|
Largsc w/rmvl foreign bdy(s)
|
$245.70 |
$245.70 |
$245.70 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,467.20 |
$1,467.20 |
$1,467.20 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$1,467.20 |
$1,467.20 |
$1,467.20 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$1,467.20 |
$1,467.20 |
$1,467.20 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$245.70 |
$245.70 |
$245.70 |
$660.10
|
|
Lateral canthopexy
|
$1,879.15 |
$1,879.15 |
$1,879.15 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$1,990.80 |
$1,990.80 |
$1,990.80 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$5,831.00 |
$5,831.00 |
$5,831.00 |
$5,831.00
|
|
Lead ingevity 45cm pfret MRI
|
$4,494.00 |
$4,494.00 |
$4,494.00 |
$3,844.75
|
|
Lead tachy durata sj4 58cm
|
$4,905.95 |
$4,905.95 |
$4,905.95 |
$6,696.00
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$889.70 |
$889.70 |
$889.70 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$1,654.19 |
$1,654.19 |
$1,654.19 |
$1,489.57
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,654.19 |
$1,654.19 |
$1,654.19 |
$1,023.10
|
|
Lens iol ant chamb 10.5
|
$175.00 |
$175.00 |
$175.00 |
$216.48
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$145.06 |
$145.06 |
$145.06 |
$164.09
|
|
Leukocyte phagocytosis
|
$224.91 |
$224.91 |
$224.91 |
$49.28
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$621.23 |
$621.23 |
$621.23 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$4,620.05 |
$4,620.05 |
$4,620.05 |
$6,694.24
|
|
Levalbuterol non-comp unit
|
$2.59 |
$2.59 |
$2.59 |
$8.13
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$33.61 |
$33.61 |
$33.61 |
$97.62
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$87.33 |
$87.33 |
$87.33 |
$64.88
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$1,894.73 |
$1,894.73 |
$1,894.73 |
$420.60
|
|
Liberta rc ipg
|
$32,673.99 |
$32,673.99 |
$32,673.99 |
$39,840.21
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$68.93 |
$68.93 |
$68.93 |
$39.75
|
|
Ligation/biopsy of temporal artery 37609
|
$1,068.90 |
$1,068.90 |
$1,068.90 |
$2,968.00
|
|
Ligation/major artery/extremity 37618
|
$2,575.65 |
$2,575.65 |
$2,575.65 |
$1,567.80
|
|
Ligation major artery neck
|
$2,008.65 |
$2,008.65 |
$2,008.65 |
$3,724.63
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$215.59 |
$215.59 |
$215.59 |
$172.25
|
|
Lipase
|
$112.00 |
$112.00 |
$112.00 |
$83.20
|
|
Lipoprotein direct measurement hdl
|
$127.75 |
$127.75 |
$127.75 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$53.90 |
$53.90 |
$53.90 |
$60.00
|
|
Lithium therapeutic drug level
|
$163.10 |
$163.10 |
$163.10 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$4,204.55 |
$4,204.55 |
$4,204.55 |
$4,371.12
|
|
Liver Function Test
|
$128.10 |
$128.10 |
$128.10 |
$110.50
|
|
Liver imaging
|
$903.00 |
$903.00 |
$903.00 |
$1,241.25
|
|
Liver/spleen imag static only
|
$1,138.55 |
$1,138.55 |
$1,138.55 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$1,184.75 |
$1,184.75 |
$1,184.75 |
$949.00
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$43.75 |
$43.75 |
$43.75 |
$43.95
|
|
Low cost skin substitute app
|
$397.95 |
$397.95 |
$397.95 |
$1,030.00
|
|
Low cost skin substitute app
|
$1,626.10 |
$1,626.10 |
$1,626.10 |
$2,164.64
|
|
Low cost skin substitute app
|
$397.95 |
$397.95 |
$397.95 |
$1,132.56
|
|
Low cost skin substitute app
|
$397.95 |
$397.95 |
$397.95 |
$1,030.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,098.25 |
$2,098.25 |
$2,098.25 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,953.35 |
$1,953.35 |
$1,953.35 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,802.85 |
$1,802.85 |
$1,802.85 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,599.45 |
$2,599.45 |
$2,599.45 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,350.95 |
$2,350.95 |
$2,350.95 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,178.75 |
$2,178.75 |
$2,178.75 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$311.50 |
$311.50 |
$311.50 |
$344.00
|
|
Lumbar diskogram s&i
|
$2,012.50 |
$2,012.50 |
$2,012.50 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$140.70 |
