|
MRI breast w IV cont bi
|
$1,876.12 |
$1,880.00 |
$11,763.10 |
$1,876.12
|
|
MRI cardiac morph & func wo IV cont
|
$1,244.85 |
$1,880.00 |
$3,634.45 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$1,902.00 |
$2,683.00 |
$7,224.18 |
$1,946.48
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$2,193.00 |
$2,193.00 |
$6,077.00 |
$2,499.60
|
|
MRI chest without contrast
|
$1,593.75 |
$2,095.00 |
$5,290.08 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$2,270.14 |
$2,723.50 |
$7,548.66 |
$2,652.73
|
|
MRI chest w IV cont
|
$1,581.08 |
$2,408.50 |
$8,439.06 |
$2,252.39
|
|
MRI compatible system
|
$937.50 |
$937.50 |
$6,120.00 |
$2,672.33
|
|
MRI fetal ea addl gestation
|
$316.83 |
$316.83 |
$477.93 |
$577.07
|
|
MRI fetal sngl/1st gestation
|
$1,136.26 |
$1,136.26 |
$1,262.14 |
$1,108.00
|
|
MRI guid ndl plc s&i
|
$1,037.97 |
$1,880.00 |
$3,281.86 |
$1,334.45
|
|
MRI guid parenchymal tiss ablation
|
$8,746.95 |
$8,746.95 |
$8,746.95 |
$1,924.00
|
|
MRI loex nonjt w IV cont
|
$1,541.64 |
$2,645.50 |
$2,645.50 |
$2,116.20
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$2,115.46 |
$2,300.50 |
$3,264.90 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$2,753.50 |
$2,753.50 |
$3,830.86 |
$2,770.95
|
|
MRI orbit fac&nck w IV cont
|
$1,720.74 |
$2,404.00 |
$8,235.95 |
$2,204.98
|
|
MRI tmj
|
$1,658.77 |
$1,890.00 |
$7,159.04 |
$1,741.07
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$1,906.00 |
$1,906.00 |
$2,394.15 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$2,478.50 |
$2,478.50 |
$3,402.00 |
$2,669.70
|
|
MRI upper extremity w/dye
|
$1,447.90 |
$2,192.00 |
$2,687.10 |
$2,076.72
|
|
MRI w/cont, breast, bi
|
$1,994.42 |
$2,499.50 |
$4,986.02 |
$2,119.87
|
|
MRI w/cont, breast, uni
|
$2,039.11 |
$2,167.00 |
$2,479.35 |
$1,567.09
|
|
MRI without fol w/cont, breast
|
$2,056.69 |
$3,248.00 |
$10,048.70 |
$2,550.00
|
|
MRI without fol w/cont, brst, un
|
$1,938.60 |
$2,610.75 |
$2,817.50 |
$1,779.08
|
|
Mr safety determination physician/other qhp
|
$81.00 |
$81.00 |
$186.00 |
$161.40
|
|
Mr safety implant elec prepj
|
$105.00 |
$192.90 |
$204.73 |
$173.40
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$22.50 |
$45.00 |
$220.40 |
$55.00
|
|
Mr safety implt pos&/immoblj
|
$137.25 |
$137.25 |
$137.25 |
$125.00
|
|
Mr sfty implt&/fb asmt stf 1
|
$22.50 |
$50.40 |
$110.20 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$507.75 |
$507.75 |
$513.60 |
$444.00
|
|
Mr spectroscopy
|
$1,322.36 |
$1,880.00 |
$5,465.08 |
$1,340.00
|
|
Msh2 gene dup/delete variant
|
$200.50 |
$200.50 |
$200.50 |
$422.64
|
|
Msh2 gene full seq
|
$163.88 |
$351.00 |
$351.00 |
$764.00
|
|
