|
Hydralazine 20 mg/ml injection solution
|
$76.05 |
$76.05 |
$76.05 |
$48.00
|
|
Immobilizer shldr dlx str 24-36in med
|
$76.70 |
$76.70 |
$76.70 |
$118.43
|
|
Infect ag ia optc obs influenza
|
$125.45 |
$125.45 |
$125.45 |
$72.93
|
|
Infect ag if influenza a
|
$52.00 |
$52.00 |
$52.00 |
$41.30
|
|
Infect ag na orthopoxvirus amp prb each
|
$202.15 |
$202.15 |
$202.15 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$111.80 |
$111.80 |
$111.80 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$131.95 |
$131.95 |
$131.95 |
$98.58
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,539.85 |
$1,539.85 |
$1,539.85 |
$864.67
|
|
Initial nursing facility care/day 35 minutes
|
$82.14 |
$82.14 |
$82.14 |
$188.50
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$817.05 |
$817.05 |
$817.05 |
$1,214.78
|
|
Injection, peramivir
|
$1,862.38 |
$1,862.38 |
$1,862.38 |
$744.75
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,186.25 |
$1,186.25 |
$1,186.25 |
$1,391.40
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,967.55 |
$1,967.55 |
$1,967.55 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,007.20 |
$2,007.20 |
$2,007.20 |
$1,685.00
|
|
Inj. inebilizumab-cdon, 1 mg
|
$117,051.41 |
$117,051.41 |
$117,051.41 |
$70,014.65
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,125.80 |
$1,125.80 |
$1,125.80 |
$794.70
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,125.80 |
$1,125.80 |
$1,125.80 |
$1,049.50
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,010.15 |
$3,010.15 |
$3,010.15 |
$2,103.75
|
|
Insert pessary/other device
|
$178.10 |
$178.10 |
$178.10 |
$278.90
|
|
Insj phrnc nrv stim sys
|
$73,125.65 |
$73,125.65 |
$73,125.65 |
$53,251.79
|
|
Ins picad w subq port 5yr>
|
$6,530.55 |
$6,530.55 |
$6,530.55 |
$4,078.00
|
|
IV Fluids (each additional hour)
|
$178.10 |
$178.10 |
$178.10 |
$133.90
|
|
Ivp w/wo kub w/wo tomography
|
$958.75 |
$958.75 |
$958.75 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$206.05 |
$206.05 |
$206.05 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$486.20 |
$486.20 |
$486.20 |
$362.05
|
|
Kerecis marigen shld sq cm
|
$65.65 |
$65.65 |
$65.65 |
$1.00
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$27.82 |
$27.82 |
$27.82 |
$23.52
|
|
Kit lead specify 5-6-5
|
$2,735.85 |
$2,735.85 |
$2,735.85 |
$16,672.10
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$100.75 |
$100.75 |
$100.75 |
$109.20
|
|
Largsc w/rmvl foreign bdy(s)
|
$2,121.60 |
$2,121.60 |
$2,121.60 |
$765.97
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,144.65 |
$1,144.65 |
$1,144.65 |
$1,092.58
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$86.90 |
$86.90 |
$86.90 |
$55.69
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$27.82 |
$27.82 |
$27.82 |
$46.02
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$27.82 |
$27.82 |
$27.82 |
$121.00
|
|
Macroscopic exam parasite
|
$37.05 |
$37.05 |
$37.05 |
$37.05
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$156.52 |
$156.52 |
$156.52 |
$58.70
|
|
Marker biop eviva buckle ss
|
$405.60 |
$405.60 |
$405.60 |
$1,451.30
|
|
Mayo aspergillus fumigatus antibody
|
$85.80 |
$85.80 |
$85.80 |
$67.20
|
|
Mayo bordetella pertussis antibody igg
|
$81.90 |
$81.90 |
$81.90 |
$69.20
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$43.55 |
$43.55 |
$43.55 |
$106.70
|
|
Mayo gamma-globin full gene sequencing
|
$5,670.60 |
$5,670.60 |
$5,670.60 |
$1,519.25
|
|
Mayo infectious agent antigen immunoassay direct optical observation cryptococcus
|
$95.55 |
$95.55 |
$95.55 |
$89.40
|
|
Mayo itraconazole therapeutic drug level
|
$228.80 |
$228.80 |
$228.80 |
$77.85
|
|
Mayo mgle voltage-gated calcium channel antibody each
|
$53.95 |
$53.95 |
$53.95 |
$85.40
|
|
Mayo phospholipid neutralization hexagonal lupus anticoagulant
|
$185.90 |
$185.90 |
$185.90 |
$84.66
|
|
Mayo prmb primidone therapeutic drug level
|
$50.05 |
$50.05 |
$50.05 |
$66.43
|
|
Mayo vasoactive intestinal peptide
|
$274.95 |
$274.95 |
$274.95 |
$139.27
|
|
Medroxyprogesterone 150 mg/ml im injection (wrapper)
|
$442.26 |
$442.26 |
$442.26 |
$190.81
|
|
Membrane amnioband 2x2cm -cost per sq cm
|
$397.80 |
$397.80 |
$397.80 |
$504.03
|
|
Methotrexate sodium 2.5 mg tablet
|
$19.56 |
$19.56 |
$19.56 |
$8.85
|
|
Methylene blue (antidote) 5 mg/ml intravenous solution
