|
Injection,onabotulinumtoxina
|
$7,440.12 |
$7,440.12 |
$7,440.12 |
$2,154.07
|
|
Injection, pentamidine iseth
|
$2,058.48 |
$2,058.48 |
$2,058.48 |
$312.33
|
|
Injection, renflexis
|
$5,664.60 |
$5,664.60 |
$5,664.60 |
$1,356.10
|
|
Inj fluphenazine hcl 1.25 mg
|
$294.84 |
$294.84 |
$294.84 |
$44.95
|
|
Inj levocarnitine per 1 gm
|
$986.04 |
$986.04 |
$986.04 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$369.36 |
$369.36 |
$369.36 |
$303.45
|
|
Inj., meropenem, vaborbactam
|
$1,864.08 |
$1,864.08 |
$1,864.08 |
$586.20
|
|
Insitu hybridization auto
|
$1,966.68 |
$1,966.68 |
$1,966.68 |
$398.16
|
|
Insitu hybridization manual
|
$2,646.00 |
$2,646.00 |
$2,646.00 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$1,396.44 |
$1,396.44 |
$1,396.44 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$889.92 |
$889.92 |
$889.92 |
$338.40
|
|
Insulin total
|
$423.36 |
$423.36 |
$423.36 |
$67.60
|
|
Integra meshed bil wound mat
|
$148.00 |
$148.00 |
$148.00 |
$13,503.69
|
|
Intrinsic factor antibody
|
$437.40 |
$437.40 |
$437.40 |
$59.95
|
|
Intro long gi tube w/mult fluo
|
$1,586.00 |
$1,586.00 |
$1,586.00 |
$477.85
|
|
Ipratropium bromide non-comp
|
$3.24 |
$3.24 |
$3.24 |
$4.77
|
|
Iron
|
$390.96 |
$390.96 |
$390.96 |
$70.72
|
|
Iron binding capacity
|
$518.40 |
$518.40 |
$518.40 |
$63.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$490.32 |
$490.32 |
$490.32 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$962.47 |
$962.47 |
$962.47 |
$124.24
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$330.48 |
$330.48 |
$330.48 |
$56.61
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,080.00 |
$2,080.00 |
$2,080.00 |
$668.25
|
|
Kras gene variants exon 2
|
$765.72 |
$765.72 |
$765.72 |
$495.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$804.60 |
$804.60 |
$804.60 |
$188.92
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,835.00 |
$2,835.00 |
$2,835.00 |
$1,100.74
|
|
Levetiracetam therapeutic drug level
|
$612.36 |
$612.36 |
$612.36 |
$71.40
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$1,137.24 |
$1,137.24 |
$1,137.24 |
$420.60
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$89.64 |
$89.64 |
$89.64 |
$39.75
|
|
Lidocaine therapeutic drug level
|
$557.28 |
$557.28 |
$557.28 |
$83.85
|
|
Lipase
|
$491.40 |
$491.40 |
$491.40 |
$83.20
|
|
Lipoprotein blood quant
|
$662.04 |
$662.04 |
$662.04 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$491.40 |
$491.40 |
$491.40 |
$55.90
|
|
Lithium therapeutic drug level
|
$518.40 |
$518.40 |
$518.40 |
$67.60
|
|
Liver Function Test
|
$654.48 |
$654.48 |
$654.48 |
$110.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$7,014.80 |
$7,014.80 |
$7,014.80 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$6,840.08 |
$6,840.08 |
$6,840.08 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$6,677.84 |
$6,677.84 |
$6,677.84 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$12,324.63 |
$12,324.63 |
$12,324.63 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$7,983.16 |
$7,983.16 |
$7,983.16 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$7,983.16 |
$7,983.16 |
$7,983.16 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$915.20 |
$915.20 |
$915.20 |
$344.00
|
|
Lung perfusion imaging
|
$3,213.00 |
$3,213.00 |
$3,213.00 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$2,014.20 |
$2,014.20 |
$2,014.20 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$273.24 |
$273.24 |
$273.24 |
$38.58
|
|
Macroscopic exam parasite
|
$212.76 |
$212.76 |
$212.76 |
$38.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$212.76 |
$212.76 |
$212.76 |
$66.50
|
|
Mayo activated protein c resistance assay
|
$702.00 |
$702.00 |
$702.00 |
$98.70
|
|
Mayo alkaline phosphatase isoenzyme
|
$664.20 |
$664.20 |
$664.20 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$525.96 |
$525.96 |
$525.96 |
$87.60
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$709.56 |
$709.56 |
$709.56 |
$326.48
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$8,117.28 |
$8,117.28 |
$8,117.28 |
$1,909.44
