|
Leg CT Scan (with contrast, both legs)
|
$1,297.60 |
$1,960.00 |
$3,251.40 |
|
|
Leg CT Scan (without contrast, both legs)
|
$1,033.85 |
$1,382.10 |
$1,876.10 |
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,056.85 |
$1,344.30 |
$1,948.15 |
|
|
Leishmania antibody
|
$30.65 |
$30.65 |
$88.85 |
|
|
Lens, intraocular (new tech)
|
$175.00 |
$175.00 |
$175.00 |
|
|
Lens iol ant bicnvx 24.0 multi
|
$150.00 |
$295.00 |
$595.00 |
|
|
Lens iol ant chamb 10.5
|
$134.00 |
$150.00 |
$150.00 |
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$105.67 |
$201.49 |
$858.86 |
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$3,323.44 |
$16,948.42 |
$39,167.12 |
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$12,902.17 |
$14,222.76 |
$39,531.24 |
|
|
Lev 1 hosp type b ed visit
|
$140.35 |
$140.35 |
$152.55 |
|
|
Lev 2 hosp type b ed visit
|
$195.90 |
$195.90 |
$253.75 |
|
|
Lev 3 hosp type b ed visit
|
$345.40 |
$345.40 |
$421.15 |
|
|
Lev 4 hosp type b ed visit
|
$456.60 |
$456.60 |
$701.80 |
|
|
Lev 5 hosp type b ed visit
|
$677.90 |
$677.90 |
$1,052.75 |
|
|
Levalbuterol non-comp unit
|
$1.05 |
$1.05 |
$1.05 |
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$108.30 |
$231.78 |
$390.39 |
|
|
Levetiracetam therapeutic drug level
|
$4.40 |
$173.45 |
$362.50 |
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$14.79 |
$38.33 |
$182.33 |
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$312.82 |
$549.10 |
$1,174.69 |
|
|
Liberta rc ipg
|
$10,734.00 |
$10,734.00 |
$10,734.00 |
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$30.31 |
$59.39 |
$316.18 |
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$35.26 |
$49.28 |
$176.40 |
|
|
Lidocaine therapeutic drug level
|
$97.50 |
$97.50 |
$97.50 |
|
|
Lift heel adj small gl60404sm
|
$53.10 |
$53.10 |
$53.10 |
|
|
Ligation/biopsy of temporal artery 37609
|
$452.75 |
$452.75 |
$3,679.25 |
|
|
Ligation/major artery/extremity 37618
|
$533.10 |
$720.70 |
$9,253.45 |
|
|
Ligation vericose vein cluster(s) 1 leg
|
$290.15 |
$290.15 |
$290.15 |
|
|
Liletta, 52 mg
|
$1,142.59 |
$1,142.59 |
$3,187.92 |
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$241.79 |
$266.85 |
$583.15 |
|
|
Lipase
|
$78.15 |
$99.90 |
$116.05 |
|
|
Lipoprotein blood high res frac & quant
|
$97.45 |
$97.45 |
$168.75 |
|
|
Lipoprotein blood quant
|
$63.10 |
$126.15 |
$279.30 |
|
|
Lipoprotein direct measurement hdl
|
$16.90 |
$93.05 |
$197.00 |
|
|
Lipoprotein direct measurement ldl
|
$86.30 |
$116.10 |
$169.15 |
|
|
Lip surgery procedure
|
$142.60 |
$425.20 |
$3,143.45 |
|
|
Lithium therapeutic drug level
|
$74.15 |
$133.20 |
$139.70 |
|
|
Liver Function Test
|
$92.85 |
$159.35 |
$203.95 |
|
|
Liver imaging
|
$2,295.75 |
$2,295.75 |
$2,295.75 |
|
|
Liver imag w/vasclr flow
|
$1,787.55 |
$3,046.40 |
$5,068.55 |
|
|
Liver/spleen imag static only
|
$1,148.50 |
$1,972.25 |
$2,295.75 |
|
|
Liver/spleen imag w/vasclr flow
|
$1,019.15 |
$1,473.40 |
$2,204.00 |
|
|
Locm 100-199mg/ml iodine,1ml
|
$40.05 |
$40.05 |
$40.05 |
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$7.81 |
$10.97 |
$161.77 |
|
|
Low cost skin substitute app
|
$305.10 |
$305.10 |
$944.85 |
|
|
Low cost skin substitute app
|
$653.30 |
$653.30 |
$2,806.90 |
|
|
Low cost skin substitute app
|
$323.95 |
$323.95 |
$944.85 |
|
|
Low cost skin substitute app
|
$600.00 |
$600.00 |
$944.85 |
|
|
Low cost skin substitute app
|
$59.45 |
$59.45 |
$472.40 |
|
|
Low cost skin substitute app
|
$156.55 |
$156.55 |
$1,926.45 |
|
|
Low cost skin substitute app
|
$65.20 |
$65.20 |
$472.40 |
|
|
Low cost skin substitute app
|
$165.95 |
$165.95 |
