|
Infect ag ia direct hiv-1 antgn
|
$1,068.12 |
$1,068.12 |
$1,068.12 |
$95.55
|
|
Infect ag na herpes simplex quant
|
$536.71 |
$536.71 |
$536.71 |
$145.20
|
|
Infect ag na resp virus 12-25 targets
|
$3,804.46 |
$3,804.46 |
$3,804.46 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$738.10 |
$738.10 |
$738.10 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$112.20 |
$112.20 |
$112.20 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$185.20 |
$185.20 |
$185.20 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$689.10 |
$689.10 |
$689.10 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$735.03 |
$735.03 |
$735.03 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$564.52 |
$564.52 |
$564.52 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$259.34 |
$259.34 |
$259.34 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$270.60 |
$270.60 |
$270.60 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$785.31 |
$785.31 |
$785.31 |
$60.00
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$724.38 |
$724.38 |
$724.38 |
$141.48
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$890.98 |
$890.98 |
$890.98 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$945.52 |
$945.52 |
$945.52 |
$178.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$2,562.87 |
$2,562.87 |
$2,562.87 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$410.05 |
$410.05 |
$410.05 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$83.01 |
$83.01 |
$83.01 |
$103.20
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$935.22 |
$935.22 |
$935.22 |
$98.15
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$953.64 |
$953.64 |
$953.64 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$3,187.08 |
$3,187.08 |
$3,187.08 |
$727.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$367.70 |
$367.70 |
$367.70 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$966.60 |
$966.60 |
$966.60 |
$381.55
|
|
Infliximab 100 mg intravenous solution
|
$9,220.13 |
$9,220.13 |
$9,220.13 |
$2,102.08
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$189.77 |
$189.77 |
$189.77 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$804.48 |
$804.48 |
$804.48 |
$645.79
|
|
Inj, alfentanil hcl, 500mcg
|
$197.55 |
$197.55 |
$197.55 |
$19.53
|
|
Inj, artesunate, 1mg
|
$44,397.98 |
$44,397.98 |
$44,397.98 |
$18,824.75
|
|
Inj., benralizumab, 1 mg
|
$22,647.10 |
$22,647.10 |
$22,647.10 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$14,529.24 |
$14,529.24 |
$14,529.24 |
$8,698.20
|
|
Inj calcitriol per 0.1 mcg
|
$120.46 |
$120.46 |
$120.46 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$101.79 |
$101.79 |
$101.79 |
$34.59
|
|
Inj ceftolozane tazobactam
|
$781.20 |
$781.20 |
$781.20 |
$431.36
|
|
Inj crotalidae im f(ab')2 eq
|
$5,547.91 |
$5,547.91 |
$5,547.91 |
$2,735.85
|
|
Injection, fulvestrant
|
$6,624.02 |
$6,624.02 |
$6,624.02 |
$1,817.65
|
|
Injection,onabotulinumtoxina
|
$5,241.63 |
$5,241.63 |
$5,241.63 |
$2,154.07
|
|
Injection, pentamidine iseth
|
$3,268.76 |
$3,268.76 |
$3,268.76 |
$312.33
|
|
Injection, renflexis
|
$2,888.83 |
$2,888.83 |
$2,888.83 |
$1,356.10
|
|
Inj hydroxocobalamin IV 25mg
|
$3,475.98 |
$3,475.98 |
$3,475.98 |
$2,452.32
|
|
Inj levocarnitine per 1 gm
|
$208.82 |
$208.82 |
$208.82 |
$136.62
|
|
Inj mepivacaine hcl/10 ml
|
$135.43 |
$135.43 |
$135.43 |
$31.28
|
|
Inj., meropenem, vaborbactam
|
$921.50 |
$921.50 |
$921.50 |
$586.20
|
|
Inj, nithiodote, 3mg / 125mg
|
$2,991.57 |
$2,991.57 |
$2,991.57 |
$228.00
|
|
Inj progesterone per 50 mg
|
$60.99 |
$60.99 |
$60.99 |
$19.53
|
|
Inj testosterone cypionate
|
$44.53 |
$44.53 |
$44.53 |
$82.58
|
|
Inj, tofidence, 1 mg
|
$7,148.50 |
$7,148.50 |
$7,148.50 |
$346.32
|
|
Insitu hybridization auto
|
$1,425.83 |
$1,425.83 |
$1,425.83 |
$398.16
|
|
Insitu hybridization manual
|
$1,668.26 |
$1,668.26 |
$1,668.26 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$1,046.53 |
$1,046.53 |
$1,046.53 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$1,065.91 |
$1,065.91 |
