|
Knee MRI (with and without contrast)
|
$3,717.00 |
$3,717.00 |
$3,717.00 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,693.40 |
$2,693.40 |
$2,693.40 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,653.20 |
$2,653.20 |
$2,653.20 |
$2,130.88
|
|
Knee X-ray
|
$293.40 |
$293.40 |
$293.40 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$238.20 |
$238.20 |
$238.20 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$288.60 |
$288.60 |
$288.60 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$128.40 |
$128.40 |
$128.40 |
$251.20
|
|
Kyleena, 19.5 mg
|
$2,161.19 |
$2,161.19 |
$2,161.19 |
$2,125.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$53.40 |
$53.40 |
$53.40 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$49.80 |
$49.80 |
$49.80 |
$70.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$120.00 |
$120.00 |
$120.00 |
$33.60
|
|
Labioplasty 56800
|
$468.60 |
$468.60 |
$468.60 |
$3,905.53
|
|
Lactate dehydrogenase (ldh)
|
$43.80 |
$43.80 |
$43.80 |
$55.50
|
|
Lactated ringers intravenous solution
|
$43.74 |
$43.74 |
$43.74 |
$43.74
|
|
Lactic acid
|
$84.00 |
$84.00 |
$84.00 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$81.00 |
$81.00 |
$81.00 |
$82.16
|
|
Lactoferrin fecal quant
|
$87.00 |
$87.00 |
$87.00 |
$108.93
|
|
Lam facetec & foramot crv
|
$2,722.80 |
$2,722.80 |
$2,722.80 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$2,326.20 |
$2,326.20 |
$2,326.20 |
$8,412.89
|
|
Lam facetec & foramot thrc
|
$2,625.00 |
$2,625.00 |
$2,625.00 |
$8,453.60
|
|
Lamie bx/exc idrl spine lesn lmbr 63282
|
$3,634.20 |
$3,634.20 |
$3,634.20 |
$4,650.40
|
|
Lamie bx/exc idrl spine lesn thrc 63281
|
$4,352.40 |
$4,352.40 |
$4,352.40 |
$4,925.60
|
|
Lamie excise intrspinl lesion thrc 63266
|
$3,180.00 |
$3,180.00 |
$3,180.00 |
$5,339.00
|
|
Laminotomy single lumbar
|
$3,033.00 |
$3,033.00 |
$3,033.00 |
$8,453.60
|
|
Lamiotoiotiotinotomy addl cervical 63043
|
$985.20 |
$985.20 |
$985.20 |
$1,506.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$16,948.63 |
$16,948.63 |
$16,948.63 |
$19,124.00
|
|
Laparo-asst vag hysterectomy
|
$2,890.80 |
$2,890.80 |
$2,890.80 |
$6,839.00
|
|
Laparo cholecystectomy/explr
|
$2,120.40 |
$2,120.40 |
$2,120.40 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$1,349.40 |
$1,349.40 |
$1,349.40 |
$8,346.00
|
|
Laparo drng lymphocele 49323
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$5,741.00
|
|
Laparo-myomectomy complex
|
$2,199.00 |
$2,199.00 |
$2,199.00 |
$11,523.76
|
|
Laparo partial colectomy 44204
|
$2,917.80 |
$2,917.80 |
$2,917.80 |
$2,917.80
|
|
Laparo proc abdm/per/oment 49329
|
$1,492.20 |
$1,492.20 |
$1,492.20 |
$6,622.75
|
|
Laparo radical nephrectomy
|
$2,509.20 |
$2,509.20 |
