|
Ihc/icc per specimen each additional single antibody stain
|
$358.45 |
$358.45 |
$358.45 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$358.45 |
$358.45 |
$358.45 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$358.45 |
$358.45 |
$358.45 |
$274.86
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$259.59 |
$259.59 |
$259.59 |
$3,593.90
|
|
Immunoassay tumor antigen quantitative ca 125
|
$848.85 |
$848.85 |
$848.85 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$593.15 |
$593.15 |
$593.15 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$54.00 |
$54.00 |
$54.00 |
$138.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$342.86 |
$342.86 |
$342.86 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$225.33 |
$225.33 |
$225.33 |
$232.05
|
|
Implant cochlear osia osi300
|
$19,647.00 |
$19,647.00 |
$19,647.00 |
$17,423.06
|
|
Implant ureth bulk agent
|
$3,549.00 |
$3,549.00 |
$3,549.00 |
$2,139.62
|
|
In-111 pentetate dtpa / 0.5 mci
|
$8,691.06 |
$8,691.06 |
$8,691.06 |
$2,550.60
|
|
In-111 pentetreotide
|
$8,429.46 |
$8,429.46 |
$8,429.46 |
$4,944.55
|
|
Infect ag drug suscept pheno predict
|
$1,132.51 |
$1,132.51 |
$1,132.51 |
$320.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,132.51 |
$1,132.51 |
$1,132.51 |
$603.75
|
|
Infect ag if legionella pneumophila
|
$148.05 |
$148.05 |
$148.05 |
$73.46
|
|
Infect ag if pneumocystis carinii
|
$148.05 |
$148.05 |
$148.05 |
$67.46
|
|
Infect ag na resp virus 12-25 targets
|
$309.64 |
$309.64 |
$309.64 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$490.36 |
$490.36 |
$490.36 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$272.96 |
$272.96 |
$272.96 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$635.27 |
$635.27 |
$635.27 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$1,269.00 |
$1,269.00 |
$1,269.00 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$357.85 |
$357.85 |
$357.85 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$203.85 |
$203.85 |
$203.85 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$717.57 |
$717.57 |
$717.57 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$57.95 |
$57.95 |
$57.95 |
$55.31
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$287.36 |
$287.36 |
$287.36 |
$137.67
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$143.40 |
$143.40 |
$143.40 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$995.58 |
$995.58 |
$995.58 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$157.91 |
$157.91 |
$157.91 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$1,909.47 |
$1,909.47 |
$1,909.47 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$287.36 |
$287.36 |
$287.36 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$67.00 |
$67.00 |
$67.00 |
$100.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$276.44 |
$276.44 |
$276.44 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$345.47 |
$345.47 |
$345.47 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$874.89 |
$874.89 |
$874.89 |
$711.93
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$384.84 |
$384.84 |
$384.84 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,207.00 |
$1,207.00 |
$1,207.00 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$624.62 |
$624.62 |
$624.62 |
$374.50
|
|
Infliximab 100 mg intravenous solution
|
$462.80 |
$462.80 |
$462.80 |
$2,080.86
|
|
Initiation & management bipap/cpap initial day
|
$1,277.32 |
$1,277.32 |
$1,277.32 |
$576.00
|
|
Inj, biorphen, 20 micrograms
|
$87.50 |
$87.50 |
$87.50 |
$17.12
|
|
Inj cefazolin sodium, hikma
|
$23.69 |
$23.69 |
$23.69 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$136.57 |
$136.57 |
$136.57 |
$18.30
|
|
Inj, cefiderocol, 10 mg
|
$368.05 |
$368.05 |
$368.05 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$218.85 |
$218.85 |
$218.85 |
$408.00
|
|
Inj crotalidae im f(ab')2 eq
|
$3,435.77 |
$3,435.77 |
$3,435.77 |
$2,613.60
|
|
Injection, cangrelor
|
$2,003.85 |
$2,003.85 |
$2,003.85 |
$1,889.78
|
|
Inj hydroxocobalamin IV 25mg
|
$2,949.26 |
$2,949.26 |
$2,949.26 |
$2,452.32
|
|
