|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$368.40 |
$368.40 |
$368.40 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$576.00 |
$576.00 |
$576.00 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$116,523.60 |
$116,523.60 |
$116,523.60 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$648.00 |
$648.00 |
$648.00 |
$163.87
|
|
Iron
|
$133.20 |
$133.20 |
$133.20 |
$74.40
|
|
Iron binding capacity
|
$118.80 |
$118.80 |
$118.80 |
$63.79
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$321.00 |
$321.00 |
$321.00 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$86.40 |
$86.40 |
$86.40 |
$142.20
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$86.40 |
$86.40 |
$86.40 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$289.20 |
$289.20 |
$289.20 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$55.20 |
$55.20 |
$55.20 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$363.00 |
$363.00 |
$363.00 |
$439.56
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$234.00 |
$234.00 |
$234.00 |
$60.20
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$18.00 |
$18.00 |
$18.00 |
$23.50
|
|
Kidney imag w/bld flow multi
|
$1,695.00 |
$1,695.00 |
$1,695.00 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,539.60 |
$1,539.60 |
$1,539.60 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$538.20 |
$538.20 |
$538.20 |
$666.00
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$923.90 |
$923.90 |
$923.90 |
$740.00
|
|
Knee MRI (with and without contrast)
|
$3,763.20 |
$3,763.20 |
$3,763.20 |
$3,034.80
|
|
Knee MRI (without contrast)
|
$3,517.20 |
$3,517.20 |
$3,517.20 |
$2,169.60
|
|
Knee X-ray
|
$732.60 |
$732.60 |
$732.60 |
$425.55
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$33.60 |
$33.60 |
$33.60 |
$32.34
|
|
Lactate dehydrogenase (ldh)
|
$85.20 |
$85.20 |
$85.20 |
$55.50
|
|
Lactated ringers intravenous solution
|
$21.00 |
$21.00 |
$21.00 |
$45.56
|
|
Lactic acid
|
$48.00 |
$48.00 |
$48.00 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$276.00 |
$276.00 |
$276.00 |
$80.40
|
|
Lactoferrin fecal quant
|
$82.80 |
$82.80 |
$82.80 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$24,168.60 |
$24,168.60 |
$24,168.60 |
$19,124.00
|
|
Lead capillary
|
$161.40 |
$161.40 |
$161.40 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$957.60 |
$957.60 |
$957.60 |
$1,088.26
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,499.40 |
$1,499.40 |
$1,499.40 |
$1,065.00
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$274.80 |
$274.80 |
$274.80 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$32,536.80 |
$32,536.80 |
$32,536.80 |
$7,052.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$12,801.00 |
$12,801.00 |
$12,801.00 |
$9,107.80
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$27.00 |
$27.00 |
$27.00 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$160.20 |
$160.20 |
$160.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$39.00 |
$39.00 |
$39.00 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$814.80 |
$814.80 |
$814.80 |
$385.62
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$14.70 |
$14.70 |
$14.70 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$27.30 |
$27.30 |
$27.30 |
$39.37
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$135.60 |
$135.60 |
$135.60 |
$125.66
|
|
Lipase
|
$164.40 |
$164.40 |
$164.40 |
$93.58
|
|
Lipoprotein blood quant
|
$85.20 |
$85.20 |
$85.20 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$97.80 |
$97.80 |
$97.80 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$112.80 |
$112.80 |
$112.80 |
$61.60
|
|
Lithium therapeutic drug level
|
$115.20 |
$115.20 |
$115.20 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$145.80 |
$145.80 |
$145.80 |
$340.00
|
|
Liver Function Test
|
$178.80 |
$178.80 |
$178.80 |
$115.44
|
|
Liver/spleen imag static only
|
$1,539.60 |
$1,539.60 |
$1,539.60 |
$1,123.50
|
|
Liver/spleen imag w/vasclr flow
|
$1,612.20 |
