|
Intro cath dialysis circuit
|
$1,758.35 |
$1,758.35 |
$1,758.35 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$4,592.50 |
$4,592.50 |
$4,592.50 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$6,494.40 |
$6,494.40 |
$6,494.40 |
$15,625.00
|
|
Intro catheter aorta
|
$617.65 |
$617.65 |
$617.65 |
$1,861.61
|
|
Intro long gi tube
|
$1,482.80 |
$1,482.80 |
$1,482.80 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$1,070.30 |
$1,070.30 |
$1,070.30 |
$477.85
|
|
Intubation endotracheal emergency procedure
|
$900.35 |
$900.35 |
$900.35 |
$617.60
|
|
Iron
|
$143.55 |
$143.55 |
$143.55 |
$70.72
|
|
Iron binding capacity
|
$94.05 |
$94.05 |
$94.05 |
$63.00
|
|
Irradiation of blood product each unit reference
|
$62.70 |
$62.70 |
$62.70 |
$124.24
|
|
Ivc venogram s&i
|
$4,178.90 |
$4,178.90 |
$4,178.90 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$126.50 |
$126.50 |
$126.50 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$126.50 |
$126.50 |
$126.50 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$130.90 |
$130.90 |
$130.90 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$623.15 |
$623.15 |
$623.15 |
$460.85
|
|
IV inj ra drug dx study
|
$273.35 |
$273.35 |
$273.35 |
$560.00
|
|
Ivp w/nephrotomography
|
$1,537.80 |
$1,537.80 |
$1,537.80 |
$790.08
|
|
Jak2 targeted sequence analysis
|
$350.35 |
$350.35 |
$350.35 |
$378.30
|
|
Ketamine and metabolite screen - quest
|
$400.40 |
$400.40 |
$400.40 |
$68.15
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$35.20 |
$35.20 |
$35.20 |
$56.61
|
|
Kidney imaging morphology
|
$459.80 |
$459.80 |
$459.80 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$1,636.80 |
$1,636.80 |
$1,636.80 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$965.80 |
$965.80 |
$965.80 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,190.75 |
$1,190.75 |
$1,190.75 |
$668.25
|
|
Kit gene analys d816 variant
|
$616.00 |
$616.00 |
$616.00 |
$355.00
|
|
Kit lead specify 5-6-5
|
$5,073.07 |
$5,073.07 |
$5,073.07 |
$16,625.73
|
|
Knee MRI (with and without contrast)
|
$2,729.65 |
$2,729.65 |
$2,729.65 |
$2,950.00
|
|
Knee MRI (without contrast)
|
$2,484.90 |
$2,484.90 |
$2,484.90 |
$2,181.10
|
|
Knee X-ray
|
$436.15 |
$436.15 |
$436.15 |
$443.90
|
|
Kras gene addl variants
|
$444.40 |
$444.40 |
$444.40 |
$346.45
|
|
Kras gene variants exon 2
|
$1,860.65 |
$1,860.65 |
$1,860.65 |
$495.00
|
|
Lactate dehydrogenase (ldh)
|
$95.70 |
$95.70 |
$95.70 |
$53.30
|
|
Lactic acid
|
$146.85 |
$146.85 |
$146.85 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$28.60 |
$28.60 |
$28.60 |
$88.40
|
|
Lactoferrin fecal quant
|
$199.65 |
$199.65 |
$199.65 |
$106.10
|
|
Lead capillary
|
$21.45 |
$21.45 |
$21.45 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$367.76 |
$367.76 |
$367.76 |
$3,783.22
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,322.65 |
$2,322.65 |
$2,322.65 |
$1,100.74
|
|
Lens iol ant bicnvx 24.0 multi
|
$237.37 |
$237.37 |
$237.37 |
$1,546.87
|
|
Levetiracetam therapeutic drug level
|
$70.40 |
$70.40 |
$70.40 |
$71.40
|
|
Lidocaine therapeutic drug level
|
$127.05 |
$127.05 |
$127.05 |
$83.85
|
|
Lipase
|
$101.75 |
$101.75 |
$101.75 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$170.50 |
$170.50 |
$170.50 |
$89.52
|
|
Lipoprotein blood quant
|
$116.60 |
$116.60 |
$116.60 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$113.30 |
$113.30 |
$113.30 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$33.55 |
$33.55 |
$33.55 |
$60.00
|
|
Lithium therapeutic drug level
|
$145.20 |
$145.20 |
$145.20 |
$67.60
|
|
Liver Function Test
|
$158.40 |
$158.40 |
$158.40 |
$110.50
|
|
Liver imaging
|
$843.70 |
$843.70 |
$843.70 |
$1,241.25
|
|
Liver/spleen imag static only
|
$1,363.45 |
$1,363.45 |
$1,363.45 |
$1,140.78
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,349.05 |
$2,349.05 |
$2,349.05 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,152.15 |
$2,152.15 |
$2,152.15 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,956.90 |
