|
Intro cath dialysis circuit w/pta
|
$6,267.25 |
$6,267.25 |
$6,267.25 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$10,910.35 |
$10,910.35 |
$10,910.35 |
$15,625.00
|
|
Intro catheter aorta
|
$1,636.25 |
$1,636.25 |
$1,636.25 |
$1,861.61
|
|
Intro cath svc/ivc
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$1,350.75
|
|
Intro long gi tube
|
$200.75 |
$200.75 |
$200.75 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$276.65 |
$276.65 |
$276.65 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$3,192.75 |
$3,192.75 |
$3,192.75 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$3,192.75 |
$3,192.75 |
$3,192.75 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$884.95 |
$884.95 |
$884.95 |
$617.60
|
|
Iodine i-123 sod iodide mil
|
$743.60 |
$743.60 |
$743.60 |
$677.98
|
|
Ionm in operatng room 15 min
|
$37.95 |
$37.95 |
$37.95 |
$200.78
|
|
Iron
|
$55.00 |
$55.00 |
$55.00 |
$70.72
|
|
Iron binding capacity
|
$15.40 |
$15.40 |
$15.40 |
$63.00
|
|
Irradiation of blood product each unit reference
|
$102.85 |
$102.85 |
$102.85 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$71.50 |
$71.50 |
$71.50 |
$154.50
|
|
Ivc venogram s&i
|
$2,500.30 |
$2,500.30 |
$2,500.30 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$151.80 |
$151.80 |
$151.80 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$151.80 |
$151.80 |
$151.80 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$151.80 |
$151.80 |
$151.80 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$300.85 |
$300.85 |
$300.85 |
$460.85
|
|
Ivp w/nephrotomography
|
$469.15 |
$469.15 |
$469.15 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$437.80 |
$437.80 |
$437.80 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$493.90 |
$493.90 |
$493.90 |
$378.30
|
|
Jejunstmy tube plcmt
|
$1,179.20 |
$1,179.20 |
$1,179.20 |
$2,244.82
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$44.00 |
$44.00 |
$44.00 |
$56.61
|
|
Kidney imag w/bld flow multi
|
$2,038.30 |
$2,038.30 |
$2,038.30 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,898.05 |
$1,898.05 |
$1,898.05 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$489.50 |
$489.50 |
$489.50 |
$668.25
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$6,947.19 |
$6,947.19 |
$6,947.19 |
$9,482.25
|
|
Kit gene analys d816 variant
|
$687.50 |
$687.50 |
$687.50 |
$355.00
|
|
Kit lead specify 5-6-5
|
$3,957.94 |
$3,957.94 |
$3,957.94 |
$16,625.73
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,509.41 |
$1,509.41 |
$1,509.41 |
$2,249.23
|
|
Knee MRI (with and without contrast)
|
$2,532.20 |
$2,532.20 |
$2,532.20 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$2,411.75 |
$2,411.75 |
$2,411.75 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,296.80 |
$2,296.80 |
$2,296.80 |
$2,181.10
|
|
Knee X-ray
|
$304.15 |
$304.15 |
$304.15 |
$443.90
|
|
Kras gene addl variants
|
$855.25 |
$855.25 |
$855.25 |
$346.45
|
|
Kras gene variants exon 2
|
$855.25 |
$855.25 |
$855.25 |
$495.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$64.90 |
$64.90 |
$64.90 |
$100.75
|
|
Lactate dehydrogenase (ldh)
|
$53.35 |
$53.35 |
$53.35 |
$53.30
|
|
Lactic acid
|
$107.80 |
$107.80 |
$107.80 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$117.70 |
$117.70 |
$117.70 |
$88.40
|
|
Laryngoscopy w/fb removal
|
$3,105.30 |
$3,105.30 |
$3,105.30 |
$3,390.75
|
|
Lead capillary
|
$70.40 |
$70.40 |
$70.40 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$517.50 |
$517.50 |
$517.50 |
$4,159.75
|
|
Lead tachy durata sj4 58cm
|
$4,304.30 |
$4,304.30 |
$4,304.30 |
$7,149.39
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,358.50 |
$1,358.50 |
$1,358.50 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$810.60 |
$810.60 |
$810.60 |
$1,680.00
|
|
Lens iol ant bicnvx 24.0 multi
|
$342.63 |
$342.63 |
$342.63 |
$1,264.86
|
|
Lens iol ant chamb 10.5
|
$144.56 |
$144.56 |
$144.56 |
$236.77
|
|
Levetiracetam therapeutic drug level
