|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$137.80 |
$137.80 |
$137.80 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$419.90 |
$419.90 |
$419.90 |
$460.85
|
|
IV inj ra drug dx study
|
$564.85 |
$564.85 |
$564.85 |
$560.00
|
|
Ivp w/wo kub w/wo tomography
|
$840.45 |
$840.45 |
$840.45 |
$713.05
|
|
Ixabepilone 15 mg intravenous solution
|
$16,348.74 |
$16,348.74 |
$16,348.74 |
$7,216.15
|
|
Jak2 targeted sequence analysis
|
$435.50 |
$435.50 |
$435.50 |
$378.30
|
|
Jejunstmy tube plcmt
|
$4,501.25 |
$4,501.25 |
$4,501.25 |
$2,244.82
|
|
Ketamine and metabolite screen - quest
|
$506.35 |
$506.35 |
$506.35 |
$68.15
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$50.05 |
$50.05 |
$50.05 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$17.18 |
$17.18 |
$17.18 |
$30.08
|
|
Kidney imaging morphology
|
$1,311.70 |
$1,311.70 |
$1,311.70 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$2,795.65 |
$2,795.65 |
$2,795.65 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,690.00 |
$1,690.00 |
$1,690.00 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$518.70 |
$518.70 |
$518.70 |
$668.25
|
|
Kit gene analys d816 variant
|
$1,079.00 |
$1,079.00 |
$1,079.00 |
$355.00
|
|
Kit hfx iq ipg bundle
|
$1,924.73 |
$1,924.73 |
$1,924.73 |
$28,974.93
|
|
Kit lead specify 5-6-5
|
$4,023.30 |
$4,023.30 |
$4,023.30 |
$17,205.92
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$135.77 |
$135.77 |
$135.77 |
$5,329.23
|
|
Knee MRI (with and without contrast)
|
$3,771.30 |
$3,771.30 |
$3,771.30 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$3,330.60 |
$3,330.60 |
$3,330.60 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,753.40 |
$2,753.40 |
$2,753.40 |
$2,181.10
|
|
Knee X-ray
|
$603.20 |
$603.20 |
$603.20 |
$443.90
|
|
Kras gene addl variants
|
$388.70 |
$388.70 |
$388.70 |
$346.45
|
|
Kras gene variants exon 2
|
$1,889.55 |
$1,889.55 |
$1,889.55 |
$495.00
|
|
Kyleena, 19.5 mg
|
$2,211.85 |
$2,211.85 |
$2,211.85 |
$2,618.91
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$42.38 |
$42.38 |
$42.38 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$333.03 |
$333.03 |
$333.03 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$13.65 |
$13.65 |
$13.65 |
$53.30
|
|
Lactated ringers intravenous solution
|
$51.80 |
$51.80 |
$51.80 |
$54.11
|
|
Lactic acid
|
$96.20 |
$96.20 |
$96.20 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$133.90 |
$133.90 |
$133.90 |
$88.40
|
|
Lactoferrin fecal quant
|
$276.90 |
$276.90 |
$276.90 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$15,527.33 |
$15,527.33 |
$15,527.33 |
$22,903.90
|
|
Laryngoscopy telescopic
|
$1,216.80 |
$1,216.80 |
$1,216.80 |
$762.30
|
|
Lead capillary
|
$9.10 |
$9.10 |
$9.10 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$836.55 |
$836.55 |
$836.55 |
$1,100.74
|
|
Leishmania antibody
|
$68.25 |
$68.25 |
$68.25 |
$58.50
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$91.55 |
$91.55 |
$91.55 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,852.85 |
$2,852.85 |
$2,852.85 |
$3,271.64
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$50.73 |
$50.73 |
$50.73 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$155.35 |
$155.35 |
$155.35 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$52.91 |
$52.91 |
$52.91 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$139.56 |
$139.56 |
$139.56 |
$319.12
|
|
Liberta rc ipg
|
$27,970.80 |
$27,970.80 |
$27,970.80 |
$39,406.68
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$61.36 |
$61.36 |
$61.36 |
$49.11
|
|
Lidocaine therapeutic drug level
|
$75.40 |
$75.40 |
$75.40 |
$83.85
|
|
Ligation/biopsy of temporal artery 37609
|
$3,716.70 |
$3,716.70 |
$3,716.70 |
$2,968.00
|
|
Liletta, 52 mg
|
$1,160.93 |
$1,160.93 |
$1,160.93 |
$2,360.29
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$20.48 |
$20.48 |
$20.48 |
$177.90
|
|
Lipase
|
$29.90 |
