|
Infect ag phenotype na hiv-1 1-10 drugs
|
$7,102.41 |
$7,102.41 |
$7,102.41 |
$855.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$48.37 |
$48.37 |
$48.37 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$956.81 |
$956.81 |
$956.81 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$1,488.39 |
$1,488.39 |
$1,488.39 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$1,290.66 |
$1,290.66 |
$1,290.66 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$349.81 |
$349.81 |
$349.81 |
$55.31
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$2,344.03 |
$2,344.03 |
$2,344.03 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$2,013.09 |
$2,013.09 |
$2,013.09 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$122.82 |
$122.82 |
$122.82 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$2,037.09 |
$2,037.09 |
$2,037.09 |
$201.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$75.32 |
$75.32 |
$75.32 |
$100.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$816.22 |
$816.22 |
$816.22 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$787.06 |
$787.06 |
$787.06 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$268.70 |
$268.70 |
$268.70 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$711.93 |
$711.93 |
$711.93 |
$711.93
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$2,309.74 |
$2,309.74 |
$2,309.74 |
$238.80
|
|
Infectious agent nucleic acid quantification hiv-1
|
$3,273.42 |
$3,273.42 |
$3,273.42 |
$374.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,100.13 |
$1,100.13 |
$1,100.13 |
$293.04
|
|
Inj calcitriol per 0.1 mcg
|
$283.50 |
$283.50 |
$283.50 |
$22.69
|
|
Inj ceftolozane tazobactam
|
$1,055.42 |
$1,055.42 |
$1,055.42 |
$408.00
|
|
Inj crotalidae im f(ab')2 eq
|
$5,291.09 |
$5,291.09 |
$5,291.09 |
$2,613.60
|
|
Injection, cangrelor
|
$5,829.11 |
$5,829.11 |
$5,829.11 |
$1,889.78
|
|
Injection epidural blood patch or clot
|
$2,728.78 |
$2,728.78 |
$2,728.78 |
$1,156.80
|
|
Injection, famotidine, 20 mg
|
$28.74 |
$28.74 |
$28.74 |
$28.74
|
|
Injection,onabotulinumtoxina
|
$10,430.45 |
$10,430.45 |
$10,430.45 |
$2,241.61
|
|
Injection, pentamidine iseth
|
$1,759.40 |
$1,759.40 |
$1,759.40 |
$464.32
|
|
Inj hydroxocobalamin IV 25mg
|
$5,707.72 |
$5,707.72 |
$5,707.72 |
$2,452.32
|
|
Inj hydroxyprogst capoat nos
|
$3,813.49 |
$3,813.49 |
$3,813.49 |
$1,228.59
|
|
Inj multihance
|
$1,323.72 |
$1,323.72 |
$1,323.72 |
$79.42
|
|
Inj pantoprazole(hikma) 40mg
|
$79.46 |
$79.46 |
$79.46 |
$34.61
|
|
Inj proc myelogram lumbar
|
$12,388.51 |
$12,388.51 |
$12,388.51 |
$856.00
|
|
Inj testosterone cypionate
|
$537.48 |
$537.48 |
$537.48 |
$62.80
|
|
Inj vasopressin (am reg) 1 u
|
$826.21 |
$826.21 |
$826.21 |
$40.24
|
|
Insert cath pleura without image
|
$6,208.61 |
$6,208.61 |
$6,208.61 |
$2,019.00
|
|
In situ hybridization per specimen each additional single probe stain
|
$3,204.82 |
$3,204.82 |
$3,204.82 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$2,688.71 |
$2,688.71 |
$2,688.71 |
$326.04
|
|
Ins/rpl pm w/tv ld atrl
|
$12,696.98 |
$12,696.98 |
$12,696.98 |
$12,371.40
|
|
Insulin total
|
$538.43 |
$538.43 |
$538.43 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$26,989.00 |
$26,989.00 |
$26,989.00 |
$8,629.72
|
|
Intra-atrial pacing
|
$22,387.01 |
$22,387.01 |
$22,387.01 |
$4,683.25
|
|
Intracard echo interv w/s&i
|
$5,804.25 |
$5,804.25 |
$5,804.25 |
$3,429.40
|
|
Intracranial complete study
|
$3,612.81 |
$3,612.81 |
$3,612.81 |
$900.50
|
|
Intrapul surf admin endo tube
|
$486.60 |
$486.60 |
$486.60 |
$220.80
|
|
Intraventricular pacing
|
$28,513.19 |
$28,513.19 |
$28,513.19 |
$5,609.50
|
|
Intrinsic factor antibody
|
$787.06 |
$787.06 |
$787.06 |
$66.60
|
|
Intro long gi tube w/mult fluo
|
$1,585.41 |
$1,585.41 |
$1,585.41 |
$449.40
|
|
Ipratropium bromide non-comp
|
$90.37 |
$90.37 |
$90.37 |
$3.75
|
|
Iron binding capacity
|
$397.81 |
$397.81 |
$397.81 |
$63.79
|
|
Iron stain peripheral blood
|
$1,001.40 |
$1,001.40 |
$1,001.40 |
$30.55
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$359.25 |
