|
Knee MRI (with and without contrast)
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$2,120.00
|
|
Knee X-ray
|
$523.20 |
$523.20 |
$523.20 |
$387.20
|
|
Kras gene addl variants
|
$271.20 |
$271.20 |
$271.20 |
$366.56
|
|
Kras gene variants exon 2
|
$385.80 |
$385.80 |
$385.80 |
$495.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$345.00 |
$345.00 |
$345.00 |
$102.70
|
|
Lab draw <3 yrs scalp vein 36405
|
$345.00 |
$345.00 |
$345.00 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$50.65 |
$50.65 |
$50.65 |
$13.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$130.51 |
$130.51 |
$130.51 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$108.00 |
$108.00 |
$108.00 |
$50.55
|
|
Lactated ringers intravenous solution
|
$78.68 |
$78.68 |
$78.68 |
$46.35
|
|
Lactic acid
|
$201.60 |
$201.60 |
$201.60 |
$85.20
|
|
Lactoferrin fecal quant
|
$254.40 |
$254.40 |
$254.40 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,343.00 |
$14,343.00 |
$14,343.00 |
$21,470.76
|
|
Lead capillary
|
$100.20 |
$100.20 |
$100.20 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,894.80 |
$1,894.80 |
$1,894.80 |
$1,053.00
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$609.00 |
$609.00 |
$609.00 |
$609.00
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,719.00 |
$1,719.00 |
$1,719.00 |
$1,136.25
|
|
Lens iol ant chamb 10.5
|
$527.40 |
$527.40 |
$527.40 |
$191.25
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$164.09 |
$164.09 |
$164.09 |
$115.27
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$9,320.28 |
$9,320.28 |
$9,320.28 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$7,821.38 |
$7,821.38 |
$7,821.38 |
$4,308.91
|
|
Levalbuterol non-comp unit
|
$20.15 |
$20.15 |
$20.15 |
$20.15
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$172.48 |
$172.48 |
$172.48 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$283.20 |
$283.20 |
$283.20 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$64.88 |
$64.88 |
$64.88 |
$43.61
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$665.44 |
$665.44 |
$665.44 |
$343.13
|
|
Lidocaine therapeutic drug level
|
$198.60 |
$198.60 |
$198.60 |
$82.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$130.49 |
$130.49 |
$130.49 |
$84.28
|
|
Lipase
|
$166.80 |
$166.80 |
$166.80 |
$67.68
|
|
Lipoprotein blood quant
|
$229.80 |
$229.80 |
$229.80 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$148.80 |
$148.80 |
$148.80 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$93.00 |
$93.00 |
$93.00 |
$61.60
|
|
Lithium therapeutic drug level
|
$175.20 |
$175.20 |
$175.20 |
$62.40
|
|
Liver Function Test
|
$107.40 |
$107.40 |
$107.40 |
$92.85
|
|
Liver/spleen imag static only
|
$1,882.20 |
$1,882.20 |
$1,882.20 |
$1,135.20
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$261.04 |
$261.04 |
$261.04 |
$37.37
|
|
Low cost skin substitute app
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$879.60
|
|
Low cost skin substitute app
|
$3,895.20 |
$3,895.20 |
$3,895.20 |
$2,147.57
|
|
Low cost skin substitute app
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$879.60
|
|
Low cost skin substitute app
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$1,214.40
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$240.00 |
$240.00 |
$240.00 |
$328.23
|
|
Lung Function Test (Spirometry)
|
$694.20 |
$694.20 |
$694.20 |
$290.89
|
|
Lung perfusion imaging
|
$1,588.20 |
$1,588.20 |
$1,588.20 |
$919.75
|
|
Lurbinectedin 4 mg intravenous solution
|
$298.13 |
$298.13 |
$298.13 |
$298.13
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$237.20 |
$237.20 |
$237.20 |
$68.76
|
|
Lutetium lu 177 vipivotide
