|
Leuprolide 3.75 mg intramuscular syringe kit
|
$16,810.50 |
$16,810.50 |
$16,810.50 |
$9,107.80
|
|
Lev 2 hosp type b ed visit
|
$2,131.62 |
$2,131.62 |
$2,131.62 |
$359.65
|
|
Lev 3 hosp type b ed visit
|
$2,238.70 |
$2,238.70 |
$2,238.70 |
$598.15
|
|
Lev 4 hosp type b ed visit
|
$2,366.30 |
$2,366.30 |
$2,366.30 |
$915.40
|
|
Lev 5 hosp type b ed visit
|
$2,600.93 |
$2,600.93 |
$2,600.93 |
$1,542.68
|
|
Levetiracetam therapeutic drug level
|
$60.97 |
$60.97 |
$60.97 |
$88.92
|
|
Lidocaine therapeutic drug level
|
$326.24 |
$326.24 |
$326.24 |
$87.45
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$118.57 |
$118.57 |
$118.57 |
$121.00
|
|
Lipase
|
$378.03 |
$378.03 |
$378.03 |
$91.65
|
|
Lipoprotein blood high res frac & quant
|
$769.49 |
$769.49 |
$769.49 |
$86.42
|
|
Lipoprotein direct measurement hdl
|
$462.47 |
$462.47 |
$462.47 |
$57.50
|
|
Lithium therapeutic drug level
|
$406.81 |
$406.81 |
$406.81 |
$69.42
|
|
Liver Function Test
|
$1,112.95 |
$1,112.95 |
$1,112.95 |
$115.44
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$18,608.92 |
$18,608.92 |
$18,608.92 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$18,044.55 |
$18,044.55 |
$18,044.55 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$12,686.18 |
$12,686.18 |
$12,686.18 |
$2,065.69
|
|
Low frequency non-thermal Ultrasound
|
$789.12 |
$789.12 |
$789.12 |
$364.00
|
|
L/s ratio fetal lung
|
$681.21 |
$681.21 |
$681.21 |
$178.36
|
|
Lung Function Test (Spirometry)
|
$1,565.54 |
$1,565.54 |
$1,565.54 |
$295.35
|
|
Lurbinectedin 4 mg intravenous solution
|
$24,622.50 |
$24,622.50 |
$24,622.50 |
$19,182.33
|
|
Lymphatics/lymph node imaging
|
$9,607.16 |
$9,607.16 |
$9,607.16 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$608.30 |
$608.30 |
$608.30 |
$271.88
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$90.50 |
$90.50 |
$90.50 |
$59.88
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$74.12 |
$74.12 |
$74.12 |
$6,321.66
|
|
Mayo activated protein c resistance assay
|
$727.26 |
$727.26 |
$727.26 |
$97.50
|
|
Mayo alcohol definitive assay volatile screen
|
$102.04 |
$102.04 |
$102.04 |
$122.45
|
|
Mayo alkaline phosphatase isoenzyme
|
$569.91 |
$569.91 |
$569.91 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$719.58 |
$719.58 |
$719.58 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$683.11 |
$683.11 |
$683.11 |
$81.81
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$744.51 |
$744.51 |
$744.51 |
$369.00
|
|
Mayo androstenedione
|
$289.76 |
$289.76 |
$289.76 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$646.67 |
$646.67 |
$646.67 |
$73.60
|
|
Mayo antithrombin iii antigen
|
$1,216.58 |
$1,216.58 |
$1,216.58 |
$73.50
