|
Liver elastography 91200
|
$39.00 |
$170.99 |
$184.26 |
|
|
Liver Function Test
|
$8.17 |
$8.99 |
$66.80 |
|
|
Liver imaging
|
$257.35 |
$588.26 |
$633.90 |
|
|
Liver imag w/vasclr flow
|
$356.42 |
$595.79 |
$633.90 |
|
|
Liver/spleen imag static only
|
$228.71 |
$444.66 |
$509.62 |
|
|
Liver/spleen imag w/vasclr flow
|
$439.15 |
$445.16 |
$648.64 |
|
|
Lmtd oph exam general anes
|
$2,549.65 |
$2,582.26 |
$2,747.43 |
|
|
Lngth/shrt tendon leg/ankle 1 tendon
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$206.38 |
$216.74 |
$216.74 |
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$2.26 |
$2.26 |
$2.26 |
|
|
Loudness balance test
|
$340.32 |
$344.68 |
$366.72 |
|
|
Low back disk surgery
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Low cost skin substitute app
|
$668.98 |
$840.04 |
$1,398.18 |
|
|
Low cost skin substitute app
|
$703.56 |
$1,014.97 |
$2,154.21 |
|
|
Low cost skin substitute app
|
$668.98 |
$813.21 |
$1,533.41 |
|
|
Low cost skin substitute app
|
$379.64 |
$678.13 |
$1,016.16 |
|
|
Low cost skin substitute app
|
$159.05 |
$384.22 |
$492.93 |
|
|
Low cost skin substitute app
|
$210.14 |
$351.38 |
$401.95 |
|
|
Low cost skin substitute app
|
$127.96 |
$397.52 |
$454.72 |
|
|
Low cost skin substitute app
|
$105.39 |
$157.47 |
$179.70 |
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$116.22 |
$352.22 |
$488.94 |
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$194.55 |
$521.43 |
$807.13 |
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$390.30 |
$495.27 |
$768.74 |
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$116.22 |
$434.08 |
$732.15 |
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$390.30 |
$796.39 |
$1,154.98 |
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$390.30 |
$550.04 |
$797.72 |
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$264.17 |
$467.77 |
$678.39 |
|
|
Lower Back (Lumbar Spine) X-ray
|
$68.75 |
$116.22 |
$145.50 |
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$101.65 |
$133.17 |
$407.60 |
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$109.90 |
$139.64 |
$234.00 |
|
|
Lower jaw bone graft
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Lower Leg (Shin) X-ray (both sides)
|
$96.23 |
$97.54 |
$304.00 |
|
|
Low frequency non-thermal Ultrasound
|
$69.53 |
$167.10 |
$234.00 |
|
|
Lsh uterus 250 g or less
|
$3,786.00 |
$6,311.00 |
$12,260.88 |
|
|
Lsh uterus above 250 g
|
$3,786.00 |
$6,311.00 |
$12,260.88 |
|
|
Lsh w/t/o ut 250 g or less
|
$3,786.00 |
$6,311.00 |
$12,260.88 |
|
|
Lsh w/t/o uterus above 250 g
|
$3,786.00 |
$6,311.00 |
$12,260.88 |
|
|
Lso flex no ri stays pre ots
|
$28.71 |
$33.69 |
$47.48 |
|
|
L/s ratio fetal lung
|
$21.99 |
$24.19 |
$24.19 |
|
|
Lumbar diskogram s&i
|
$455.37 |
$2,134.14 |
$2,299.70 |
|
|
Lumbar Spinal Fusion (single level)
|
$3,786.00 |
$6,311.00 |
$21,657.23 |
|
|
Lumizyme injection
|
$201.97 |
$206.62 |
$206.62 |
|
|
Lung Function Test Before and After an Inhaler
|
$210.39 |
$324.40 |
$366.72 |
|
|
Lung function test (mbc/mvv)
|
$33.66 |
$64.92 |
$69.95 |
|
|
Lung Function Test (Spirometry)
|
$106.81 |
$173.18 |
$193.48 |
|
|
Lung perfusion imaging
|
$217.10 |
$405.27 |
$473.22 |
|
|
Lurbinectedin 4 mg intravenous solution
|
$203.60 |
$206.13 |
$206.13 |
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$40.62 |
$41.96 |
$41.96 |
|
|
Lutetium lu 177 dotatat ther
|
$145.15 |
$312.69 |
