|
Intrinsic factor antibody
|
$62.40 |
$62.40 |
$62.40 |
$63.15
|
|
Intro cath dialysis circuit
|
$1,716.00 |
$1,716.00 |
$1,716.00 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$10,528.00 |
$10,528.00 |
$10,528.00 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$21,761.60 |
$21,761.60 |
$21,761.60 |
$16,262.40
|
|
Intro cath svc/ivc
|
$1,604.80 |
$1,604.80 |
$1,604.80 |
$1,323.27
|
|
Intubation endotracheal emergency procedure
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$598.80
|
|
Iron
|
$20.00 |
$20.00 |
$20.00 |
$72.29
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$268.40 |
$268.40 |
$268.40 |
$187.06
|
|
Ivc venogram s&i
|
$9,049.60 |
$9,049.60 |
$9,049.60 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$223.20 |
$223.20 |
$223.20 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$160.00 |
$160.00 |
$160.00 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$162.40 |
$162.40 |
$162.40 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$773.60 |
$773.60 |
$773.60 |
$437.45
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$34.40 |
$34.40 |
$34.40 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$30.00 |
$30.00 |
$30.00 |
$23.77
|
|
Kidney function study
|
$1,713.60 |
$1,713.60 |
$1,713.60 |
$968.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,428.80 |
$1,428.80 |
$1,428.80 |
$673.36
|
|
Knee MRI (with and without contrast)
|
$712.50 |
$712.50 |
$712.50 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$645.00 |
$645.00 |
$645.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$462.00 |
$462.00 |
$462.00 |
$2,110.76
|
|
Knee X-ray
|
$529.60 |
$529.60 |
$529.60 |
$425.55
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$39.60 |
$39.60 |
$39.60 |
$33.60
|
|
Lactate dehydrogenase (ldh)
|
$25.00 |
$25.00 |
$25.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$32.80 |
$32.80 |
$32.80 |
$44.91
|
|
Lactic acid
|
$75.20 |
$75.20 |
$75.20 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$82.40 |
$82.40 |
$82.40 |
$81.00
|
|
Lead capillary
|
$50.40 |
$50.40 |
$50.40 |
$55.25
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$1,092.58
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$131.80 |
$131.80 |
$131.80 |
$164.09
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$21.00 |
$21.00 |
$21.00 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$55.20 |
$55.20 |
$55.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$165.00 |
$165.00 |
$165.00 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$750.80 |
$750.80 |
$750.80 |
$420.60
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$114.40 |
$114.40 |
$114.40 |
$40.54
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$122.60 |
$122.60 |
$122.60 |
$121.00
|
|
Lipase
|
$28.00 |
$28.00 |
$28.00 |
$91.65
|
|
Lipoprotein blood quant
|
$170.40 |
$170.40 |
$170.40 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$34.40 |
$34.40 |
$34.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$44.00 |
$44.00 |
$44.00 |
$61.60
|
|
Lithium therapeutic drug level
|
$27.20 |
$27.20 |
$27.20 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$2,094.40 |
$2,094.40 |
$2,094.40 |
$365.28
|
|
Liver Function Test
|
$25.00 |
$25.00 |
$25.00 |
$115.44
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$25.20 |
$25.20 |
$25.20 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$569.00 |
$569.00 |
$569.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$472.00 |
$472.00 |
$472.00 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$286.00 |
$286.00 |
$286.00 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$700.50 |
$700.50 |
$700.50 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$635.50 |
$635.50 |
$635.50 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$454.00 |
$454.00 |
$454.00 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$484.00 |
$484.00 |
$484.00 |
