|
Knee MRI (without contrast)
|
$3,637.20 |
$3,637.20 |
$3,637.20 |
$2,120.00
|
|
Knee X-ray
|
$952.80 |
$952.80 |
$952.80 |
$387.20
|
|
Kras gene variants exon 2
|
$280.80 |
$280.80 |
$280.80 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$50.65 |
$50.65 |
$50.65 |
$13.00
|
|
Lactate dehydrogenase (ldh)
|
$120.00 |
$120.00 |
$120.00 |
$50.55
|
|
Lactated ringers intravenous solution
|
$78.68 |
$78.68 |
$78.68 |
$46.35
|
|
Lactic acid
|
$237.00 |
$237.00 |
$237.00 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$149.40 |
$149.40 |
$149.40 |
$88.40
|
|
Lactoferrin fecal quant
|
$266.40 |
$266.40 |
$266.40 |
$106.10
|
|
Lead capillary
|
$191.40 |
$191.40 |
$191.40 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$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
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$9,502.54 |
$9,502.54 |
$9,502.54 |
$5,001.00
|
|
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
|
$358.80 |
$358.80 |
$358.80 |
$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
|
$247.80 |
$247.80 |
$247.80 |
$82.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$130.49 |
$130.49 |
$130.49 |
$84.28
|
|
Lipase
|
$191.40 |
$191.40 |
$191.40 |
$67.68
|
|
Lipoprotein blood quant
|
$269.40 |
$269.40 |
$269.40 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$196.80 |
$196.80 |
$196.80 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$185.40 |
$185.40 |
$185.40 |
$61.60
|
|
Listeria monocytogenes
|
$95.40 |
$95.40 |
$95.40 |
$60.84
|
|
Lithium therapeutic drug level
|
$208.80 |
$208.80 |
$208.80 |
$62.40
|
|
Liver Function Test
|
$294.00 |
$294.00 |
$294.00 |
$92.85
|
|
Locm 100-199mg/ml iodine,1ml
|
$2.57 |
$2.57 |
$2.57 |
$2.57
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$43.95 |
$43.95 |
$43.95 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,834.40 |
$2,834.40 |
$2,834.40 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,362.80 |
$2,362.80 |
$2,362.80 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,890.00 |
$1,890.00 |
$1,890.00 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,995.20 |
$2,995.20 |
$2,995.20 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,496.60 |
$2,496.60 |
$2,496.60 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,996.80 |
$1,996.80 |
$1,996.80 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$397.80 |
$397.80 |
$397.80 |
$328.23
|
|
L/s ratio fetal lung
|
$318.60 |
$318.60 |
$318.60 |
$173.55
|
|
Lung Function Test (Spirometry)
|
$339.60 |
$339.60 |
$339.60 |
$290.89
|
|
Macroscopic exam arthropod
|
$109.80 |
$109.80 |
$109.80 |
$38.50
|
|
Magnesium
|
$162.00 |
$162.00 |
$162.00 |
$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
|
$149.40 |
$149.40 |
$149.40 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$141.60 |
$141.60 |
$141.60 |
$147.72
|
|
Mannitol 12.5 gm/50 ml inj
|
$40.12 |
$40.12 |
$40.12 |
$33.24
|
|
Marker biop eviva buckle ss
|
$248.40 |
$248.40 |
$248.40 |
$1,126.34
|
|
Mastoids complete
|
$638.40 |
$638.40 |
$638.40 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$211.80 |
$211.80 |
$211.80 |
$76.70
|
|
Mayo aathr protein s free
|
$648.60 |
$648.60 |
$648.60 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$100.26
|
|
Mayo alkaline phosphatase isoenzyme
|
$381.60 |
$381.60 |
$381.60 |
$83.85
|
|
Mayo alpha 1 antitrypsin
|
$312.00 |
$312.00 |
$312.00 |
$91.80
|
|
Mayo amikacin trough therapeutic drug level
|
$251.40 |
$251.40 |
$251.40 |
$112.89
|
|