$312.69 |
|
|
Lutetium lu 177 vipivotide
|
$115.06 |
$253.18 |
$253.18 |
|
|
Lvad shower bag heartmate
|
$108.36 |
$127.14 |
$179.17 |
|
|
Lw ntsty Ultrasound stimj bone healg
|
$26.76 |
$3,986.00 |
$6,839.00 |
|
|
Lyme dis dna dir probe
|
$20.05 |
$22.06 |
$22.06 |
|
|
Lymphatics/lymph node imaging
|
$332.04 |
$502.26 |
$633.90 |
|
|
Lymphocyte culture mixed
|
$36.56 |
$40.22 |
$40.22 |
|
|
Lymphocyte transformation mitogen
|
$49.03 |
$53.93 |
$319.50 |
|
|
Lymphocytotoxicity assay
|
$189.51 |
$208.46 |
$208.46 |
|
|
Lymphocytotoxicity assay
|
$47.59 |
$52.35 |
$52.35 |
|
|
Lymph vessel x-ray arm/leg
|
$279.12 |
$675.68 |
$728.10 |
|
|
Lymph vessel x-ray arms/legs
|
$660.35 |
$1,697.72 |
$1,829.42 |
|
|
Lymph vessel x-ray trunk
|
$1,020.59 |
$3,439.84 |
$3,706.68 |
|
|
Lymph vessel x-ray trunk
|
$1,392.89 |
$3,439.84 |
$3,706.68 |
|
|
Lysis intranasal synechia 30560
|
$556.55 |
$3,986.00 |
$6,839.00 |
|
|
Lysis of labial adhesions
|
$3,474.84 |
$3,986.00 |
$6,839.00 |
|
|
Lysis penil circumic lesion
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Macro exam dissect molec study ea
|
$18.07 |
$24.58 |
$30.63 |
|
|
Macroscopic exam arthropod
|
$4.27 |
$4.70 |
$4.70 |
|
|
Macroscopic exam parasite
|
$4.31 |
$4.74 |
$4.74 |
|
|
Magnesium
|
$6.70 |
$7.37 |
$55.20 |
|
|
Magnetic image bone marrow
|
$264.17 |
$267.55 |
$284.66 |
|
|
Makena, 10 mg
|
$14.46 |
$14.46 |
$14.46 |
|
|
Malaria antibody
|
$13.19 |
$14.51 |
$14.51 |
|
|
Male sling procedure
|
$3,786.00 |
$6,311.00 |
$15,300.65 |
|
|
Manipulate finger w/anesth
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Manipulate wrist w/anesthes
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Manipulation of hip joint
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Manipulation of spine
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Manipulat palm cord post inj
|
$262.16 |
$3,986.00 |
$6,839.00 |
|
|
Manual diff wbc count b-coat
|
$5.07 |
$5.58 |
$5.58 |
|
|
Mapping functional cort/subcort ea add'l hr
|
$177.46 |
$177.46 |
$177.46 |
|
|
Map tachycard site(s)
|
$1,178.68 |
$1,814.71 |
$1,924.22 |
|
|
Margetuximab-cmkb 25 mg/ml intravenous solution
|
$48.21 |
$50.45 |
$50.45 |
|
|
Marker lymphatic sentimag magtrace 10 vial
|
$1,137.96 |
$11,379.91 |
$11,379.91 |
|
|
Mastectomy partial
|
$3,786.00 |
$4,509.59 |
$6,839.00 |
|
|
Mast mod rad
|
$3,786.00 |
$6,311.00 |
$7,680.06 |
|
|
Mastoidectomy
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Mastoidectomy complete 69502
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Mastoids complete
|
$71.46 |
$114.33 |
$125.23 |
|
|
Mastoid surgery revision
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Mastopexy
|
$3,786.00 |
$6,311.00 |
$7,680.06 |
|
|
Mast simple complete
|
$3,786.00 |
$6,311.00 |
$7,680.06 |
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$363.50 |
$426.50 |
$601.04 |
|
|
M.avium-intra dna amp prob
|
$35.09 |
$38.60 |
$38.60 |
|
|
M.avium-intra dna dir prob
|
$27.29 |
$30.02 |
$30.02 |
|
|
M.avium-intra dna quant
|
$42.84 |
$47.12 |
$47.12 |
|
|
Maxillofacial fixation
|
$3,786.00 |
$6,311.00 |
$6,966.64 |
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$14.46 |
$15.91 |
$15.91 |
|
|
Mayo aathr protein s free
|
$15.32 |
$16.85 |
$16.85 |
|
|
Mayo activated protein c resistance assay
|
$15.32 |
$16.85 |
$16.85 |
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$38.57 |
$42.43 |
$42.43 |
|
