|
MRI brain without dye
|
$109.72 |
$109.72 |
$109.72 |
$2,005.45
|
|
MRI brain without & w/dye
|
$115.18 |
$115.18 |
$115.18 |
$2,813.09
|
|
MRI breast c- unilateral
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$1,128.00
|
|
MRI breast c-+ w/cad uni
|
$2,103.08 |
$2,103.08 |
$2,103.08 |
$1,704.95
|
|
MRI breast without cont bi
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$1,793.40
|
|
MRI breast w IV cont bi
|
$2,103.08 |
$2,103.08 |
$2,103.08 |
$1,875.95
|
|
MRI cardiac morph & func wo IV cont
|
$80.34 |
$80.34 |
$80.34 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$89.18 |
$89.18 |
$89.18 |
$1,928.40
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$101.92 |
$101.92 |
$101.92 |
$2,499.60
|
|
MRI chest without contrast
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$3,765.86 |
$3,765.86 |
$3,765.86 |
$2,652.73
|
|
MRI chest w IV cont
|
$3,054.72 |
$3,054.72 |
$3,054.72 |
$2,221.45
|
|
MRI fetal ea addl gestation
|
$64.48 |
$64.48 |
$64.48 |
$577.07
|
|
MRI fetal sngl/1st gestation
|
$104.26 |
$104.26 |
$104.26 |
$1,136.26
|
|
MRI guid ndl plc s&i
|
$2,638.84 |
$2,638.84 |
$2,638.84 |
$1,264.76
|
|
MRI guid parenchymal tiss ablation
|
$145.08 |
$145.08 |
$145.08 |
$1,924.00
|
|
MRI loex nonjt w IV cont
|
$3,013.28 |
$3,013.28 |
$3,013.28 |
$2,092.50
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$2,088.20
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$3,765.86 |
$3,765.86 |
$3,765.86 |
$2,777.40
|
|
MRI orbit fac&nck w IV cont
|
$3,013.28 |
$3,013.28 |
$3,013.28 |
$2,172.95
|
|
MRI tmj
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$1,731.30
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$1,960.00
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$3,765.86 |
$3,765.86 |
$3,765.86 |
$2,669.70
|
|
MRI upper extremity w/dye
|
$3,013.28 |
$3,013.28 |
$3,013.28 |
$2,017.05
|
|
Mr safety determination physician/other qhp
|
$742.96 |
$742.96 |
$742.96 |
$161.40
|
|
Mr safety implant elec prepj
|
$774.04 |
$774.04 |
$774.04 |
$173.40
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$155.40 |
$155.40 |
$155.40 |
$53.54
|
|
Mr safety implt pos&/immoblj
|
$500.98 |
$500.98 |
$500.98 |
$126.57
|
|
Mr sfty implt&/fb asmt stf 1
|
$206.46 |
$206.46 |
$206.46 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$2,039.44 |
$2,039.44 |
$2,039.44 |
$444.00
|
|
Mr spectroscopy
|
$742.96 |
$742.96 |
$742.96 |
$1,322.36
|
|
Msh2 gene dup/delete variant
|
$599.40 |
$599.40 |
$599.40 |
$403.20
|
|
Msh2 gene full seq
|
$1,073.74 |
$1,073.74 |
$1,073.74 |
$764.00
|
|
Msh6 gene dup/delete variant
|
$668.96 |
$668.96 |
$668.96 |
$476.00
|
|
Msh6 gene full seq
|
$1,804.86 |
$1,804.86 |
$1,804.86 |
$1,160.50
|
|
Mt bone graft microvasc
|
$2,004.34 |
$2,004.34 |
$2,004.34 |
$7,413.38
|
|
Mthfr gene analy common variants
|
$183.52 |
$183.52 |
$183.52 |
$184.00
|
|
M.tuberculo dna dir probe
|
$20.80 |
$20.80 |
$20.80 |
$58.40
|
|
M.tuberculo dna quant
|
$33.28 |
$33.28 |
$33.28 |
$59.12
|
|
Mucin synovial fluid
|
$4.68 |
$4.68 |
$4.68 |
$33.57
|
|
Mucopolysaccharides
|
$22.36 |
$22.36 |
$22.36 |
$178.36
|
|
Mucormycosis antibody
|
$11.96 |
$11.96 |
$11.96 |
$38.40
|
|
Multi family grp psychotherapy
|
$22.36 |
$22.36 |
$22.36 |
$250.25
|
|
Multifocal erg w/i&r
|
$23.92 |
$23.92 |
$23.92 |
$386.40
|
|
Multiple sleep latency test
|
$41.08 |
$41.08 |
$41.08 |
$2,481.00
|
|
Mumps antibody igg
|
$82.14 |
$82.14 |
$82.14 |
$78.00
|
|
Muscle-skin graft arm
|
$886.34 |
$886.34 |
$886.34 |
$3,014.40
|
|
Muscle-skin graft leg
|
$920.66 |
$920.66 |
$920.66 |
$4,633.78
|
|
Muscle-skin graft trunk
|
$1,095.38 |
$1,095.38 |
$1,095.38 |
$4,332.25
|
|
Muscle test cran nerv unilat
|
$1,094.46 |
$1,094.46 |
$1,094.46 |
$385.07
|
|
Muscle test hemidiaphragm
|
$47.06 |
