|
MRA chest wwo IV cont
|
$2,018.52 |
$2,018.52 |
$2,018.52 |
$2,492.05
|
|
MRA w/cont, abd
|
$1,341.90 |
$1,341.90 |
$1,341.90 |
$1,509.90
|
|
MRA w/cont, lwr ext
|
$1,752.48 |
$1,752.48 |
$1,752.48 |
$1,191.96
|
|
Mra, w/dye, upper extremity
|
$991.71 |
$991.71 |
$991.71 |
$943.83
|
|
MRA without cont, abd
|
$1,435.05 |
$1,435.05 |
$1,435.05 |
$1,523.97
|
|
MRA without cont, lwr ext
|
$1,766.79 |
$1,766.79 |
$1,766.79 |
$1,091.98
|
|
Mra, without dye, upper extr
|
$1,039.32 |
$1,039.32 |
$1,039.32 |
$697.86
|
|
MRA without fol w/cont, abd
|
$1,892.07 |
$1,892.07 |
$1,892.07 |
$3,331.46
|
|
MRA without fol w/cont, lwr ext
|
$1,824.75 |
$1,824.75 |
$1,824.75 |
$1,954.80
|
|
MRA without fol w/cont, pelvis
|
$1,754.19 |
$1,754.19 |
$1,754.19 |
$2,305.60
|
|
Mra, w/o&w/dye, upper extr
|
$1,005.57 |
$1,005.57 |
$1,005.57 |
$1,085.03
|
|
Mr elastography
|
$353.70 |
$353.70 |
$353.70 |
$684.06
|
|
MRI breast c- unilateral
|
$786.96 |
$786.96 |
$786.96 |
$1,097.50
|
|
MRI breast without cont bi
|
$786.96 |
$786.96 |
$786.96 |
$1,778.00
|
|
MRI chest without contrast
|
$1,072.53 |
$1,072.53 |
$1,072.53 |
$1,810.38
|
|
MRI chest without & w/contrast
|
$1,698.75 |
$1,698.75 |
$1,698.75 |
$2,564.10
|
|
MRI chest w IV cont
|
$1,175.13 |
$1,175.13 |
$1,175.13 |
$2,105.25
|
|
MRI fetal ea addl gestation
|
$221.94 |
$221.94 |
$221.94 |
$576.10
|
|
MRI fetal sngl/1st gestation
|
$443.70 |
$443.70 |
$443.70 |
$1,136.26
|
|
MRI loex nonjt w IV cont
|
$741.42 |
$741.42 |
$741.42 |
$2,035.00
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$524.88 |
$524.88 |
$524.88 |
$2,096.84
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$772.02 |
$772.02 |
$772.02 |
$2,713.80
|
|
MRI orbit/face/neck without contrast
|
$718.47 |
$718.47 |
$718.47 |
$1,813.00
|
|
MRI orbit/face/neck without & w/contrast
|
$1,279.98 |
$1,279.98 |
$1,279.98 |
$2,674.83
|
|
MRI orbit fac&nck w IV cont
|
$1,264.50 |
$1,264.50 |
$1,264.50 |
$2,120.25
|
|
MRI tmj
|
$699.75 |
$699.75 |
$699.75 |
$1,818.25
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$540.09 |
$540.09 |
$540.09 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$1,064.34 |
$1,064.34 |
$1,064.34 |
$2,655.25
|
|
MRI upper extremity w/dye
|
$688.59 |
$688.59 |
$688.59 |
$1,968.59
|
|
MRI w/cont, breast, bi
|
$1,225.98 |
$1,225.98 |
$1,225.98 |
$1,831.25
|
|
MRI w/cont, breast, uni
|
$1,225.98 |
$1,225.98 |
$1,225.98 |
$836.00
|
|
MRI without fol w/cont, brst, un
|
$1,225.98 |
$1,225.98 |
$1,225.98 |
$888.25
|
|
Mr safety determination physician/other qhp
|
$111.60 |
$111.60 |
$111.60 |
$160.20
|
|
Mr safety implant elec prepj
|
$115.92 |
$115.92 |
$115.92 |
$168.60
|
|
Mr safety implt pos&/immoblj
|
$75.60 |
$75.60 |
$75.60 |
$137.25
|
|
Mr sfty implt&/fb asmt stf 1
|
$30.96 |
$30.96 |
$30.96 |
$45.00
|
|
Mr sfty med physics xm cstmz
|
$304.92 |
$304.92 |
$304.92 |
$402.40
|
|
Mr spectroscopy
|
$2,136.51 |
$2,136.51 |
$2,136.51 |
$1,322.36
|
|
Mthfr gene analy common variants
|
$272.34 |
$272.34 |
$272.34 |
$211.70
|
|
Mucopolysaccharides
|
$400.68 |
$400.68 |
$400.68 |
$205.15
|
|
Mumps antibody igg
|
$55.62 |
$55.62 |
$55.62 |
$78.00
|
|
Mycophenolate mofetil 250 mg capsule
|
$5.76 |
$5.76 |
$5.76 |
$18.12
|
|
Mycoplasma antibody igm
|
$74.25 |
$74.25 |
$74.25 |
$79.20
|
|
Myd88 gene p.leu265pro vrnt
|
$405.54 |
$405.54 |
$405.54 |
$397.50
|
|
Myelography via inj w/s&i 2+ regions
|
$2,178.36 |
$2,178.36 |
$2,178.36 |
$2,352.78
|
|
Myelography via inj w/s&i cervical
|
$2,178.36 |
$2,178.36 |
$2,178.36 |
$1,910.79
|
|
Myelography via inj w/s&i lumbosacral
|
$2,178.36 |
$2,178.36 |
$2,178.36 |
$2,006.40
|
|
Myelography via inj w/s&i thoracic
|
$2,178.36 |
$2,178.36 |
$2,178.36 |
$1,931.60
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$129.69 |
$129.69 |
$129.69 |
$134.40
|
|
Nasopharyngoscopy w/endoscope
|
$323.46 |
$323.46 |
$323.46 |
$298.52
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$11,151.27 |
$11,151.27 |
$11,151.27 |
$22,257.60
|
|
Natriuretic peptide
|
$205.83 |
$205.83 |
$205.83 |
