|
Knee arthroscopy/surgery
|
$2,224.20 |
$2,224.20 |
$2,224.20 |
$8,979.74
|
|
Knee arthroscopy/surgery
|
$2,805.66 |
$2,805.66 |
$2,805.66 |
$6,411.60
|
|
Knee control full kneecap
|
$210.54 |
$210.54 |
$210.54 |
$192.00
|
|
Knee disc/dial lock/adj flex
|
$277.86 |
$277.86 |
$277.86 |
$288.41
|
|
Knee MRI (with and without contrast)
|
$4,374.48 |
$4,374.48 |
$4,374.48 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,300.00 |
$3,300.00 |
$3,300.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,846.48 |
$3,846.48 |
$3,846.48 |
$2,110.76
|
|
Knee X-ray
|
$880.44 |
$880.44 |
$880.44 |
$425.55
|
|
Kyleena, 19.5 mg
|
$2,519.22 |
$2,519.22 |
$2,519.22 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$19.90 |
$19.90 |
$19.90 |
$33.60
|
|
Labioplasty 56800
|
$576.84 |
$576.84 |
$576.84 |
$3,786.00
|
|
Lactate dehydrogenase (ldh)
|
$36.96 |
$36.96 |
$36.96 |
$55.50
|
|
Lactated ringers intravenous solution
|
$32.36 |
$32.36 |
$32.36 |
$44.91
|
|
Lactic acid
|
$159.72 |
$159.72 |
$159.72 |
$107.00
|
|
Lam facetc/frmt arthrd lum 1
|
$555.06 |
$555.06 |
$555.06 |
$582.40
|
|
Lam facetec & foramot crv
|
$2,860.44 |
$2,860.44 |
$2,860.44 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$3,719.76 |
$3,719.76 |
$3,719.76 |
$8,412.89
|
|
Lam facetec & foramot thrc
|
$2,742.96 |
$2,742.96 |
$2,742.96 |
$8,453.60
|
|
Lam factc/frmt arthrd lum ea
|
$492.36 |
$492.36 |
$492.36 |
$492.80
|
|
Lamie excise intrspinl lesion thrc 63266
|
$3,773.22 |
$3,773.22 |
$3,773.22 |
$5,339.00
|
|
Laminotomy single cervical
|
$3,065.70 |
$3,065.70 |
$3,065.70 |
$8,412.89
|
|
Laminotomy single lumbar
|
$2,893.44 |
$2,893.44 |
$2,893.44 |
$8,453.60
|
|
Lamiotoiotiotinotomy addl cervical 63043
|
$627.66 |
$627.66 |
$627.66 |
$1,506.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,190.00 |
$14,190.00 |
$14,190.00 |
$19,124.00
|
|
Laparo ablate renal cyst
|
$2,060.52 |
$2,060.52 |
$2,060.52 |
$9,367.23
|
|
Laparo-asst vag hysterectomy
|
$1,983.96 |
$1,983.96 |
$1,983.96 |
$6,839.00
|
|
Laparo cholecystectomy/explr
|
$2,479.62 |
$2,479.62 |
$2,479.62 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$1,598.52 |
$1,598.52 |
$1,598.52 |
$8,346.00
|
|
Laparo drng lymphocele 49323
|
$1,430.88 |
$1,430.88 |
$1,430.88 |
$5,741.00
|
|
Laparo new ureter/bladder
|
$3,094.08 |
$3,094.08 |
$3,094.08 |
$9,116.80
|
|
Laparo partial colectomy 44204
|
$3,375.90 |
$3,375.90 |
$3,375.90 |
$2,917.80
|
|
Laparo partial nephrectomy
|
$3,341.58 |
$3,341.58 |
$3,341.58 |
$12,320.22
|
|
Laparo proc abdm/per/oment 49329
|
$2,047.32 |
$2,047.32 |
$2,047.32 |
$6,622.75
|
|
Laparo radical nephrectomy
