|
Insulin total
|
$72.20 |
$72.20 |
$72.20 |
$72.15
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$124.05 |
$124.05 |
$124.05 |
$104.31
|
|
Intrinsic factor antibody
|
$74.40 |
$74.40 |
$74.40 |
$76.77
|
|
Intro long gi tube w/mult fluo
|
$215.79 |
$215.79 |
$215.79 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$432.89 |
$432.89 |
$432.89 |
$565.00
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$2.99 |
$2.99 |
$2.99 |
$145.52
|
|
Ipratropium bromide non-comp
|
$0.29 |
$0.29 |
$0.29 |
$2.43
|
|
Iron
|
$449.37 |
$449.37 |
$449.37 |
$67.50
|
|
Iron binding capacity
|
$49.31 |
$49.31 |
$49.31 |
$55.00
|
|
Iron dextran 50 mg/ml injection solution
|
$38.16 |
$38.16 |
$38.16 |
$38.16
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1.37 |
$1.37 |
$1.37 |
$211.09
|
|
Irrigation implantable venous access device for drug delivery systems
|
$46.80 |
$46.80 |
$46.80 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$155.85 |
$155.85 |
$155.85 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$36.90 |
$36.90 |
$36.90 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$36.93 |
$36.93 |
$36.93 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$148.43 |
$148.43 |
$148.43 |
$476.50
|
|
Ivp w/wo kub w/wo tomography
|
$328.65 |
$328.65 |
$328.65 |
$687.80
|
|
Jejunstmy tube plcmt
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$2,174.40
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$44.42 |
$44.42 |
$44.42 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$7.02 |
$7.02 |
$7.02 |
$17.11
|
|
Kidney imag w/bld flow multi
|
$607.47 |
$607.47 |
$607.47 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$567.90 |
$567.90 |
$567.90 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$239.15 |
$239.15 |
$239.15 |
$618.54
|
|
Knee MRI (with and without contrast)
|
$1,021.52 |
$1,021.52 |
$1,021.52 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$1,207.62 |
$1,207.62 |
$1,207.62 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$974.03 |
$974.03 |
$974.03 |
$2,120.00
|
|
Knee X-ray
|
$153.44 |
$153.44 |
$153.44 |
$387.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$0.44 |
$0.44 |
$0.44 |
$13.00
|
|
Lactate dehydrogenase (ldh)
|
$34.23 |
$34.23 |
$34.23 |
$50.55
|
|
Lactated ringers intravenous solution
|
$46.35 |
$46.35 |
$46.35 |
$46.35
|
|
Lactic acid
|
$68.00 |
$68.00 |
$68.00 |
$85.20
|
|
Laryngoscopy with biopsy
|
$1,404.29 |
$1,404.29 |
$1,404.29 |
$3,297.83
|
|
Lead capillary
|
$66.32 |
$66.32 |
$66.32 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$634.37 |
$634.37 |
$634.37 |
$1,053.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$0.18 |
$0.18 |
$0.18 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$148.74 |
$148.74 |
$148.74 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$14.63 |
$14.63 |
$14.63 |
$43.61
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$20.31 |
$20.31 |
$20.31 |
$343.13
|
|
Lidocaine therapeutic drug level
|
$77.45 |
$77.45 |
$77.45 |
$82.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$46.65 |
$46.65 |
$46.65 |
$84.28
|
|
Lipase
|
$41.90 |
$41.90 |
$41.90 |
$67.68
|
|
Lipoprotein blood quant
|
$28.82 |
$28.82 |
$28.82 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$53.36 |
$53.36 |
$53.36 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$81.65 |
$81.65 |
$81.65 |
$61.60
|
|
Lithium therapeutic drug level
|
$50.33 |
$50.33 |
$50.33 |
$62.40
|
|
Liver Function Test
|
$105.26 |
$105.26 |
$105.26 |
$92.85
|
|
Liver/spleen imag static only
|
$540.84 |
$540.84 |
$540.84 |
$1,135.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$5.45 |
$5.45 |
$5.45 |
$2.57
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$6.12 |
$6.12 |
$6.12 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$904.56 |
$904.56 |
$904.56 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,009.76 |