Inj, levothyroxine, freskabi
|
$159.65 |
$159.65 |
$159.65 |
$363.97
|
|
Inj mepivacaine hcl/10 ml
|
$33.19 |
$33.19 |
$33.19 |
$33.86
|
|
Inj meropenem (wg crit care)
|
$78.96 |
$78.96 |
$78.96 |
$77.97
|
|
Inj testosterone cypionate
|
$387.69 |
$387.69 |
$387.69 |
$62.80
|
|
Inj vocal cord bulking agent
|
$4,620.00 |
$4,620.00 |
$4,620.00 |
$1,480.00
|
|
Insitu hybridization auto
|
$1,139.20 |
$1,139.20 |
$1,139.20 |
$371.00
|
|
Insitu hybridization manual
|
$276.30 |
$276.30 |
$276.30 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$398.70 |
$398.70 |
$398.70 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$391.26 |
$391.26 |
$391.26 |
$326.04
|
|
Insulin total
|
$563.40 |
$563.40 |
$563.40 |
$66.64
|
|
Interrog device eval heart
|
$141.93 |
$141.93 |
$141.93 |
$162.40
|
|
Intrinsic factor antibody
|
$837.09 |
$837.09 |
$837.09 |
$66.60
|
|
Ipratropium bromide non-comp
|
$48.86 |
$48.86 |
$48.86 |
$3.75
|
|
Iron
|
$254.43 |
$254.43 |
$254.43 |
$74.40
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$512.19 |
$512.19 |
$512.19 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$327.68 |
$327.68 |
$327.68 |
$119.83
|
|
Irrigation implantable venous access device for drug delivery systems
|
$157.70 |
$157.70 |
$157.70 |
$142.20
|
|
Ivc venogram s&i
|
$3,345.32 |
$3,345.32 |
$3,345.32 |
$3,316.95
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$362.18 |
$362.18 |
$362.18 |
$60.20
|
|
Kidney img w/bldflw sgl without rx
|
$4,968.96 |
$4,968.96 |
$4,968.96 |
$1,427.40
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$464.00 |
$464.00 |
$464.00 |
$740.00
|
|
Kras gene variants exon 2
|
$869.63 |
$869.63 |
$869.63 |
$486.45
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$157.94 |
$157.94 |
$157.94 |
$175.92
|
|
Lactoferrin fecal qualitative
|
$189.00 |
$189.00 |
$189.00 |
$80.40
|
|
Lactoferrin fecal quant
|
$279.96 |
$279.96 |
$279.96 |
$106.10
|
|
Levetiracetam therapeutic drug level
|
$121.30 |
$121.30 |
$121.30 |
$88.92
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$301.06 |
$301.06 |
$301.06 |
$385.62
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$91.27 |
$91.27 |
$91.27 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$465.59 |
$465.59 |
$465.59 |
$89.70
|
|
Liletta, 52 mg
|
$1,863.03 |
$1,863.03 |
$1,863.03 |
$1,453.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$672.57 |
$672.57 |
$672.57 |
$125.66
|
|
Lipoprotein blood quant
|
$134.27 |
$134.27 |
$134.27 |
$102.05
|
|
Lithium therapeutic drug level
|
$313.28 |
$313.28 |
$313.28 |
$69.42
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$208.12 |
$208.12 |
$208.12 |
$37.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$13,771.84 |
$13,771.84 |
$13,771.84 |
$2,445.30
|
|
Lung perfusion imaging
|
$4,151.37 |
$4,151.37 |
$4,151.37 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$4,983.27 |
$4,983.27 |
$4,983.27 |
$1,448.00
|
|
Macroscopic exam parasite
|
$11.59 |
$11.59 |
$11.59 |
$36.40
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$164.81 |
$164.81 |
$164.81 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$299.55 |
$299.55 |
$299.55 |
$152.54
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$367.45 |
$367.45 |
$367.45 |
$66.36
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$710.47 |
$710.47 |
$710.47 |
$102.96
|
|
Mayo alkaline phosphatase isoenzyme
|
$414.80 |
$414.80 |
$414.80 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$167.98 |
$167.98 |
$167.98 |
$105.11
|
|
Mayo alpha 1 antitrypsin
|
$929.32 |
$929.32 |
$929.32 |
$89.05
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$374.73 |
$374.73 |
$374.73 |
$359.00
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$7,098.27 |
$7,098.27 |
$7,098.27 |
$1,860.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$1,043.87 |
$1,043.87 |
$1,043.87 |
$73.08
|
|
Mayo barbiturates definitive assay confirmation urine
|
$838.93 |
$838.93 |
$838.93 |
$91.50
|
|
Mayo blastomyces antibody immunodiffusion
|
$156.90 |
$156.90 |
$156.90 |
$57.85
|
|
Mayo c1 esterase inhibitor
|
$102.21 |
$102.21 |
$102.21 |
$85.00
|