|
$2,983.86 |
$2,983.86 |
$2,983.86 |
$6,360.80
|
|
Laparo remove w/ureter
|
$2,996.40 |
$2,996.40 |
$2,996.40 |
$6,593.60
|
|
Laparoscopic myomectomy
|
$2,020.26 |
$2,020.26 |
$2,020.26 |
$6,461.32
|
|
Laparoscopic nephrectomy
|
$2,699.40 |
$2,699.40 |
$2,699.40 |
$5,686.20
|
|
Laparoscopic proc
|
$2,524.50 |
$2,524.50 |
$2,524.50 |
$2,215.20
|
|
Laparoscopic salpingostomy 58673
|
$1,770.12 |
$1,770.12 |
$1,770.12 |
$5,214.15
|
|
Laparoscopy aspiration
|
$836.22 |
$836.22 |
$836.22 |
$6,839.00
|
|
Laparoscopy biopsy
|
$772.86 |
$772.86 |
$772.86 |
$6,376.26
|
|
Laparoscopye procstom 43659
|
$693.66 |
$693.66 |
$693.66 |
$6,448.00
|
|
Laparoscopy excise lesions
|
$1,601.82 |
$1,601.82 |
$1,601.82 |
$6,904.15
|
|
Laparoscopy fundoplasty
|
$2,367.42 |
$2,367.42 |
$2,367.42 |
$11,424.40
|
|
Laparoscopy gastrostomy
|
$1,302.18 |
$1,302.18 |
$1,302.18 |
$6,457.82
|
|
Laparoscopy lymphadenectomy
|
$1,491.60 |
$1,491.60 |
$1,491.60 |
$12,320.22
|
|
Laparoscopy lymph node biop
|
$1,164.24 |
$1,164.24 |
$1,164.24 |
$6,904.15
|
|
Laparoscopy lysis
|
$1,532.52 |
$1,532.52 |
$1,532.52 |
$5,419.00
|
|
Laparoscopy orchiectomy
|
$1,485.66 |
$1,485.66 |
$1,485.66 |
$6,311.00
|
|
Laparoscopy pyeloplasty
|
$2,773.98 |
$2,773.98 |
$2,773.98 |
$11,963.98
|
|
Laparoscopy remove adnexa
|
$2,192.52 |
$2,192.52 |
$2,192.52 |
$8,607.55
|
|
Laparoscopy splenectomy
|
$375.54 |
$375.54 |
$375.54 |
$10,488.40
|
|
Laparoscopy surg colpopexy
|
$2,183.28 |
$2,183.28 |
$2,183.28 |
$10,897.60
|
|
Laparoscopy tubal block 58671
|
$841.50 |
$841.50 |
$841.50 |
$5,166.25
|
|
Laparo sling operation 51992
|
$1,869.12 |
$1,869.12 |
$1,869.12 |
$5,353.60
|
|
Laparotomy; inject/aspirate liver cyst 47015
|
$2,576.64 |
$2,576.64 |
$2,576.64 |
$1,659.80
|
|
Laparo urethral suspension
|
$1,681.68 |
$1,681.68 |
$1,681.68 |
$5,353.60
|
|
Laparo-vag hyst incl t/o
|
$2,203.74 |
$2,203.74 |
$2,203.74 |
$12,100.40
|
|
Laparo-vag hyst w/t/o compl
|
$2,912.58 |
$2,912.58 |
$2,912.58 |
$8,917.26
|
|
Lap close enterostomy with resect 44227
|
$3,633.96 |
$3,633.96 |
$3,633.96 |
$3,582.00
|
|
Lap colectomy/coloproctostomy 44207
|
$3,975.18 |
$3,975.18 |
$3,975.18 |
$4,491.20
|
|
Lap colectomy/coloproctostomy w/clst 44208
|
$4,331.58 |
$4,331.58 |
$4,331.58 |
$4,896.80
|
|
Lap colectomy part w/ileum 44205
|
$2,938.32 |
$2,938.32 |
$2,938.32 |
$2,938.32
|
|
Lap colectomy w/proctectomy 44211
|
$755.04 |
$755.04 |
$755.04 |
$3,222.00
|
|
Lap colostomy 44188
|
$2,692.14 |
$2,692.14 |
$2,692.14 |
$3,008.00
|
|
Lap enterectomy 44202
|
$3,049.86 |
$3,049.86 |
$3,049.86 |
$2,142.00
|
|
Lap enterolysis
|
$2,032.80 |
$2,032.80 |
