|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$45.76 |
$45.76 |
$45.76 |
$168.92
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$900.28 |
$900.28 |
$900.28 |
$3,818.36
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$29.51 |
$29.51 |
$29.51 |
$78.05
|
|
Levetiracetam therapeutic drug level
|
$21.32 |
$21.32 |
$21.32 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$23.28 |
$23.28 |
$23.28 |
$62.72
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$136.57 |
$136.57 |
$136.57 |
$367.10
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$26.77 |
$26.77 |
$26.77 |
$38.00
|
|
Lidocaine therapeutic drug level
|
$71.04 |
$71.04 |
$71.04 |
$83.85
|
|
Ligate/strip long leg vein
|
$1,846.16 |
$1,846.16 |
$1,846.16 |
$3,724.63
|
|
Ligation/biopsy of temporal artery 37609
|
$1,194.96 |
$1,194.96 |
$1,194.96 |
$2,968.00
|
|
Ligation/divis of long saph vein 37700
|
$3,234.99 |
$3,234.99 |
$3,234.99 |
$3,724.63
|
|
Lig/band angioaccess av fistula
|
$2,425.13 |
$2,425.13 |
$2,425.13 |
$4,240.23
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$43.47 |
$43.47 |
$43.47 |
$159.18
|
|
Lipase
|
$124.62 |
$124.62 |
$124.62 |
$83.20
|
|
Lipoprotein blood quant
|
$61.87 |
$61.87 |
$61.87 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$11.84 |
$11.84 |
$11.84 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$18.36 |
$18.36 |
$18.36 |
$60.00
|
|
Lithium therapeutic drug level
|
$59.20 |
$59.20 |
$59.20 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$5,621.64 |
$5,621.64 |
$5,621.64 |
$4,371.12
|
|
Liver Function Test
|
$150.08 |
$150.08 |
$150.08 |
$110.50
|
|
Liver imaging
|
$324.42 |
$324.42 |
$324.42 |
$1,241.25
|
|
Liver/spleen imag static only
|
$510.31 |
$510.31 |
$510.31 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$479.52 |
$479.52 |
$479.52 |
$949.00
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$31.03 |
$31.03 |
$31.03 |
$43.75
|
|
Low cost skin substitute app
|
$606.80 |
$606.80 |
$606.80 |
$1,030.00
|
|
Low cost skin substitute app
|
$1,981.72 |
$1,981.72 |
$1,981.72 |
$2,164.64
|
|
Low cost skin substitute app
|
$606.80 |
$606.80 |
$606.80 |
$1,167.60
|
|
Low cost skin substitute app
|
$606.80 |
$606.80 |
$606.80 |
$1,030.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,256.23 |
$1,256.23 |
$1,256.23 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,158.84 |
$1,158.84 |
$1,158.84 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$884.75 |
$884.75 |
$884.75 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,177.08 |
$2,177.08 |
$2,177.08 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,565.25 |
$1,565.25 |
$1,565.25 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,422.88 |
$1,422.88 |
$1,422.88 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$248.35 |
$248.35 |
$248.35 |
$344.00
|
|
Lumbar diskogram s&i
|
$629.60 |
$629.60 |
$629.60 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$222.00 |
$222.00 |
$222.00 |
$298.50
|
|
Lung perfusion imaging
|
$326.79 |
$326.79 |
$326.79 |
$1,100.39
|
|
Lurbinectedin 4 mg intravenous solution
|
$17,393.41 |
$17,393.41 |
$17,393.41 |
$21,982.48
|
|
Lymphatics/lymph node imaging
|
$814.89 |
$814.89 |
$814.89 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$4.44 |
$4.44 |
$4.44 |
$38.58
|
|
Macroscopic exam parasite
|
$5.04 |
$5.04 |
$5.04 |
$38.50
|
|
Magnesium
|
$15.40 |
$15.40 |
$15.40 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$24.78 |
$24.78 |
$24.78 |
$64.61
|
|
Mammosite ced
|
$80.22 |
$80.22 |
$80.22 |
$4,707.50
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$57.72 |
$57.72 |
$57.72 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$77.26 |
$77.26 |
$77.26 |
$178.75
|
|
Manipulation of hip joint
|
$1,608.17 |
$1,608.17 |
$1,608.17 |
$1,893.86
|
|
Mannitol 12.5 gm/50 ml inj
|
$23.10 |
$23.10 |
$23.10 |
$27.63
|
|
Manual diff wbc count b-coat
|