$1,956.90 |
$1,956.90 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,102.55 |
$3,102.55 |
$3,102.55 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,844.60 |
$2,844.60 |
$2,844.60 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,586.10 |
$2,586.10 |
$2,586.10 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$445.50 |
$445.50 |
$445.50 |
$344.00
|
|
Lumbar diskogram s&i
|
$1,109.35 |
$1,109.35 |
$1,109.35 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$117.15 |
$117.15 |
$117.15 |
$298.50
|
|
Lung perfusion imaging
|
$1,581.80 |
$1,581.80 |
$1,581.80 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$1,178.10 |
$1,178.10 |
$1,178.10 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$123.20 |
$123.20 |
$123.20 |
$38.58
|
|
Macroscopic exam parasite
|
$168.85 |
$168.85 |
$168.85 |
$38.50
|
|
Magnesium
|
$103.40 |
$103.40 |
$103.40 |
$71.50
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$151.80 |
$151.80 |
$151.80 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$241.45 |
$241.45 |
$241.45 |
$178.75
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$36.30 |
$36.30 |
$36.30 |
$66.50
|
|
Mayo aathr protein s free
|
$86.35 |
$86.35 |
$86.35 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$86.35 |
$86.35 |
$86.35 |
$98.70
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$360.25 |
$360.25 |
$360.25 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$146.85 |
$146.85 |
$146.85 |
$101.44
|
|
Mayo alcohol definitive assay volatile screen
|
$194.70 |
$194.70 |
$194.70 |
$118.95
|
|
Mayo alkaline phosphatase isoenzyme
|
$118.80 |
$118.80 |
$118.80 |
$66.30
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$344.30 |
$344.30 |
$344.30 |
$115.92
|
|
Mayo alpha 1 antitrypsin
|
$49.50 |
$49.50 |
$49.50 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$19.25 |
$19.25 |
$19.25 |
$81.81
|
|
Mayo amphu amphetamines definitive assay 3 or 4 urine
|
$29.70 |
$29.70 |
$29.70 |
$92.30
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$166.10 |
$166.10 |
$166.10 |
$73.60
|
|
Mayo analysis gene calr common variants exon 9
|
$677.60 |
$677.60 |
$677.60 |
$472.31
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$992.75 |
$992.75 |
$992.75 |
$326.48
|
|
Mayo analysis gene smn1 dosage/deletion
|
$524.70 |
$524.70 |
$524.70 |
$328.80
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$5,079.25 |
$5,079.25 |
$5,079.25 |
$1,909.44
|
|
Mayo androstenedione
|
$62.15 |
$62.15 |
$62.15 |
$105.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$23.10 |
$23.10 |
$23.10 |
$72.46
|
|
Mayo antithrombin iii antigen
|
$44.00 |
$44.00 |
$44.00 |
$68.90
|
|
Mayo aspergillus fumigatus antibody
|
$86.35 |
$86.35 |
$86.35 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$271.15 |
$271.15 |
$271.15 |
$157.95
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$142.45 |
$142.45 |
$142.45 |
$105.00
|
|
Mayo barbiturates definitive assay confirmation urine
|
$136.40 |
$136.40 |
$136.40 |
$91.65
|
|
Mayo bart bartonella henselae antibody igg
|
$23.10 |
$23.10 |
$23.10 |
$45.75
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$699.05 |
$699.05 |
$699.05 |
$353.60
|
|
Mayo bcrfx analysis translocation bcr/abl1 other breakpoint qualitative/quantitative
|
$125.95 |
$125.95 |
$125.95 |
$373.75
|
|
Mayo blastomyces antibody immunodiffusion
|
$35.75 |
$35.75 |
$35.75 |
$57.85
|
|
Mayo bnzu sedative hypnotics definitive urine
|
$338.25 |
$338.25 |
$338.25 |
$66.00
|
|
Mayo bordetella pertussis antibody igg
|
$136.40 |
$136.40 |
$136.40 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$71.50 |
$71.50 |
$71.50 |
$48.57
|
|
Mayo c1 esterase inhibitor
|
$334.95 |
$334.95 |
$334.95 |
$88.35
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$333.85 |
$333.85 |
$333.85 |
$96.85
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$59.95 |
$59.95 |
$59.95 |
$83.97
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$178.20 |
$178.20 |
$178.20 |
$110.00
|
