|
Intrinsic factor antibody
|
$175.80 |
$175.80 |
$175.80 |
$76.77
|
|
Intro long gi tube
|
$860.40 |
$860.40 |
$860.40 |
$880.75
|
|
Intro long gi tube w/mult fluo
|
$598.80 |
$598.80 |
$598.80 |
$469.00
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$53.60 |
$53.60 |
$53.60 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$261.10 |
$261.10 |
$261.10 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$181.38 |
$181.38 |
$181.38 |
$254.59
|
|
Iron
|
$126.60 |
$126.60 |
$126.60 |
$67.50
|
|
Iron binding capacity
|
$151.80 |
$151.80 |
$151.80 |
$55.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$660.70 |
$660.70 |
$660.70 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$370.80 |
$370.80 |
$370.80 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$252.60 |
$252.60 |
$252.60 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$132.00 |
$132.00 |
$132.00 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$106.80 |
$106.80 |
$106.80 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$132.00 |
$132.00 |
$132.00 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$524.40 |
$524.40 |
$524.40 |
$476.50
|
|
IV inj ra drug dx study
|
$232.80 |
$232.80 |
$232.80 |
$473.22
|
|
Ivp w/wo kub w/wo tomography
|
$838.20 |
$838.20 |
$838.20 |
$687.80
|
|
Ixabepilone 15 mg intravenous solution
|
$197.51 |
$197.51 |
$197.51 |
$189.96
|
|
Jak2 targeted sequence analysis
|
$333.60 |
$333.60 |
$333.60 |
$465.74
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$132.00 |
$132.00 |
$132.00 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$39.01 |
$39.01 |
$39.01 |
$17.11
|
|
Kidney imag w/bld flow multi
|
$2,457.60 |
$2,457.60 |
$2,457.60 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$1,951.80 |
$1,951.80 |
$1,951.80 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$559.80 |
$559.80 |
$559.80 |
$618.54
|
|
Knee MRI (with and without contrast)
|
$3,796.80 |
$3,796.80 |
$3,796.80 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$1,581.60 |
$1,581.60 |
$1,581.60 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$2,532.00 |
$2,532.00 |
$2,532.00 |
$2,120.00
|
|
Knee X-ray
|
$822.00 |
$822.00 |
$822.00 |
$387.20
|
|
Kras gene addl variants
|
$294.00 |
$294.00 |
$294.00 |
$366.56
|
|
Kras gene variants exon 2
|
$259.80 |
$259.80 |
$259.80 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$44.90 |
$44.90 |
$44.90 |
$13.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$130.51 |
$130.51 |
$130.51 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$111.60 |
$111.60 |
$111.60 |
$50.55
|
|
Lactated ringers intravenous solution
|
$78.68 |
$78.68 |
$78.68 |
$46.35
|
|
Lactic acid
|
$207.00 |
$207.00 |
$207.00 |
$85.20
|
|
Lactoferrin fecal quant
|
$206.40 |
$206.40 |
$206.40 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,343.00 |
$14,343.00 |
$14,343.00 |
$21,470.76
|
|
Lead capillary
|
$153.60 |
$153.60 |
$153.60 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,510.20 |
$1,510.20 |
$1,510.20 |
$1,053.00
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$267.00 |
$267.00 |
$267.00 |
$609.00
|
|
Lens iol ant bicnvx 24.0 multi
|
$555.00 |
$555.00 |
$555.00 |
$1,136.25
|
|
Lens iol ant chamb 10.5
|
$438.00 |
$438.00 |
$438.00 |
$191.25
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$164.09 |
$164.09 |
$164.09 |
$115.27
|
|
Leukocyte phagocytosis
|
$198.60 |
$198.60 |
$198.60 |
$92.88
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$9,502.54 |
$9,502.54 |
$9,502.54 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,530.56 |
$2,530.56 |
$2,530.56 |
$4,308.91
|
|
Levalbuterol non-comp unit
|
$20.15 |
$20.15 |
$20.15 |
$20.15
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$63.61 |
$63.61 |
$63.61 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$294.60 |
