|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$100.00 |
$100.00 |
$100.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$5.19 |
$5.19 |
$5.19 |
$4.06
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$374.60 |
$374.60 |
$374.60 |
$173.98
|
|
Iron
|
$74.40 |
$74.40 |
$74.40 |
$75.00
|
|
Iron binding capacity
|
$74.40 |
$74.40 |
$74.40 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$88.15 |
$88.15 |
$88.15 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$66.40 |
$66.40 |
$66.40 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$237.60 |
$237.60 |
$237.60 |
$146.11
|
|
IV Fluids (each additional hour)
|
$179.20 |
$179.20 |
$179.20 |
$133.90
|
|
IV Fluids (first hour)
|
$596.80 |
$596.80 |
$596.80 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$191.20 |
$191.20 |
$191.20 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$384.00 |
$384.00 |
$384.00 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$244.00 |
$244.00 |
$244.00 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$551.20 |
$551.20 |
$551.20 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$240.80 |
$240.80 |
$240.80 |
$167.50
|
|
IV Push Injection (first drug)
|
$374.40 |
$374.40 |
$374.40 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$1,248.80 |
$1,248.80 |
$1,248.80 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$486.40 |
$486.40 |
$486.40 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$540.00 |
$540.00 |
$540.00 |
$362.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$97.60 |
$97.60 |
$97.60 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$62.36 |
$62.36 |
$62.36 |
$23.52
|
|
Kidney function study
|
$1,944.80 |
$1,944.80 |
$1,944.80 |
$935.22
|
|
Kidney imag w/bld flow multi
|
$2,884.80 |
$2,884.80 |
$2,884.80 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$2,041.60 |
$2,041.60 |
$2,041.60 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$996.80 |
$996.80 |
$996.80 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$728.80 |
$728.80 |
$728.80 |
$490.75
|
|
Knee MRI (with and without contrast)
|
$4,088.00 |
$4,088.00 |
$4,088.00 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,437.60 |
$3,437.60 |
$3,437.60 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,818.40 |
$2,818.40 |
$2,818.40 |
$2,130.88
|
|
Knee X-ray
|
$540.00 |
$540.00 |
$540.00 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$372.80 |
$372.80 |
$372.80 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$415.20 |
$415.20 |
$415.20 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$407.20 |
$407.20 |
$407.20 |
$251.20
|
|
Ko elastic w/joints pre ots
|
$84.80 |
$84.80 |
$84.80 |
$137.05
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$62.64 |
$62.64 |
$62.64 |
$33.60
|
|
Lactate dehydrogenase (ldh)
|
$82.40 |
$82.40 |
$82.40 |
$55.50
|
|
Lactated ringers intravenous solution
|
$80.00 |
$80.00 |
$80.00 |
$43.74
|
|
Lactic acid
|
$128.80 |
$128.80 |
$128.80 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$197.60 |
$197.60 |
$197.60 |
$82.16
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$812.00 |
$812.00 |
$812.00 |
$740.40
|
|
Lead capillary
|
$128.80 |
$128.80 |
$128.80 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,357.60 |
$1,357.60 |
$1,357.60 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,652.80 |
$2,652.80 |
$2,652.80 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,307.20 |
$2,307.20 |
$2,307.20 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,336.80 |
$1,336.80 |
$1,336.80 |
$1,092.58
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$73.72 |
$73.72 |
$73.72 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$4,396.20 |
$4,396.20 |
$4,396.20 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,037.62 |
$2,037.62 |
$2,037.62 |
$8,348.12
|
|
Levalbuterol non-comp unit
|
$6.20 |
$6.20 |
$6.20 |
$6.48
