|
IV Fluids (first hour)
|
$461.60 |
$461.60 |
$461.60 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$196.00 |
$196.00 |
$196.00 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$208.00 |
$208.00 |
$208.00 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$161.60 |
$161.60 |
$161.60 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$491.20 |
$491.20 |
$491.20 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$153.60 |
$153.60 |
$153.60 |
$167.50
|
|
IV Push Injection (first drug)
|
$368.00 |
$368.00 |
$368.00 |
$252.76
|
|
Ivp w/nephrotomography
|
$728.80 |
$728.80 |
$728.80 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$714.40 |
$714.40 |
$714.40 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$452.00 |
$452.00 |
$452.00 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$478.40 |
$478.40 |
$478.40 |
$362.05
|
|
Kidney function study
|
$1,542.40 |
$1,542.40 |
$1,542.40 |
$935.22
|
|
Kidney imaging morphology
|
$936.80 |
$936.80 |
$936.80 |
$785.00
|
|
Kidney img w/bldflw sgl without rx
|
$1,843.20 |
$1,843.20 |
$1,843.20 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$854.40 |
$854.40 |
$854.40 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$627.20 |
$627.20 |
$627.20 |
$490.75
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$9,400.00 |
$9,400.00 |
$9,400.00 |
$9,423.50
|
|
Kit lead specify 5-6-5
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,058.00 |
$2,058.00 |
$2,058.00 |
$1,635.87
|
|
Knee MRI (with and without contrast)
|
$3,904.80 |
$3,904.80 |
$3,904.80 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$2,130.88
|
|
Knee X-ray
|
$435.20 |
$435.20 |
$435.20 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$313.60 |
$313.60 |
$313.60 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$384.80 |
$384.80 |
$384.80 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$308.00 |
$308.00 |
$308.00 |
$251.20
|
|
Ko w/0 joint rigid molded to
|
$284.80 |
$284.80 |
$284.80 |
$1,230.99
|
|
Lactated ringers intravenous solution
|
$80.00 |
$80.00 |
$80.00 |
$43.74
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$754.40 |
$754.40 |
$754.40 |
$740.40
|
|
Largsc w/removal lesion
|
$4,350.40 |
$4,350.40 |
$4,350.40 |
$4,362.99
|
|
Largsc w/rmvl foreign bdy(s)
|
$1,319.20 |
$1,319.20 |
$1,319.20 |
$765.97
|
|
Laryngoscopy with biopsy
|
$2,954.40 |
$2,954.40 |
$2,954.40 |
$3,297.83
|
|
Lead acuity x4 spiral l 86cm
|
$3,660.00 |
$3,660.00 |
$3,660.00 |
$5,460.00
|
|
Lead ingevity 45cm pfret MRI
|
$2,462.40 |
$2,462.40 |
$2,462.40 |
$2,928.00
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,419.20 |
$1,419.20 |
$1,419.20 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,528.80 |
$2,528.80 |
$2,528.80 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,224.00 |
$2,224.00 |
$2,224.00 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,285.60 |
$1,285.60 |
$1,285.60 |
$1,092.58
|
|
Levalbuterol non-comp unit
|
$288.94 |
$288.94 |
$288.94 |
$6.48
|
|
Ligate leg veins radical 37760
|
$3,687.20 |
$3,687.20 |
$3,687.20 |
$3,439.84
|
|
Ligation/divis of long saph vein 37700
|
$4,721.60 |
$4,721.60 |
$4,721.60 |
$4,255.00
|
|
Ligation/major artery/extremity 37618
|
$3,609.60 |
$3,609.60 |
$3,609.60 |
$1,567.80
|
|
Ligation vericose vein cluster(s) 1 leg
|
$4,247.20 |
$4,247.20 |
$4,247.20 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$7,232.00 |
$7,232.00 |
$7,232.00 |
$4,676.50
|
|
Lithotripsy transluminal coronary percutaneous
|
$3,814.40 |
$3,814.40 |
$3,814.40 |
$4,371.12
|
|
Liver/spleen imag static only
|
$1,554.40 |
$1,554.40 |
$1,554.40 |
$1,138.55
|
|
Liver/spleen imag w/vasclr flow
|
$744.00 |
$744.00 |
$744.00 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$40.00 |
$40.00 |
$40.00 |
$49.70
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$1,642.40 |
$1,642.40 |
$1,642.40 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,604.00 |
$2,604.00 |
$2,604.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,371.20 |