$176.15
|
|
Natural killer cells total count
|
$77.85 |
$77.85 |
$77.85 |
$131.82
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$2,390.22 |
$2,390.22 |
$2,390.22 |
$2,055.15
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,169.09 |
$2,169.09 |
$2,169.09 |
$1,766.05
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,821.42 |
$1,821.42 |
$1,821.42 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$1,902.24 |
$1,902.24 |
$1,902.24 |
$2,854.80
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$1,300.32 |
$1,300.32 |
$1,300.32 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$1,175.13 |
$1,175.13 |
$1,175.13 |
$2,001.81
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$640.80 |
$640.80 |
$640.80 |
$2,651.36
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$504.09 |
$504.09 |
$504.09 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$573.84 |
$573.84 |
$573.84 |
$1,790.58
|
|
Neisseria meningitidis
|
$55.08 |
$55.08 |
$55.08 |
$59.15
|
|
Nelarabine injection
|
$1,370.07 |
$1,370.07 |
$1,370.07 |
$1,051.57
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$18.81 |
$18.81 |
$18.81 |
$56.70
|
|
Nerve teasing preparations
|
$608.94 |
$608.94 |
$608.94 |
$698.49
|
|
N-invas est c ffr sw aly cta
|
$1,310.85 |
$1,310.85 |
$1,310.85 |
$2,020.50
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$9,769.86 |
$9,769.86 |
$9,769.86 |
$17,658.98
|
|
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution
|
$295.83 |
$295.83 |
$295.83 |
$85,051.55
|
|
Njx interlaminar crv/thrc
|
$2,074.68 |
$2,074.68 |
$2,074.68 |
$1,908.87
|
|
Njx interlaminar lmbr/sac
|
$2,074.68 |
$2,074.68 |
$2,074.68 |
$2,074.68
|
|
Nm imaging gastrointestinal acute blood loss
|
$534.78 |
$534.78 |
$534.78 |
$1,264.90
|
|
Npm1 gene
|
$490.86 |
$490.86 |
$490.86 |
$430.95
|
|
Nras gene variants exon 2&3
|
$385.38 |
$385.38 |
$385.38 |
$554.45
|
|
Nudt15 gene common variants
|
$207.45 |
$207.45 |
$207.45 |
$320.50
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$10,767.51 |
$10,767.51 |
$10,767.51 |
$14,996.94
|
|
Observation per hour
|
$75.15 |
$75.15 |
$75.15 |
$79.30
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$28,416.96 |
$28,416.96 |
$28,416.96 |
$54,942.65
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$11.07 |
$11.07 |
$11.07 |
$73.13
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$4,933.53 |
$4,933.53 |
$4,933.53 |
$14,506.60
|
|
Oncoprotein her-2/neu
|
$200.97 |
$200.97 |
$200.97 |
$161.60
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$3.15 |
$3.15 |
$3.15 |
$34.32
|
|
Oph Ultrasound dx quan a-scan only
|
$314.82 |
$314.82 |
$314.82 |
$189.75
|
|
Organic acids total quant ea spec
|
$242.64 |
$242.64 |
$242.64 |
$151.36
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$62.56 |
$62.56 |
$62.56 |
$65.07
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$284.85 |
$284.85 |
$284.85 |
$284.85
|
|
Ortho ewhf rigd without jnt cstm w
|
$725.31 |
$725.31 |
$725.31 |
$782.70
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$539.73 |
$539.73 |
$539.73 |
$801.60
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$231.66 |
$231.66 |
$231.66 |
$213.39
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$249.12 |
$249.12 |
$249.12 |
$389.25
|
|
Ortho hnd without jnt w/fit&adj
|
$210.96 |
$210.96 |
$210.96 |
$240.24
|
|
Orthopantogram
|
$104.13 |
$104.13 |
$104.13 |
$219.22
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$267.57 |
$267.57 |
$267.57 |
$269.58
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$585.45 |
$585.45 |
$585.45 |
$532.80
|
|
Oscillation chest wall mechanical per session
|
$125.46 |
$125.46 |
$125.46 |
$221.34
|
|
Osmolality blood
|
$147.87 |
$147.87 |
$147.87 |
$67.60
|
|
Osmolality urine
|
$115.65 |
$115.65 |
$115.65 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$161.64 |
$161.64 |
$161.64 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$161.64 |
$161.64 |
$161.64 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$141.39 |
$141.39 |
$141.39 |
$270.58
|