Mayo analysis gene calr common variants exon 9
|
$607.80 |
$607.80 |
$607.80 |
$517.60
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$688.80 |
$688.80 |
$688.80 |
$343.20
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,842.60 |
$1,842.60 |
$1,842.60 |
$1,922.13
|
|
Mayo androstenedione
|
$221.40 |
$221.40 |
$221.40 |
$131.30
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$334.20 |
$334.20 |
$334.20 |
$86.40
|
|
Mayo antithrombin iii antigen
|
$568.80 |
$568.80 |
$568.80 |
$75.00
|
|
Mayo aspergillus fumigatus antibody
|
$90.00 |
$90.00 |
$90.00 |
$72.60
|
|
Mayo avwpr vw factor activity
|
$325.80 |
$325.80 |
$325.80 |
$159.66
|
|
Mayo bart bartonella henselae antibody igg
|
$212.40 |
$212.40 |
$212.40 |
$52.00
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$324.60 |
$324.60 |
$324.60 |
$364.90
|
|
Mayo blastomyces antibody immunodiffusion
|
$225.60 |
$225.60 |
$225.60 |
$67.60
|
|
Mayo bordetella pertussis antibody igg
|
$185.40 |
$185.40 |
$185.40 |
$59.15
|
|
Mayo brcmg brucella antibody igm
|
$134.40 |
$134.40 |
$134.40 |
$56.80
|
|
Mayo c1 esterase inhibitor
|
$263.40 |
$263.40 |
$263.40 |
$124.80
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$216.00 |
$216.00 |
$216.00 |
$104.55
|
|
Mayo cdcom hla class ii typing low resolution one locus each
|
$192.60 |
$192.60 |
$192.60 |
$274.40
|
|
Mayo ceruloplasmin
|
$246.60 |
$246.60 |
$246.60 |
$70.85
|
|
Mayo chemiluminescent parathyroid related peptide
|
$394.80 |
$394.80 |
$394.80 |
$125.50
|
|
Mayo chikv chikungunya antibodies igg
|
$330.60 |
$330.60 |
$330.60 |
$122.00
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$288.00 |
$288.00 |
$288.00 |
$59.11
|
|
Mayo chlap chlamydia pneumoniae antibody igm
|
$117.00 |
$117.00 |
$117.00 |
$54.40
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$1,440.60 |
$1,440.60 |
$1,440.60 |
$380.40
|
|
Mayo chromium
|
$147.60 |
$147.60 |
$147.60 |
$89.25
|
|
Mayo coccidioides antibody
|
$231.60 |
$231.60 |
$231.60 |
$61.10
|
|
Mayo cocou cortisone urine
|
$438.60 |
$438.60 |
$438.60 |
$222.62
|
|
Mayo cortisol free
|
$351.00 |
$351.00 |
$351.00 |
$109.85
|
|
Mayo covid-19 antibody nucleocapsid total
|
$82.20 |
$82.20 |
$82.20 |
$77.63
|
|
Mayo coxiella brunetii (q fever) igg antibody
|
$153.00 |
$153.00 |
$153.00 |
$67.80
|
|
Mayo cyanide
|
$216.00 |
$216.00 |
$216.00 |
$98.40
|
|
Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual
|
$438.60 |
$438.60 |
$438.60 |
$780.00
|
|
Mayo deoxyribonuclease antibody titer
|
$153.00 |
$153.00 |
$153.00 |
$74.40
|
|
Mayo dhea (dehydroepiandrosterone)
|
$270.00 |
$270.00 |
$270.00 |
$113.10
|
|
Mayo efpo chloride stool
|
$120.00 |
$120.00 |
$120.00 |
$45.00
|
|
Mayo estriol
|
$233.40 |
$233.40 |
$233.40 |
$102.50
|
|
Mayo estrone
|
$313.20 |
$313.20 |
$313.20 |
$105.00
|
|
Mayo ethosuximide therapeutic drug level
|
$214.80 |
$214.80 |
$214.80 |
$81.60
|
|
Mayo factor ii
|
$295.20 |
$295.20 |
$295.20 |
$96.76
|
|
Mayo factor v
|
$450.00 |
$450.00 |
$450.00 |
$119.60
|
|
Mayo factor vii
|
$722.40 |
$722.40 |
$722.40 |
$124.80
|
|
Mayo factor viii vw factor antigen
|
$460.80 |
$460.80 |
$460.80 |
$116.40
|
|
Mayo factor viii vw factor multimetric analysis
|
$361.80 |
$361.80 |
$361.80 |
$147.63
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$345.00 |
$345.00 |
$345.00 |
$133.25
|
|
Mayo factor x
|
$492.60 |
$492.60 |
$492.60 |
$130.65
|
|
Mayo factor xi
|
$320.40 |
$320.40 |
$320.40 |
$120.96
|
|
Mayo fat/lipids feces quantitative
|
$233.40 |
$233.40 |
$233.40 |
$76.05
|