Msh6 gene dup/delete variant
|
$401.50 |
$401.50 |
$401.50 |
$476.00
|
|
Msh6 gene full seq
|
$275.58 |
$590.50 |
$590.50 |
$1,160.50
|
|
Msh6 gene known variants
|
$17,346.88 |
$17,346.88 |
$17,346.88 |
$369.60
|
|
Mthfr gene analy common variants
|
$94.00 |
$123.00 |
$4,603.35 |
$184.00
|
|
Mucin synovial fluid
|
$12.50 |
$12.50 |
$12.50 |
$33.57
|
|
Mucopolysaccharides
|
$270.00 |
$270.00 |
$1,085.90 |
$178.36
|
|
Multi family grp psychotherapy
|
$543.60 |
$543.60 |
$543.60 |
$250.25
|
|
Multifocal erg w/i&r
|
$574.20 |
$574.20 |
$574.20 |
$386.40
|
|
Multiple sleep latency test
|
$2,061.50 |
$2,061.50 |
$2,763.80 |
$2,466.00
|
|
Mumps antibody igg
|
$54.50 |
$54.50 |
$498.60 |
$78.00
|
|
Muscle test cran nerv unilat
|
$236.00 |
$236.00 |
$385.07 |
$385.07
|
|
Muscle test hemidiaphragm
|
$300.55 |
$300.55 |
$300.55 |
$296.40
|
|
Muscle test larynx
|
$258.50 |
$258.50 |
$287.64 |
$296.80
|
|
Muscle test one fiber
|
$497.35 |
$497.35 |
$3,728.97 |
$432.00
|
|
Mycobacteria dna amp probe
|
$213.50 |
$496.29 |
$3,733.67 |
$234.00
|
|
Mycobacteria dna quant
|
$288.75 |
$288.75 |
$288.75 |
$141.45
|
|
Mycophenolate mofetil 250 mg capsule
|
$0.94 |
$10.79 |
$1,491.41 |
$10.79
|
|
Mycophenolic acid
|
$7.75 |
$14.25 |
$18.11 |
$12.84
|
|
Mycoplasma antibody igm
|
$66.00 |
$66.00 |
$192.45 |
$77.35
|
|
Myd88 gene p.leu265pro vrnt
|
$240.00 |
$240.00 |
$1,107.00 |
$416.00
|
|
Myelogphy 2/> spine regions
|
$1,459.50 |
$1,615.24 |
$4,785.50 |
$1,494.22
|
|
Myelography l-s spine
|
$1,305.60 |
$1,350.68 |
$3,591.53 |
$1,334.09
|
|
Myelography neck spine
|
$875.40 |
$1,198.65 |
$4,806.27 |
$1,241.50
|
|
Myelography thoracic spine
|
$1,014.13 |
$1,255.35 |
$3,497.36 |
$1,255.00
|
|
Myelography via inj w/s&i 2+ regions
|
$1,300.20 |
$1,300.20 |
$2,421.26 |
$2,267.34
|
|
Myelography via inj w/s&i cervical
|
$1,300.20 |
$1,300.20 |
$1,629.67 |
$1,775.40
|
|
Myelography via inj w/s&i lumbosacral
|
$1,300.20 |
$1,300.20 |
$1,923.03 |
$1,850.00
|
|
Myelography via inj w/s&i thoracic
|
$1,300.20 |
$1,300.20 |
$2,218.31 |
$1,745.94
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$121.50 |
$121.50 |
$1,007.00 |
$130.41
|
|
Myocrd img pet 1std rst/strs
|
$1,584.32 |
$1,680.00 |
$21,509.03 |
$3,627.73
|
|
Myocrd img pet 1 std w/ct
|
$1,731.60 |
$1,731.60 |
$26,221.67 |
$3,314.15
|
|
Myocrd img pet 2rtracer
|
$2,700.60 |
$2,700.60 |
$21,509.03 |
$4,835.00
|
|
Myocrd img pet 2rtracer CT
|
$3,300.60 |
$3,300.60 |
$28,057.42 |
$5,083.90
|
|
Myocrd img pet mlt rst&strs
|
$1,680.00 |
$1,680.00 |
$23,259.18 |
$4,060.00
|
|
Myocrd img pet rst&strs CT
|
$2,700.60 |
$2,700.60 |
$32,368.92 |
$4,846.40
|
|
Myocrd img pet rst/strs w/ct
|
$1,731.60 |