$1,065.91 |
$338.40
|
|
Insulin total
|
$523.09 |
$523.09 |
$523.09 |
$67.60
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$10,006.00 |
$10,006.00 |
$10,006.00 |
$9,970.16
|
|
Interrogate subq defib
|
$155.52 |
$155.52 |
$155.52 |
$139.10
|
|
Intra-atrial pacing
|
$15,888.96 |
$15,888.96 |
$15,888.96 |
$5,155.51
|
|
Intra-atrial recording
|
$16,183.20 |
$16,183.20 |
$16,183.20 |
$5,707.00
|
|
Intracard echo interv w/s&i
|
$16,691.40 |
$16,691.40 |
$16,691.40 |
$3,982.59
|
|
Intracranial complete study
|
$3,584.72 |
$3,584.72 |
$3,584.72 |
$883.30
|
|
Intraventricular pacing
|
$15,888.96 |
$15,888.96 |
$15,888.96 |
$5,775.22
|
|
Intrinsic factor antibody
|
$423.36 |
$423.36 |
$423.36 |
$59.95
|
|
Intro long gi tube w/mult fluo
|
$1,796.25 |
$1,796.25 |
$1,796.25 |
$477.85
|
|
Ipratropium bromide non-comp
|
$48.28 |
$48.28 |
$48.28 |
$4.77
|
|
Iron
|
$484.15 |
$484.15 |
$484.15 |
$70.72
|
|
Iron binding capacity
|
$642.10 |
$642.10 |
$642.10 |
$63.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$780.42 |
$780.42 |
$780.42 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$1,029.25 |
$1,029.25 |
$1,029.25 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$658.38 |
$658.38 |
$658.38 |
$154.50
|
|
Ivc venogram s&i
|
$9,962.41 |
$9,962.41 |
$9,962.41 |
$3,332.55
|
|
Ivp w/nephrotomography
|
$3,674.42 |
$3,674.42 |
$3,674.42 |
$790.08
|
|
Ixabepilone 15 mg intravenous solution
|
$23,490.81 |
$23,490.81 |
$23,490.81 |
$10,695.32
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$406.63 |
$406.63 |
$406.63 |
$56.61
|
|
Kidney img w/bldflw sgl without rx
|
$3,482.91 |
$3,482.91 |
$3,482.91 |
$1,468.04
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$484.51 |
$484.51 |
$484.51 |
$188.92
|
|
Lactoferrin fecal qualitative
|
$658.63 |
$658.63 |
$658.63 |
$88.40
|
|
Lead capillary
|
$323.25 |
$323.25 |
$323.25 |
$62.40
|
|
Levetiracetam therapeutic drug level
|
$871.37 |
$871.37 |
$871.37 |
$71.40
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$820.50 |
$820.50 |
$820.50 |
$420.60
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$80.45 |
$80.45 |
$80.45 |
$39.75
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$1,173.67 |
$1,173.67 |
$1,173.67 |
$172.25
|
|
Lipase
|
$595.34 |
$595.34 |
$595.34 |
$83.20
|
|
Lipoprotein blood quant
|
$821.35 |
$821.35 |
$821.35 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$595.34 |
$595.34 |
$595.34 |
$55.90
|
|
Lithium therapeutic drug level
|
$642.10 |
$642.10 |
$642.10 |
$67.60
|
|
Liver Function Test
|
$809.97 |
$809.97 |
$809.97 |
$110.50
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$11,566.72 |
$11,566.72 |
$11,566.72 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$7,495.26 |
$7,495.26 |
$7,495.26 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$7,495.26 |
$7,495.26 |
$7,495.26 |
$2,060.27
|
|
Lumbar diskogram s&i
|
$6,827.97 |
$6,827.97 |
$6,827.97 |
$2,358.23
|
|
Lung perfusion imaging
|
$2,948.94 |
$2,948.94 |
$2,948.94 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$1,938.18 |
$1,938.18 |
$1,938.18 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$81.94 |
$81.94 |
$81.94 |
$38.58
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$205.16 |
$205.16 |
$205.16 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$296.48 |
$296.48 |
$296.48 |
$178.75
|
|
Mannitol 12.5 gm/50 ml inj
|
$223.30 |
$223.30 |
$223.30 |
$28.48
|
|
Map tachycard site(s)
|
$1,293.38 |
$1,293.38 |
$1,293.38 |
$3,960.00
|
|
Marker lymphatic sentimag magtrace 10 vial
|
$12,138.00 |
$12,138.00 |
$12,138.00 |
$1,753.29
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$266.77 |
$266.77 |
$266.77 |
$66.50
|
|
Mayo activated protein c resistance assay
|
$715.00 |
$715.00 |
$715.00 |
$98.70
|
|
Mayo alpha 1 antitrypsin
|
$663.71 |
$663.71 |
$663.71 |
$87.60
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$1,068.93 |
$1,068.93 |
$1,068.93 |
$326.48
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$6,185.86 |
$6,185.86 |
$6,185.86 |
$1,909.44
|