$47.06 |
$47.06 |
$296.40
|
|
Muscle test larynx
|
$453.62 |
$453.62 |
$453.62 |
$296.80
|
|
Muscle test one fiber
|
$106.08 |
$106.08 |
$106.08 |
$442.40
|
|
Muscle transfers
|
$834.60 |
$834.60 |
$834.60 |
$8,453.60
|
|
Muscle transfer shoulder/arm
|
$942.50 |
$942.50 |
$942.50 |
$8,434.13
|
|
Musc myoq/fscq flp h&n pedcl
|
$749.84 |
$749.84 |
$749.84 |
$4,331.73
|
|
Musc/tdn transfer upr a/e 1
|
$554.06 |
$554.06 |
$554.06 |
$7,807.24
|
|
Mycobacteria dna amp probe
|
$37.44 |
$37.44 |
$37.44 |
$234.00
|
|
Mycobacteria dna dir probe
|
$15.60 |
$15.60 |
$15.60 |
$65.17
|
|
Mycobacteria dna quant
|
$33.28 |
$33.28 |
$33.28 |
$141.45
|
|
Mycoplasma antibody igm
|
$83.62 |
$83.62 |
$83.62 |
$78.40
|
|
Myd88 gene p.leu265pro vrnt
|
$493.58 |
$493.58 |
$493.58 |
$417.00
|
|
Myelogphy 2/> spine regions
|
$3,054.72 |
$3,054.72 |
$3,054.72 |
$1,569.51
|
|
Myelography l-s spine
|
$3,054.72 |
$3,054.72 |
$3,054.72 |
$1,334.09
|
|
Myelography neck spine
|
$3,054.72 |
$3,054.72 |
$3,054.72 |
$1,241.50
|
|
Myelography thoracic spine
|
$3,054.72 |
$3,054.72 |
$3,054.72 |
$1,255.00
|
|
Myelography via inj w/s&i 2+ regions
|
$2,221.48 |
$2,221.48 |
$2,221.48 |
$2,267.34
|
|
Myelography via inj w/s&i cervical
|
$2,221.48 |
$2,221.48 |
$2,221.48 |
$1,784.80
|
|
Myelography via inj w/s&i lumbosacral
|
$2,221.48 |
$2,221.48 |
$2,221.48 |
$1,850.00
|
|
Myelography via inj w/s&i thoracic
|
$2,221.48 |
$2,221.48 |
$2,221.48 |
$1,745.94
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$73.26 |
$73.26 |
$73.26 |
$129.69
|
|
Myocardial resection 33542
|
$1,887.60 |
$1,887.60 |
$1,887.60 |
$6,414.40
|
|
Myocrd img pet 1std rst/strs
|
$52.26 |
$52.26 |
$52.26 |
$3,627.73
|
|
Myocrd img pet 1 std w/ct
|
$7,178.00 |
$7,178.00 |
$7,178.00 |
$3,346.20
|
|
Myocrd img pet 2rtracer
|
$69.94 |
$69.94 |
$69.94 |
$4,835.00
|
|
Myocrd img pet 2rtracer CT
|
$74.62 |
$74.62 |
$74.62 |
$5,083.90
|
|
Myocrd img pet mlt rst&strs
|
$60.58 |
$60.58 |
$60.58 |
$4,060.00
|
|
Myocrd img pet rst&strs CT
|
$63.44 |
$63.44 |
$63.44 |
$4,846.40
|
|
Myocrd img pet rst/strs w/ct
|
$54.34 |
$54.34 |
$54.34 |
$3,311.85
|
|
Myomectomy abdom complex
|
$842.40 |
$842.40 |
$842.40 |
$1,893.60
|
|
Myomectomy abdom method
|
$672.36 |
$672.36 |
$672.36 |
$2,064.48
|
|
Myomectomy vag method
|
$410.02 |
$410.02 |
$410.02 |
$3,762.53
|
|
Myringoplasty
|
$360.36 |
$360.36 |
$360.36 |
$3,837.72
|
|
Nafcillin 2 gram solution for injection
|
$128.81 |
$128.81 |
$128.81 |
$84.00
|
|
Nalbuphine 10 mg/ml injection solution
|
$35.70 |
$35.70 |
$35.70 |
$37.81
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$30.03 |
$30.03 |
$30.03 |
$70.87
|
|
Narcosynthesis
|
$88.92 |
$88.92 |
$88.92 |
$378.40
|
|
Nasal endoscopy dx uni/bi separate proc
|
$546.12 |
$546.12 |
$546.12 |
$353.62
|
|
Nasal function studies
|
$19.76 |
$19.76 |
$19.76 |
$348.00
|
|
Nasal/sinus endoscopy surg
|
$146.38 |
$146.38 |
$146.38 |
$4,881.00
|
|
Nasal/sinus endoscopy surg
|
$834.34 |
$834.34 |
$834.34 |
$5,662.40
|
|
Nasal/sinus endoscopy surg
|
$892.58 |
$892.58 |
$892.58 |
$5,085.60
|
|
Nasal/sinus endoscopy surg w/bx 31237
|
$117.00 |
$117.00 |
$117.00 |
$2,831.51
|
|
Nasal/sinus endo spendt remove tiss 31288
|
$170.30 |
$170.30 |
$170.30 |
$5,741.00
|
|
Nasal/sinus endo surg w/concha bullosa resct 31240
|
$115.96 |
$115.96 |
$115.96 |
$2,040.67
|
|
Nasal/sinus endo w/ethmoidectomy part 31254
|
$176.80 |
$176.80 |
$176.80 |
$6,698.00
|
|
Nasal/sinus endo w/ethmoidectomy tot 31255
|
$234.78 |
$234.78 |
$234.78 |
$7,662.21
|
|
Nasal/sinus endo w/front sinus expl 31276
|
$274.56 |
$274.56 |
$274.56 |
$6,698.00
|
|
Nasal/sinus maxillary endoscopy dx 31233
|
$98.28 |
$98.28 |
$98.28 |
$973.39
|
|
Nasal/sinus sphenoid endoscopy dx 31235
|
$117.00 |
$117.00 |
$117.00 |
$2,232.24
|
