|
Inj mepivacaine hcl/10 ml
|
$114.60 |
$114.60 |
$114.60 |
$33.86
|
|
Inj multihance
|
$384.00 |
$384.00 |
$384.00 |
$73.49
|
|
Inj vasopressin (am reg) 1 u
|
$198.20 |
$198.20 |
$198.20 |
$41.79
|
|
Inj w/fluor eval cv device
|
$567.20 |
$567.20 |
$567.20 |
$503.92
|
|
Insertion catheter bladder non indwelling
|
$150.40 |
$150.40 |
$150.40 |
$205.40
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$549.60 |
$549.60 |
$549.60 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,868.80 |
$1,868.80 |
$1,868.80 |
$2,419.65
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,737.60 |
$4,737.60 |
$4,737.60 |
$5,223.20
|
|
Ins tun cv cath wo subq prt/pm
|
$2,836.00 |
$2,836.00 |
$2,836.00 |
$4,202.70
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$55.20 |
$55.20 |
$55.20 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$566.40 |
$566.40 |
$566.40 |
$288.11
|
|
Iron
|
$20.00 |
$20.00 |
$20.00 |
$72.29
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$222.00 |
$222.00 |
$222.00 |
$187.06
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$154.40 |
$154.40 |
$154.40 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$448.00 |
$448.00 |
$448.00 |
$437.45
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$26.80 |
$26.80 |
$26.80 |
$23.77
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$772.80 |
$772.80 |
$772.80 |
$673.36
|
|
Knee X-ray
|
$442.40 |
$442.40 |
$442.40 |
$425.55
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$50.20 |
$50.20 |
$50.20 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$813.40 |
$813.40 |
$813.40 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$25.00 |
$25.00 |
$25.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$30.40 |
$30.40 |
$30.40 |
$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)
|
$869.60 |
$869.60 |
$869.60 |
$1,092.58
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$19.40 |
$19.40 |
$19.40 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$55.20 |
$55.20 |
$55.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$136.40 |
$136.40 |
$136.40 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$621.00 |
$621.00 |
$621.00 |
$420.60
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$91.20 |
$91.20 |
$91.20 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$121.00 |
$121.00 |
$121.00 |
$40.54
|
|
Lipase
|
$28.00 |
$28.00 |
$28.00 |
$91.65
|
|
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 Function Test
|
$25.00 |
$25.00 |
$25.00 |
$115.44
|
|
Locm 100-199mg/ml iodine,1ml
|
$373.80 |
$373.80 |
$373.80 |
$48.19
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$25.80 |
$25.80 |
$25.80 |
$37.37
|
|
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 (without contrast)
|
$454.00 |
$454.00 |
$454.00 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$339.20 |
$339.20 |
$339.20 |
$356.16
|
|
Magnesium
|
$30.00 |
$30.00 |
$30.00 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$38.60 |
$38.60 |
$38.60 |
$59.88
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$228.80 |
$228.80 |
$228.80 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$328.00 |
$328.00 |
$328.00 |
$160.80
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$12,294.32 |
$12,294.32 |
$12,294.32 |
$6,321.66
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$162.40 |
$162.40 |
$162.40 |
$96.73
|
|
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal
|
$48.80 |
$48.80 |
$48.80 |
$109.00
|
|
Mayo infectious agent nucleic acid quantification cytomegalovirus
|
$178.40 |
$178.40 |
$178.40 |
$230.65
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$76.80 |
$76.80 |
$76.80 |
$70.56
|
|
Mayo microsomal antibody liver-kidney
|
$60.80 |
$60.80 |
$60.80 |
$81.00
|
|
Mayo muscle-specific kinase (musk) antibody
|
$76.80 |
$76.80 |
$76.80 |
$232.50
|
|
Mayo mycophenolic acid therapeutic drug level
|
$73.60 |
$73.60 |
$73.60 |
$78.47
|
|