$1,612.20 |
$1,612.20 |
$1,067.48
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$4.20 |
$4.20 |
$4.20 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,442.80 |
$3,442.80 |
$3,442.80 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,910.60 |
$2,910.60 |
$2,910.60 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,389.20 |
$2,389.20 |
$2,389.20 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,315.80 |
$4,315.80 |
$4,315.80 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,509.40 |
$3,509.40 |
$3,509.40 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$349.80 |
$349.80 |
$349.80 |
$352.32
|
|
Lung Function Test (Spirometry)
|
$198.60 |
$198.60 |
$198.60 |
$295.35
|
|
Lung perfusion imaging
|
$801.60 |
$801.60 |
$801.60 |
$1,075.25
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$36,126.00 |
$36,126.00 |
$36,126.00 |
$21,867.91
|
|
Lymphatics/lymph node imaging
|
$852.00 |
$852.00 |
$852.00 |
$1,448.00
|
|
Macroscopic exam parasite
|
$28.80 |
$28.80 |
$28.80 |
$36.40
|
|
Magnesium
|
$473.40 |
$473.40 |
$473.40 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$28.20 |
$28.20 |
$28.20 |
$58.70
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$91.80 |
$91.80 |
$91.80 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$105.00 |
$105.00 |
$105.00 |
$152.54
|
|
Marker biop eviva buckle ss
|
$132.26 |
$132.26 |
$132.26 |
$1,152.48
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$82.79 |
$82.79 |
$82.79 |
$5,065.63
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$27.60 |
$27.60 |
$27.60 |
$66.36
|
|
Mayo aathr protein s free
|
$198.00 |
$198.00 |
$198.00 |
$130.08
|
|
Mayo activated protein c resistance assay
|
$238.80 |
$238.80 |
$238.80 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$161.40 |
$161.40 |
$161.40 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$330.60 |
$330.60 |
$330.60 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$93.60 |
$93.60 |
$93.60 |
$82.80
|
|
Mayo analysis gene calr common variants exon 9
|
$1,233.60 |
$1,233.60 |
$1,233.60 |
$467.61
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$277.20 |
$277.20 |
$277.20 |
$359.00
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$2,297.40 |
$2,297.40 |
$2,297.40 |
$1,860.00
|
|
Mayo androstenedione
|
$336.00 |
$336.00 |
$336.00 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$250.80 |
$250.80 |
$250.80 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$127.20 |
$127.20 |
$127.20 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$27.60 |
$27.60 |
$27.60 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$516.60 |
$516.60 |
$516.60 |
$165.78
|
|
Mayo bart bartonella henselae antibody igg
|
$87.60 |
$87.60 |
$87.60 |
$45.50
|
|
Mayo blastomyces antibody immunodiffusion
|
$95.40 |
$95.40 |
$95.40 |
$57.85
|
|
Mayo bordetella pertussis antibody igg
|
$160.20 |
$160.20 |
$160.20 |
$69.00
|
|
Mayo c1 esterase inhibitor
|
$18.00 |
$18.00 |
$18.00 |
$85.00
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$37.20 |
$37.20 |
$37.20 |
$82.68
|
|
Mayo ceruloplasmin
|
$198.00 |
$198.00 |
$198.00 |
$69.60
|
|
Mayo chemiluminescent parathyroid related peptide
|
$266.40 |
$266.40 |
$266.40 |
$113.88
|
|
Mayo chikv chikungunya antibodies igg
|
$112.80 |
$112.80 |
$112.80 |
$109.20
|
|
Mayo chlap chlamydia pneumoniae antibody igg
|
$39.00 |
$39.00 |
$39.00 |
$53.30
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$1,348.20 |
$1,348.20 |
$1,348.20 |
$346.32
|
|
Mayo chromium
|
$229.80 |
$229.80 |
$229.80 |
$70.85
|
|
Mayo coccidioides antibody
|
$79.20 |
$79.20 |
$79.20 |
$55.20
|
|
Mayo cocou cortisone urine
|
$891.60 |
$891.60 |
$891.60 |
$207.26
|
|
Mayo cortisol free
|
$73.80 |
$73.80 |
$73.80 |
$94.95
|
|
Mayo covid-19 antibody nucleocapsid total
|
$96.00 |
$96.00 |
$96.00 |
$70.20
|
|
Mayo deoxyribonuclease antibody titer
|
$27.00 |
$27.00 |
$27.00 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$184.20 |
$184.20 |
$184.20 |
$113.10
|