$359.25 |
$359.25 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$237.49 |
$237.49 |
$237.49 |
$119.83
|
|
Ivc venogram s&i
|
$7,650.32 |
$7,650.32 |
$7,650.32 |
$3,316.95
|
|
John cunningham antibody
|
$1,109.43 |
$1,109.43 |
$1,109.43 |
$72.60
|
|
Kafo fem fx cast molded to p
|
$10,441.00 |
$10,441.00 |
$10,441.00 |
$3,130.66
|
|
Ketogenic steroids fract
|
$1,833.05 |
$1,833.05 |
$1,833.05 |
$82.74
|
|
Kidney img w/bldflw sgl without rx
|
$6,321.00 |
$6,321.00 |
$6,321.00 |
$1,427.40
|
|
Knee disc/dial lock/adj flex
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$288.41
|
|
Ko rigid without joints pre ots
|
$209.00 |
$209.00 |
$209.00 |
$214.97
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$350.85 |
$350.85 |
$350.85 |
$175.92
|
|
Lactoferrin fecal qualitative
|
$68.95 |
$68.95 |
$68.95 |
$80.40
|
|
Lactoferrin fecal quant
|
$157.75 |
$157.75 |
$157.75 |
$106.10
|
|
Leishmania antibody
|
$329.22 |
$329.22 |
$329.22 |
$68.25
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$5,058.61 |
$5,058.61 |
$5,058.61 |
$7,052.00
|
|
Lev 1 hosp type b ed visit
|
$1,478.97 |
$1,478.97 |
$1,478.97 |
$186.98
|
|
Lev 2 hosp type b ed visit
|
$1,782.77 |
$1,782.77 |
$1,782.77 |
$359.65
|
|
Lev 3 hosp type b ed visit
|
$3,386.92 |
$3,386.92 |
$3,386.92 |
$598.15
|
|
Levalbuterol non-comp con
|
$121.55 |
$121.55 |
$121.55 |
$21.60
|
|
Levetiracetam therapeutic drug level
|
$1,054.56 |
$1,054.56 |
$1,054.56 |
$88.92
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$790.61 |
$790.61 |
$790.61 |
$385.62
|
|
Lidocaine therapeutic drug level
|
$483.56 |
$483.56 |
$483.56 |
$89.70
|
|
Limited ankle motion ea jnt
|
$375.00 |
$375.00 |
$375.00 |
$123.05
|
|
Liver/spleen imag static only
|
$2,140.15 |
$2,140.15 |
$2,140.15 |
$1,123.50
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$12,618.85 |
$12,618.85 |
$12,618.85 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$10,464.17 |
$10,464.17 |
$10,464.17 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$9,795.44 |
$9,795.44 |
$9,795.44 |
$2,096.84
|
|
Low frequency non-thermal Ultrasound
|
$710.92 |
$710.92 |
$710.92 |
$364.00
|
|
Lso sc r pos/lat pnl pre cst
|
$3,778.00 |
$3,778.00 |
$3,778.00 |
$577.00
|
|
Lso s/c shell/panel custom
|
$15,470.22 |
$15,470.22 |
$15,470.22 |
$2,252.16
|
|
L/s ratio fetal lung
|
$2,529.23 |
$2,529.23 |
$2,529.23 |
$176.15
|
|
Lumbar diskogram s&i
|
$5,066.35 |
$5,066.35 |
$5,066.35 |
$2,358.23
|
|
Lung perfusion imaging
|
$5,585.51 |
$5,585.51 |
$5,585.51 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$4,980.80 |
$4,980.80 |
$4,980.80 |
$1,448.00
|
|
Lymphocyte transformation mitogen
|
$1,208.89 |
$1,208.89 |
$1,208.89 |
$266.20
|
|
Macroscopic exam parasite
|
$286.36 |
$286.36 |
$286.36 |
$36.40
|
|
Makena, 10 mg
|
$5,743.29 |
$5,743.29 |
$5,743.29 |
$1,405.80
|
|
Mannitol 12.5 gm/50 ml inj
|
$42.18 |
$42.18 |
$42.18 |
$27.81
|
|
Map tachycard site(s)
|
$10,727.78 |
$10,727.78 |
$10,727.78 |
$3,875.95
|
|
Mastoids complete
|
$1,232.50 |
$1,232.50 |
$1,232.50 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$817.92 |
$817.92 |
$817.92 |
$66.36
|
|
Mayo aathr protein s free
|
$1,568.98 |
$1,568.98 |
$1,568.98 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$1,409.51 |
$1,409.51 |
$1,409.51 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$908.81 |
$908.81 |
$908.81 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$1,677.01 |
$1,677.01 |
$1,677.01 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$392.67 |
$392.67 |
$392.67 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$608.73 |
$608.73 |
$608.73 |
$82.80
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$1,675.28 |
$1,675.28 |
$1,675.28 |
$359.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$4,120.69 |
$4,120.69 |
$4,120.69 |
$361.50
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$12,678.72 |
$12,678.72 |
$12,678.72 |
$1,860.00
|
|
Mayo androstenedione
|
$2,388.62 |
$2,388.62 |
$2,388.62 |
$110.00
|
|
Mayo antithrombin iii antigen
|
$708.19 |
$708.19 |
$708.19 |
$72.35
|