|
$151.80 |
$151.80 |
$151.80 |
$71.40
|
|
Lidocaine therapeutic drug level
|
$24.20 |
$24.20 |
$24.20 |
$83.85
|
|
Ligation major artery neck
|
$5,715.60 |
$5,715.60 |
$5,715.60 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$2,615.80 |
$2,615.80 |
$2,615.80 |
$4,240.23
|
|
Lipase
|
$66.00 |
$66.00 |
$66.00 |
$83.20
|
|
Lipoprotein blood quant
|
$267.85 |
$267.85 |
$267.85 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$67.10 |
$67.10 |
$67.10 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$77.55 |
$77.55 |
$77.55 |
$60.00
|
|
Lithium therapeutic drug level
|
$70.95 |
$70.95 |
$70.95 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$2,472.25 |
$2,472.25 |
$2,472.25 |
$4,371.12
|
|
Liver elastography 91200
|
$322.30 |
$322.30 |
$322.30 |
$291.74
|
|
Liver Function Test
|
$93.50 |
$93.50 |
$93.50 |
$110.50
|
|
Liver imag w/vasclr flow
|
$2,256.65 |
$2,256.65 |
$2,256.65 |
$1,255.15
|
|
Liver/spleen imag static only
|
$1,936.00 |
$1,936.00 |
$1,936.00 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$1,936.00 |
$1,936.00 |
$1,936.00 |
$949.00
|
|
Low cost skin substitute app
|
$1,442.10 |
$1,442.10 |
$1,442.10 |
$1,036.56
|
|
Low cost skin substitute app
|
$2,985.95 |
$2,985.95 |
$2,985.95 |
$2,164.64
|
|
Low cost skin substitute app
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$1,174.27
|
|
Low cost skin substitute app
|
$3,015.10 |
$3,015.10 |
$3,015.10 |
$1,036.75
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,648.90 |
$1,648.90 |
$1,648.90 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,570.25 |
$1,570.25 |
$1,570.25 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,495.45 |
$1,495.45 |
$1,495.45 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,488.75 |
$2,488.75 |
$2,488.75 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,369.95 |
$2,369.95 |
$2,369.95 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,257.20 |
$2,257.20 |
$2,257.20 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$304.15 |
$304.15 |
$304.15 |
$344.00
|
|
Lumbar diskogram s&i
|
$3,359.40 |
$3,359.40 |
$3,359.40 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$369.60 |
$369.60 |
$369.60 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$172.15 |
$172.15 |
$172.15 |
$298.50
|
|
Lung perfusion imaging
|
$1,936.00 |
$1,936.00 |
$1,936.00 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$1,936.00 |
$1,936.00 |
$1,936.00 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$10.45 |
$10.45 |
$10.45 |
$38.58
|
|
Macroscopic exam parasite
|
$58.85 |
$58.85 |
$58.85 |
$38.50
|
|
Magnesium
|
$116.05 |
$116.05 |
$116.05 |
$71.50
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$91.30 |
$91.30 |
$91.30 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$118.25 |
$118.25 |
$118.25 |
$178.75
|
|
Map tachycard site(s)
|
$4,856.50 |
$4,856.50 |
$4,856.50 |
$3,960.00
|
|
Marker biop eviva buckle ss
|
$235.90 |
$235.90 |
$235.90 |
$1,213.20
|
|
M.avium-intra dna amp prob
|
$80.85 |
$80.85 |
$80.85 |
$113.31
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$117.70 |
$117.70 |
$117.70 |
$66.50
|
|
Mayo aathr protein s free
|
$124.30 |
$124.30 |
$124.30 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$94.05 |
$94.05 |
$94.05 |
$98.70
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$63.80 |
$63.80 |
$63.80 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$194.15 |
$194.15 |
$194.15 |
$101.44
|
|
Mayo alcohol definitive assay volatile screen
|
$194.70 |
$194.70 |
$194.70 |
$118.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$77.00 |
$77.00 |
$77.00 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$33.00 |
$33.00 |
$33.00 |
$115.92
|
|
Mayo alpha 1 antitrypsin
|
$119.90 |
$119.90 |
$119.90 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$138.05 |
$138.05 |
$138.05 |
$81.81
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$82.50 |
$82.50 |
$82.50 |
$92.30
|