|
$365.28 |
$365.28 |
$365.28 |
$332.80
|
|
Lymphatics/lymph node imaging
|
$2,064.00 |
$2,064.00 |
$2,064.00 |
$1,330.00
|
|
Macroscopic exam arthropod
|
$88.80 |
$88.80 |
$88.80 |
$38.50
|
|
Magnesium
|
$122.40 |
$122.40 |
$122.40 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$118.81 |
$118.81 |
$118.81 |
$39.81
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$151.80 |
$151.80 |
$151.80 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$131.40 |
$131.40 |
$131.40 |
$147.72
|
|
Mannitol 12.5 gm/50 ml inj
|
$40.12 |
$40.12 |
$40.12 |
$33.24
|
|
Marker biop eviva buckle ss
|
$205.80 |
$205.80 |
$205.80 |
$1,126.34
|
|
Mastoids complete
|
$390.00 |
$390.00 |
$390.00 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$292.80 |
$292.80 |
$292.80 |
$76.70
|
|
Mayo aathr protein s free
|
$304.80 |
$304.80 |
$304.80 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$510.60 |
$510.60 |
$510.60 |
$100.26
|
|
Mayo alkaline phosphatase isoenzyme
|
$197.40 |
$197.40 |
$197.40 |
$83.85
|
|
Mayo alpha 1 antitrypsin
|
$252.00 |
$252.00 |
$252.00 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$234.60 |
$234.60 |
$234.60 |
$112.89
|
|
Mayo analysis gene calr common variants exon 9
|
$546.60 |
$546.60 |
$546.60 |
$517.60
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$643.80 |
$643.80 |
$643.80 |
$343.20
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,112.00 |
$2,112.00 |
$2,112.00 |
$1,922.13
|
|
Mayo androstenedione
|
$347.40 |
$347.40 |
$347.40 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$302.40 |
$302.40 |
$302.40 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$499.20 |
$499.20 |
$499.20 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$151.80 |
$151.80 |
$151.80 |
$72.60
|
|
Mayo avwpr vw factor activity
|
$344.40 |
$344.40 |
$344.40 |
$159.66
|
|
Mayo bart bartonella henselae antibody igg
|
$112.80 |
$112.80 |
$112.80 |
$52.00
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$447.00 |
$447.00 |
$447.00 |
$364.90
|
|
Mayo blastomyces antibody immunodiffusion
|
$160.80 |
$160.80 |
$160.80 |
$67.60
|
|
Mayo bordetella pertussis antibody igg
|
$30.60 |
$30.60 |
$30.60 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$43.20 |
$43.20 |
$43.20 |
$56.80
|
|
Mayo c1 esterase inhibitor
|
$201.60 |
$201.60 |
$201.60 |
$124.80
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$266.40 |
$266.40 |
$266.40 |
$104.55
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$191.40 |
$191.40 |
$191.40 |
$274.40
|
|
Mayo ceruloplasmin
|
$223.80 |
$223.80 |
$223.80 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$174.00 |
$174.00 |
$174.00 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$281.40 |
$281.40 |
$281.40 |
$122.00
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$30.60 |
$30.60 |
$30.60 |
$59.11
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$30.60 |
$30.60 |
$30.60 |
$54.40
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$1,697.40 |
$1,697.40 |
$1,697.40 |
$380.40
|
|
Mayo chromium
|
$181.20 |
$181.20 |
$181.20 |
$89.25
|
|
Mayo coccidioides antibody
|
$154.80 |
$154.80 |
$154.80 |
$61.10
|
|
Mayo cocou cortisone urine
|
$301.20 |
$301.20 |
$301.20 |
$222.62
|
|
Mayo cortisol free
|
$306.00 |
$306.00 |
$306.00 |
$109.85
|
|
Mayo covid-19 antibody nucleocapsid total
|
$81.60 |
$81.60 |
$81.60 |
$77.63
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$49.80 |
$49.80 |
$49.80 |
$67.80
|
|
Mayo cyanide
|
$165.00 |
$165.00 |
$165.00 |
$98.40
|
|
Mayo deoxyribonuclease antibody titer
|
$148.20 |
$148.20 |
$148.20 |
$74.40
|
|
Mayo dhea (dehydroepiandrosterone)
|
$284.40 |
$284.40 |
$284.40 |
$113.10
|
