42 |
|
|
Myelography via inj w/s&i 2+ regions
|
$863.44 |
$3,986.00 |
$6,839.00 |
|
|
Myelography via inj w/s&i cervical
|
$863.44 |
$3,986.00 |
$6,839.00 |
|
|
Myelography via inj w/s&i lumbosacral
|
$863.44 |
$3,986.00 |
$6,839.00 |
|
|
Myelography via inj w/s&i thoracic
|
$863.44 |
$3,986.00 |
$6,839.00 |
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$11.53 |
$12.68 |
$56.50 |
|
|
Myocrd img pet 1std rst/strs
|
$1,594.06 |
$1,614.45 |
$1,717.72 |
|
|
Myocrd img pet 1 std w/ct
|
$887.41 |
$1,614.45 |
$1,717.72 |
|
|
Myocrd img pet 2rtracer
|
$2,022.37 |
$2,048.24 |
$2,179.26 |
|
|
Myocrd img pet 2rtracer CT
|
$989.49 |
$2,158.93 |
$2,297.03 |
|
|
Myocrd img pet mlt rst&strs
|
$1,594.06 |
$1,614.45 |
$1,717.72 |
|
|
Myocrd img pet rst&strs CT
|
$1,105.09 |
$2,490.99 |
$2,650.32 |
|
|
Myocrd img pet rst/strs w/ct
|
$716.22 |
$1,614.45 |
$1,717.72 |
|
|
Myomectomy vag method
|
$3,474.84 |
$3,986.00 |
$6,839.00 |
|
|
Myringoplasty
|
$3,544.29 |
$3,986.00 |
$6,839.00 |
|
|
Naltrexone, depot form
|
$4.12 |
$4.24 |
$4.24 |
|
|
Narcosynthesis
|
$175.59 |
$177.84 |
$189.21 |
|
|
Nasal endoscopy dx uni/bi separate proc
|
$212.17 |
$3,986.00 |
$6,839.00 |
|
|
Nasal endoscopy with removal of nasal foreign body
|
$253.79 |
$3,986.00 |
$6,839.00 |
|
|
Nasal function studies
|
$340.32 |
$344.68 |
$366.72 |
|
|
Nasal/sinus endoscopy surg
|
$3,786.00 |
$6,311.00 |
$8,152.32 |
|
|
Nasal/sinus endoscopy surg w/bx 31237
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Nasal/sinus endo spendt remove tiss 31288
|
$3,786.00 |
$6,311.00 |
$8,152.32 |
|
|
Nasal/sinus endo surg w/concha bullosa resct 31240
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Nasal/sinus endo w/ethmoidectomy part 31254
|
$3,786.00 |
$6,311.00 |
$8,152.32 |
|
|
Nasal/sinus endo w/ethmoidectomy tot 31255
|
$3,786.00 |
$6,311.00 |
$8,152.32 |
|
|
Nasal/sinus endo w/front sinus expl 31276
|
$3,786.00 |
$6,311.00 |
$8,152.32 |
|
|
Nasal/sinus maxillary endoscopy dx 31233
|
$424.38 |
$3,986.00 |
$6,839.00 |
|
|
Nasal/sinus sphenoid endoscopy dx 31235
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Nasal sinus therapy
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Nasopharyngoscopy w/endoscope
|
$161.04 |
$214.89 |
$228.63 |
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$24.13 |
$24.13 |
$24.15 |
|
|
Natriuretic peptide
|
$39.26 |
$43.19 |
$183.50 |
|
|
Natural killer cells total count
|
$37.73 |
$41.50 |
$109.20 |
|
|
Nav srv peer sup 60 min pr m
|
$101.09 |
$102.38 |
$108.93 |
|
|
N block inj common digit
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
N block inj hypogas plxs
|
$972.98 |
$3,986.00 |
$6,839.00 |
|
|
Nctrnl pen tmscn&/rgdity tst
|
$265.80 |
$3,986.00 |
$6,839.00 |
|
|
Ndl emg musc 1 xtr/non-limb
|
$70.38 |
$142.67 |
$151.80 |
|
|
Ndl insj without njx 1 or 2 musc
|
$26.76 |
$3,986.00 |
$6,839.00 |
|
|
Ndl insj without njx 3+ musc
|
$26.76 |
$3,986.00 |
$6,839.00 |
|
|
Ndl oculoelectromyography 1+
|
$64.92 |
$65.75 |
$69.95 |
|
|
Ndsc dcmprn 1 ntrspc lumbar
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Nebulizer Breathing Treatment
|
$102.03 |
$140.25 |
$239.52 |
|
|
Neck Airway (Soft Tissue) X-ray
|
$55.98 |
$96.03 |
$174.00 |
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$194.55 |
$711.38 |
$900.88 |
|
