|
Lo sag rig pnl stays pre cst
|
$85.20 |
$85.20 |
$184.32 |
|
|
Loudness balance test
|
$93.60 |
$93.60 |
$93.60 |
|
|
Low back disk surgery
|
$2,107.80 |
$46,123.32 |
$53,118.92 |
|
|
Low cost skin substitute app
|
$594.55 |
$1,207.50 |
$2,502.72 |
|
|
Low cost skin substitute app
|
$1,975.68 |
$2,600.00 |
$5,344.56 |
|
|
Low cost skin substitute app
|
$552.20 |
$1,030.00 |
$2,969.40 |
|
|
Low cost skin substitute app
|
$1,030.00 |
$1,030.00 |
$1,595.52 |
|
|
Low cost skin substitute app
|
$248.40 |
$515.00 |
$1,210.30 |
|
|
Low cost skin substitute app
|
$650.00 |
$650.00 |
$3,416.40 |
|
|
Low cost skin substitute app
|
$248.40 |
$515.00 |
$3,444.00 |
|
|
Low cost skin substitute app
|
$515.00 |
$515.00 |
$1,019.52 |
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$37.29 |
$248.40 |
$781.20 |
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$750.00 |
$2,729.65 |
$5,317.92 |
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$700.00 |
$2,446.20 |
$4,254.48 |
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$500.28 |
$2,161.16 |
$3,577.20 |
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,350.00 |
$4,119.60 |
$6,309.36 |
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,275.60 |
$3,435.60 |
$5,068.80 |
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,125.00 |
$2,997.60 |
$4,771.20 |
|
|
Lower Back (Lumbar Spine) X-ray
|
$127.50 |
$471.20 |
$688.32 |
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$150.00 |
$562.80 |
$931.68 |
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$175.00 |
$635.00 |
$1,169.00 |
|
|
Lower jaw bone graft
|
$10,059.20 |
$10,059.20 |
$10,059.20 |
|
|
Lower Leg (Shin) X-ray (both sides)
|
$53.13 |
$426.60 |
$873.60 |
|
|
Low frequency non-thermal Ultrasound
|
$137.50 |
$371.20 |
$728.00 |
|
|
Lsh uterus 250 g or less
|
$1,679.40 |
$1,679.40 |
$51,380.38 |
|
|
Lsh uterus above 250 g
|
$1,907.40 |
$1,907.40 |
$2,100.00 |
|
|
Lsh w/t/o ut 250 g or less
|
$1,875.60 |
$50,804.79 |
$81,843.16 |
|
|
Lsh w/t/o uterus above 250 g
|
$2,064.60 |
$2,262.40 |
$95,189.07 |
|
|
Lso flex no ri stays pre ots
|
$75.60 |
$255.50 |
$1,246.00 |
|
|
Lso full corset
|
$1,405.60 |
$1,405.60 |
$1,405.60 |
|
|
Lso s/c shell/panel custom
|
$10,573.50 |
$10,573.50 |
$10,573.50 |
|
|
L/s ratio fetal lung
|
$55.20 |
$672.70 |
$672.70 |
|
|
Lumbar diskogram s&i
|
$1,230.00 |
$3,420.00 |
$6,103.20 |
|
|
Lumbar Spinal Fusion (single level)
|
$2,995.20 |
$2,995.20 |
$3,842.40 |
|
|
Lumizyme injection
|
$216.00 |
$740.59 |
$1,789.05 |
|
|
Lung Function Test Before and After an Inhaler
|
$200.00 |
$560.00 |
$1,471.40 |
|
|
Lung function test (mbc/mvv)
|
$37.50 |
$123.00 |
$508.20 |
|
|
Lung Function Test (Spirometry)
|
$72.50 |
$307.50 |
$739.20 |
|
|
Lung perfusion imaging
|
$433.75 |
$1,120.80 |
$2,243.52 |
|
|
Lung volume reduction 32491
|
$2,248.20 |
$2,248.20 |
$2,248.20 |
|
|
Lurbinectedin 4 mg intravenous solution
|
$311.01 |
$6,431.90 |
$51,657.20 |
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$88.79 |
$8,985.14 |
$77,340.72 |
|
|
Lutetium lu 177 dotatat ther
|
$347.50 |
$923.30 |
$165,072.07 |
|
|
Lutetium lu 177 vipivotide
|
$267.50 |
$526.40 |
$134,422.30 |
|
|
Lvad shower bag heartmate
|
$536.91 |
$536.91 |
$2,292.00 |
|
|
Lw ntsty Ultrasound stimj bone healg
|
$132.00 |
$132.00 |
$132.00 |
|
|
Lyme dis dna dir probe
|
$50.40 |
$50.40 |
$50.40 |
|
|
Lymphadenect/stage/pelv/paraaortic 38562