|
$4,520.75 |
$4,520.75 |
$4,520.75 |
$1,069.32
|
|
Methylprednisolone 4 mg tablet
|
$19.17 |
$19.17 |
$19.17 |
$4.62
|
|
Methylprednisolone sodium succinate 1,000 mg intravenous solution
|
$257.27 |
$257.27 |
$257.27 |
$188.51
|
|
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback
|
$156.52 |
$156.52 |
$156.52 |
$23.55
|
|
Micafungin 100 mg intravenous solution
|
$1,015.23 |
$1,015.23 |
$1,015.23 |
$327.37
|
|
Mid and Lower Back (Thoracolumbar Spine) X-ray
|
$356.85 |
$356.85 |
$356.85 |
$288.00
|
|
Minocycline hydrochloride
|
$1,403.35 |
$1,403.35 |
$1,403.35 |
$623.04
|
|
Mitomycin 40 mg intravenous solution
|
$4,520.75 |
$4,520.75 |
$4,520.75 |
$1,683.75
|
|
Mnpj anes sho jt fixj aprats
|
$1,936.35 |
$1,936.35 |
$1,936.35 |
$2,211.05
|
|
Morphine 4 mg/ml injection (wrapper)
|
$48.62 |
$48.62 |
$48.62 |
$72.00
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted
|
$251.55 |
$251.55 |
$251.55 |
$330.60
|
|
MRA w/cont, abd
|
$592.80 |
$592.80 |
$592.80 |
$1,907.28
|
|
MRI loex nonjt w IV cont
|
$2,414.10 |
$2,414.10 |
$2,414.10 |
$2,116.20
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$2,946.45 |
$2,946.45 |
$2,946.45 |
$2,753.50
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$2,125.50 |
$2,125.50 |
$2,125.50 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$2,997.80 |
$2,997.80 |
$2,997.80 |
$2,655.25
|
|
MRI w/cont, breast, bi
|
$3,148.60 |
$3,148.60 |
$3,148.60 |
$2,119.87
|
|
Myelography via inj w/s&i lumbosacral
|
$2,369.25 |
$2,369.25 |
$2,369.25 |
$1,850.00
|
|
Ndl insj without njx 1 or 2 musc
|
$22.75 |
$22.75 |
$22.75 |
$39.77
|
|
Neck Soft Tissue CT Scan (with and without contrast)
|
$2,323.10 |
$2,323.10 |
$2,323.10 |
$1,940.00
|
|
Neck Soft Tissue CT Scan (without contrast)
|
$1,546.35 |
$1,546.35 |
$1,546.35 |
$1,312.00
|
|
Neurolysis celiac plexus
|
$2,046.85 |
$2,046.85 |
$2,046.85 |
$1,780.24
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$138.58 |
$138.58 |
$138.58 |
$251.32
|
|
Observation per hour
|
$136.50 |
$136.50 |
$136.50 |
$82.50
|
|
Occupational Therapy Evaluation (high complexity)
|
$368.55 |
$368.55 |
$368.55 |
$297.00
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$36.79 |
$36.79 |
$36.79 |
$90.00
|
|
Ocular instrumnt screen bil
|
$6.50 |
$6.50 |
$6.50 |
$13.60
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$27.82 |
$27.82 |
$27.82 |
$22.62
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$79.30 |
$79.30 |
$79.30 |
$88.54
|
|
Oxytocin 10 unit/ml injection solution
|
$107.83 |
$107.83 |
$107.83 |
$50.40
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$38.48 |
$38.48 |
$38.48 |
$28.90
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$216.45 |
$216.45 |
$216.45 |
$245.67
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$4.55 |
$4.55 |
$4.55 |
$4,921.76
|
|
Pelvic CT scan (with and without contrast)
|
$1,918.80 |
$1,918.80 |
$1,918.80 |
$1,890.36
|
|
Pelvic MRI (without contrast)
|
$2,011.10 |
$2,011.10 |
$2,011.10 |
$1,916.50
|
|
Perq tx big toe fracture w/manip 28496
|
$7,889.70 |
$7,889.70 |
$7,889.70 |
$3,981.06
|
|
Pet CT whole body initial
|
$3,845.40 |
$3,845.40 |
$3,845.40 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$4,616.30 |
$4,616.30 |
$4,616.30 |
$4,060.00
|
|
Pfc sigma fem post aug sz3 8mm
|
$5,077.21 |
$5,077.21 |
$5,077.21 |
$39,920.50
|
|
Phentolaine mesylate inj
|
$2,659.93 |
$2,659.93 |
$2,659.93 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$271.44 |
$271.44 |
$271.44 |
$62.98
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$265.85 |
$265.85 |
$265.85 |
$90.25
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$720.20 |
$720.20 |
$720.20 |
$1,130.58
|
|
Pinworm exam
|
$34.45 |
$34.45 |
$34.45 |
$39.62
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$98.41 |
$98.41 |
$98.41 |
$81.36
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,836.90 |
$1,836.90 |
$1,836.90 |
$1,332.43
|
|
Plcmt dlyd xtn pros 1st vsl
|
$3,573.05 |
$3,573.05 |
$3,573.05 |
$3,793.50
|
|
Plc pq device breast ea addl lesion MRI guide
|
$2,050.75 |
$2,050.75 |
$2,050.75 |
$1,421.06
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$156.52 |
$156.52 |
$156.52 |
$62.79
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$7,946.25 |
$7,946.25 |
$7,946.25 |
$4,811.54
|