|
|
Mayo avwpr vw factor activity
|
$491.24 |
$491.24 |
$491.24 |
$171.50
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$1,212.86 |
$1,212.86 |
$1,212.86 |
$328.20
|
|
Mayo c1 esterase inhibitor
|
$197.65 |
$197.65 |
$197.65 |
$86.73
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$740.70 |
$740.70 |
$740.70 |
$107.10
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$748.38 |
$748.38 |
$748.38 |
$80.16
|
|
Mayo ceruloplasmin
|
$556.49 |
$556.49 |
$556.49 |
$68.40
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$5,355.67 |
$5,355.67 |
$5,355.67 |
$360.33
|
|
Mayo chromium
|
$809.77 |
$809.77 |
$809.77 |
$74.94
|
|
Mayo cocaine definitive assay confirmation urine
|
$255.20 |
$255.20 |
$255.20 |
$100.00
|
|
Mayo cortisol free
|
$711.91 |
$711.91 |
$711.91 |
$94.95
|
|
Mayo cyanide
|
$138.16 |
$138.16 |
$138.16 |
$87.50
|
|
Mayo deoxyribonuclease antibody titer
|
$518.12 |
$518.12 |
$518.12 |
$56.80
|
|
Mayo dhea (dehydroepiandrosterone)
|
$1,135.99 |
$1,135.99 |
$1,135.99 |
$105.60
|
|
Mayo efpo chloride stool
|
$318.55 |
$318.55 |
$318.55 |
$43.41
|
|
Mayo estriol
|
$667.79 |
$667.79 |
$667.79 |
$90.34
|
|
Mayo estrone
|
$698.49 |
$698.49 |
$698.49 |
$85.00
|
|
Mayo ethosuximide therapeutic drug level
|
$567.99 |
$567.99 |
$567.99 |
$69.55
|
|
Mayo everolimus therapeutic drug level
|
$1,064.98 |
$1,064.98 |
$1,064.98 |
$97.50
|
|
Mayo factor ii
|
$216.82 |
$216.82 |
$216.82 |
$99.06
|
|
Mayo factor v
|
$602.14 |
$602.14 |
$602.14 |
$127.80
|
|
Mayo factor vii
|
$602.14 |
$602.14 |
$602.14 |
$155.00
|
|
Mayo factor viii vw factor antigen
|
$600.60 |
$600.60 |
$600.60 |
$122.62
|
|
Mayo factor viii vw factor multimetric analysis
|
$130.49 |
$130.49 |
$130.49 |
$130.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$679.29 |
$679.29 |
$679.29 |
$141.00
|
|
Mayo factor x
|
$232.20 |
$232.20 |
$232.20 |
$155.00
|
|
Mayo factor xi
|
$237.96 |
$237.96 |
$237.96 |
$122.20
|
|
Mayo fat/lipids feces quantitative
|
$372.25 |
$372.25 |
$372.25 |
$76.05
|
|
Mayo fbl culture fungi blood
|
$905.64 |
$905.64 |
$905.64 |
$105.60
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$46.92 |
$46.92 |
$46.92 |
$66.43
|
|
Mayo gamma-globin full gene sequencing
|
$3,343.28 |
$3,343.28 |
$3,343.28 |
$1,460.30
|
|
Mayo hemosiderin qualitative urine
|
$207.23 |
$207.23 |
$207.23 |
$33.57
|
|
Mayo hla typing a/b/c single antigen
|
$1,149.43 |
$1,149.43 |
$1,149.43 |
$122.80
|
|
Mayo hvdip HIV 1 antibody
|
$406.81 |
$406.81 |
$406.81 |
$74.25
|
|
Mayo hvdip HIV 2 antibody
|
$408.70 |
$408.70 |
$408.70 |
$77.77
|
|
Mayo infectious agent antigen immunoassay ql/sq multi step aspergillus bal
|
$449.03 |
$449.03 |
$449.03 |
$109.00
|
|