$1,009.76 |
$1,009.76 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$934.41 |
$934.41 |
$934.41 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,424.84 |
$1,424.84 |
$1,424.84 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,013.60 |
$1,013.60 |
$1,013.60 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$976.83 |
$976.83 |
$976.83 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$180.96 |
$180.96 |
$180.96 |
$328.23
|
|
L/s ratio fetal lung
|
$136.38 |
$136.38 |
$136.38 |
$173.55
|
|
Lung function test (mbc/mvv)
|
$147.30 |
$147.30 |
$147.30 |
$166.95
|
|
Lung Function Test (Spirometry)
|
$170.06 |
$170.06 |
$170.06 |
$290.89
|
|
Lung perfusion imaging
|
$657.60 |
$657.60 |
$657.60 |
$919.75
|
|
Lymphatics/lymph node imaging
|
$718.83 |
$718.83 |
$718.83 |
$1,330.00
|
|
Macroscopic exam arthropod
|
$3.63 |
$3.63 |
$3.63 |
$38.50
|
|
Macroscopic exam parasite
|
$3.66 |
$3.66 |
$3.66 |
$35.98
|
|
Magnesium
|
$73.44 |
$73.44 |
$73.44 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$8.84 |
$8.84 |
$8.84 |
$39.81
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$75.56 |
$75.56 |
$75.56 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$79.35 |
$79.35 |
$79.35 |
$147.72
|
|
M.avium-intra dna amp prob
|
$112.07 |
$112.07 |
$112.07 |
$113.31
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$59.13 |
$59.13 |
$59.13 |
$76.70
|
|
Mayo aathr protein s free
|
$130.08 |
$130.08 |
$130.08 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$96.39 |
$96.39 |
$96.39 |
$100.26
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$233.06 |
$233.06 |
$233.06 |
$172.80
|
|
Mayo alkaline phosphatase isoenzyme
|
$56.60 |
$56.60 |
$56.60 |
$83.85
|
|
Mayo alpha 1 antitrypsin
|
$75.17 |
$75.17 |
$75.17 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$84.27 |
$84.27 |
$84.27 |
$112.89
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$77.21 |
$77.21 |
$77.21 |
$343.20
|
|
Mayo androstenedione
|
$103.88 |
$103.88 |
$103.88 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$74.24 |
$74.24 |
$74.24 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$146.76 |
$146.76 |
$146.76 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$72.60 |
$72.60 |
$72.60 |
$72.60
|
|
Mayo avwpr vw factor activity
|
$26.00 |
$26.00 |
$26.00 |
$159.66
|
|
Mayo bart bartonella henselae antibody igg
|
$77.12 |
$77.12 |
$77.12 |
$52.00
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$523.67 |
$523.67 |
$523.67 |
$364.90
|
|
Mayo blastomyces antibody immunodiffusion
|
$78.45 |
$78.45 |
$78.45 |
$67.60
|
|
Mayo bordetella pertussis antibody igg
|
$118.08 |
$118.08 |
$118.08 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$70.43 |
$70.43 |
$70.43 |
$56.80
|
|
Mayo c1 esterase inhibitor
|
$171.29 |
$171.29 |
$171.29 |
$124.80
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$149.78 |
$149.78 |
$149.78 |
$84.00
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$65.37 |
$65.37 |
$65.37 |
$110.02
|
|
Mayo ceruloplasmin
|
$68.25 |
$68.25 |
$68.25 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$87.44 |
$87.44 |
$87.44 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$239.06 |
$239.06 |
$239.06 |
$122.00
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$41.96 |
$41.96 |
$41.96 |
$59.11
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$45.02 |
$45.02 |
$45.02 |
$54.40
|
|
Mayo chromium
|
$80.60 |
$80.60 |
$80.60 |
$89.25
|
|
Mayo coccidioides antibody
|
$75.56 |
$75.56 |
$75.56 |
$61.10
|
|
Mayo cocou cortisone urine
|
$20.31 |
$20.31 |
$20.31 |
$222.62
|
|
Mayo cortisol free
|
$83.06 |
$83.06 |
$83.06 |
$109.85
|
|
Mayo covid-19 antibody nucleocapsid total
|
$26.03 |
$26.03 |
$26.03 |
$77.63
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$43.04 |
$43.04 |
$43.04 |
$67.80
|
