|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$630.80 |
$630.80 |
$630.80 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,425.20 |
$2,425.20 |
$2,425.20 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,302.80 |
$1,302.80 |
$1,302.80 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$433.60 |
$433.60 |
$433.60 |
$356.16
|
|
Lso flex no ri stays pre ots
|
$14.40 |
$14.40 |
$14.40 |
$164.80
|
|
Lso r post pnl sj-t9 pre cst
|
$99.20 |
$99.20 |
$99.20 |
$326.82
|
|
Lso sc r pos/lat pnl pre cst
|
$175.20 |
$175.20 |
$175.20 |
$577.00
|
|
Lso s/c shell/panel custom
|
$640.00 |
$640.00 |
$640.00 |
$2,252.16
|
|
L/s ratio fetal lung
|
$97.20 |
$97.20 |
$97.20 |
$178.36
|
|
Lumbar derotation pad
|
$48.80 |
$48.80 |
$48.80 |
$168.53
|
|
Lung Function Test (Spirometry)
|
$293.20 |
$293.20 |
$293.20 |
$295.35
|
|
Lung perfusion imaging
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$1,059.97
|
|
Lvad shower bag heartmate
|
$1,285.20 |
$1,285.20 |
$1,285.20 |
$905.92
|
|
Lwr ext dynamic prosth pylon
|
$173.20 |
$173.20 |
$173.20 |
$313.60
|
|
Lymphatics/lymph node imaging
|
$1,622.00 |
$1,622.00 |
$1,622.00 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$30.40 |
$30.40 |
$30.40 |
$271.88
|
|
Lymph vessel x-ray arm/leg
|
$1,185.20 |
$1,185.20 |
$1,185.20 |
$972.06
|
|
Lymph vessel x-ray trunk
|
$4,338.40 |
$4,338.40 |
$4,338.40 |
$2,542.41
|
|
Macroscopic exam arthropod
|
$5.20 |
$5.20 |
$5.20 |
$38.58
|
|
Magnesium
|
$29.60 |
$29.60 |
$29.60 |
$72.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$25.88 |
$25.88 |
$25.88 |
$59.88
|
|
Magnetic image bone marrow
|
$1,302.80 |
$1,302.80 |
$1,302.80 |
$1,302.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$225.20 |
$225.20 |
$225.20 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$230.00 |
$230.00 |
$230.00 |
$160.80
|
|
Map tachycard site(s)
|
$2,383.20 |
$2,383.20 |
$2,383.20 |
$4,082.82
|
|
Marker biop eviva buckle ss
|
$3,326.80 |
$3,326.80 |
$3,326.80 |
$1,451.30
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$9,556.40 |
$9,556.40 |
$9,556.40 |
$6,321.66
|
|
M.avium-intra dna amp prob
|
$43.20 |
$43.20 |
$43.20 |
$141.00
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$64.40 |
$64.40 |
$64.40 |
$65.00
|
|
Mayo aathr protein s free
|
$67.60 |
$67.60 |
$67.60 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$67.60 |
$67.60 |
$67.60 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$51.60 |
$51.60 |
$51.60 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$36.00 |
$36.00 |
$36.00 |
$100.00
|
|
Mayo alcohol definitive assay volatile screen
|
$44.80 |
$44.80 |
$44.80 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$66.00 |
$66.00 |
$66.00 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$60.80 |
$60.80 |
$60.80 |
$111.69
|
|
Mayo alpha 1 antitrypsin
|
$59.20 |
$59.20 |
$59.20 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$67.20 |
$67.20 |
$67.20 |
$81.81
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$304.40 |
$304.40 |
$304.40 |
$75.90
|
|
Mayo analysis gene calr common variants exon 9
|
$537.60 |
$537.60 |
$537.60 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$405.20 |
$405.20 |
$405.20 |
$369.00
|
|
Mayo analysis gene smn1 dosage/deletion
|
$490.00 |
$490.00 |
$490.00 |
$368.25
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$4,150.80 |
$4,150.80 |
$4,150.80 |
$1,860.00
|
|
Mayo androstenedione
|
$128.80 |
$128.80 |
$128.80 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$64.80 |
$64.80 |
$64.80 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$48.40 |
$48.40 |
$48.40 |
$73.50
|
|
Mayo aspergillus fumigatus antibody
|
$67.20 |
$67.20 |
$67.20 |
$66.50
|
|
Mayo avwpr vw factor activity
|
$110.40 |
$110.40 |
$110.40 |
$171.50
|
|
Mayo barbiturates definitive assay confirmation urine