$294.60 |
$294.60 |
$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
|
$420.60 |
$420.60 |
$420.60 |
$343.13
|
|
Lidocaine therapeutic drug level
|
$227.40 |
$227.40 |
$227.40 |
$82.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$130.49 |
$130.49 |
$130.49 |
$84.28
|
|
Lipase
|
$171.00 |
$171.00 |
$171.00 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$132.00 |
$132.00 |
$132.00 |
$90.60
|
|
Lipoprotein blood quant
|
$303.60 |
$303.60 |
$303.60 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$185.40 |
$185.40 |
$185.40 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$160.80 |
$160.80 |
$160.80 |
$61.60
|
|
Lithium therapeutic drug level
|
$177.60 |
$177.60 |
$177.60 |
$62.40
|
|
Liver Function Test
|
$270.00 |
$270.00 |
$270.00 |
$92.85
|
|
Liver/spleen imag static only
|
$1,792.20 |
$1,792.20 |
$1,792.20 |
$1,135.20
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$41.24 |
$41.24 |
$41.24 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,417.40 |
$2,417.40 |
$2,417.40 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,014.80 |
$2,014.80 |
$2,014.80 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,611.60 |
$1,611.60 |
$1,611.60 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,687.40 |
$2,687.40 |
$2,687.40 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,239.80 |
$2,239.80 |
$2,239.80 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,791.60 |
$1,791.60 |
$1,791.60 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$245.40 |
$245.40 |
$245.40 |
$328.23
|
|
L/s ratio fetal lung
|
$234.00 |
$234.00 |
$234.00 |
$173.55
|
|
Lumbar diskogram s&i
|
$2,056.20 |
$2,056.20 |
$2,056.20 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$457.80 |
$457.80 |
$457.80 |
$290.89
|
|
Lung perfusion imaging
|
$1,340.40 |
$1,340.40 |
$1,340.40 |
$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
|
|
Lymphatics/lymph node imaging
|
$1,969.20 |
$1,969.20 |
$1,969.20 |
$1,330.00
|
|
Macroscopic exam arthropod
|
$91.80 |
$91.80 |
$91.80 |
$38.50
|
|
Macroscopic exam parasite
|
$104.40 |
$104.40 |
$104.40 |
$35.98
|
|
Magnesium
|
$132.00 |
$132.00 |
$132.00 |
$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
|
$151.20 |
$151.20 |
$151.20 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$151.20 |
$151.20 |
$151.20 |
$147.72
|
|
Mannitol 12.5 gm/50 ml inj
|
$40.12 |
$40.12 |
$40.12 |
$33.24
|
|
Marker biop eviva buckle ss
|
$200.40 |
$200.40 |
$200.40 |
$1,126.34
|
|
Mastoids complete
|
$550.80 |
$550.80 |
$550.80 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$358.80 |
$358.80 |
$358.80 |
$76.70
|
|
Mayo aathr protein s free
|
$440.40 |
$440.40 |
$440.40 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$294.00 |
$294.00 |
$294.00 |
$100.26
|
|
Mayo alkaline phosphatase isoenzyme
|
$280.80 |
$280.80 |
$280.80 |
$83.85
|
|
Mayo alpha 1 antitrypsin
|
$258.60 |
$258.60 |
$258.60 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$233.40 |
$233.40 |
$233.40 |
$112.89
|
|
Mayo analysis gene calr common variants exon 9
|
$219.00 |
$219.00 |
$219.00 |
$517.60
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$635.40 |
$635.40 |
$635.40 |
$343.20
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,842.60 |
$1,842.60 |
$1,842.60 |
$1,922.13
|
|
Mayo androstenedione
|
$200.40 |
$200.40 |
$200.40 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$308.40 |
$308.40 |
$308.40 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$513.60 |
$513.60 |
$513.60 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$79.80 |
$79.80 |
$79.80 |
$72.60
|
|
Mayo avwpr vw factor activity
|
$55.80 |
$55.80 |
$55.80 |
$159.66
|
|
Mayo bart bartonella henselae antibody igg
|
$175.80 |
$175.80 |
$175.80 |
$52.00
|