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$60.98 |
$60.98 |
$60.98 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$160.00 |
$160.00 |
$160.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$107.46 |
$107.46 |
$107.46 |
$55.69
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$60.25 |
$60.25 |
$60.25 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$108.18 |
$108.18 |
$108.18 |
$39.75
|
|
Ligate leg veins radical 37760
|
$6,402.40 |
$6,402.40 |
$6,402.40 |
$3,439.84
|
|
Ligation/divis of long saph vein 37700
|
$6,522.40 |
$6,522.40 |
$6,522.40 |
$4,255.00
|
|
Ligation vericose vein cluster(s) 1 leg
|
$5,698.40 |
$5,698.40 |
$5,698.40 |
$3,724.63
|
|
Lincomycin injection
|
$69.15 |
$69.15 |
$69.15 |
$64.31
|
|
Lipase
|
$208.00 |
$208.00 |
$208.00 |
$93.58
|
|
Lipoprotein direct measurement hdl
|
$85.60 |
$85.60 |
$85.60 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$112.00 |
$112.00 |
$112.00 |
$61.60
|
|
Lithium therapeutic drug level
|
$84.80 |
$84.80 |
$84.80 |
$69.75
|
|
Liver Function Test
|
$175.20 |
$175.20 |
$175.20 |
$115.44
|
|
Liver imaging
|
$1,852.80 |
$1,852.80 |
$1,852.80 |
$1,109.00
|
|
Liver imag w/vasclr flow
|
$1,864.80 |
$1,864.80 |
$1,864.80 |
$1,227.60
|
|
Liver/spleen imag static only
|
$1,676.00 |
$1,676.00 |
$1,676.00 |
$1,138.55
|
|
Liver/spleen imag w/vasclr flow
|
$1,992.80 |
$1,992.80 |
$1,992.80 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$20.00 |
$20.00 |
$20.00 |
$49.70
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$61.44 |
$61.44 |
$61.44 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,769.60 |
$2,769.60 |
$2,769.60 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,399.20 |
$4,399.20 |
$4,399.20 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,508.00 |
$3,508.00 |
$3,508.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$3,189.60 |
$3,189.60 |
$3,189.60 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$501.60 |
$501.60 |
$501.60 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$710.40 |
$710.40 |
$710.40 |
$505.83
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$756.00 |
$756.00 |
$756.00 |
$540.60
|
|
Lower Leg (Shin) X-ray (both sides)
|
$456.00 |
$456.00 |
$456.00 |
$338.40
|
|
Lung Function Test Before and After an Inhaler
|
$663.20 |
$663.20 |
$663.20 |
$549.83
|
|
Lung Function Test (Spirometry)
|
$277.60 |
$277.60 |
$277.60 |
$296.91
|
|
Lung perfusion imaging
|
$1,500.80 |
$1,500.80 |
$1,500.80 |
$1,069.25
|
|
Macroscopic exam arthropod
|
$40.00 |
$40.00 |
$40.00 |
$38.58
|
|
Macroscopic exam parasite
|
$116.00 |
$116.00 |
$116.00 |
$37.05
|
|
Magnesium
|
$88.80 |
$88.80 |
$88.80 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$132.22 |
$132.22 |
$132.22 |
$58.70
|
|
Makena, 10 mg
|
$1,099.52 |
$1,099.52 |
$1,099.52 |
$1,405.80
|
|
Marker biop eviva buckle ss
|
$339.20 |
$339.20 |
$339.20 |
$1,451.30
|
|
Mastoids complete
|
$420.00 |
$420.00 |
$420.00 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$48.80 |
$48.80 |
$48.80 |
$65.28
|
|
Mayo aathr protein s free
|
$501.60 |
$501.60 |
$501.60 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$243.20 |
$243.20 |
$243.20 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$204.00 |
$204.00 |
$204.00 |
$172.90
|
|
Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation
|
$115.20 |
$115.20 |
$115.20 |
$101.07
|
|
Mayo alcohol definitive assay volatile screen
|
$155.20 |
$155.20 |
$155.20 |
$126.36
|
|
Mayo alkaline phosphatase isoenzyme
|
$50.40 |
$50.40 |
$50.40 |
$66.60
|
|
Mayo alkaloids definitive assay nicotine/cotinine
|
$88.80 |
$88.80 |
$88.80 |
$112.77
|
|
Mayo alpha 1 antitrypsin
|
$155.20 |
$155.20 |
$155.20 |
$89.05
|
|
Mayo amikacin trough therapeutic drug level
|
$40.00 |
$40.00 |
$40.00 |
$81.81
|
|
Mayo amphu methylenedioxyamphetamines definitive assay urine
|
$88.00 |
$88.00 |
$88.00 |
$78.10
|