$2,032.80 |
$6,376.26
|
|
Lap esophageal lengthening addl 43283
|
$335.28 |
$335.28 |
$335.28 |
$388.00
|
|
Lap gastric bypass/roux-en-y
|
$3,805.56 |
$3,805.56 |
$3,805.56 |
$4,255.20
|
|
Lap ileo/jejuno-stomy 44187
|
$2,433.42 |
$2,433.42 |
$2,433.42 |
$2,716.80
|
|
Lap ing hernia repair init
|
$1,468.50 |
$1,468.50 |
$1,468.50 |
$8,312.83
|
|
Lap ing hernia repair recur
|
$1,273.80 |
$1,273.80 |
$1,273.80 |
$6,463.42
|
|
Lap insert tunnel ip cath
|
$852.72 |
$852.72 |
$852.72 |
$6,895.20
|
|
Lap jejunostomy 44186
|
$1,446.72 |
$1,446.72 |
$1,446.72 |
$6,376.26
|
|
Lap mobil splenic fl add-on 44213
|
$403.26 |
$403.26 |
$403.26 |
$622.40
|
|
Lap paraesophag hern repair
|
$3,343.56 |
$3,343.56 |
$3,343.56 |
$12,260.88
|
|
Lap paraesoph her rpr w/mesh
|
$3,765.96 |
$3,765.96 |
$3,765.96 |
$10,029.60
|
|
Lap part colectomy w/stoma 44206
|
$3,815.46 |
$3,815.46 |
$3,815.46 |
$4,307.20
|
|
Lap place gastr adj device
|
$2,494.14 |
$2,494.14 |
$2,494.14 |
$10,522.00
|
|
Lap proctopexy w/sig resect 45402
|
$3,351.48 |
$3,351.48 |
$3,351.48 |
$3,351.48
|
|
Lap removal of rectum w/colostomy 45395
|
$693.00 |
$693.00 |
$693.00 |
$4,880.80
|
|
Lap resect s/intestine addl 44203
|
$516.78 |
$516.78 |
$516.78 |
$516.78
|
|
Lap revision perm ip cath
|
$908.16 |
$908.16 |
$908.16 |
$6,904.15
|
|
Lap rmvl gastr adj all parts
|
$2,124.54 |
$2,124.54 |
$2,124.54 |
$4,502.13
|
|
Lap rmvl gastr adj device
|
$2,100.12 |
$2,100.12 |
$2,100.12 |
$4,502.13
|
|
Lap sleeve gastrectomy
|
$2,383.26 |
$2,383.26 |
$2,383.26 |
$2,733.60
|
|
Laps surg prst8ect rpbic rad
|
$2,678.94 |
$2,678.94 |
$2,678.94 |
$12,320.22
|
|
Laps surg prst8ect smpl stot
|
$2,356.20 |
$2,356.20 |
$2,356.20 |
$12,320.22
|
|
Lap tot proctocolectomy 44210
|
$3,918.42 |
$3,918.42 |
$3,918.42 |
$3,798.00
|
|
Lap w/omentopexy add-on 49326
|
$402.60 |
$402.60 |
$402.60 |
$463.20
|
|
Largsc w/njx augmentation
|
$337.92 |
$337.92 |
$337.92 |
$3,297.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$302.28 |
$302.28 |
$302.28 |
$765.97
|
|
Laryngoscope w/vc inj
|
$514.14 |
$514.14 |
$514.14 |
$4,108.00
|
|
Laryngoscopic sensory i&r
|
$52.80 |
$52.80 |
$52.80 |
$74.40
|
|
Laryngoscopic sensory vid
|
$256.08 |
$256.08 |
$256.08 |
$336.00
|
|
Laryngoscop w/vc inj + scope
|
$558.36 |
$558.36 |
$558.36 |
$4,362.99
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$361.68 |
$361.68 |
$361.68 |
$2,480.71
|
|
Laryngoscopy telescopic
|
$460.02 |
$460.02 |
$460.02 |
$852.80
|
|
Laryngoscopy w/biopsy
|
$427.02 |
$427.02 |
$427.02 |
$4,362.99
|
|
Laryngoscopy w/bx & op scope
|
$472.56 |
$472.56 |
$472.56 |
$4,362.99
|
