|
Lsh w/t/o ut 250 g or less
|
$43,254.79 |
$43,254.79 |
$43,254.79 |
$7,961.97
|
|
Lsh w/t/o uterus above 250 g
|
$32,384.42 |
$32,384.42 |
$32,384.42 |
$11,533.76
|
|
Lso corset front
|
$595.03 |
$595.03 |
$595.03 |
$207.32
|
|
Lso flex no ri stays pre ots
|
$642.92 |
$642.92 |
$642.92 |
$164.80
|
|
Lso full corset
|
$845.26 |
$845.26 |
$845.26 |
$322.50
|
|
Lso r post pnl sj-t9 pre cst
|
$959.31 |
$959.31 |
$959.31 |
$326.82
|
|
Lso sag-coronal panel custom
|
$9,486.51 |
$9,486.51 |
$9,486.51 |
$2,518.78
|
|
Lso sag-co shell pnl pre ots
|
$7,323.86 |
$7,323.86 |
$7,323.86 |
$3,065.30
|
|
Lso sag ctr rigi pos pre ots
|
$915.67 |
$915.67 |
$915.67 |
$388.83
|
|
Lso sagit rigid panel prefab
|
$5,648.89 |
$5,648.89 |
$5,648.89 |
$1,990.83
|
|
Lso sagittal rigid panel cus
|
$7,664.63 |
$7,664.63 |
$7,664.63 |
$2,849.78
|
|
Lso sc r pos/lat pnl pre cst
|
$1,474.64 |
$1,474.64 |
$1,474.64 |
$577.00
|
|
Lso sc r pos/lat pnl pre ots
|
$1,621.11 |
$1,621.11 |
$1,621.11 |
$678.49
|
|
Lso s/c shell/panel custom
|
$5,381.04 |
$5,381.04 |
$5,381.04 |
$2,252.16
|
|
Lumbar bolster pad
|
$442.66 |
$442.66 |
$442.66 |
$169.29
|
|
Lumbar derotation pad
|
$514.14 |
$514.14 |
$514.14 |
$168.53
|
|
Lumbar or lumbar rib pad
|
$501.22 |
$501.22 |
$501.22 |
$191.69
|
|
Lumbar sling
|
$568.88 |
$568.88 |
$568.88 |
$217.56
|
|
Lumbar Spinal Fusion (single level)
|
$86,365.31 |
$86,365.31 |
$86,365.31 |
$14,331.20
|
|
Lung Function Test (Spirometry)
|
$259.80 |
$259.80 |
$259.80 |
$295.35
|
|
Lung perfusion imaging
|
$847.20 |
$847.20 |
$847.20 |
$1,059.97
|
|
Lurbinectedin 4 mg intravenous solution
|
$41,085.00 |
$41,085.00 |
$47,025.00 |
$19,182.33
|
|
Lutetium lu 177 dotatat ther
|
$146,411.74 |
$146,411.74 |
$146,411.74 |
$333.50
|
|
Lutetium lu 177 vipivotide
|
$121,564.51 |
$121,564.51 |
$121,564.51 |
$345.87
|
|
Lvad shower bag heartmate
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$905.92
|
|
Lymphatics/lymph node imaging
|
$1,251.60 |
$1,251.60 |
$1,251.60 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$239.40 |
$239.40 |
$239.40 |
$271.88
|
|
Macroscopic exam arthropod
|
$135.60 |
$135.60 |
$135.60 |
$38.58
|
|
Macroscopic exam parasite
|
$13.20 |
$13.20 |
$13.20 |
$36.55
|
|
Magnesium
|
$82.20 |
$82.20 |
$82.20 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$77.29 |
$77.29 |
$86.49 |
$59.88
|
|
Male sling procedure
|
$59,428.63 |
$59,428.63 |
$59,428.63 |
$8,465.18
|
|
Mammosite ced
|
$18,966.75 |
$18,966.75 |
$18,966.75 |
$5,031.60
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$88.80 |
$88.80 |
$88.80 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$127.20 |
$127.20 |
$127.20 |
$160.80
|
|
Man's shoe oxford brace
|
$417.27 |
$417.27 |
$417.27 |
$175.11
|
|
Mapping io sentinel lymph node
|
$23,889.19 |
$23,889.19 |
$25,120.37 |
$650.00
|
|
Map tachycard site(s)
|
$4,937.40 |
$4,937.40 |
$4,937.40 |
$4,082.82
|
|
Marker biop eviva buckle ss
|
$35,425.50 |
$35,425.50 |
$35,425.50 |
$1,451.30
|
|
Marsupialization liver lesion 47300
|
$20,726.09 |
$20,726.09 |
$20,726.09 |
$2,771.20
|
|
Mastectomy partial
|
$21,320.19 |
$21,320.19 |
$44,790.63 |
$4,531.42
|
|
Mast mod rad
|
$68,936.99 |
$68,936.99 |
$68,936.99 |
$7,127.17
|
|
Mastopexy
|
$41,619.26 |
$41,619.26 |
$59,568.03 |
$6,591.20
|
|
Mast simple complete
|
$68,936.99 |
$68,936.99 |
$80,811.30 |
$6,174.00
|
|
Matrion 1 sq cm
|
$48,498.45 |
$48,498.45 |
$48,498.45 |
$361.00
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$203,712.30 |
$203,712.30 |
$203,712.30 |
$6,321.66
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$115.80 |
$115.80 |
$115.80 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$98.40 |
$98.40 |
$98.40 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$71.40 |
$71.40 |
$71.40 |
$122.45
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$34.80 |
$34.80 |
$34.80 |
$111.69
|
|
Mayo amikacin trough therapeutic drug level
|
$89.40 |
$89.40 |
