|
IV Fluids (first hour)
|
$415.80 |
$415.80 |
$415.80 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$220.80 |
$220.80 |
$220.80 |
$162.68
|
|
IV inj ra drug dx study
|
$368.40 |
$368.40 |
$368.40 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$214.80 |
$214.80 |
$214.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$147.00 |
$147.00 |
$147.00 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$525.00 |
$525.00 |
$525.00 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$211.80 |
$211.80 |
$211.80 |
$167.50
|
|
IV Push Injection (first drug)
|
$303.60 |
$303.60 |
$303.60 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$281.40 |
$281.40 |
$281.40 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$197.51 |
$197.51 |
$197.51 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$333.60 |
$333.60 |
$333.60 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$281.40 |
$281.40 |
$281.40 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$281.40 |
$281.40 |
$281.40 |
$362.05
|
|
John cunningham antibody
|
$970.80 |
$970.80 |
$970.80 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$94.20 |
$94.20 |
$94.20 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$39.01 |
$39.01 |
$39.01 |
$23.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,600.20 |
$1,600.20 |
$1,600.20 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$523.80 |
$523.80 |
$523.80 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$523.80 |
$523.80 |
$523.80 |
$490.75
|
|
Kit sound processor cochlear osia 2
|
$18,128.40 |
$18,128.40 |
$18,128.40 |
$8,425.00
|
|
Knee MRI (with and without contrast)
|
$4,352.40 |
$4,352.40 |
$4,352.40 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,179.00 |
$1,179.00 |
$1,179.00 |
$2,130.88
|
|
Knee X-ray
|
$310.80 |
$310.80 |
$310.80 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$562.80 |
$562.80 |
$562.80 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$281.40 |
$281.40 |
$281.40 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$281.40 |
$281.40 |
$281.40 |
$251.20
|
|
Kras gene addl variants
|
$364.20 |
$364.20 |
$364.20 |
$387.20
|
|
Kras gene variants exon 2
|
$392.40 |
$392.40 |
$392.40 |
$536.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$50.65 |
$50.65 |
$50.65 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$196.60 |
$196.60 |
$196.60 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$60.00 |
$60.00 |
$60.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$85.20 |
$85.20 |
$85.20 |
$43.74
|
|
Lactic acid
|
$109.80 |
$109.80 |
$109.80 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$59.40 |
$59.40 |
$59.40 |
$82.16
|
|
Lactoferrin fecal quant
|
$522.60 |
$522.60 |
$522.60 |
$108.93
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,343.00 |
$14,343.00 |
$14,343.00 |
$19,124.00
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$901.80 |
$901.80 |
$901.80 |
$740.40
|
|
Laryngoscopy telescopic
|
$2,118.60 |
$2,118.60 |
$2,118.60 |
$852.80
|
|
Lead capillary
|
$102.00 |
$102.00 |
$102.00 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,173.60 |
$1,173.60 |
$1,173.60 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$968.40 |
$968.40 |
$968.40 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,381.20 |
$1,381.20 |
$1,381.20 |
$1,092.58
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$639.00 |
$639.00 |
$639.00 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,886.40 |
$1,886.40 |
$1,886.40 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$1,164.60 |
$1,164.60 |
$1,164.60 |
$377.71
|
|
Lepirudin
|
$1,259.22 |
$1,259.22 |
$1,259.22 |
$1,259.22
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$310.43 |
$310.43 |
$310.43 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$10,015.55 |