Mayo organic acid methylmalonic single quantitative
|
$88.00 |
$88.00 |
$88.00 |
$102.00
|
|
Mayo pntft phenytoin free therapeutic drug level
|
$57.60 |
$57.60 |
$57.60 |
$69.00
|
|
Mayo psaft prostate specific antigen free
|
$45.00 |
$45.00 |
$45.00 |
$90.00
|
|
Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative
|
$76.80 |
$76.80 |
$76.80 |
$240.00
|
|
Mayo repu protein electrophoresis urine
|
$45.00 |
$45.00 |
$45.00 |
$93.62
|
|
Mayo syphilis test non-treponemal antibody qualitative vdrl
|
$17.60 |
$17.60 |
$17.60 |
$48.75
|
|
Mayo thyroglobulin
|
$66.40 |
$66.40 |
$66.40 |
$95.00
|
|
Mayo valpg valproic acid free therapeutic drug level
|
$56.80 |
$56.80 |
$56.80 |
$62.00
|
|
Meropenem 1 gram intravenous solution
|
$53.00 |
$53.00 |
$53.00 |
$57.18
|
|
Metabolic Blood Panel (Basic)
|
$20.00 |
$20.00 |
$20.00 |
$117.15
|
|
Metabolic Blood Panel (Comprehensive)
|
$25.00 |
$25.00 |
$25.00 |
$157.50
|
|
Metabolic panel ionized ca
|
$89.60 |
$89.60 |
$89.60 |
$141.60
|
|
Methotrexate sodium 2.5 mg tablet
|
$4.60 |
$4.60 |
$4.60 |
$8.73
|
|
Methylene blue (antidote) 5 mg/ml intravenous solution
|
$849.00 |
$849.00 |
$849.00 |
$1,111.02
|
|
Methylprednisolone 4 mg tablet
|
$8.40 |
$8.40 |
$8.40 |
$4.49
|
|
Methylprednisolone acetate 40 mg/ml suspension for injection
|
$97.60 |
$97.60 |
$97.60 |
$62.85
|
|
Methylprednisolone sodium succinate 1,000 mg intravenous solution
|
$128.60 |
$128.60 |
$128.60 |
$188.51
|
|
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr
|
$30.40 |
$30.40 |
$30.40 |
$16.19
|
|
Metoprolol tartrate 5 mg/5 ml intravenous (wrapper)
|
$44.40 |
$44.40 |
$44.40 |
$8.55
|
|
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback
|
$36.40 |
$36.40 |
$36.40 |
$23.55
|
|
Micafungin 100 mg intravenous solution
|
$211.40 |
$211.40 |
$211.40 |
$327.37
|
|
Midazolam 1 mg/ml injection solution
|
$48.20 |
$48.20 |
$48.20 |
$63.51
|
|
Milrinone 20 mg/100 ml(200 mcg/ml) in 5 % dextrose intravenous piggybk
|
$311.40 |
$311.40 |
$311.40 |
$90.18
|
|
Morphine 4 mg/ml injection (wrapper)
|
$143.20 |
$143.20 |
$143.20 |
$73.22
|
|
Morphine 4 mg/ml injection (wrapper)|discarded drug not administered
|
$35.00 |
$35.00 |
$35.00 |
$27.00
|
|
Morphine (pf) 0.25 mg/0.5 ml injection (neo/ped) - cnr
|
$2,124.40 |
$2,124.40 |
$2,124.40 |
$161.32
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$712.50 |
$712.50 |
$712.50 |
$2,753.50
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$463.50 |
$463.50 |
$463.50 |
$1,951.95
|
|
Mycophenolate mofetil 250 mg capsule
|
$3,104.20 |
$3,104.20 |
$3,104.20 |
$10.79
|
|
Mycophenolic acid
|
$10.00 |
$10.00 |
$10.00 |
$12.84
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$47.20 |
$47.20 |
$47.20 |
$135.50
|
|
Nafcillin 2 gram solution for injection
|
$81.20 |
$81.20 |
$81.20 |
$84.00
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$147.20 |
$147.20 |
$147.20 |
$70.87
|
|
Natriuretic peptide
|
$80.00 |
$80.00 |
$80.00 |
$176.15
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$282.00 |
$282.00 |
$282.00 |
$1,498.90
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$701.50 |
$701.50 |
$701.50 |
$2,855.40
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$454.00 |
$454.00 |
$454.00 |
$2,003.30
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$79.80 |
$79.80 |
$79.80 |
$60.38
|
|
No pt prsnt train initial 30
|
$201.60 |
$201.60 |
$201.60 |
$61.33
|
|
Nr lnr acclrtr tx max 5 sessions
|
$4,364.80 |
$4,364.80 |
$4,364.80 |
$6,737.40
|
|
Ntsty modul rad tx dlvr cplx
|
$2,984.80 |
$2,984.80 |
$2,984.80 |
$2,503.00
|
|
Observation direct referral from physician office for admission
|
$159.20 |
$159.20 |
$159.20 |
$384.00
|
|
Observation per hour
|
$487.20 |
$487.20 |
$487.20 |
$81.22
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$34.20 |
$34.20 |
$34.20 |
$90.00
|
|
Olanzapine 10 mg intramuscular solution
|
$146.60 |
$146.60 |
$146.60 |
$109.58
|