|
|
Mayo avwpr vw factor activity
|
$822.96 |
$822.96 |
$822.96 |
$157.95
|
|
Mayo brcmg brucella antibody igm
|
$359.64 |
$359.64 |
$359.64 |
$48.57
|
|
Mayo c1 esterase inhibitor
|
$954.72 |
$954.72 |
$954.72 |
$88.35
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$1,116.72 |
$1,116.72 |
$1,116.72 |
$83.97
|
|
Mayo ceruloplasmin
|
$419.04 |
$419.04 |
$419.04 |
$65.08
|
|
Mayo chemiluminescent parathyroid related peptide
|
$508.68 |
$508.68 |
$508.68 |
$123.73
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$147.96 |
$147.96 |
$147.96 |
$54.40
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$212.76 |
$212.76 |
$212.76 |
$50.88
|
|
Mayo coccidioides antibody
|
$162.00 |
$162.00 |
$162.00 |
$58.37
|
|
Mayo cocou cortisone urine
|
$644.76 |
$644.76 |
$644.76 |
$207.26
|
|
Mayo cortisol free
|
$899.64 |
$899.64 |
$899.64 |
$100.00
|
|
Mayo covid-19 antibody nucleocapsid total
|
$64.80 |
$64.80 |
$64.80 |
$72.60
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$438.48 |
$438.48 |
$438.48 |
$61.02
|
|
Mayo deoxyribonuclease antibody titer
|
$162.00 |
$162.00 |
$162.00 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$1,148.04 |
$1,148.04 |
$1,148.04 |
$88.45
|
|
Mayo estriol
|
$250.56 |
$250.56 |
$250.56 |
$98.70
|
|
Mayo factor v
|
$1,096.20 |
$1,096.20 |
$1,096.20 |
$125.48
|
|
Mayo factor vii
|
$822.96 |
$822.96 |
$822.96 |
$141.00
|
|
Mayo factor viii vw factor antigen
|
$962.28 |
$962.28 |
$962.28 |
$110.50
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$2,552.04 |
$2,552.04 |
$2,552.04 |
$129.60
|
|
Mayo factor x
|
$822.96 |
$822.96 |
$822.96 |
$139.50
|
|
Mayo fbl culture fungi blood
|
$592.92 |
$592.92 |
$592.92 |
$102.20
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$962.28 |
$962.28 |
$962.28 |
$165.00
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-2
|
$1,543.32 |
$1,543.32 |
$1,543.32 |
$115.20
|
|
Mayo hvdip HIV 1 antibody
|
$1,008.72 |
$1,008.72 |
$1,008.72 |
$67.57
|
|
Mayo hvdip HIV 2 antibody
|
$763.56 |
$763.56 |
$763.56 |
$67.60
|
|
Mayo hydroxyprogesterone 17-d
|
$899.64 |
$899.64 |
$899.64 |
$93.45
|
|
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal
|
$824.04 |
$824.04 |
$824.04 |
$107.62
|
|
Mayo infectious agent nucleic acid amplified probe enterovirus
|
$911.52 |
$911.52 |
$911.52 |
$178.00
|
|
Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae
|
$905.04 |
$905.04 |
$905.04 |
$157.30
|
|
Mayo infectious agent nucleic acid quantification cytomegalovirus
|
$881.28 |
$881.28 |
$881.28 |
$233.75
|
|
Mayo infectious disease hepatitis c chronic six biochemical assays
|
$236.52 |
$236.52 |
$236.52 |
$230.10
|
|
Mayo insft insulin free
|
$166.32 |
$166.32 |
$166.32 |
$57.85
|
|
Mayo lacosamide therapeutic drug level
|
$751.68 |
$751.68 |
$751.68 |
$99.20
|
|
Mayo lamotrigine therapeutic drug level
|
$612.36 |
$612.36 |
$612.36 |
$66.43
|
|
Mayo ld_i lactate dehydrogenase isoenzymes
|
$545.40 |
$545.40 |
$545.40 |
$55.12
|
|
Mayo legionella antibody
|
$228.96 |
$228.96 |
$228.96 |
$80.60
|
|
Mayo leptospira antibody igm
|
$379.08 |
$379.08 |
$379.08 |
$76.05
|
|
Mayo metanephrines plasma
|
$625.32 |
$625.32 |
$625.32 |
$104.50
|
|
Mayo mgle voltage-gated calcium channel antibody each
|
$504.36 |
$504.36 |
$504.36 |
$95.70
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$253.80 |
$253.80 |
$253.80 |
$65.00
|
|
Mayo mycophenolic acid therapeutic drug level
|
$612.36 |
$612.36 |
$612.36 |
$77.39
|
|
Mayo myoglobin
|
$409.32 |
$409.32 |
$409.32 |
$94.32
|
|
Mayo organic acid methylmalonic single quantitative
|
$867.24 |
$867.24 |
$867.24 |
$104.13
|
|
Mayo organic acids qualitative each specimen
|
$552.00 |
$552.00 |
$552.00 |
$105.30
|
|
Mayo oxalate 24 hour urine
|
$575.64 |
$575.64 |
$575.64 |
$65.00
|
|
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme)
|
$2,012.04 |
$2,012.04 |
$2,012.04 |
$184.17
|
|
Mayo phospholipid neutralization hexagonal lupus anticoagulant
|
$907.20 |
$907.20 |
$907.20 |
$80.60
|
|
Mayo pntft phenytoin free therapeutic drug level
|
$451.44 |
$451.44 |
$451.44 |
$71.20
|