$140.70 |
$140.70 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$302.40 |
$302.40 |
$302.40 |
$298.50
|
|
Lung perfusion imaging
|
$1,242.15 |
$1,242.15 |
$1,242.15 |
$1,100.39
|
|
Lvad shower bag heartmate
|
$833.49 |
$833.49 |
$833.49 |
$972.60
|
|
Lymphatics/lymph node imaging
|
$814.10 |
$814.10 |
$814.10 |
$1,543.75
|
|
Lymph vessel x-ray arm/leg
|
$773.15 |
$773.15 |
$773.15 |
$862.57
|
|
Lymph vessel x-ray arms/legs
|
$1,541.75 |
$1,541.75 |
$1,541.75 |
$2,229.24
|
|
Lymph vessel x-ray trunk
|
$2,049.25 |
$2,049.25 |
$2,049.25 |
$2,542.41
|
|
Lymph vessel x-ray trunk
|
$3,844.40 |
$3,844.40 |
$3,844.40 |
$3,380.00
|
|
Macroscopic exam parasite
|
$225.75 |
$225.75 |
$225.75 |
$38.50
|
|
Magnesium
|
$96.60 |
$96.60 |
$96.60 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$86.56 |
$86.56 |
$86.56 |
$69.30
|
|
Makena, 10 mg
|
$3,147.76 |
$3,147.76 |
$3,147.76 |
$120.48
|
|
Mammosite ced
|
$3,762.50 |
$3,762.50 |
$3,762.50 |
$5,100.00
|
|
Manipulate wrist w/anesthes
|
$1,058.05 |
$1,058.05 |
$1,058.05 |
$2,084.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$187.60 |
$187.60 |
$187.60 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$281.40 |
$281.40 |
$281.40 |
$178.75
|
|
Mapping functional cort/subcort ea add'l hr
|
$211.75 |
$211.75 |
$211.75 |
$705.82
|
|
Map tachycard site(s)
|
$1,339.80 |
$1,339.80 |
$1,339.80 |
$3,960.00
|
|
Marker biop eviva buckle ss
|
$3,969.37 |
$3,969.37 |
$3,969.37 |
$1,213.20
|
|
Marker lymphatic sentimag magtrace 10 vial
|
$1,542.63 |
$1,542.63 |
$1,542.63 |
$1,753.29
|
|
Mastoids complete
|
$455.00 |
$455.00 |
$455.00 |
$271.95
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$6,785.68 |
$6,785.68 |
$6,785.68 |
$6,321.00
|
|
Mayo aathr protein s free
|
$121.10 |
$121.10 |
$121.10 |
$130.00
|
|
Mayo alcohol definitive assay volatile screen
|
$167.30 |
$167.30 |
$167.30 |
$118.95
|
|
Mayo amikacin trough therapeutic drug level
|
$10.76 |
$10.76 |
$10.76 |
$81.81
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$64.75 |
$64.75 |
$64.75 |
$326.48
|
|
Mayo barbiturates definitive assay confirmation urine
|
$39.01 |
$39.01 |
$39.01 |
$91.65
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$52.50 |
$52.50 |
$52.50 |
$353.60
|
|
Mayo c1 esterase inhibitor
|
$167.30 |
$167.30 |
$167.30 |
$88.35
|
|
Mayo chemiluminescent parathyroid related peptide
|
$8.75 |
$8.75 |
$8.75 |
$123.73
|
|
Mayo cocou cortisone urine
|
$66.15 |
$66.15 |
$66.15 |
$207.26
|
|
Mayo covid-19 antibody nucleocapsid total
|
$28.00 |
$28.00 |
$28.00 |
$72.60
|
|
Mayo everolimus therapeutic drug level
|
$7.12 |
$7.12 |
$7.12 |
$80.50
|
|
Mayo fbl culture fungi blood
|
$420.00 |
$420.00 |
$420.00 |
$102.20
|
|
Mayo fibrinogen antigen
|
$94.50 |
$94.50 |
$94.50 |
$94.50
|
|
Mayo gamma-globin full gene sequencing
|
$135.80 |
$135.80 |
$135.80 |
$1,446.90
|
|
Mayo hip12 infectious agent nucleic acid amplified probe hiv-1 rna qualitative
|
$136.14 |
$136.14 |
$136.14 |
$165.00
|
|
Mayo hvdip HIV 1 antibody
|
$127.40 |
$127.40 |
$127.40 |
$67.57
|
|
Mayo hvdip HIV 2 antibody
|
$5.15 |
$5.15 |
$5.15 |
$67.60
|
|
Mayo immunoassay c1 esterase inhibitor antibody quantitative
|
$46.81 |
$46.81 |
$46.81 |
$202.63
|
|
Mayo immunoassay tumor antigen quantitative ca 27.29
|
$57.75 |
$57.75 |
$57.75 |
$112.50
|
|
Mayo infectious agent antigen immunoassay direct optical observation cryptococcus
|
$216.30 |
$216.30 |
$216.30 |
$81.04
|
|
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal
|
$44.08 |
$44.08 |
$44.08 |
$107.62
|
|
Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae
|
$82.34 |
$82.34 |
$82.34 |
$157.30
|
|
Mayo microsomal antibody liver-kidney
|
$31.50 |
$31.50 |
$31.50 |
$90.00
|
|
Mayo mitotane (lysodren) therapeutic drug level
|
$30.45 |
$30.45 |
$30.45 |
$167.70
|
|
Mayo paval fluorescent antibody screen agna type 1
|
$21.00 |
$21.00 |
$21.00 |
$190.20
|
|
Mayo radioimmunoassay procollagen i intact n-terminal antibody quantitative
|
$63.21 |
$63.21 |
$63.21 |
$263.97
|
|
Mayo repu protein electrophoresis urine
|
$239.40 |
$239.40 |
$239.40 |
$92.70
|