$2,371.20 |
$2,371.20 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,230.40 |
$4,230.40 |
$4,230.40 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,348.00 |
$3,348.00 |
$3,348.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$439.20 |
$439.20 |
$439.20 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$598.40 |
$598.40 |
$598.40 |
$505.83
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$564.00 |
$564.00 |
$564.00 |
$540.60
|
|
Lower Leg (Shin) X-ray (both sides)
|
$342.40 |
$342.40 |
$342.40 |
$338.40
|
|
Lumbar diskogram s&i
|
$3,684.00 |
$3,684.00 |
$3,684.00 |
$2,358.23
|
|
Lung Function Test Before and After an Inhaler
|
$496.80 |
$496.80 |
$496.80 |
$549.83
|
|
Lung Function Test (Spirometry)
|
$273.60 |
$273.60 |
$273.60 |
$296.91
|
|
Lung perfusion imaging
|
$1,438.40 |
$1,438.40 |
$1,438.40 |
$1,069.25
|
|
Lymphatics/lymph node imaging
|
$2,256.00 |
$2,256.00 |
$2,256.00 |
$1,491.70
|
|
Lymph vessel x-ray trunk
|
$1,918.40 |
$1,918.40 |
$1,918.40 |
$3,452.15
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$100.91 |
$100.91 |
$100.91 |
$58.70
|
|
Magnetic image bone marrow
|
$2,785.60 |
$2,785.60 |
$2,785.60 |
$1,329.39
|
|
Marker biop eviva buckle ss
|
$774.40 |
$774.40 |
$774.40 |
$1,451.30
|
|
Mastoids complete
|
$354.40 |
$354.40 |
$354.40 |
$299.50
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$30.32 |
$30.32 |
$30.32 |
$4,472.40
|
|
Mayo hla typing a/b/c single antigen
|
$160.80 |
$160.80 |
$160.80 |
$122.80
|
|
Mayo semb semen analysis volume/count/motility/differential strict morphologic criteria
|
$180.80 |
$180.80 |
$180.80 |
$140.00
|
|
Measure kidney pressure
|
$560.00 |
$560.00 |
$560.00 |
$803.99
|
|
Membrane amnioband 2x2cm -cost per sq cm
|
$388.80 |
$388.80 |
$388.80 |
$504.03
|
|
Mid and Lower Back (Thoracolumbar Spine) X-ray
|
$367.20 |
$367.20 |
$367.20 |
$288.00
|
|
Middle cerebral artery echo
|
$494.40 |
$494.40 |
$494.40 |
$331.68
|
|
Monitor reveal linq ii cardiac
|
$6,648.00 |
$6,648.00 |
$6,648.00 |
$9,446.50
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual
|
$339.20 |
$339.20 |
$339.20 |
$318.43
|
|
MRA abdomen post contrast
|
$3,240.00 |
$3,240.00 |
$3,240.00 |
$2,144.35
|
|
MRA aorta thoracic w/wo contrast
|
$3,060.00 |
$3,060.00 |
$3,060.00 |
$2,331.37
|
|
MRA ext low(run-off)pst cntrst
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$2,564.48
|
|
MRA pelvis
|
$2,864.00 |
$2,864.00 |
$2,864.00 |
$2,277.26
|
|
MRA upper extremity post contrast-bil
|
$3,440.80 |
$3,440.80 |
$3,440.80 |
$2,452.45
|
|
MRI cardiac morph & func wo IV cont
|
$2,902.40 |
$2,902.40 |
$2,902.40 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$3,546.40 |
$3,546.40 |
$3,546.40 |
$1,946.48
|
|
MRI chest without contrast
|
$3,223.20 |
$3,223.20 |
$3,223.20 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$3,868.00 |
$3,868.00 |
$3,868.00 |
$2,652.73
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$3,253.60 |
$3,253.60 |
$3,253.60 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$3,580.80 |
$3,580.80 |
$3,580.80 |
$2,753.50
|
|
MRI orbit fac&nck w IV cont
|
$3,516.00 |
$3,516.00 |
$3,516.00 |
$2,203.50
|
|
MRI tmj
|
$2,836.80 |
$2,836.80 |
$2,836.80 |
$1,741.07
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$2,579.20 |
$2,579.20 |
$2,579.20 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$3,544.80 |
$3,544.80 |
$3,544.80 |
$2,655.25
|
|
Multiple sleep latency test
|
$3,174.40 |
$3,174.40 |
$3,174.40 |
$2,466.00
|
|
Myelogphy 2/> spine regions
|
$2,453.60 |
$2,453.60 |
$2,453.60 |
$1,494.22
|
|
Myelography l-s spine
|
$1,810.40 |
$1,810.40 |
$1,810.40 |
$1,334.09
|
|
Myelography neck spine
|
$1,972.00 |
$1,972.00 |
$1,972.00 |
$1,241.50
|
|
Myelography thoracic spine
|
$1,817.60 |
$1,817.60 |
$1,817.60 |
$1,255.00
|
|
Myelography via inj w/s&i cervical
|
$2,568.00 |
$2,568.00 |
$2,568.00 |
$1,760.85
|
|
Myelography via inj w/s&i lumbosacral
|
$2,941.60 |
$2,941.60 |
$2,941.60 |
$1,850.00
|