|
$59.20 |
$59.20 |
$59.20 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$45.60 |
$45.60 |
$45.60 |
$45.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$320.00 |
$320.00 |
$320.00 |
$328.20
|
|
Mayo blastomyces antibody immunodiffusion
|
$56.80 |
$56.80 |
$56.80 |
$55.04
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$99.60 |
$99.60 |
$99.60 |
$61.21
|
|
Mayo bordetella pertussis antibody igg
|
$58.00 |
$58.00 |
$58.00 |
$69.20
|
|
Mayo brcmg brucella antibody igm
|
$35.60 |
$35.60 |
$35.60 |
$44.10
|
|
Mayo c1 esterase inhibitor
|
$60.00 |
$60.00 |
$60.00 |
$86.73
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$305.20 |
$305.20 |
$305.20 |
$107.10
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$48.00 |
$48.00 |
$48.00 |
$80.16
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$118.80 |
$118.80 |
$118.80 |
$110.00
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$212.80 |
$212.80 |
$212.80 |
$281.50
|
|
Mayo ceruloplasmin
|
$48.00 |
$48.00 |
$48.00 |
$68.40
|
|
Mayo chemiluminescent parathyroid related peptide
|
$62.40 |
$62.40 |
$62.40 |
$123.73
|
|
Mayo chikv chikungunya antibodies igg
|
$56.80 |
$56.80 |
$56.80 |
$109.20
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$52.40 |
$52.40 |
$52.40 |
$52.66
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$56.00 |
$56.00 |
$56.00 |
$49.29
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$267.60 |
$267.60 |
$267.60 |
$360.33
|
|
Mayo chromium
|
$89.20 |
$89.20 |
$89.20 |
$74.94
|
|
Mayo cocaine definitive assay confirmation urine
|
$834.40 |
$834.40 |
$834.40 |
$100.00
|
|
Mayo coccidioides antibody
|
$50.80 |
$50.80 |
$50.80 |
$53.90
|
|
Mayo cocou cortisone urine
|
$86.80 |
$86.80 |
$86.80 |
$213.92
|
|
Mayo cortisol free
|
$73.60 |
$73.60 |
$73.60 |
$94.95
|
|
Mayo covid-19 antibody nucleocapsid total
|
$32.00 |
$32.00 |
$32.00 |
$71.50
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$53.60 |
$53.60 |
$53.60 |
$58.10
|
|
Mayo csmpu benzodiazepines definitive assay >=13 urine
|
$75.60 |
$75.60 |
$75.60 |
$92.50
|
|
Mayo csmpu opiod/analogs definitive assay >=5 urine
|
$38.80 |
$38.80 |
$38.80 |
$66.00
|
|
Mayo cyanide
|
$86.40 |
$86.40 |
$86.40 |
$87.50
|
|
Mayo deoxyribonuclease antibody titer
|
$58.40 |
$58.40 |
$58.40 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$111.60 |
$111.60 |
$111.60 |
$105.60
|
|
Mayo dihydrotestosterone
|
$74.00 |
$74.00 |
$74.00 |
$74.25
|
|
Mayo efpo chloride stool
|
$21.60 |
$21.60 |
$21.60 |
$43.41
|
|
Mayo estriol
|
$107.20 |
$107.20 |
$107.20 |
$90.34
|
|
Mayo estrone
|
$110.00 |
$110.00 |
$110.00 |
$85.00
|
|
Mayo ethosuximide therapeutic drug level
|
$18.80 |
$18.80 |
$18.80 |
$69.55
|
|
Mayo everolimus therapeutic drug level
|
$60.80 |
$60.80 |
$60.80 |
$97.50
|
|
Mayo factor ii
|
$13.20 |
$13.20 |
$13.20 |
$99.06
|
|
Mayo factor v
|
$78.00 |
$78.00 |
$78.00 |
$127.80
|
|
Mayo factor vii
|
$79.20 |
$79.20 |
$79.20 |
$155.00
|
|
Mayo factor viii vw factor antigen
|
$101.20 |
$101.20 |
$101.20 |
$122.62
|
|
Mayo factor viii vw factor multimetric analysis
|
$101.20 |
$101.20 |
$101.20 |
$130.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$101.20 |
$101.20 |
$101.20 |
$141.00
|
|
Mayo factor x
|
$79.20 |
$79.20 |
$79.20 |
$155.00
|
|
Mayo factor xi
|
$79.20 |
$79.20 |
$79.20 |
$122.20
|
|
Mayo fat/lipids feces quantitative
|
$74.40 |
$74.40 |
$74.40 |
$76.05
|
|
Mayo fbl culture fungi blood
|
$73.20 |
$73.20 |
$73.20 |
$105.60
|
|
Mayo ffspg allergen clam igg
|
$28.00 |
$28.00 |
$28.00 |
$35.10
|
|
Mayo fibrinogen antigen
|
$14.40 |
$14.40 |
$14.40 |
$76.44
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$77.60 |
$77.60 |
$77.60 |
$66.43
|
|
Mayo gamma-globin full gene sequencing
|
$123.20 |
$123.20 |
$123.20 |
$1,460.30
|