$1,731.60 |
$26,221.67 |
$3,311.85
|
|
Nafcillin 2 gram solution for injection
|
$31.37 |
$31.37 |
$84.00 |
$84.00
|
|
Nalbuphine 10 mg/ml injection solution
|
$11.62 |
$98.85 |
$141.23 |
$37.81
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$28.62 |
$41.62 |
$118.80 |
$70.87
|
|
Naltrexone, depot form
|
$3,249.40 |
$3,249.40 |
$3,249.40 |
$3,249.40
|
|
Nasal endoscopy dx uni/bi separate proc
|
$322.50 |
$322.50 |
$469.58 |
$351.52
|
|
Nasal endoscopy with removal of nasal foreign body
|
$217.20 |
$217.20 |
$4,141.64 |
$406.00
|
|
Nasal function studies
|
$1,383.75 |
$1,383.75 |
$1,383.75 |
$348.00
|
|
Nasal/sinus endoscopy surg w/bx 31237
|
$1,923.97 |
$1,923.97 |
$1,923.97 |
$2,831.51
|
|
Nasal/sinus maxillary endoscopy dx 31233
|
$456.46 |
$456.46 |
$456.46 |
$973.39
|
|
Nasopharyngoscopy w/endoscope
|
$351.67 |
$351.67 |
$351.67 |
$293.58
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$15,367.89 |
$15,367.89 |
$16,254.52 |
$16,254.52
|
|
Natriuretic peptide
|
$214.95 |
$389.00 |
$906.00 |
$176.15
|
|
Natural killer cells total count
|
$109.00 |
$109.00 |
$431.25 |
$135.00
|
|
Navigational bronchoscopy 31627
|
$1,751.25 |
$1,751.25 |
$1,751.25 |
$1,751.25
|
|
N block inj common digit
|
$454.74 |
$454.74 |
$454.74 |
$540.80
|
|
N block inj hypogas plxs
|
$1,402.50 |
$1,402.50 |
$1,973.95 |
$1,912.00
|
|
Ndl emg musc 1 xtr/non-limb
|
$140.25 |
$141.50 |
$299.32 |
$225.25
|
|
Ndl insj without njx 1 or 2 musc
|
$129.36 |
$129.36 |
$129.36 |
$39.77
|
|
Ndl insj without njx 3+ musc
|
$131.95 |
$131.95 |
$131.95 |
$45.00
|
|
Nebulizer Breathing Treatment
|
$151.00 |
$151.00 |
$310.80 |
$203.49
|
|
Neck Airway (Soft Tissue) X-ray
|
$175.80 |
$187.00 |
$775.76 |
$237.76
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$2,745.50 |
$3,061.80 |
$6,026.62 |
$2,032.54
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,304.59 |
$2,429.00 |
$5,496.23 |
$1,719.75
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,042.26 |
$2,112.50 |
$4,883.82 |
$1,470.00
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$3,146.00 |
$3,264.90 |
$8,587.26 |
$2,881.80
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$2,231.16 |
$2,783.00 |
$7,326.39 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,266.09 |
$2,419.00 |
$6,305.67 |
$2,039.44
|
|
Neck (Cervical Spine) X-ray (2 to 3 views)
|
$325.79 |
$467.00 |
$983.29 |
$334.40
|
|
Neck (Cervical Spine) X-ray (4 to 5 views)
|
$453.04 |
$706.00 |
$1,629.76 |
$463.20
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$477.64 |
$1,080.00 |
$1,703.18 |
$508.50
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$2,644.00 |
$2,830.05 |
$5,259.41 |
$2,679.60
|