$33.75 |
$33.75 |
$33.75 |
$22.75
|
|
Map tachycard site(s)
|
$612.72 |
$612.72 |
$612.72 |
$3,960.00
|
|
Marker biop eviva buckle ss
|
$82.00 |
$82.00 |
$82.00 |
$1,213.20
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$64.83 |
$64.83 |
$64.83 |
$66.50
|
|
Mayo aathr protein s free
|
$27.24 |
$27.24 |
$27.24 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$20.13 |
$20.13 |
$20.13 |
$98.70
|
|
Mayo alkaline phosphatase isoenzyme
|
$23.98 |
$23.98 |
$23.98 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$68.97 |
$68.97 |
$68.97 |
$87.60
|
|
Mayo amikacin trough therapeutic drug level
|
$21.91 |
$21.91 |
$21.91 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$214.01 |
$214.01 |
$214.01 |
$472.31
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$128.76 |
$128.76 |
$128.76 |
$326.48
|
|
Mayo androstenedione
|
$48.84 |
$48.84 |
$48.84 |
$105.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$156.59 |
$156.59 |
$156.59 |
$72.46
|
|
Mayo antithrombin iii antigen
|
$14.80 |
$14.80 |
$14.80 |
$68.90
|
|
Mayo aspergillus fumigatus antibody
|
$48.55 |
$48.55 |
$48.55 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$164.88 |
$164.88 |
$164.88 |
$157.95
|
|
Mayo babpb infectious agent nucleic acid amplified probe babesia microti
|
$41.44 |
$41.44 |
$41.44 |
$105.00
|
|
Mayo bart bartonella henselae antibody igg
|
$14.51 |
$14.51 |
$14.51 |
$45.75
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$337.74 |
$337.74 |
$337.74 |
$353.60
|
|
Mayo blastomyces antibody immunodiffusion
|
$23.68 |
$23.68 |
$23.68 |
$57.85
|
|
Mayo bordetella pertussis antibody igg
|
$68.08 |
$68.08 |
$68.08 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$53.88 |
$53.88 |
$53.88 |
$48.57
|
|
Mayo c1 esterase inhibitor
|
$30.79 |
$30.79 |
$30.79 |
$88.35
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$16.88 |
$16.88 |
$16.88 |
$96.85
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$31.08 |
$31.08 |
$31.08 |
$83.97
|
|
Mayo cd20b mononuclear cell antigen nos quantitative each
|
$31.08 |
$31.08 |
$31.08 |
$110.00
|
|
Mayo ceruloplasmin
|
$20.72 |
$20.72 |
$20.72 |
$65.08
|
|
Mayo chemiluminescent parathyroid related peptide
|
$67.79 |
$67.79 |
$67.79 |
$123.73
|
|
Mayo chikv chikungunya antibodies igg
|
$40.85 |
$40.85 |
$40.85 |
$102.40
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$14.80 |
$14.80 |
$14.80 |
$54.40
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$17.17 |
$17.17 |
$17.17 |
$50.88
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$145.34 |
$145.34 |
$145.34 |
$353.99
|
|
Mayo chromium
|
$26.94 |
$26.94 |
$26.94 |
$70.85
|
|
Mayo coccidioides antibody
|
$30.49 |
$30.49 |
$30.49 |
$58.37
|
|
Mayo cocou cortisone urine
|
$38.19 |
$38.19 |
$38.19 |
$207.26
|
|
Mayo cortisol free
|
$29.90 |
$29.90 |
$29.90 |
$100.00
|
|
Mayo covid-19 antibody nucleocapsid total
|
$72.52 |
$72.52 |
$72.52 |
$72.60
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$22.80 |
$22.80 |
$22.80 |
$61.02
|
|
Mayo cyanide
|
$32.27 |
$32.27 |
$32.27 |
$87.10
|
|
Mayo deoxyribonuclease antibody titer
|
$17.17 |
$17.17 |
$17.17 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$44.11 |
$44.11 |
$44.11 |
$88.45
|
|
Mayo dihydrotestosterone
|
$34.34 |
$34.34 |
$34.34 |
$81.90
|
|
Mayo efpo chloride stool
|
$37.30 |
$37.30 |
$37.30 |
$44.20
|
|
Mayo estrone
|
$33.45 |
$33.45 |
$33.45 |
$84.70
|
|
Mayo ethosuximide therapeutic drug level
|
$27.24 |
$27.24 |
$27.24 |
$70.40
|
|
Mayo everolimus therapeutic drug level
|
$18.36 |
$18.36 |
$18.36 |
$80.50
|
|
Mayo factor ii
|
$162.51 |
$162.51 |
$162.51 |
$93.00
|
|
Mayo factor v
|
$158.36 |
$158.36 |
$158.36 |
$125.48
|
|
Mayo factor vii
|
$160.14 |
$160.14 |
$160.14 |
$141.00
|
|
Mayo factor viii vw factor antigen
|
$43.52 |
$43.52 |
$43.52 |
$110.50
|
|
Mayo factor viii vw factor multimetric analysis
|
$84.96 |
$84.96 |
$84.96 |
$125.00
|