$10,015.55 |
$10,015.55 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$7,821.38 |
$7,821.38 |
$7,821.38 |
$8,348.12
|
|
Leuprolide acetate injeciton
|
$1,346.20 |
$1,346.20 |
$1,346.20 |
$1,322.50
|
|
Levalbuterol non-comp unit
|
$20.15 |
$20.15 |
$20.15 |
$6.48
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$124.96 |
$124.96 |
$124.96 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$88.80 |
$88.80 |
$88.80 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$64.88 |
$64.88 |
$64.88 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$665.44 |
$665.44 |
$665.44 |
$420.60
|
|
L hrt cath chd nm/abn nt cnj
|
$10,704.00 |
$10,704.00 |
$10,704.00 |
$6,104.00
|
|
Lidocaine therapeutic drug level
|
$147.60 |
$147.60 |
$147.60 |
$87.45
|
|
Lifileucel til/dose 7.5b-72b snij
|
$23,715.32 |
$23,715.32 |
$23,715.32 |
$30,744.64
|
|
Lincomycin injection
|
$225.14 |
$225.14 |
$225.14 |
$64.31
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$206.92 |
$206.92 |
$206.92 |
$121.00
|
|
Lipase
|
$94.20 |
$94.20 |
$94.20 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$87.00 |
$87.00 |
$87.00 |
$87.00
|
|
Lipoprotein blood quant
|
$130.80 |
$130.80 |
$130.80 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$47.40 |
$47.40 |
$47.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$55.20 |
$55.20 |
$55.20 |
$61.60
|
|
Lithium therapeutic drug level
|
$99.00 |
$99.00 |
$99.00 |
$69.75
|
|
Lithotripsy transluminal coronary percutaneous
|
$11,035.80 |
$11,035.80 |
$11,035.80 |
$4,371.12
|
|
Liver Function Test
|
$37.80 |
$37.80 |
$37.80 |
$115.44
|
|
Liver/spleen imag static only
|
$1,825.20 |
$1,825.20 |
$1,825.20 |
$1,138.55
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$5,840.40 |
$5,840.40 |
$5,840.40 |
$3,878.80
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$383.01 |
$383.01 |
$383.01 |
$62,704.30
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$261.04 |
$261.04 |
$261.04 |
$37.20
|
|
Low cost skin substitute app
|
$1,242.60 |
$1,242.60 |
$1,242.60 |
$933.60
|
|
Low cost skin substitute app
|
$4,545.00 |
$4,545.00 |
$4,545.00 |
$2,164.64
|
|
Low cost skin substitute app
|
$1,242.60 |
$1,242.60 |
$1,242.60 |
$1,012.00
|
|
Low cost skin substitute app
|
$1,356.60 |
$1,356.60 |
$1,356.60 |
$1,016.16
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$885.00 |
$885.00 |
$885.00 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$885.00 |
$885.00 |
$885.00 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,287.00 |
$1,287.00 |
$1,287.00 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$281.40 |
$281.40 |
$281.40 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$310.80 |
$310.80 |
$310.80 |
$505.83
|
|
Lower Leg (Shin) X-ray (both sides)
|
$281.40 |
$281.40 |
$281.40 |
$338.40
|
|
Low frequency non-thermal Ultrasound
|
$184.20 |
$184.20 |
$184.20 |
$364.77
|
|
Lso sc r pos/lat pnl pre cst
|
$1,068.60 |
$1,068.60 |
$1,068.60 |
$577.00
|
|
L/s ratio fetal lung
|
$134.40 |
$134.40 |
$134.40 |
$176.15
|
|
Lumbar diskogram s&i
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$2,358.23
|
|
Lung Function Test Before and After an Inhaler
|
$583.80 |
$583.80 |
$583.80 |
$549.83
|
|
Lung function test (mbc/mvv)
|
$40.20 |
$40.20 |
$40.20 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$330.60 |
$330.60 |
$330.60 |
$296.91
|
|
Lung perfusion imaging
|
$1,133.40 |
$1,133.40 |
$1,133.40 |
$1,069.25
|
|
Lurbinectedin 4 mg intravenous solution
|
$298.13 |
$298.13 |
$298.13 |
$19,182.33
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$237.20 |
$237.20 |
$237.20 |
$22,771.63
|
|
Lutetium lu 177 vipivotide
|
$365.28 |
$365.28 |
$365.28 |
$357.85
|
|
Lymphatics/lymph node imaging
|
$1,207.80 |
$1,207.80 |
$1,207.80 |
$1,491.70
|