$165.95 |
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$178.00 |
$382.45 |
$939.75 |
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,504.65 |
$2,812.75 |
$3,248.75 |
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,310.45 |
$2,049.00 |
$5,227.40 |
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,267.40 |
$1,430.20 |
$2,649.25 |
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,183.30 |
$3,301.70 |
$3,956.45 |
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,854.70 |
$2,133.25 |
$3,136.80 |
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,293.45 |
$1,442.30 |
$2,554.55 |
|
|
Lower Back (Lumbar Spine) X-ray
|
$263.85 |
$473.75 |
$804.45 |
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$268.30 |
$577.60 |
$1,187.75 |
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$622.80 |
$754.45 |
$1,518.35 |
|
|
Lower Leg (Shin) X-ray (both sides)
|
$197.15 |
$332.00 |
$480.40 |
|
|
Lung Function Test Before and After an Inhaler
|
$467.80 |
$530.40 |
$835.45 |
|
|
Lung Function Test (Spirometry)
|
$129.75 |
$224.05 |
$332.00 |
|
|
Lung perfusion imaging
|
$1,171.30 |
$1,599.35 |
$1,889.60 |
|
|
Lurbinectedin 4 mg intravenous solution
|
$19,365.06 |
$19,365.06 |
$21,347.15 |
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$14,835.07 |
$28,886.22 |
$31,842.83 |
|
|
Lymphatics/lymph node imaging
|
$1,930.45 |
$2,286.35 |
$3,944.20 |
|
|
Lymphocyte transformation mitogen
|
$510.95 |
$510.95 |
$510.95 |
|
|
Lymph vessel x-ray arm/leg
|
$1,192.45 |
$1,192.45 |
$1,192.45 |
|
|
Lymph vessel x-ray arms/legs
|
$1,269.75 |
$1,269.75 |
$1,269.75 |
|
|
Lymph vessel x-ray trunk
|
$1,192.45 |
$1,192.45 |
$1,192.45 |
|
|
Lymph vessel x-ray trunk
|
$1,269.75 |
$1,269.75 |
$1,269.75 |
|
|
Macro exam dissect molec study ea
|
$22.95 |
$73.75 |
$118.75 |
|
|
Macroscopic exam arthropod
|
$54.20 |
$54.20 |
$54.20 |
|
|
Macroscopic exam parasite
|
$11.95 |
$33.25 |
$183.60 |
|
|
Magnesium
|
$46.65 |
$76.70 |
$114.65 |
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$17.51 |
$80.31 |
$187.97 |
|
|
Magnetic image bone marrow
|
$2,110.95 |
$2,110.95 |
$2,110.95 |
|
|
Mammosite ced
|
$155.00 |
$155.00 |
$155.00 |
|
|
Mannitol 12.5 gm/50 ml inj
|
$16.12 |
$36.81 |
$42.59 |
|
|
Marker biop eviva buckle ss
|
$111.05 |
$344.40 |
$1,081.85 |
|
|
Marker lymphatic sentimag magtrace 10 vial
|
$1,332.85 |
$1,332.85 |
$1,332.85 |
|
|
Mastoids complete
|
$448.85 |
$456.50 |
$714.60 |
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$32.55 |
$35.65 |
$140.25 |
|
|
Mayo aathr protein s free
|
$80.45 |
$103.20 |
$201.45 |
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$202.00 |
$347.35 |
$611.55 |
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$181.65 |
$201.55 |
$299.50 |
|
|
Mayo alcohol definitive assay volatile screen
|
$90.70 |
$183.60 |
$256.45 |
|
|
Mayo alkaline phosphatase isoenzyme
|
$31.90 |
$78.50 |
$152.10 |
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$96.10 |
$99.00 |
$227.00 |
|
|
Mayo alpha 1 antitrypsin
|
$30.90 |
$105.80 |
$165.35 |
|
|
Mayo amikacin trough therapeutic drug level
|
$69.90 |
$125.05 |
$183.55 |
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$36.70 |
$265.45 |
$284.10 |
|
|
Mayo analysis gene calr common variants exon 9
|
$457.05 |
$645.30 |
$834.35 |
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$330.50 |
$530.45 |
$1,003.30 |
|
|
Mayo analysis gene smn1 dosage/deletion
|
$239.05 |
$460.55 |
$976.90 |
|
|
Mayo analysis microarray cytogenomic copy number/snp variants
|
$1,082.95 |
$3,221.10 |
$7,730.65 |
|
|
Mayo androstenedione
|
$193.70 |
$199.25 |
$274.60 |
|