$2,509.20 |
$6,360.80
|
|
Laparoscopic myomectomy
|
$1,741.80 |
$1,741.80 |
$1,741.80 |
$6,461.32
|
|
Laparoscopic proc
|
$2,215.20 |
$2,215.20 |
$2,215.20 |
$2,215.20
|
|
Laparoscopic salpingostomy 58673
|
$1,560.60 |
$1,560.60 |
$1,560.60 |
$5,214.15
|
|
Laparoscopy adrenalectomy
|
$2,259.00 |
$2,259.00 |
$2,259.00 |
$5,888.00
|
|
Laparoscopy aspiration
|
$706.20 |
$706.20 |
$706.20 |
$6,904.15
|
|
Laparoscopy biopsy
|
$654.60 |
$654.60 |
$654.60 |
$6,463.42
|
|
Laparoscopye procstom 43659
|
$2,683.80 |
$2,683.80 |
$2,683.80 |
$6,448.00
|
|
Laparoscopy excise lesions
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$7,243.60
|
|
Laparoscopy fundoplasty
|
$2,041.80 |
$2,041.80 |
$2,041.80 |
$11,424.40
|
|
Laparoscopy gastrostomy
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$6,457.82
|
|
Laparoscopy lymphadenectomy
|
$1,561.20 |
$1,561.20 |
$1,561.20 |
$12,320.22
|
|
Laparoscopy lymphadenectomy
|
$1,836.00 |
$1,836.00 |
$1,836.00 |
$8,932.00
|
|
Laparoscopy lymph node biop
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$6,904.15
|
|
Laparoscopy lysis
|
$1,306.80 |
$1,306.80 |
$1,306.80 |
$5,814.32
|
|
Laparoscopy remove adnexa
|
$1,254.60 |
$1,254.60 |
$1,254.60 |
$8,782.80
|
|
Laparoscopy splenectomy
|
$2,075.40 |
$2,075.40 |
$2,075.40 |
$10,488.40
|
|
Laparoscopy surg colpopexy
|
$1,546.80 |
$1,546.80 |
$1,546.80 |
$10,897.60
|
|
Laparoscopy tubal block 58671
|
$710.40 |
$710.40 |
$710.40 |
$5,510.40
|
|
Laparo sling operation 51992
|
$1,666.80 |
$1,666.80 |
$1,666.80 |
$5,353.60
|
|
Laparotomy; inject/aspirate liver cyst 47015
|
$1,699.80 |
$1,699.80 |
$1,699.80 |
$1,659.80
|
|
Laparo total proctocolectomy
|
$2,792.40 |
$2,792.40 |
$2,792.40 |
$5,071.20
|
|
Laparo urethral suspension
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$5,353.60
|
|
Laparo-vag hyst incl t/o
|
$1,910.40 |
$1,910.40 |
$1,910.40 |
$12,100.40
|
|
Laparo-vag hyst w/t/o compl
|
$4,488.60 |
$4,488.60 |
$4,488.60 |
$8,917.26
|
|
Laparscpy ablat 1>lvr tum cryo
|
$2,394.00 |
$2,394.00 |
$2,394.00 |
$11,221.60
|
|
Lap close enterostomy with resect 44227
|
$3,582.00 |
$3,582.00 |
$3,582.00 |
$3,582.00
|
|
Lap colectomy/coloproctostomy 44207
|
$2,662.20 |
$2,662.20 |
$2,662.20 |
$4,491.20
|
|
Lap colectomy/coloproctostomy w/clst 44208
|
$3,781.80 |
$3,781.80 |
$3,781.80 |
$4,896.80
|
|
Lap colectomy part w/ileum 44205
|
$2,540.40 |
$2,540.40 |
$2,540.40 |
$2,938.32
|
|
Lap colectomy w/proctectomy 44211
|
$3,222.00 |
$3,222.00 |
$3,222.00 |
$3,222.00
|
|
Lap colostomy 44188
|
$2,318.40 |
$2,318.40 |
$2,318.40 |
$3,008.00
|
|
Lap enterectomy 44202
|
$2,142.00 |
$2,142.00 |
$2,142.00 |
$2,142.00
|
|
Lap enterolysis
|
$1,736.40 |
$1,736.40 |
$1,736.40 |
$6,463.42
|
|