$29.90 |
$29.90 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$79.95 |
$79.95 |
$79.95 |
$89.52
|
|
Lipoprotein blood quant
|
$41.60 |
$41.60 |
$41.60 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$20.80 |
$20.80 |
$20.80 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$31.20 |
$31.20 |
$31.20 |
$60.00
|
|
Listeria monocytogenes
|
$107.90 |
$107.90 |
$107.90 |
$95.40
|
|
Lithium therapeutic drug level
|
$26.65 |
$26.65 |
$26.65 |
$67.60
|
|
Liver Function Test
|
$14.95 |
$14.95 |
$14.95 |
$110.50
|
|
Liver imaging
|
$1,541.80 |
$1,541.80 |
$1,541.80 |
$1,241.25
|
|
Liver imag w/vasclr flow
|
$1,357.20 |
$1,357.20 |
$1,357.20 |
$1,255.15
|
|
Liver/spleen imag static only
|
$1,267.50 |
$1,267.50 |
$1,267.50 |
$1,140.78
|
|
Locm 100-199mg/ml iodine,1ml
|
$625.01 |
$625.01 |
$625.01 |
$16.54
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$76,416.24 |
$76,416.24 |
$76,416.24 |
$76,416.24
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$23.63 |
$23.63 |
$23.63 |
$45.56
|
|
Low cost skin substitute app
|
$566.80 |
$566.80 |
$566.80 |
$862.55
|
|
Low cost skin substitute app
|
$1,132.95 |
$1,132.95 |
$1,132.95 |
$2,164.64
|
|
Low cost skin substitute app
|
$814.45 |
$814.45 |
$814.45 |
$933.40
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,067.30 |
$1,067.30 |
$1,067.30 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$970.45 |
$970.45 |
$970.45 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$882.70 |
$882.70 |
$882.70 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,029.95 |
$2,029.95 |
$2,029.95 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,793.35 |
$1,793.35 |
$1,793.35 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,482.00 |
$1,482.00 |
$1,482.00 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$264.55 |
$264.55 |
$264.55 |
$344.00
|
|
Low frequency non-thermal Ultrasound
|
$547.95 |
$547.95 |
$547.95 |
$275.88
|
|
L/s ratio fetal lung
|
$261.95 |
$261.95 |
$261.95 |
$168.00
|
|
Lumbar diskogram s&i
|
$1,586.00 |
$1,586.00 |
$1,586.00 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$425.10 |
$425.10 |
$425.10 |
$298.50
|
|
Lung perfusion imaging
|
$774.80 |
$774.80 |
$774.80 |
$1,100.39
|
|
Lurbinectedin 4 mg intravenous solution
|
$22,297.54 |
$22,297.54 |
$22,297.54 |
$21,982.48
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$13,361.30 |
$13,361.30 |
$13,361.30 |
$29,435.46
|
|
Lvad shower bag heartmate
|
$584.34 |
$584.34 |
$584.34 |
$1,090.58
|
|
Lymphatics/lymph node imaging
|
$1,155.70 |
$1,155.70 |
$1,155.70 |
$1,543.75
|
|
Lymphocyte transformation mitogen
|
$433.55 |
$433.55 |
$433.55 |
$266.20
|
|
Lymph vessel x-ray arm/leg
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$862.57
|
|
Lymph vessel x-ray arms/legs
|
$5,569.85 |
$5,569.85 |
$5,569.85 |
$2,229.24
|
|
Lymph vessel x-ray trunk
|
$7,029.75 |
$7,029.75 |
$7,029.75 |
$2,542.41
|
|
Lymph vessel x-ray trunk
|
$7,029.75 |
$7,029.75 |
$7,029.75 |
$3,380.00
|
|
Macroscopic exam arthropod
|
$54.60 |
$54.60 |
$54.60 |
$38.58
|
|
Macroscopic exam parasite
|
$48.10 |
$48.10 |
$48.10 |
$38.50
|
|
Magnesium
|
$38.35 |
$38.35 |
$38.35 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$43.65 |
$43.65 |
$43.65 |
$65.49
|
|
Magnetic image bone marrow
|
$1,425.45 |
$1,425.45 |
$1,425.45 |
$1,152.80
|
|
Malaria antibody
|
$16.25 |
$16.25 |
$16.25 |
$38.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$211.25 |
$211.25 |
$211.25 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$211.25 |
$211.25 |
$211.25 |
$178.75
|
|
Map tachycard site(s)
|
$5,484.05 |
$5,484.05 |
$5,484.05 |
$3,960.00
|
|
Marker biop eviva buckle ss
|
$209.64 |
$209.64 |
$209.64 |
$1,213.20
|
|
Mastoids complete
|
$847.60 |
$847.60 |
$847.60 |
$271.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$78.65 |
$78.65 |
$78.65 |
$66.50
|
|
Mayo aathr protein s free
|
$272.35 |
$272.35 |
$272.35 |
$130.00
|