$356.16
|
|
Lung Function Test (Spirometry)
|
$324.00 |
$324.00 |
$324.00 |
$295.35
|
|
Lung perfusion imaging
|
$1,713.60 |
$1,713.60 |
$1,713.60 |
$1,059.97
|
|
Lymphatics/lymph node imaging
|
$2,225.60 |
$2,225.60 |
$2,225.60 |
$1,463.22
|
|
Macro exam dissect molec study ea
|
$368.00 |
$368.00 |
$368.00 |
$67.08
|
|
Macroscopic exam arthropod
|
$16.80 |
$16.80 |
$16.80 |
$38.58
|
|
Macroscopic exam parasite
|
$18.40 |
$18.40 |
$18.40 |
$36.55
|
|
Magnesium
|
$30.00 |
$30.00 |
$30.00 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$112.80 |
$112.80 |
$112.80 |
$59.88
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$240.00 |
$240.00 |
$240.00 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$328.00 |
$328.00 |
$328.00 |
$160.80
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$60.00 |
$60.00 |
$60.00 |
$65.00
|
|
Mayo aathr protein s free
|
$115.20 |
$115.20 |
$115.20 |
$130.00
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$117.60 |
$117.60 |
$117.60 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$61.60 |
$61.60 |
$61.60 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$56.00 |
$56.00 |
$56.00 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$62.40 |
$62.40 |
$62.40 |
$81.81
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$380.80 |
$380.80 |
$380.80 |
$369.00
|
|
Mayo androstenedione
|
$121.60 |
$121.60 |
$121.60 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$60.80 |
$60.80 |
$60.80 |
$73.60
|
|
Mayo aspergillus fumigatus antibody
|
$62.40 |
$62.40 |
$62.40 |
$66.50
|
|
Mayo avwpr vw factor activity
|
$174.40 |
$174.40 |
$174.40 |
$171.50
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$162.40 |
$162.40 |
$162.40 |
$96.73
|
|
Mayo bart bartonella henselae antibody igg
|
$42.40 |
$42.40 |
$42.40 |
$45.50
|
|
Mayo blastomyces antibody immunodiffusion
|
$64.00 |
$64.00 |
$64.00 |
$55.04
|
|
Mayo brcmg brucella antibody igm
|
$37.60 |
$37.60 |
$37.60 |
$44.10
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$69.60 |
$69.60 |
$69.60 |
$80.16
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$508.00 |
$508.00 |
$508.00 |
$281.50
|
|
Mayo ceruloplasmin
|
$44.80 |
$44.80 |
$44.80 |
$68.40
|
|
Mayo chemiluminescent parathyroid related peptide
|
$59.20 |
$59.20 |
$59.20 |
$123.73
|
|
Mayo chikv chikungunya antibodies igg
|
$53.60 |
$53.60 |
$53.60 |
$109.20
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$48.80 |
$48.80 |
$48.80 |
$52.66
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$52.80 |
$52.80 |
$52.80 |
$49.29
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$581.60 |
$581.60 |
$581.60 |
$360.33
|
|
Mayo chromium
|
$84.00 |
$84.00 |
$84.00 |
$74.94
|
|
Mayo coccidioides antibody
|
$57.60 |
$57.60 |
$57.60 |
$53.90
|
|
Mayo cocou cortisone urine
|
$100.00 |
$100.00 |
$100.00 |
$213.92
|
|
Mayo cortisol free
|
$69.60 |
$69.60 |
$69.60 |
$94.95
|
|
Mayo covid-19 antibody nucleocapsid total
|
$140.00 |
$140.00 |
$140.00 |
$71.50
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$50.40 |
$50.40 |
$50.40 |
$58.10
|
|
Mayo deoxyribonuclease antibody titer
|
$66.40 |
$66.40 |
$66.40 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$104.80 |
$104.80 |
$104.80 |
$105.60
|
|
Mayo dihydrotestosterone
|
$121.60 |
$121.60 |
$121.60 |
$74.25
|
|
Mayo estrone
|
$124.80 |
$124.80 |
$124.80 |
$85.00
|
|
Mayo ethosuximide therapeutic drug level
|
$68.00 |
$68.00 |
$68.00 |
$69.55
|
|
Mayo everolimus therapeutic drug level
|
$57.60 |
$57.60 |
$57.60 |
$97.50
|
|
Mayo factor ii
|
$54.40 |
$54.40 |
$54.40 |
$99.06
|
|
Mayo factor v
|
$132.80 |
$132.80 |
$132.80 |
$127.80
|
|
Mayo factor viii vw factor antigen
|
$172.00 |
$172.00 |
$172.00 |
$122.62
|
|
Mayo factor viii vw factor multimetric analysis
|
$628.80 |
$628.80 |
$628.80 |
$130.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$172.00 |
$172.00 |
$172.00 |
$141.00
|