$89.40 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$712.80 |
$712.80 |
$712.80 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$712.80 |
$712.80 |
$712.80 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$791.40 |
$791.40 |
$791.40 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,585.40 |
$2,585.40 |
$2,585.40 |
$1,860.00
|
|
Mayo androstenedione
|
$87.60 |
$87.60 |
$87.60 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$119.40 |
$119.40 |
$119.40 |
$73.60
|
|
Mayo bart bartonella henselae antibody igg
|
$76.20 |
$76.20 |
$76.20 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$287.40 |
$287.40 |
$287.40 |
$328.20
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$644.40 |
$644.40 |
$644.40 |
$312.98
|
|
Mayo blastomyces antibody immunodiffusion
|
$85.80 |
$85.80 |
$85.80 |
$55.04
|
|
Mayo brcmg brucella antibody igm
|
$57.60 |
$57.60 |
$57.60 |
$44.10
|
|
Mayo c1 esterase inhibitor
|
$94.80 |
$94.80 |
$94.80 |
$86.73
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$122.40 |
$122.40 |
$122.40 |
$80.16
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$142.20 |
$142.20 |
$142.20 |
$110.00
|
|
Mayo chemiluminescent parathyroid related peptide
|
$188.40 |
$188.40 |
$188.40 |
$123.73
|
|
Mayo chikv chikungunya antibodies igg
|
$184.80 |
$184.80 |
$184.80 |
$109.20
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$59.40 |
$59.40 |
$59.40 |
$52.66
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$57.60 |
$57.60 |
$57.60 |
$49.29
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$499.20 |
$499.20 |
$499.20 |
$360.33
|
|
Mayo chromium
|
$123.00 |
$123.00 |
$123.00 |
$74.94
|
|
Mayo cocou cortisone urine
|
$214.20 |
$214.20 |
$214.20 |
$213.92
|
|
Mayo cortisol free
|
$112.20 |
$112.20 |
$112.20 |
$94.95
|
|
Mayo covid-19 antibody nucleocapsid total
|
$133.20 |
$133.20 |
$133.20 |
$71.50
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$76.80 |
$76.80 |
$76.80 |
$58.10
|
|
Mayo cyanide
|
$58.20 |
$58.20 |
$58.20 |
$87.50
|
|
Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual
|
$488.40 |
$488.40 |
$488.40 |
$578.82
|
|
Mayo deoxyribonuclease antibody titer
|
$61.20 |
$61.20 |
$61.20 |
$56.80
|
|
Mayo dihydrotestosterone
|
$228.00 |
$228.00 |
$228.00 |
$74.25
|
|
Mayo dipstick analyte single step qualitative/semiqualitative synovial fluid
|
$391.80 |
$391.80 |
$391.80 |
$35.28
|
|
Mayo efpo chloride stool
|
$51.60 |
$51.60 |
$51.60 |
$43.41
|
|
Mayo estrone
|
$210.60 |
$210.60 |
$210.60 |
$85.00
|
|
Mayo ethosuximide therapeutic drug level
|
$58.80 |
$58.80 |
$58.80 |
$69.55
|
|
Mayo everolimus therapeutic drug level
|
$41.40 |
$41.40 |
$41.40 |
$97.50
|
|
Mayo factor ii
|
$304.20 |
$304.20 |
$304.20 |
$99.06
|
|
Mayo factor viii vw factor multimetric analysis
|
$444.00 |
$444.00 |
$444.00 |
$130.00
|
|
Mayo factor x
|
$399.60 |
$399.60 |
$399.60 |
$155.00
|
|
Mayo factor xi
|
$208.20 |
$208.20 |
$208.20 |
$122.20
|
|
Mayo fbl culture fungi blood
|
$106.80 |
$106.80 |
$106.80 |
$105.60
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$78.60 |
$78.60 |
$78.60 |
$66.43
|
|
Mayo gamma-globin full gene sequencing
|
$3,150.00 |
$3,150.00 |
$3,150.00 |
$1,460.30
|
|
Mayo hemosiderin qualitative urine
|
$35.40 |
$35.40 |
$35.40 |
$33.57
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$340.80 |
$340.80 |
$340.80 |
$165.55
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-2
|
$105.60 |
$105.60 |
$105.60 |
$122.00
|
|
Mayo hiser histoplasma antibodies immunodiffusion
|
$93.60 |
$93.60 |
$93.60 |
$52.67
|
|
Mayo hvdip HIV 1 antibody
|
$113.40 |
$113.40 |
$113.40 |
$74.25
|
|
Mayo hvdip HIV 2 antibody
|
$181.20 |
$181.20 |
$181.20 |
$77.77
|
|
Mayo hydroxyprogesterone 17-d
|
$159.00 |
$159.00 |
$159.00 |
$106.65
|
|
Mayo immunoassay c1 esterase inhibitor antibody quantitative
|
$596.40 |
$596.40 |
$596.40 |
$210.80
|
|
Mayo immunoassay tumor antigen quantitative ca 27.29
|
$144.00 |
$144.00 |
$144.00 |
$107.14
|