Lap esophageal lengthening addl 43283
|
$306.60 |
$306.60 |
$306.60 |
$388.00
|
|
Lap fimbrioplasty 58672
|
$1,434.60 |
$1,434.60 |
$1,434.60 |
$6,904.15
|
|
Lap gastric bypass/roux-en-y
|
$3,167.40 |
$3,167.40 |
$3,167.40 |
$4,255.20
|
|
Lap ileo/jejuno-stomy 44187
|
$2,098.20 |
$2,098.20 |
$2,098.20 |
$2,716.80
|
|
Lap inc hernia repair 49654
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$6,538.43
|
|
Lap inc hernia repair recurr 49656
|
$1,657.80 |
$1,657.80 |
$1,657.80 |
$2,072.28
|
|
Lap inc hern recur comp 49657
|
$2,383.20 |
$2,383.20 |
$2,383.20 |
$9,770.08
|
|
Lap inc hern repair comp 49655
|
$1,872.60 |
$1,872.60 |
$1,872.60 |
$9,853.46
|
|
Lap ing hernia repair init
|
$802.80 |
$802.80 |
$802.80 |
$9,605.51
|
|
Lap ing hernia repair recur
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$6,870.89
|
|
Lap insert tunnel ip cath
|
$744.00 |
$744.00 |
$744.00 |
$6,895.20
|
|
Lap jejunostomy 44186
|
$1,230.60 |
$1,230.60 |
$1,230.60 |
$6,376.26
|
|
Lap mobil splenic fl add-on 44213
|
$360.60 |
$360.60 |
$360.60 |
$622.40
|
|
Lap myotomy heller
|
$2,444.40 |
$2,444.40 |
$2,444.40 |
$3,158.40
|
|
Lap paraesophag hern repair
|
$2,922.00 |
$2,922.00 |
$2,922.00 |
$12,260.88
|
|
Lap paraesoph her rpr w/mesh
|
$4,945.80 |
$4,945.80 |
$4,945.80 |
$10,029.60
|
|
Lap part colectomy w/stoma 44206
|
$3,747.60 |
$3,747.60 |
$3,747.60 |
$4,307.20
|
|
Lap proctopexy w/sig resect 45402
|
$2,220.60 |
$2,220.60 |
$2,220.60 |
$3,351.48
|
|
Lap removal of rectum w/colostomy 45395
|
$3,786.60 |
$3,786.60 |
$3,786.60 |
$4,880.80
|
|
Lap resect s/intestine addl 44203
|
$487.20 |
$487.20 |
$487.20 |
$516.78
|
|
Lap revision perm ip cath
|
$793.20 |
$793.20 |
$793.20 |
$6,904.15
|
|
Lap rmvl gastr adj all parts
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$4,502.13
|
|
Laps esophgl sphnctr agmntj 43284
|
$969.00 |
$969.00 |
$969.00 |
$10,500.26
|
|
Lap sleeve gastrectomy
|
$2,071.80 |
$2,071.80 |
$2,071.80 |
$2,733.60
|
|
Lap tot proctocolectomy 44210
|
$3,798.00 |
$3,798.00 |
$3,798.00 |
$3,798.00
|
|
Lapt stg/restg ovarian tubal/prim mal 2nd 58960
|
$1,803.00 |
$1,803.00 |
$1,803.00 |
$1,803.00
|
|
Lap vent/abd hernia repair 49652
|
$1,348.80 |
$1,348.80 |
$1,348.80 |
$7,349.98
|
|
Lap vent/abd hern proc comp 49653
|
$1,683.60 |
$1,683.60 |
$1,683.60 |
$7,777.76
|
|
Lap w/omentopexy add-on 49326
|
$408.00 |
$408.00 |
$408.00 |
$463.20
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$531.00 |
$531.00 |
$531.00 |
$740.40
|
|
Laryngoscope w/vc inj
|
$667.20 |
$667.20 |
$667.20 |
$4,108.00
|
|
Laryngoscop w/vc inj + scope
|
$514.80 |
$514.80 |
$514.80 |
$4,539.60
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$492.60 |
$492.60 |
$492.60 |
$2,514.60
|