Mayo infectious agent nucleic acid amplified probe mycoplasma pneumoniae
|
$988.26 |
$988.26 |
$988.26 |
$155.00
|
|
Mayo infliximab therapeutic drug level
|
$1,094.63 |
$1,094.63 |
$1,094.63 |
$150.40
|
|
Mayo inhab inhibin a
|
$715.74 |
$715.74 |
$715.74 |
$79.95
|
|
Mayo insft insulin free
|
$278.24 |
$278.24 |
$278.24 |
$55.00
|
|
Mayo insulin antibodies
|
$602.14 |
$602.14 |
$602.14 |
$97.80
|
|
Mayo lacosamide therapeutic drug level
|
$424.08 |
$424.08 |
$424.08 |
$104.00
|
|
Mayo lamotrigine therapeutic drug level
|
$51.59 |
$51.59 |
$51.59 |
$66.43
|
|
Mayo leptospira antibody igm
|
$656.27 |
$656.27 |
$656.27 |
$81.06
|
|
Mayo lipoprotein electrophoresis
|
$1,061.94 |
$1,061.94 |
$1,061.94 |
$50.70
|
|
Mayo metanephrines plasma
|
$1,020.87 |
$1,020.87 |
$1,020.87 |
$122.40
|
|
Mayo methadone definitive assay confirmation urine
|
$73.33 |
$73.33 |
$73.33 |
$97.20
|
|
Mayo mgrm acetylcholine receptor binding antibody
|
$450.94 |
$450.94 |
$450.94 |
$70.56
|
|
Mayo muramidase
|
$450.94 |
$450.94 |
$450.94 |
$59.50
|
|
Mayo nickel
|
$65.23 |
$65.23 |
$65.23 |
$69.56
|
|
Mayo opatu opioid/analogs definitive assay 1 or 2
|
$249.46 |
$249.46 |
$249.46 |
$72.14
|
|
Mayo opatu oxycodone definitive assay
|
$326.24 |
$326.24 |
$326.24 |
$84.50
|
|
Mayo organic acids qualitative each specimen
|
$211.06 |
$211.06 |
$211.06 |
$112.50
|
|
Mayo oxalate 24 hour urine
|
$550.71 |
$550.71 |
$550.71 |
$67.14
|
|
Mayo pancreatic elastase fecal qualitative or semi quantitative
|
$1,780.75 |
$1,780.75 |
$1,780.75 |
$156.00
|
|
Mayo pborb infectious agent nucleic acid amplified probe borrelia burgdorferi (lyme)
|
$1,544.71 |
$1,544.71 |
$1,544.71 |
$177.60
|
|
Mayo pntft phenytoin free therapeutic drug level
|
$147.75 |
$147.75 |
$147.75 |
$69.00
|
|
Mayo pqnu porphobilinogen urine quantitative 24 hour urine
|
$239.35 |
$239.35 |
$239.35 |
$48.00
|
|
Mayo pregnenolone
|
$1,189.73 |
$1,189.73 |
$1,189.73 |
$78.40
|
|
Mayo prmb primidone therapeutic drug level
|
$842.41 |
$842.41 |
$842.41 |
$66.43
|
|
Mayo proinsulin
|
$1,477.57 |
$1,477.57 |
$1,477.57 |
$97.50
|
|
Mayo psaft prostate specific antigen free
|
$188.05 |
$188.05 |
$188.05 |
$90.00
|
|
Mayo renin
|
$765.62 |
$765.62 |
$765.62 |
$102.60
|
|
Mayo serotonin
|
$2,548.30 |
$2,548.30 |
$2,548.30 |
$113.10
|
|
Mayo sirolimus therapeutic drug level
|
$1,613.81 |
$1,613.81 |
$1,613.81 |
$99.81
|
|
Mayo syphilis test non-treponemal antibody qualitative vdrl
|
$220.65 |
$220.65 |
$220.65 |
$48.75
|
|
Mayo tcgr analysis gene rearrangement trb@ abnormal clonal population(s) amplification
|
$1,612.01 |
$1,612.01 |
$1,612.01 |
$507.60
|
|
Mayo tgrp testosterone free
|
$1,560.05 |
$1,560.05 |
$1,560.05 |
$99.00
|