|
$1,335.60 |
$1,335.60 |
$1,748.00 |
|
|
Lymphatics/lymph node imaging
|
$339.00 |
$1,411.80 |
$3,181.68 |
|
|
Lymphocyte culture mixed
|
$92.00 |
$92.00 |
$92.00 |
|
|
Lymphocyte transformation mitogen
|
$123.20 |
$704.90 |
$1,796.40 |
|
|
Lymphocytotoxicity assay
|
$239.04 |
$255.00 |
$379.20 |
|
|
Lymphocytotoxicity assay
|
$120.00 |
$120.00 |
$120.00 |
|
|
Lymph vessel x-ray arm/leg
|
$367.62 |
$1,558.20 |
$1,558.20 |
|
|
Lymph vessel x-ray arms/legs
|
$549.12 |
$1,635.90 |
$2,390.00 |
|
|
Lymph vessel x-ray trunk
|
$549.12 |
$898.10 |
$4,700.00 |
|
|
Lymph vessel x-ray trunk
|
$1,681.35 |
$2,283.40 |
$5,833.20 |
|
|
Lysis intranasal synechia 30560
|
$526.80 |
$714.40 |
$50,143.09 |
|
|
Lysis of labial adhesions
|
$281.40 |
$4,480.80 |
$16,021.80 |
|
|
Lysis penil circumic lesion
|
$511.20 |
$2,123.40 |
$14,835.09 |
|
|
Macro exam dissect molec study ea
|
$47.19 |
$77.60 |
$43,504.85 |
|
|
Macroscopic exam arthropod
|
$33.84 |
$77.50 |
$203.00 |
|
|
Macroscopic exam parasite
|
$13.86 |
$67.50 |
$215.28 |
|
|
Magnesium
|
$31.25 |
$81.20 |
$336.00 |
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$16.38 |
$32.76 |
$319.37 |
|
|
Magnetic image bone marrow
|
$880.80 |
$2,445.00 |
$4,920.60 |
|
|
Makena, 10 mg
|
$35.20 |
$428.82 |
$6,123.06 |
|
|
Malaria antibody
|
$48.57 |
$115.80 |
$121.80 |
|
|
Male sling procedure
|
$1,900.80 |
$78,636.66 |
$78,636.66 |
|
|
Mammosite ced
|
$105.00 |
$105.00 |
$105.00 |
|
|
Management of liver hemorrhage 47361
|
$4,383.00 |
$4,383.00 |
$7,440.00 |
|
|
Manipulate finger w/anesth
|
$507.60 |
$507.60 |
$1,675.20 |
|
|
Manipulate wrist w/anesthes
|
$613.80 |
$613.80 |
$2,084.80 |
|
|
Manipulation of hip joint
|
$410.40 |
$410.40 |
$449.60 |
|
|
Manipulation of spine
|
$320.80 |
$320.80 |
$320.80 |
|
|
Manipulat palm cord post inj
|
$521.60 |
$521.60 |
$521.60 |
|
|
Mannitol 12.5 gm/50 ml inj
|
$3.95 |
$17.29 |
$211.68 |
|
|
Man's shoe oxford brace
|
$188.80 |
$188.80 |
$188.80 |
|
|
Manual diff wbc count b-coat
|
$11.20 |
$20.00 |
$56.16 |
|
|
Mapping functional cort/subcort ea add'l hr
|
$250.14 |
$1,629.60 |
$2,458.80 |
|
|
Mapping io sentinel lymph node
|
$256.80 |
$47,754.03 |
$56,918.55 |
|
|
Map tachycard site(s)
|
$1,425.00 |
$5,115.00 |
$8,255.80 |
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$95.53 |
$381.98 |
$24,904.25 |
|
|
Marker biop eviva buckle ss
|
$71.28 |
$949.46 |
$7,744.32 |
|
|
Marsupialization liver lesion 47300
|
$2,128.20 |
$2,128.20 |
$61,961.25 |
|
|
Mastectomy form
|
$221.04 |
$221.04 |
$221.04 |
|
|
Mastectomy partial
|
$1,211.40 |
$1,211.40 |
$3,208.00 |
|
|
Mast mod rad
|
$2,229.60 |
$2,229.60 |
$5,886.40 |
|
|
Mastoidectomy
|
$3,524.80 |
$60,513.96 |
$60,513.96 |
|
|
Mastoidectomy complete 69502
|
$1,909.80 |
$4,686.40 |
$64,770.17 |
|
|
Mastoids complete
|
$79.86 |
$531.30 |
$1,455.20 |
|
|
Mastoid surgery revision
|
$6,180.80 |
$60,828.29 |
$60,828.29 |
|
|
Mastopexy
|
$1,756.80 |
$3,820.80 |
$6,679.75 |
|
|
Mast radical
|
$5,561.60 |
$5,561.60 |
$5,561.60 |
|
|
Mast rad urban type
|
$5,900.80 |
$5,900.80 |
$5,900.80 |
|
|
Mast simple complete
|
$1,876.80 |
$1,876.80 |
$4,684.80 |
|
|
Matrion 1 sq cm
|
$162.00 |
$162.00 |
$162.00 |
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$5,442.13 |
$9,288.00 |
$26,172.52 |
|
|
M.avium-intra dna amp prob
|
$88.80 |
$175.00 |
$272.16 |
|
|
M.avium-intra dna dir prob
|
$58.40 |
$58.40 |
$58.40 |
|
